RE: 24 hours Urine Collection better or Serum Cystatin C, in a patien with high BUN. 5 hours ago

For sake of completeness check stool OB ------------------------------ Keith Klein MD, FASN Cedar Sinai Medical Center Beverly Hills CA (310) 657...

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RE: 24 hours Urine Collection better or Serum Cystatin C, in a patien with high BUN. 12 hours ago

Dr. Cancarini. I Don' t disagree with your hypothesis that CCr + C urea /2 might be a more "accurate " estimate of GFR than creatinine or Cystatin ...

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RE: 24 hours Urine Collection better or Serum Cystatin C, in a patien with high BUN. 13 hours ago

My guess GFR is much less than you think, closer to that suggested by hign BUN, like not enough. May be ask lab what of meds may be interfering wit...

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RE: 24 hours Urine Collection better or Serum Cystatin C, in a patien with high BUN. 13 hours ago

4 eGFR and urinary clearances and I still have no idea what this patients kidney function really is. Itvis time for a measured GFR. -------------...

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RE: IgG kappa MGRS x3: recrudescence and worse response to cybord- time for rebiopsy? 14 hours ago

Did you ever perform a bone marrow FISH to examine clonality of PC in marrow and as a possible indication for Daratumumab? ---------------------...

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RE: IgG kappa MGRS x3: recrudescence and worse response to cybord- time for rebiopsy? 16 hours ago

A year ago, the use of daratumumab for active relapse had been brought up by Drs. Glassock and Leung, thank you. Given the effectiveness of Darat...

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RE: 24 hours Urine Collection better or Serum Cystatin C, in a patien with high BUN. 17 hours ago

Very true. Good idea. Thank you. _________________________________________ Ashraf El-Meanawy, MD, MS, PhD, FASN Professor of Medi...

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RE: 24 hours Urine Collection better or Serum Cystatin C, in a patien with high BUN. 17 hours ago

Dr. El-Meanawy, Another study that looked at the role of urea in uremic syndrome by supplementing dialysate with urea: https://pubmed.ncbi.n...

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RE: Lab potassium normal range 18 hours ago

Here is an interesting reference. Wang J et al Comp Struct Biotechnology J. 2024; 24: 1-11. ------------------------------ Richard Glassock MD, F...

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RE: 24 hours Urine Collection better or Serum Cystatin C, in a patien with high BUN. 20 hours ago

At GFR values ​​<20 ml/min, the urea clearance (which underestimates) and creatinine clearance (which overestimates) can be averaged and the result...

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RE: Lab potassium normal range 21 hours ago

Very interesting discussion. The definition of a normal range for blood K concentration must clearly specify the serum or plasma source of the spec...

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RE: Lab potassium normal range 22 hours ago

Thanks Kamyar. We are attempting to advocate for the same expansion (or retention) of P-K NR. But I would think that all clinical labs would be und...

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RE: Lab potassium normal range 22 hours ago

Thanks. Would you be able to provide those references? ------------------------------ Theodore Saad MD, FASN [Christiana Care Health System] Newa...

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RE: Lab potassium normal range 22 hours ago

Thanks. Yes, the root of our "problem" here is the difference between S-K and P-K. Our lab has reported ONLY P-K results for several years. When th...

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RE: PIGN with only proteinuria? 23 hours ago

I woul agree that the clinical and pathological picture is most compatible with an Atypical non-hypocomolementemic " PIGN." Of unknown etiology. It...

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RE: Lab potassium normal range 23 hours ago

At one of the major university centers, we successfully advocated for the pathology department to expand the normal serum potassium reference range...

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RE: PIGN with only proteinuria? 1 day ago

To be more complete with the pathology findings, which will aid in the discussion. The pattern is Focal segmental endocapillary proliferative with ...

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RE: 24 hours Urine Collection better or Serum Cystatin C, in a patien with high BUN. 1 day ago

'He has received total 40.8 g of protein in 24 hours the days of 24 hours urine collection' which is exactly what this gives us when I used 60 KG...

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RE: 24 hours Urine Collection better or Serum Cystatin C, in a patien with high BUN. 1 day ago

Dr Chander : Very weird results I think he is male ; do not have weight have assumed 110 lb = 50.2 Kg Creatinine excretion 7.8 dl at 365 mg/dl = 28...

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RE: 24 hours Urine Collection better or Serum Cystatin C, in a patien with high BUN. 1 day ago

Urine creatinine concentration very high and 24 hour excretion rate of creatinine greatly exceeds what would be expected in a malnourished ,sarcope...

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RE: 24 hours Urine Collection better or Serum Cystatin C, in a patien with high BUN. 1 day ago

Sure. He has received total 40.8 g of protein in 24 hours the days of 24 hours urine collection and 340.8g prior to that. Feed doesn't have crea...

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RE: PLA2R-positive membranous nephropathy, rituximab intolerance 1 day ago

to piggy back on PLA2r MN, I have a pediatric pt with his condition, received 3 ritux so far ( 6 wk interval roughly), but he is still not negative...

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RE: 24 hours Urine Collection better or Serum Cystatin C, in a patien with high BUN. 1 day ago

Dr Chander It may be possible instructive to play with numbers Could you upload desidentified data? Patient weight ( ideal Edema free) daily prote...

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RE: Asymptomatic Segmental Arterial Mediolysis Right Renal Artery 1 day ago

Can you show the angiogram? Why this could not be fibromuscular dysplasia? Was the GI bleeding due to arteriolitis of celiac or gastric artery? SMA...

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RE: 24 hours Urine Collection better or Serum Cystatin C, in a patien with high BUN. 1 day ago

Thank you, everyone - that was a great discussion. We stopped the tube feeds, and the BUN remained stable; however, it worsened upon resuming feeds...

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RE: recurrent multidrug-resistant Pseudomonas urinary tract infections 1 day ago

Can you specify what urologic workup was done? In this scenario, I would typically start with a diagnostic cystoscopy, cross-sectional excretory im...

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RE: membranous nephropathy 1 day ago

I think that is the smart call ------------------------------ Roger Rodby MD, FASN Professor of Medicine Rush University Nephrology Associates...

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RE: membranous nephropathy 1 day ago

Anti PLA2r titer came back 820. Pt is being treated with oral cytoxan and steroids by the treating physician. Thanks ----------------------------...

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RE: PLA2R-positive membranous nephropathy, rituximab intolerance 1 day ago

Thank you Dr. Rodby and Dr. Vasquez! ------------------------------ Raman Anam MD Assistant Professor of Medicine LSU Health Shreveport Shrevepor...

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RE: recurrent multidrug-resistant Pseudomonas urinary tract infections 1 day ago

Correction > > "Wouldn't use Bactrim for your patient due to CKD & not useful for Pseudomonas." ------------------------------ Sinasi Salman MD, ...

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RE: Asymptomatic Segmental Arterial Mediolysis Right Renal Artery 2 days ago

Great question. No good answers. Uncommon condition that remains stable or regresses in 75% and progresses in 25%. Biomarkers predicting progressio...

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RE: 24 hours Urine Collection better or Serum Cystatin C, in a patien with high BUN. 2 days ago

Prof El-Meanawy : Never saw reference but told that early on to prove relative non toxicity of urea, very uremic patients were dialyzed against a b...

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Asymptomatic Segmental Arterial Mediolysis Right Renal Artery 2 days ago

Hi, Seeking any experience with potential Segmental Arterial Mediolysis (SAM) and indication/ need for stenting? 74F presented with recurrent j...

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RE: recurrent multidrug-resistant Pseudomonas urinary tract infections 2 days ago

Ciprofloxacin maybe effective while sensitivity reported as R There are 2 antibiotics that can penetrate into calcifications/stones [harbors f...

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RE: 24 hours Urine Collection better or Serum Cystatin C, in a patien with high BUN. 2 days ago

Cystatin-C is sold as a great alternative and more accurate in elderly, this is not true. Many factors affect Cystatin-C level. 24h urine creatin...

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RE: Lab potassium normal range 2 days ago

In large population based studies the mean plasma K concentration in subjects with an eGFR of 90ml/ min/1.73m2 or more is 3.98mmol /L with a 95% co...

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RE: Lab potassium normal range 2 days ago

Normal serum and plasma potassium levels are not the same. Serum potassium is generally 0.4-0.5mmol/ L higher than Plasma potassium concentration. ...

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recurrent multidrug-resistant Pseudomonas urinary tract infections 2 days ago

A patient with a history of lymphoma and prolonged hospitalization has developed recurrent urinary tract infections (UTIs) caused by multidrug-resi...

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RE: PLA2R-positive membranous nephropathy, rituximab intolerance 2 days ago

Yes Dr. Rodby- that's the Majesty Protocol : https://www.clinicaltrials.gov/study/NCT04629248 ------------------------------ George Vasquez-Rios ...

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Lab potassium normal range 2 days ago

Our hospital chemistry laboratory recently changed the plasma potassium normal range to 3.5-4.5 mmol/L (male) and 3.4-4.4 mmol/L (female). Previous...

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RE: PLA2R-positive membranous nephropathy, rituximab intolerance 2 days ago

what I have seen is similar to Rituximab, 1 gram followed by another 1 gram 2 weeks later ------------------------------ Roger Rodby MD, FA...

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DEADLINE TOMORROW: Case Report Reviewer Volunteer Application Closes May 7! 2 days ago

ASN invites ASN Fellows-in-Training members to serve as reviewers for case reports submitted by trainees for Kidney Week 2025. The reviewing/gradin...

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DEADLINE TOMORROW: Case Report Reviewer Volunteer Application Closes May 7! 2 days ago

If you are interested serving as a reviewer, please complete this form by May 7: https://www.asn-online.org/apply/?ID=21 ASN invites ASN Fellow...

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RE: PLA2R-positive membranous nephropathy, rituximab intolerance 3 days ago

Could you share your standard obinutuzumab induction protocol? Thank you! ------------------------------ Raman Anam MD Assistant Professor of Med...

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RE: PLA2R-positive membranous nephropathy, rituximab intolerance 3 days ago

Thank you Dr Vasquez-Rios! ------------------------------ Raman Anam MD Assistant Professor of Medicine LSU Health Shreveport Shreveport LA (786)...

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RE: PLA2R-positive membranous nephropathy, rituximab intolerance 3 days ago

Thank you Dr. Glassock! ------------------------------ Raman Anam MD Assistant Professor of Medicine LSU Health Shreveport Shreveport LA (786)266...

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RE: 24 hours Urine Collection better or Serum Cystatin C, in a patien with high BUN. 3 days ago

Thanks for the References. The Selistre L et al paper in CKJ in 2023 is the best one, in my opinion, and strongly supports your views. Except for o...

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RE: 24 hours Urine Collection better or Serum Cystatin C, in a patien with high BUN. 3 days ago

Prof. Glassock: Agree that patient may be too ill to benefit from dialysis but sometimes I have been proven wrong, patients that looked that they w...

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RE: PLA2R-positive membranous nephropathy, rituximab intolerance 3 days ago

Agree - obinutuzumab is a great option for PLA2R-MN in patients with intolerance to rituximab or in whom you want to spare from CYC. Obi, it's a fu...

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RE: 24 hours Urine Collection better or Serum Cystatin C, in a patien with high BUN. 3 days ago

I seriously doubt that the average of urea and creatinine clearance woukd be any better than a CCr in estimating true GFR in this case. Having some...

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