RE: NEPHROCALCINOSIS 1 hour ago

Obviously I didn't think that through. I agree that X linked seems unlikely with a paternal inheritance. Also the actual relationship of the uncles...

View Discussion

GN in post transplant 2 hours ago

hello everyone Would appreciate input on this challenging case 58 year old male with hx of ESKD 2/2 anti-GBM disease, B/L native nephrect...

View Discussion

GN in post transplant 2 hours ago

Hello everyone Would appreciate the input on this challenging case 58 year old male with hx of ESKD 2/2 anti-GBM disease, B/L native nephrec...

View Discussion

RE: NEPHROCALCINOSIS 2 hours ago

The one unresolved issue is father to son inheritance, that should not occur in pure X-linked disease, ------------------------------ Richard Gla...

View Discussion

RE: Transplantation case 2 hours ago

Thanks for posting this Very interesting case on the kidney transplantation community. It certainly appears that your patient recurrent episodes of...

View Discussion

RE: NEPHROCALCINOSIS 3 hours ago

I would also put my money on Dents disease. The other X linked condition leading to possible nephrocalcinosis is X linked hypophosphatemia. Obvious...

View Discussion

RE: Transplantation case 3 hours ago

Can you give us serial serum creatinine levels over the last year? Would be instructive ------------------------------ Satish Balan MD DM DNB Se...

View Discussion

RE: NEPHROCALCINOSIS 6 hours ago

Thanks a lot prof glassock and dr shahzad. Much appreciated. ------------------------------ Hassan Abdullah MBBS Resident Nephrology Shaikh Zayed...

View Discussion

RE: NEPHROCALCINOSIS 8 hours ago

I do appreciate expert reply of Prof .Glascock, Thanks a lot ------------------------------ Ahmed Yasin, MD,FASN Saudi German Hospitals Group Mad...

View Discussion

RE: NEPHROCALCINOSIS 16 hours ago

X-linked inheritance and absence of a history of hypokalemia makes distal (Type 1) RTA less likely, but genetic studies should be very revealing. ...

View Discussion

RE: Type 1 Cryo proliferative GN without identifiable clone on treatment without improvement in proteinuria 17 hours ago

PS: And yes, he is on lisinopril 40 and Farxiga 10. ------------------------------ Jeffrey Reynolds, MD, MBA Partner/Nephrologist PACT Kidney Cen...

View Discussion

RE: Type 1 Cryo proliferative GN without identifiable clone on treatment without improvement in proteinuria 17 hours ago

Thank you so much, Dr. Glassock for the thoughtful response. Good point about the larger microtubules suggesting possible immunotactoid. The seru...

View Discussion

Transplantation case 18 hours ago

31-year-old male kidney transplant recipientwith end-stage kidney disease secondary to reflux nephropathy, previously on hemodialysis since 2009, w...

View Discussion

RE: NEPHROCALCINOSIS 18 hours ago

Any 24 hour urine stone profile Urine PH or ammonia With distal RTA one would expect medullary calcinosis more than cortical Distal (type 1) ren...

View Discussion

RE: Type 1 Cryo proliferative GN without identifiable clone on treatment without improvement in proteinuria 19 hours ago

What happened to the serum levels of the Kappa IgG paraprotein with the Dara/ velcade/ steroid therapy. I assume that the patient does not have CLL...

View Discussion

Type 1 Cryo proliferative GN without identifiable clone on treatment without improvement in proteinuria 19 hours ago

I would greatly appreciate your help on this case. 72 year old male (physician) in excellent health referred 2 years ago for mild proteinuria whi...

View Discussion

RE: NEPHROCALCINOSIS 20 hours ago

Cortical nephrocalcinosis can occur late in conditions like Dent disease and Primary hyperoxaluria . The normal urine oxalate excretion makes Prima...

View Discussion

RE: NEPHROCALCINOSIS 21 hours ago

Is cortical nephrocalcinosis classic for this? Things like cortical necrosis usually lead to cortical nephrocalcinosis. Any relevance of the locati...

View Discussion

RE: NEPHROCALCINOSIS 22 hours ago

Definitely do genetic testing. This looks like X-linked disease so he may have Dent Disease, which commonly results in Nephrocalcinosis . The hypoc...

View Discussion

NEPHROCALCINOSIS 22 hours ago

I have 30 year old patient with cortical nephrocalcinosis, bilateral renal stones ,creatinine 1.5 mg on potassium citrate and hydrochlorothiazide. ...

View Discussion

RE: Refractory ICI-Associated Nephritis with Progressive AKI, Eosinophilia, and Rash After Nephrectomy – Looking for Management Suggestions 22 hours ago

Thank you Dr Pierce. Appreciate your pointing out your experience & the similarity in histopath appearance. I do recall from a good number of years...

View Discussion

Transplantation case 23 hours ago

31-year-old male kidney transplant recipient with end-stage kidney disease secondary to reflux nephropathy, previously on hemodialysis since 2009, ...

View Discussion

Transplant 1 day ago

The Open Forum is a great place to post cases, but I would ask in the future please post transplant related cases on the Kidney Transplantation com...

View Discussion

RE: Transplant Case- can recurrent Ig A in transplant patient present without proteinuria and midly low C3 and more significant lower C4. 1 day ago

Please try to post transplant related cases on our Kidney Transplatation community - thanks ------------------------------ [Mark] [Lerman] [MD,...

View Discussion

RE: Refractory ICI-Associated Nephritis with Progressive AKI, Eosinophilia, and Rash After Nephrectomy – Looking for Management Suggestions 1 day ago

I had a case many years ago, before a lot was known about treatment, except steroids. The biopsy reminded me of T cell mediated rejection of a tran...

View Discussion

RE: treatment of C3GN after developing meningococcal infection with iptacopan 1 day ago

Thank you so much Dr. Glassock. The problem is that her meningococcal serotyping was non-typable, which indicates that it is a strain beyond the on...

View Discussion

RE: Refractory ICI-Associated Nephritis with Progressive AKI, Eosinophilia, and Rash After Nephrectomy – Looking for Management Suggestions 1 day ago

@Mario Rubin: No personal experience. Blocking IL-5 axis has been used only for eosinophil-rich AIN. ------------------------------ K.K. Venkat M...

View Discussion

RE: Refractory ICI-Associated Nephritis with Progressive AKI, Eosinophilia, and Rash After Nephrectomy – Looking for Management Suggestions 1 day ago

The group at MD Anderson in Houston has pioneered the use of infliximab (as stated in several posts) and it's benefits in the management of steroid...

View Discussion

RE: Refractory ICI-Associated Nephritis with Progressive AKI, Eosinophilia, and Rash After Nephrectomy – Looking for Management Suggestions 1 day ago

Another recent approach to steroid-refractory, eosinophil-rich AIN caused by ICIs is blocking the IL-5 axis. Eosinophil activation depends on the I...

View Discussion

RE: Case of intermittent Hyokalaemia with preserved kidney function 1 day ago

Serum sodium 143-145 and serum K less than 3 suggest primary hyperaldosteronism Before calling this white-coat hypertension, I would like to kno...

View Discussion

RE: Refractory ICI-Associated Nephritis with Progressive AKI, Eosinophilia, and Rash After Nephrectomy – Looking for Management Suggestions 2 days ago

Hi, I am current Onco-Nephrology fellow at MD Anderson we see a lot of similar cases. We give them infliximab. I also attached the recent stu...

View Discussion

RE: Refractory ICI-Associated Nephritis with Progressive AKI, Eosinophilia, and Rash After Nephrectomy – Looking for Management Suggestions 2 days ago

Murad: I attach another article on use of Infliximab, as well ------------------------------ Prem Chandran MD Adj Clinical Professor, Univ o...

View Discussion

RE: Case of intermittent Hyokalaemia with preserved kidney function 2 days ago

She does have high U K/Cr and FE K suggesting renal K loss. No evidence of primary aldosteronism or Barters or Gittelman. With this BMI could she...

View Discussion

RE: Case of intermittent Hyokalaemia with preserved kidney function 2 days ago

Do you have a spot urine K:creatinine ratio synchronous with a serum K that shows hypokalemia . This would be the most accurate determination of re...

View Discussion

RE: Case of intermittent Hyokalaemia with preserved kidney function 3 days ago

I was implying that the HTN was obesity related, and that the K may not be part of a syndrome since it is often normal or so I interpreted the orig...

View Discussion

RE: Refractory ICI-Associated Nephritis with Progressive AKI, Eosinophilia, and Rash After Nephrectomy – Looking for Management Suggestions 3 days ago

I do not have personal experience but I attach an article using infliximab. This reminds me of steroid unresponsive sarcoidosis where infliximab ca...

View Discussion

Refractory ICI-Associated Nephritis with Progressive AKI, Eosinophilia, and Rash After Nephrectomy – Looking for Management Suggestions 3 days ago

I would appreciate input from colleagues regarding a challenging case. A patient with advanced right RCC and suspected left supraclavicular nodal...

View Discussion

RE: treatment of C3GN after developing meningococcal infection with iptacopan 3 days ago

Addendum- according to the ACIP- only Penucillin V , Ciprofloxacin, Rifampin are recommended for meningococcalprophylaxis. Amoxicillin is not recom...

View Discussion

RE: treatment of C3GN after developing meningococcal infection with iptacopan 3 days ago

Extremely complex case and a classic "between a rock and a hard place " situationist.. evidence based advice is impossible. . I know of no data on ...

View Discussion

RE: nocturnal polyuria 3 days ago

@Prem Chandran: I agree with you that the initial non-albumin dominant tubular proteinuria in a primary TI disorder can become albumin-dominant eve...

View Discussion

RE: nocturnal polyuria 3 days ago

Thank you Dr Venkat: I follow you well. In tubulopathies, there is often glomerular sclerosis & altered glomerular permeability, especially in the ...

View Discussion

RE: nocturnal polyuria 3 days ago

I fully agree. For completeness sake, let's add the diagnostic role of urinary retinol binding protein (molecular weight = 21.2 kDa) which has been...

View Discussion

RE: nocturnal polyuria 3 days ago

@Prem Chandran, the following two statements are from Google AI: 1. "In a healthy kidney, the glomerular filtration barrier is highly restrictive t...

View Discussion

RE: nocturnal polyuria 3 days ago

TOO cumbersome. I would stick to the UPCR where a normal ratio in a recumbent position (less than 0.2mg/mg creatinine) with a high ratio in samples...

View Discussion

RE: nocturnal polyuria 3 days ago

Never mind. I found it. Selectivity as a clue to diagnosis of postural proteinuria F J Frey et al. Lancet. 1979. Now I need to read it and e...

View Discussion

RE: nocturnal polyuria 3 days ago

Thank you for the clarification. Dr. Rodby's post was quite clear and it is followed by many seeking a quick and simple method of differentiating g...

View Discussion

RE: nocturnal polyuria 3 days ago

Dr Venkat: Respectfully, with regard to your sentence:'In contrast, in UAlb/Cr vs UPr/Cr ratio on same sample of urine, one is looking at relative ...

View Discussion

RE: nocturnal polyuria 3 days ago

Mario: With respect, thank you for the history lesson!. I never interacted with Dr Stuart Cameron. I did not do my fellowship in the sixties. Mine ...

View Discussion

RE: Case of intermittent Hyokalaemia with preserved kidney function 3 days ago

Thanks prof Glassock . How do interprets above ? --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

View Discussion

RE: Case of intermittent Hyokalaemia with preserved kidney function 3 days ago

Same time urine collected and analysed Potassium creatinine ratio o calculate is 7.36 implies k wasting with low serum k But this case k normal -...

View Discussion