RE: Pd Patient And Lipid Lowering Agent 2 hours ago

Dr. Soobadar- Are you using Fish Oils in these doses in your HD patients. If so , what kind of side effects are the patients experiencing? Just c...

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RE: Pd Patient And Lipid Lowering Agent 2 hours ago

The Fish oil dosing regimen is described in the NEJM paper . It is 4.0 gms of Fish daily containing 1.6 gm of EPA and 0.8 gm of DHA. Give itca try....

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RE: Pd Patient And Lipid Lowering Agent 5 hours ago

Richter scale: >7 Wow, this is big. Thank you Dr Glassock. Can you also please help us about the amount of fish oil to reach these goals? ----...

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RE: AKI - 3 weeks post normal vaginal delivery 8 hours ago

Thank you Dr. Mohammed. ANA panel negative, complements negative. MPO/PR3 negative. Cryo pending. ADAMTS13 pending. patient has transferr...

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RE: AKI - 3 weeks post normal vaginal delivery 18 hours ago

Thank you for sharing this case for discussion. While TMA renal limited is possible, it is not classical. Postpartum is one of the important trigge...

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RE: High output HF from AVF? 18 hours ago

Thank you for sharing this case. What is the cardiology team's opinion on the assessment for high-output heart failure? Is there any evidence of pu...

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RE: Tumoral calcinosis in a PD patient 19 hours ago

Would it be time to consider Aluminum binders? After a few months check levels Anyone checking calcidiol levels and supplementing? Would hemodiafil...

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RE: Tumoral calcinosis in a PD patient 1 day ago

I would definitely avoid bisphosphonates in this situation. What is the current serum PO4?Do you feel comfortable decreasing or stopping the calcit...

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RE: Tumoral calcinosis in a PD patient 1 day ago

His Pth is 230. Ionized calcium is actually 1.0, lower than normal so I have been avoiding sensipar and even bispgospanate for the time being and s...

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RE: AKI - 3 weeks post normal vaginal delivery 1 day ago

Dr, Mellas raises an important question. My impression from the littersaturec is that the elevation in serum LDH is very much related to the durati...

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RE: AKI - 3 weeks post normal vaginal delivery 1 day ago

Thanks Dr. Mellas, LDH was hovering normal upper, today in 400s. Patient left last night to be at her transplant center for higher level of ca...

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RE: AKI - 3 weeks post normal vaginal delivery 1 day ago

A few questions to Dr Kaur. If the patient has renal cortical necrosis why is LDH not higher? Why can you not give gadolinium if Group II or II...

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RE: AKI - 3 weeks post normal vaginal delivery 1 day ago

Thank you Dr. Glassock! Renal biopsy done. Renal function worsening. ------------------------------ T. Kaur, MD FACP Nephrologist/HTN/Kidney Sto...

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RE: Non-necrotizing granulomatous interstitial nephritis 1 day ago

I shall. I agree with you. Hematopathology has become an integral part of onco-nephrology. For educational purposes, I was underscoring the phenoty...

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RE: Non-necrotizing granulomatous interstitial nephritis 1 day ago

Thank you! Please let me know of any typos so I can correct them for the final version! 😀 Regarding CLL diagnosis, we should consult with hemato...

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RE: Non-necrotizing granulomatous interstitial nephritis 1 day ago

Got your paper Lynn. Now, I have a lovely weekend reading material! KUDOS! I guess, looking for CD5 expression will aid in the diagnosis of CLL. Ma...

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RE: transplant recurrent FSGS 1 day ago

Thank you Dr. Cravedi. Very helpful information. I guess the final chapter remains to be written. Best. Mario ------------------------------ M...

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RE: transplant recurrent FSGS 1 day ago

Thank you, Dr. Rubin, for the kind words. Yes, together with Dr. Angeletti in Genoa, Italy, we have accumulated some experience with this approach...

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RE: Non-necrotizing granulomatous interstitial nephritis 1 day ago

Thank you, Jonathan! I still have to correct the proofs... but the final version when available is supposed to be open access too so everyone can...

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RE: Non-necrotizing granulomatous interstitial nephritis 1 day ago

Also good time to highlight Dr. Cornell's tour de force review on all things tubulointerstitial forthcoming in KI: https://www.kidney-international...

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RE: Non-necrotizing granulomatous interstitial nephritis 1 day ago

Came here to point out the same thing- although unlikely, you don't want to miss CLL as a cause of granulomatous interstitial nephritis. The CLL ca...

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RE: transplant recurrent FSGS 1 day ago

Thank you for sharing this interesting paper. The authors make several key points but 2 of them called my attention: 1. Circulating levels of ant...

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RE: transplant recurrent FSGS 1 day ago

There is a very elegant study by Angiletti and Cravedi exploring the hypothesis that autoreactive IgM plays a pathogenic role in nephrotic syndrome...

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RE: transplant recurrent FSGS 1 day ago

@Paolo Cravedi Paolo Cravedi (a superb immunologist) is, most likely behind this idea of combining anti B cell- Plasma cell therapy and I am wond...

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RE: Non-necrotizing granulomatous interstitial nephritis 1 day ago

About 20-30% of patients with Sarcoidosis present in a renal limited fashion- so this case is somewhat atypical but by no means rare. Early steroid...

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RE: Non-necrotizing granulomatous interstitial nephritis 1 day ago

Thank you all for the invaluable insights and guidance on this case. To update the panel, the patient's ANA 23-profile (including anti-SSA and ant...

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RE: Non-necrotizing granulomatous interstitial nephritis 1 day ago

Assuming that the patient is not taking any drugs known to produce granulomatous interstitial nephritis, my AI consults - (Expert AI (UpToDate ) an...

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RE: Tumoral calcinosis in a PD patient 1 day ago

Tumoral calcinosis is poorly understood, but as this is progressive I would treat this as calciphylaxis with HD, sodium thiosulfate (STS) avoid Ca ...

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RE: transplant recurrent FSGS 1 day ago

I have attached the article referred to by Dr Venturelli I find it interesting that they would use BOTH anti-CD 20 and anti-CD 38 since anti CD 3...

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RE: Non-necrotizing granulomatous interstitial nephritis 1 day ago

I agree with everyone and everything above, and Dr Glassock's additional suggested work-up, and yet when you are done you will start steroids for S...

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RE: transplant recurrent FSGS 1 day ago

Dr. Hirsch I cannot say anything about pre transplant treatment and I acknowledge but working with our pediatric colleagues we have seen responses ...

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RE: Radioiodine treatment in Patient with CKD stage 4 1 day ago

https://community.asn-online.org/communities/community-home/digestviewer/viewthread?MessageKey=b916ea5e-55bd-49cf-a2d4-0ba62a9d1e3e&CommunityKey=a6...

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RE: Non-necrotizing granulomatous interstitial nephritis 1 day ago

Other rare ddx for GIN also include inflammatory bowel disease, BCG therapy, the CLL. ------------------------------ Jonathan Zuckerman MD, PhD ...

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RE: Non-necrotizing granulomatous interstitial nephritis 1 day ago

Dr. Duong this is probably a very obvious point but consider that in TINU uveitis can occur several months after interstitial nephritis --------...

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RE: Non-necrotizing granulomatous interstitial nephritis 1 day ago

Interesting question. I am not aware of any studies have evaluated such findings to that degree of granularity (if anyone know any, please share). ...

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Tumoral calcinosis in a PD patient 1 day ago

I have this 47 TO male patient with ESRD due to DM, HTN, PVD, high phosphorous in past who developed painful gluteal masses and imaging and finally...

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RE: Non-necrotizing granulomatous interstitial nephritis 1 day ago

Dr. Zuckerman - Dr. Zuckerman -thanks for your review and interpretation of the digital renal pathology in this case. How do you define "exube...

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RE: transplant recurrent FSGS 1 day ago

Thank you for sharing this interesting case. This is a presentation that we not uncommonly encounter in kidney transplantation. At our center,...

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RE: Non-necrotizing granulomatous interstitial nephritis 1 day ago

The granuloma formation in this case is exuberant. While the most common etiology for GIN is drug/allergic TIN, would definitely consider sarcoidos...

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RE: AKI - 3 weeks post normal vaginal delivery 1 day ago

Tragic case. The Findings suggest the uncommon occurrence of incomplete or partial bilateral renal cortical necrosis ,following a "normal vaginal d...

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RE: Non-necrotizing granulomatous interstitial nephritis 1 day ago

Thanks you for your full description of this Challenging case . Given the clinical and pathological fibdibgs, I doubt this is renal /pulmonary myco...

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Non-necrotizing granulomatous interstitial nephritis 2 days ago

Dear colleagues, I'd like to share a diagnostically challenging case from our nephrology unit, on which I would value the community's input. Pati...

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RE: Post Partum AKI 2 days ago

Last creatinine os 4.6 frm 2.8, p/c of 17, blood pressure of 130/92 Her Bicarbonate is 17 Phosphate 6 Calcium 7.5. I pulsed her, treated her and pl...

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AKI - 3 weeks post normal vaginal delivery 2 days ago

Hello All, I have a 31 y/o'clock female, h/o Caroli's disease s/p Liver Transplant 2010, currently on Tacrolimus (trough goal about 3), had a no...

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RE: MPGN with negative IMF 2 days ago

I think the EM findings likely make Fibrillary GN an untenable diagnosis, unless the images were not examined at high magnification. Could you plea...

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RE: Radioiodine treatment in Patient with CKD stage 4 2 days ago

zahmad@kidneycareok.com thank you ------------------------------ Zubair Ahmad MD Tulsa OK (585) 329-9640 ------------------------------

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RE: transplant recurrent FSGS 2 days ago

@Sheldon Hirsch I do not have the answer to your excellent points. Clearly, there is a permeability factor(s) in the sera of patients with recurr...

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RE: transplant recurrent FSGS 2 days ago

Related...in the reference provided, 40% of patients with neg anti-nephrin Ab still lost their allograft function by six months. Perhaps there is m...

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RE: transplant recurrent FSGS 2 days ago

Excellent question. I do not have the "answer". As you know, the permeability factor story has changed overtime: the Sabin factor, SUPAR and now an...

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RE: transplant recurrent FSGS 2 days ago

@Mario Rubin, Do you think that anti-nephrin antibodies is the elusive permeability factor or may there be more to the story, I ask because you w...

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