RE: technical 11 hours ago

thanks Satish ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KPCOP EC [Past Medical Director Kidney Pancreas Transplant M...

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RE: complex case of nephrotic syndrome in liver transplant patients 12 hours ago

If this is Sirolimus induced diffuse Podocytopathy. Then there is no reason to suspect a high risk for relapse following repeat Liver transplantati...

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RE: complex case of nephrotic syndrome in liver transplant patients 14 hours ago

Hi update , This patient was discussed at mdt. Campath induction and if relapse of DP for obi ( apparently West London renal unit used Campath indu...

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RE: Effect Of Plasma Exchange On Complement (c3,c4) 14 hours ago

Dr. Soobadar.. As Dr. Venkat (and his Google AI assistant ) states the levels of C3 and C4 after PLEX (using 5% albumin for replacement fluid ) wil...

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RE: Effect Of Plasma Exchange On Complement (c3,c4) 15 hours ago

Interesting question. It depends on intensity of PLEX (volume removed per session and number sessions per week) and the type of replacement fluids....

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RE: Effect Of Plasma Exchange On Complement (c3,c4) 15 hours ago

From Google AI: "Therapeutic plasma exchange (TPE) mechanically removes complement proteins. As a result, C3 and C4 levels acutely decrease by 35...

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RE: Gross hematuria in a patient with failed renal allograft 18 hours ago

I stated: the renal parenchyma looks quite heterogenous implying an intra-renal process (edema from the rejection process and/or a renal infarct) ...

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RE: Gross hematuria in a patient with failed renal allograft 19 hours ago

I looked at the CT images again and frankly speaking, without upper cuts, I really cannot tell whether the allograft is in the right or left lower ...

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RE: Gross hematuria in a patient with failed renal allograft 19 hours ago

@Amit Joshi Thank you. The RLQ allograft (if I have my anatomy correct) is HUGE. In addition, i think that not only there is a medial collection ...

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RE: Gross hematuria in a patient with failed renal allograft 19 hours ago

Many aspects of this case do not make sense to me, personally. Let's see why: The patient presents with generalized weakness, states that he...

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Effect Of Plasma Exchange On Complement (c3,c4) 19 hours ago

Dear colleagues Interested to know your thoughts Can plasma exchange reduce c3,c4 level My thought is yes but appreciate your idea / input Bw

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RE: Gross hematuria in a patient with failed renal allograft 19 hours ago

Thank you Dr. Mohammed, one of the question that came up was to decide between graft nephrectomy vs. embolization is bleeding persists. --------...

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RE: Gross hematuria in a patient with failed renal allograft 19 hours ago

I have uploaded some of the images. Thank you Dr. Rubin. ------------------------------ Amit Joshi Chicago IL ------------------------------ Fil...

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RE: technical 21 hours ago

In the browser can go to your photo and click on that. Then click on your name which is the first item in the menu. You will reach your personal ho...

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RE: Gross hematuria in a patient with failed renal allograft 1 day ago

So would a repeat ct angiogram or conventional angiogram be more helpful in establishing the cause????? --------------------------------- Syed Moh...

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RE: Gross hematuria in a patient with failed renal allograft 1 day ago

How much sensitive the angiogram is to pick a small AVF post biopsy and an aneurysm which periodically and intermittently bleeds and may be missed ...

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RE: Gross hematuria in a patient with failed renal allograft 1 day ago

Thank you Dr. Lerman He is hemodynamically stable- required 1 unit PRBC in last week, BP are stable 100-140s systolic. No fever, abdominal pa...

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RE: Gross hematuria in a patient with failed renal allograft 1 day ago

key points to be considered Post-graft biopsy gross hematuria , first, we need to rule out biopsy-related vascular complications like AVF, pseu...

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RE: cause of AKI 1 day ago

Negative prof glassock --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: cause of AKI 1 day ago

Immunofluorescence microscopy using antibody reagents to kappa and lambda light chains. Were the tubular casts positive for monotypic light chains....

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RE: Gross hematuria in a patient with failed renal allograft 1 day ago

@Amit Joshi Would It be possible for you to post the CT images of the renal allograft? Thank you ------------------------------ Mario Rubin, M....

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RE: calcium deficit and replacement 1 day ago

Thanks he had line and dialysis today Bad Aki , fluid overload , acidosis , low calcium anuria Can someone help with how to calculate na , k and ...

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RE: cause of AKI 1 day ago

What stains you referring to prof glassock ? If ? Congo red negative --------------------------------- Muhammad Soobadar MBChB UK --------------...

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RE: Renal Biopsy Findings Post Cyclophosphamide In Mpo+ve Patients 1 day ago

@ prof glassock update -there is a rheumatologist with expertise in CTD / scleroderma reviewed patient There was no clinical evidence of sclerode...

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RE: cause of AKI 1 day ago

Were the stains for light chains in casts positive and monotypic? if yes, this might be myeloma cast Nephropathy. , but the exuberant inflammatory ...

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RE: cause of AKI 1 day ago

Not back yet Thanks --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Gross hematuria in a patient with failed renal allograft 1 day ago

thanks -a few comments would consider color doppler as very sensitive for post biopsy AVM, selective arteriogram of allograft if bleeding does no...

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RE: cause of AKI 1 day ago

What were the results of free light chains and immunoelectrophoresis of serum .? ------------------------------ Richard Glassock MD, FASN Emerit...

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RE: cause of AKI 1 day ago

thanks prog glassock offending meds stopped LFT normal ------------------------------ Muhammad Soobadar MBChB UK -----------------------...

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RE: Fibronectin glomerulopath 1 day ago

Thanks- any progression on EM to report? Just curious! ------------------------------ Richard Glassock MD, FASN Emeritus Professor Geffen School...

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RE: Fibronectin glomerulopath 1 day ago

then idiopathic nodular glomerulosclerosis would be unusual. ------------------------------ Roger Rodby MD, FASN Professor of Medicine Rush Univ...

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RE: calcium deficit and replacement 1 day ago

I dont see the urgency to treat this level of mild hypocalcemia with anything other than dialysis, and I think it can wait. If the patient had E...

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RE: Gross hematuria in a patient with failed renal allograft 1 day ago

failed kidney transplants commonly bleed when you taper off IS, sometimes pain only , sometimes fever only, but rejection takes over. The kicker he...

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RE: Gross hematuria in a patient with failed renal allograft 1 day ago

Hi Dr. Lerman, I was initially suspecting AVM related to the biopsy of the transplanted kidney. He had CT angio that was negative and subsequent ...

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technical 1 day ago

Mark Fitzgerald-technical question-after a potential reply to a post is saved as draft-how do you retrieve it for final posting? ----------------...

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RE: calcium deficit and replacement 1 day ago

I have no idea how to calculate calcium or bicarbonate deficits, but I agree with Dr. Mellas that any predictive equation is likely to be inaccurat...

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RE: Gross hematuria in a patient with failed renal allograft 1 day ago

Dr.Joshi -was a color Doppler ultrasound performed, which did not show any evidence of AVm or pseudo Aneurysm related to the transplant biopsy? you...

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RE: calcium deficit and replacement 1 day ago

Word of caution. HCO3- deficit calculations in metabolic acidosis are fairly reliable. Ca is far more complex. An accurate equation to calculate a...

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RE: Fibronectin glomerulopath 1 day ago

Not a current or past smoker. ------------------------------ Sangeeth Kumar Thiruvalla TMM Thiruvalla ------------------------------

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RE: C3 or MGRS 1 day ago

We don't do formalin fixation, so there would be no need for Pronase digestion. We just do frozen sections , and the IF has already detected kappa ...

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RE: cause of AKI 1 day ago

Too early to see any response.- were all potentially offending medicatons stoped? Any signs of liver injury? ------------------------------ Richa...

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RE: cause of AKI 2 days ago

Prof glassock thanks so much Creatinine at presentation 19 5 days of steroids 40 mg and dialysis dependent --------------------------------- M...

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RE: Membranous Nephropathy treatment 2 days ago

1.Do you have availability of oral cyclophosphamide (if ritux not possible ),will replace both cni and mmf with ponticelli regimen 2. 145 trough c...

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RE: C3 or MGRS 2 days ago

Looks like having tubular involvement by monoclonal proteins as evident by glucosuria,Hypokalemia . Pronase digestion of the paraffin embedded tiss...

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RE: calcium deficit and replacement 2 days ago

If the patient is in AKI , probably performing Dialysis , TONIGHT, against a high calcium bath ( 1.5 mmol/l or 3 mg/dl) may be preferable , as it w...

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RE: calcium deficit and replacement 2 days ago

Your calculation of calcium deficit is incorrect and cannot be used to clinically guide IV calcium therapy. In hypocalcemic states. Is the patient ...

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RE: cause of AKI 2 days ago

This might be Ashwagandha induced TIN. Serum FLC and IEP must be done, steroid therapy likely indicated. Any liver injury present. ? ------------...

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RE: calcium deficit and replacement 2 days ago

Why not give oral calcium carbonate. or acetate. I do not see any clear need for IV calcium, What is the cause of AKI.? If rhabdomyolysis extra cal...

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cause of AKI 2 days ago

47 Female went to GP few weeks with funny taste in mouth making her feel sick. Had been taking PPI for several months - GP advised come off i...

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RE: calcium deficit and replacement 2 days ago

trying to correct calcium before bicarbonate in case low calcium causes tetany ------------------------------ Muhammad Soobadar MBChB UK --------...

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