RE: Hydroxychloroquine and clearance 3 hours ago

I am equally mystified by the “Swedish Study” of Chloroquine in COVID19 and its reported premature closure for safety reasons. It was originally re...

View Discussion

RE: Hydroxychloroquine and clearance 4 hours ago

Dr Fein, I had the same question from Dr Glassock's answer.  I do not see anything published that is related to a Swedish experience that is associ...

View Discussion

RE: COVID19 and ACE2 7 hours ago

something related to this- GIAPREZA™ (Angiotensin II) in Italy for Compassionate Use in Patients with Septic Shock Associated with COVID-19 ---...

View Discussion

RE: Protective factors for COVID19 pneumonia in CKD - registret data 7 hours ago

There was no trial, only clinical use. And many physicians were quite surprised by this decision. My feeling is that the ID people had problems adj...

View Discussion

RE: Protective factors for COVID19 pneumonia in CKD - registret data 7 hours ago

Was the stoppage of Chloroquine in COVID19 taken as an action within an organized Clinical Trial overseen by a DMC or was it something else? I can’...

View Discussion

RE: Protective factors for COVID19 pneumonia in CKD - registret data 7 hours ago

To clarify, since I work in Sweden, there have been no ongoing studies in Sweden with  chloroquine in COVID19 neither in patients with CKD nor in o...

View Discussion

RE: Protective factors for COVID19 pneumonia in CKD - registret data 9 hours ago

Understood completely. I would still try the paquenil. I have always found the Scandinavians amongst the most impressive nations in many respects. ...

View Discussion

RE: Hydroxychloroquine and clearance 10 hours ago

Is there a reference for the Swedish experience. As always we are all. very concerned that these mass protocols might actually be contributing to h...

View Discussion

RE: Limiting staff exposure with CRRT/IHD in COVID 11 hours ago

Can you please share how exactly you do that? Is the tablet focused on the machine/patient? Do your nurses have realtime access to vitals, blood fl...

View Discussion

RE: Protective factors for COVID19 pneumonia in CKD - registret data 11 hours ago

The issue is two fold- 1) a myocarditis can commonly accompany COVID19- how can we be sure that HCQ is “safe” in these circumstances; 2) HCQ is com...

View Discussion

RE: Vascular Access procedures in an Era of Covid 11 hours ago

Our group operates a VAC for the SSM network in St Louis. Our case load is down about 50%. We are doing thrombectomies, venous catheters, PD cathet...

View Discussion

RE: Protective factors for COVID19 pneumonia in CKD - registret data 12 hours ago

I have been following these conversations for the past several weeks. Having seen plaqeunil used, on countless patients, for several years in many ...

View Discussion

RE: Vascular Access procedures in an Era of Covid 14 hours ago

Hi Richard, We are having a similar debate.  In addition to declot and angioplasty of fistulas and grafts, our suggestions to our surgical and inte...

View Discussion

RE: Hydroxychloroquine and clearance 14 hours ago

Dosing: Renal Impairment: Adult There are no dosage adjustments provided in the manufacturer's labeling; renal clearance accounts for 15 to 25% o...

View Discussion

RE: Limiting staff exposure with CRRT/IHD in COVID 14 hours ago

We have come up with remote video monitoring option on surface tablet thats' left inside the patient room. HD staff stay outside the room monitorin...

View Discussion

RE: TMA with Covid-19 1 day ago

Altogether, the data provided in the Keith et al (2020) retrospective analysis of PLEX in ARDS (propensity matched) is mainly hypothesis generating...

View Discussion

RE: TMA with Covid-19 1 day ago

Interesting thanks for the reference ------------------------------ Aqeel Siddiqui MD Nephrology Associates Wynnewood PA --------------------------...

View Discussion

RE: Hydroxychloroquine and clearance 1 day ago

Thank you for your expedite answer.  I was thinking more on the efficacy of HD to treat a potentially lethal acute hydroxyxhloroquine toxicity not ...

View Discussion

RE: CRRT - Citrate anticoagulation with Ca-containing solutions 1 day ago

No personal experience but there is a body of literature on use of Ca-containing dialysate/replacement with RCA removing/reducing Ca infusion requi...

View Discussion

RE: Hydroxychloroquine and clearance 1 day ago

A trial of Chloroquine in ESRD patients with COVID19 in Sweden was just abruptly stopped for safety reasons. Extreme caution should be observed in ...

View Discussion

Hydroxychloroquine and clearance 1 day ago

I am reading an old comprehensive review from 06/1979 about the side effects and toxicities (acute and chronic, voluntary and involuntary)  of chlo...

View Discussion

RE: TMA with Covid-19 1 day ago

Interesting case. i think the question you are really asking is whether there is any role for plasma exchange to treat TMA that is probably seconda...

View Discussion

RE: CRRT - Citrate anticoagulation with Ca-containing solutions 1 day ago

We have always used calcium containing solutions for CVVHD, Metabolic alkalosis is expected with ACD and you can prevent or treat it by adding norm...

View Discussion

RE: Protective factors for COVID19 pneumonia in CKD - registret data 1 day ago

Thanks- interesting data. Hypothesis generating - not proof of principle. But encouraging for HCQ, nonetheless. ? Adjustments for confounders. Sent...

View Discussion

Protective factors for COVID19 pneumonia in CKD - registret data 1 day ago

This is very interesting registry data from Spain, collected during the last few weeks March 18 - April 4. The link is in Spanish and from twitter ...

View Discussion

RE: Transplant Medications And COVID-19 1 day ago

@Mark Lerman Dr Lerman, Covid positive without or with pneumonia? I guess we are going to see many asymptomatic or minimally symptomatic KTRs with...

View Discussion

RE: Transplant Medications And COVID-19 1 day ago

Agree with aggressive work up including bronchoscopy to confirm COVID19 and exclude bacterial and or fungal infection. What is CRP,ferritin, IL6 le...

View Discussion

Vascular Access procedures in an Era of Covid 1 day ago

I wonder what other's experiences are with regard to obtaining vascular access procedures (both surgical and Interventional) in an era of covid. Cu...

View Discussion

RE: Lupus Nephritis 1 day ago

Good point! I see her today in "video" clinic and will assess. ------------------------------ Brian Thornton MD Summit Nephrology Medical Group, In...

View Discussion

RE: Lupus Nephritis 1 day ago

Thank you for the input. Although she was worsening on MMF, she has had no response to the cytoxan and perhaps it is time to consider RTX and MMF. ...

View Discussion

RE: Lupus Nephritis 1 day ago

No current evidence of MAHA. No TMA noted on biopsy. Unfortunately the lab did not provide MPV. ------------------------------ Brian Thornton MD Su...

View Discussion

RE: Lupus Nephritis 1 day ago

​Brian Is she taking her prednisone? (And " She says she is " is not the right answer.) Joanne Bargman ------------------------------ Joanne Bargma...

View Discussion

RE: Limiting staff exposure with CRRT/IHD in COVID 1 day ago

I have heard suggestions of decreasing treatment times in hospitalized patients. My first concern would be that patients with respiratory compromis...

View Discussion

RE: Transplant Medications And COVID-19 1 day ago

Since superinfections are common in immunosuppressed transplant recipients (CMV predisposing to infections by other microbes is a good example) and...

View Discussion

RE: Histiocytic Nephropathy 1 day ago

Are there any therapies available directed specifically against CD-68 +ve cells? A hematologist/oncologist may be able to help. -------------------...

View Discussion

RE: TMA with Covid-19 1 day ago

Picture was not Consistent with DIC. Tocilizumab is a good option as we do have a available in the hospital for COVID-19 in severe cases. cr did co...

View Discussion

RE: Transplant Medications And COVID-19 1 day ago

Done with contrast to rule out PE. Showed diffuse ground glass opacities and no PE. --------------------------------- Mohammad Alsawah MD Detroit ...

View Discussion

RE: Lupus Nephritis 1 day ago

Sounds like she couldn't tolerate MMF due to GI issues and can't tolerate CYC because of cytopenias.  I was also wondering if you could convert you...

View Discussion

RE: Transplant Medications And COVID-19 1 day ago

False negative COVID19 tests are fairly common, depending on sampling method. False positive COVID tests are quite uncommon. Because this patients ...

View Discussion

RE: Histiocytic Nephropathy 1 day ago

Are the EM results available yet. Was a liver biopsy done? Sent from my iPad

View Discussion

RE: Transplant Medications And COVID-19 1 day ago

What would you do if they have bilateral lung infiltrate and fever and require high level of oxygen. It’s getting pretty common to see KTR in the i...

View Discussion

RE: Histiocytic Nephropathy 1 day ago

Now Day 9 of admission, patient continues to be anuric while on steroids( solumedrol pulse followed by Oral 1 mg per kg Prednisolone) As the patien...

View Discussion

RE: Histiocytic Nephropathy 1 day ago

Sorry for my previous misinformation.  I just Discussed with Dr.Swarnalatha our Renal Pathologist, she confirmed that the Oil red O stain was done ...

View Discussion

RE: Histiocytic Nephropathy 1 day ago

Lipid stain was not on frozen section. And the CD68 extensive positivity puts to rest the doubts about LCAT, it is histiocytic glomerular and inter...

View Discussion

RE: LDL apheresis in recurrent FSGS 2 days ago

Yes, when he was on intensive TPE schedule of three times a week early post transplant, proteinuria was down to subnephrotic range of 2-3 grams. --...

View Discussion

RE: TMA with Covid-19 2 days ago

I’d suspect Covid-19-assoc DIC on top of her established metastatic breast CA/chemotherapy-related TMA. Are labs c/w DIC? Did MAHA resolve post-dox...

View Discussion

RE: LDL apheresis in recurrent FSGS 2 days ago

Does proteinuria resolve with more frequent PLEX? ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] [Past Medical Director Kidney ...

View Discussion

RE: TMA with Covid-19 2 days ago

Consider tocilizumab if D-DIMER,FERRITIN,CRP,,IL6 IS ELEVATED The content in this comment/discussion is not intended to be medical advice for a par...

View Discussion

RE: Transplant Medications And COVID-19 2 days ago

From AST - Immunosuppres s ion in COVID-19 positive patients There is absence of consensus at this point: In patients with COVID-19 without pneum...

View Discussion

RE: covid 19, cytokines and crrt 2 days ago

In addition to counterarguments already noted, another taken from toxicokinetics has to do with endogenous pro-inflammatory cytokine clearance in t...

View Discussion