Dialyzer reaction 4 hours ago

Good evening I am Jinwook Park, a nephrologist at Louisville KY. I'd really appreciate any thoughts or similar experiences on this case. Than...

View Discussion

RE: Postural hypotension 7 hours ago

Why is he so anemiic ? Have you done a bone survey And a serum Free light chain ? ------------------------------ Richard Glassock MD, FASN Lagun...

View Discussion

RE: Gross Hematuria 7 hours ago

Besides sickle cell trait (as already mentioned by Dr. Lerman), hypercalciuria (without overt nephrolithiasis) may cause recurrent gross hematuria ...

View Discussion

RE: Gross Hematuria 11 hours ago

The patient is Caucasian Jewish. CT Angiogram was negative for "Nutcracker". Urine cytology was negative. She has stopped running and will see what...

View Discussion

RE: Postural hypotension 11 hours ago

Looks like Diabetic autonomic neuropathy to me. Have you done Valsalva's maneuver? ------------------------------ Richard Glassock MD, FASN Lagun...

View Discussion

Postural hypotension 14 hours ago

Requesting opinion on this case: A 68 year old male presented with history of hypotensive episodes for the past 7–8 years, which are worse in the ...

View Discussion

RE: Nephrotic range proteinuria, kidney biopsy showing lupus 16 hours ago

Thanks for posting the report. While there is 1 glom with segmental hypercellularity, it seems mild at best, so while this could qualify as a cla...

View Discussion

RE: Nephrotic range proteinuria, kidney biopsy showing lupus 18 hours ago

Thanks Dr Glassock and Dr Venkat I have a attached a copy of kidney biopsy report as well as UA ANA neg c3,c4 neg anemia...

View Discussion

RE: Nephrotic range proteinuria, kidney biopsy showing lupus 19 hours ago

"negative serologies for anti-dsDNA, ANCA, and anti-PLA2R antibodies" Was ANA also negative? Coomb's test? ------------------------------ K.K. ...

View Discussion

RE: Nephrotic range proteinuria, kidney biopsy showing lupus 21 hours ago

Also- what is the nature of the anemia in this case? What is the result of the hematological indices snd blood smear.? --------------------------...

View Discussion

RE: Nephrotic range proteinuria, kidney biopsy showing lupus 21 hours ago

It would help if you can post a deidentified copy of thr kidney biopsy report (LM, IF, EM). Was the biopsy stained for DNA JB9 and IgG subclasses? ...

View Discussion

Nephrotic range proteinuria, kidney biopsy showing lupus 1 day ago

Greetings to all the members, I would appreciate your input in this case. A 40-year-old woman was evaluated for incidentally detected nephrotic-ran...

View Discussion

RE: Gross Hematuria 1 day ago

Thanks for all the good ideas. I have passed them on to the patient's internist and if he comes with a dx will let you know. Mike E -----------...

View Discussion

RE: Pd Question 1 day ago

One more point; a patient intubated usually very sick and catabolic. Still need to maintain nutrition. Probably hemo better than PD in handling cat...

View Discussion

RE: Pd Question 1 day ago

Thanks prof bargman very helpful and dr Jose Last question what antibiotics do colleagues use for cyst penetrance ? Kr ----------------------...

View Discussion

Reminder: Encourage fellows to volunteer as case report reviewers for Kidney Week 2026! 1 day ago

ASN invites ASN Fellows-in-Training members to serve as reviewers for case reports submitted by trainees for Kidney Week 2026. The reviewing/gradin...

View Discussion

Reminder: Volunteer by April 29 to serve as a case report reviewer for Kidney Week 2026! 1 day ago

ASN invites ASN Fellows-in-Training members to serve as reviewers for case reports submitted by trainees for Kidney Week 2026. The reviewing/gradin...

View Discussion

RE: Pd Question 1 day ago

HAve seen a couple; Pulmonary folks did not want anything lifting diaphracm, plus fear of peritoneo-pleural leaks so catheter and hemo plus drain a...

View Discussion

RE: complex case of nephrotic syndrome in liver transplant patients 1 day ago

How long did you observe the patient without therapy after stopping Sirolimus? This is crucial information lacking in your presentation ---------...

View Discussion

RE: Pd Question 1 day ago

There are a lot of theories as to why intensivists are so opposed to PD, especially because there is no evidence for this. Probably much of this is...

View Discussion

RE: complex case of nephrotic syndrome in liver transplant patients 1 day ago

Rituxan seemed to have done the trick . --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

View Discussion

RE: complex case of nephrotic syndrome in liver transplant patients 1 day ago

Hi prof glassock thanks for reply Sirolimus was stopped and despite that nephrotic syndrome did not resolve. Steroids was tried and did not impro...

View Discussion

RE: complex case of nephrotic syndrome in liver transplant patients 2 days ago

This case seems to be an example of Sirolimus induced podocytopathy with spontaneous resolution upon stopping the agent. I know of no evidence for ...

View Discussion

RE: Gross Hematuria 2 days ago

Sorry for my late entry into the dialogue generated by this case. The fact that she is a habitual distance runner raises the possibility of exercis...

View Discussion

RE: Pd Question 2 days ago

@ prof bargman Would appreciate your thoughts on this. For PD patient who get acutely unwell and needing intubation ventilation not for pd peritoni...

View Discussion

RE: decision to stop dialysis in patients who lack capacity and family members have divergent views. 2 days ago

thanks everyone. family had sought IMCA but they said they don't have anything to offer. patient admitted with general deterioration and all ...

View Discussion

complex case of nephrotic syndrome in liver transplant patients 2 days ago

22 female complex patient with liver transplant due to Auto immune hepatitis developed nephrotic syndrome while on Sirolimus. Liver transplant team...

View Discussion

RE: Gross Hematuria 2 days ago

I think I would ask her to stop running for a few weeks! Also are the urine RBCs acanthcytic If that is a word) at all? Does she have albumin...

View Discussion

RE: Gross Hematuria 2 days ago

Hi Michael, this is a longshot, but if the patient is African-American would get a hemoglobin electrophoresis to rule out sickle cell trait, which ...

View Discussion

RE: Membranous nephropathy 3 days ago

Thank you for the clarification. For those interested, these are the references which support Dr. Glassock's statement: Sethi et al., Kidne...

View Discussion

RE: Membranous nephropathy 3 days ago

That is mostly due to NELL1 which was negative in this case. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8...

View Discussion

RE: Membranous nephropathy 3 days ago

I was under the impression that, although not a single IgG subclass is reliably specific, IgG1 and IgG2 are the most common isotypes identified in ...

View Discussion

RE: Membranous nephropathy 3 days ago

Thanks Vito

View Discussion

RE: Gross Hematuria 3 days ago

Any clots in the urine? ------------------------------ K.K. Venkat MD Troy MI (248) 420 7798 ------------------------------

View Discussion

RE: Gross Hematuria 3 days ago

Its all "nuts" to me! ------------------------------ Michael Emmett MD Chief of Internal Medicine Emeritus Baylor University Medical Center Dalla...

View Discussion

RE: Gross Hematuria 3 days ago

Wops - I meant nutcracker syndrome not nutmeg syndrome. Sorry for the typo. ME ------------------------------ Michael Emmett MD Chief of Intern...

View Discussion

RE: Gross Hematuria 3 days ago

Is this gross hematuria or pigmenturia (Hb, Mb)? Was this documented by a careful examination of the urine sediment? I thought that the Nutmeg Synd...

View Discussion

Gross Hematuria 3 days ago

An internist colleague, David Cohen at Lankenau Hospital in Philadelphia, has asked me to consider the following case and we both would appreciate ...

View Discussion

RE: IgAN and pregnancy 3 days ago

that was a nice response to steroids and there is evidence that steroids do have a few years of memory , see attached abstract from Kidney wee...

View Discussion

RE: Membranous nephropathy 3 days ago

Since the biopsy was negative for PLA2R and NELL 1 I doubt that staining for IgG subclass is going to help with treatment decision making. There is...

View Discussion

RE: Membranous nephropathy 3 days ago

Thanks Dr. Campese for your opinion. Congo red was negative. IgG was positive (3+), subtyping of IgG was not done. ----------------------------...

View Discussion

RE: IgAN and pregnancy 3 days ago

How much steroids have been given? I would probably continue her RAASi till pregnancy is confirmed just as Dr Glassock has said but I would also pe...

View Discussion

RE: Sarcoid assoc Ca stones 3 days ago

Vit d 1,25 55 pth 45 Ca 10.1 ------------------------------ Jonathan Slater MD Renal & Transplant Associates of New England Longmeadow MA ...

View Discussion

RE: IgAN and pregnancy 3 days ago

Thanks for the additional information. The course if steroids was definitely indicated snd her course so far has been satisfactory/ of course, she ...

View Discussion

RE: IgAN and pregnancy 3 days ago

She is 36 years in age and not a diabetic. Her BMI is 18.5kg/m2 and her baseline blood pressure is 100-120/60s mmHg. Pre treatment hematuria was 7 ...

View Discussion

RE: IgAN and pregnancy 3 days ago

Diffucult problem. Before opining -i need to know her BMI , diabetes status, Oxford MEST-C score, hematuria severity, Blood pressure and eGFR trend...

View Discussion

IgAN and pregnancy 3 days ago

Dear seniors, I wish to draw on your experience in the management of IgAN in pregnant ladies. My lovely patient was diagnosed with biopsy prove...

View Discussion

RE: Sarcoid assoc Ca stones Monday, April 13 @ 9:23 PM

As @John Asplin said "Both what have been referred to as absorptive and renal leak hypercalciuria are treated with thiazides." Part of the point th...

View Discussion

RE: Membranous nephropathy Monday, April 13 @ 9:06 PM

Thanks Dr. Garrick for your advice. The duodenal biopsy report is pending. I shall post it as soon as it's available. --------------------------...

View Discussion

RE: Membranous nephropathy Monday, April 13 @ 4:39 PM

Understood Thanks Dr. Rodby. ------------------------------ Emilio Venturelli MD Scuola di specializzazione in Nefrologia, Università degli st...

View Discussion