RE: hyponatremia management 20 minutes ago

In patients with hyponatremia due to cirrhosis or HFrEF with a marginal diuresis, low U Na, and high U osm the crucial problem is debilitating rena...

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RE: catastorphic apla 37 minutes ago

so plaquenil i found out does antithrombotic properties but not immediate effect so asa for mu etc.. i think will just weight out risk vs benefits ...

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RE: Kidney Transplant Patient Recently Switched Ti Belatacept You to Prograf toxicity now has persistent EBV Viremia despite immune to EBV 1 hour ago

no good data that would support serial EBV surveillance for D+/R+ transplants. In some published studies up to 60% patients with kidney transplants...

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RE: catastorphic apla 1 hour ago

hello, so is there any role for plaquenil for catastrophic apla?? recap: apla positive with skin lung and renal tma on biopsy s/ p plex normalizati...

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RE: catastorphic apla 1 hour ago

hello, so is there any role for plaquenil for catastrophic apla?? recap: apla positive with skin lung and renal tma on biopsy s/ p plex normalizati...

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Kidney Transplant Patient Recently Switched Ti Belatacept You to Prograf toxicity now has persistent EBV Viremia despite immune to EBV 1 hour ago

Request to the panel for advice regarding two of my kidney transplant patient with similar situation Patient number 1 78-year-old Caucasian female ...

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RE: RetroPeritoneal fibrosis case 2 hours ago

Unfortunately v don't hav d facility for serum igG4 levels ------------------------------ Batool Butt MBBS Doctor Hospital Islamabad 03335570895 --...

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RE: RetroPeritoneal fibrosis case 3 hours ago

Has IgG4 related disease been excluded? Sent from my iPad

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Finals for ETC Model by CMS 3 hours ago

So the final rules for the ETC model are out. @Sri Lekha Tummalapalli does a terrific job summarizing this 960+ page rule book! Catch her summary h...

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RetroPeritoneal fibrosis case 3 hours ago

A 70 yr male.,hypertensive for the last 25 yr, also had bilateral stenting 18yrs back, removed after 3 mths, remained asymptomatic, now presented i...

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RE: hyponatremia management 3 hours ago

Regarding your question on use of oral urea, theoretically inducing osmotic diuresis should increase his free water excretion. However, non absorbe...

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RE: Nephrolithiasis in a 2 year old boy - Dent's Disease? 3 hours ago

I send an article on citraturia in children according to age and sex. ------------------------------ Yessica Gutierrez MD residente de nefrologia I...

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RE: Nephrolithiasis in a 2 year old boy - Dent's Disease? 5 hours ago

As asked for by Dr. Asplin, I have posted below information on the genes included in the panel tested in this child. Dr. Asplin, does this list cov...

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RE: living related kidney transplant after hematopoietic stem cell transplantation with complete donor chimerism 5 hours ago

This patient has developed total chimerism after his BMT. He now has received a kidney transplant from the same donor. This patient should not requ...

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RE: hyponatremia management 6 hours ago

On 17 th of September, blood level of sodium 126, glucose 160, osmolarity 314. If Sosm was in fact 314 with these levels of sodium and glucose, BUN...

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RE: Nephrolithiasis in a 2 year old boy - Dent's Disease? 6 hours ago

The urine citrate cannot really be interpreted without a simultaneous creatinine excretion. The reference range of 320 mg/day quoted above is for a...

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RE: Nephrolithiasis in a 2 year old boy - Dent's Disease? 6 hours ago

Sorry- I had thus case confused with another post. There are no systemic acud-bSe disorders present in this case. Sent from my iPad

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RE: COLLAPSING GN / SLE in A Young Girl 6 hours ago

Hello was hiv checked ? ------------------------------ Matthew D'Costa MD Rochester MN ------------------------------

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RE: Nephrolithiasis in a 2 year old boy - Dent's Disease? 9 hours ago

In MSK it is mentioned that decreased renal concentrating capacity and impaired urinary acidification are common clinical features. In most patient...

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RE: Nephrolithiasis in a 2 year old boy - Dent's Disease? 9 hours ago

Interesting idea, but MSK would not explain the diversity of acid-base changes Observed, unless you invoke Hickam’s Dictum. Sent from my iPad

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RE: Nephrolithiasis in a 2 year old boy - Dent's Disease? 9 hours ago

Hello, I am currently a last year resident of nephrology in the Monterrey, Mexico. Regarding the case, we must have the possibility of diagnosing M...

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RE: living related kidney transplant after hematopoietic stem cell transplantation with complete donor chimerism 21 hours ago

My mistake , mean’t zero HLA mismatch or in this case HLA identical donor - but concern is still infection over rejection suggesting long term IS s...

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RE: living related kidney transplant after hematopoietic stem cell transplantation with complete donor chimerism 22 hours ago

The donor HLA profile is identical match to the recipient. ------------------------------ Hon shen Png MBChB Nephrology fellow  Hospital Kuala Lump...

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RE: COLLAPSING GN / SLE in A Young Girl 22 hours ago

How confident are you that thus is a manifestation of SLE (Lupus podocytopathy, Collapsing variant.). I am not, thsrefire,  I am reluctant to sugge...

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RE: hyponatremia management 1 day ago

Gfr has now stabilized in 50s although the best line could be in 70s with a reminder that this is a cirrhotic patient who denies any alcohol abuse ...

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hyponatremia management 1 day ago

Gentleman age 69 with insulin-requiring type 2 diabetes proteinuria, essential hypertension, cirrhosis and morbid obesity with chronic lymphatic in...

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RE: COLLAPSING GN / SLE in A Young Girl 1 day ago

Decrease in SCr is encouraging. Increase in BUN is probably secondary to catabolic effect of IV steroid boluses. Mycophenolate 250 mg TID might hav...

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RE: Renal Impairment,Severe Anemia And Hyponatremia In A KTR 1 day ago

Update on the case: its 4th day of his admission..patient has received 3 days of pulse steroids, renal biopsy taken, hyponatremia has improved to 1...

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RE: COLLAPSING GN / SLE in A Young Girl 1 day ago

Dr.Desai, You are right about creatinine time lines I feel steroids +- Ritux might buy time but will most likely end up on dialysis . -------------...

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RE: living related kidney transplant after hematopoietic stem cell transplantation with complete donor chimerism 1 day ago

The original post says: " His younger brother was a full HLA-matched donor for the HSCT in 2012." I interpreted  full HLA-matched to mean 2 haploty...

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RE: Renal Impairment,Severe Anemia And Hyponatremia In A KTR 1 day ago

Sorry about not making myself clear. I was just trying to say that hypochromia/microcytosis can be seen in both thalassmia and iron deficiency. Agr...

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RE: Chronic TMA 1 day ago

I wouldn't put much stock in "staining for C5b-9" on a renal biopsy. I don't know what technique that is referring to, but that staining is extreme...

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RE: Chronic TMA 1 day ago

I also agree with eculizumab but would check ADAMTS13 prior to administration.  All of the trials with eculizumab were in ADAMTS13 normal patients....

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RE: A case of RTA 1 day ago

​Is she a vegetarian?  Urine pH can be that high in non-meat eaters. A urine amino acld could confirm Fanconi or partial Fanconi syndrome. MGRS is ...

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RE: Nephrolithiasis in a 2 year old boy - Dent's Disease? 1 day ago

I claim no particular expertise in reading pediatric ultrasounds, so I leave that to others to discuss. But if the child does have a 1 cm stone it ...

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RE: Chronic TMA 1 day ago

I would seriously consider Eculizumab therapy in this patient, because of the immunopathological findings and progressive CKD. Sent from my iPad

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RE: living related kidney transplant after hematopoietic stem cell transplantation with complete donor chimerism 1 day ago

Thanks I could not find any reference on haplo-identical donor for both HSCT and kidney transplant. I think the question that needs to be answered ...

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RE: COLLAPSING GN / SLE in A Young Girl 1 day ago

Dr.Glassock, CXR - was clear / CT nog done --------------------------------- Shobha Shakamuri MD East Texas Kidney Specialists Longview TX (903)...

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RE: Nephrolithiasis in a 2 year old boy - Dent's Disease? 1 day ago

A 24 hours urine examination for cystinuria, hyperoxaluria, hyperuricosuria etc should be done after confirming stone. The following article would ...

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RE: COLLAPSING GN / SLE in A Young Girl 1 day ago

CRP - 0.94 / 0.74 , PT / INR 10.9/1.0. PTT - 38.1 ferritin, IL 6 - not done Ordered ferritin, d diner ordered IL 6 usually don’t do it - send out -...

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RE: Membranous/RVT 1 day ago

What is the evidence that CYC based regimens produce ‘faster” clinical remissions than RTX based regimens? there are no published head-to-head comp...

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RE: Renal Impairment,Severe Anemia And Hyponatremia In A KTR 1 day ago

@K.K Venkat my point was not that Thalassemia trait does not have microcytosis but if near normal hgl before then presenting with AKI and significa...

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RE: COLLAPSING GN / SLE in A Young Girl 1 day ago

So pre-biopsy the peak Cr = 5.3 Post-biopsy and pulse steroids Cr = 4.2 Was maintained on MMF but has really relapsed Ritux could be an option...se...

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RE: Nephrolithiasis in a 2 year old boy - Dent's Disease? 1 day ago

1. In case stones confirmed cystinuria and hyperoxaluria need to be ruled out 2. Not each gene variant causing pathologic mutation​ ---------------...

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RE: COLLAPSING GN / SLE in A Young Girl 1 day ago

What did chest CT show? The SARS -COV-2 tests might be “false negative”. Do you gave a ferritin/Il6level?this might be Collapsing FSGS superimposed...

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RE: COLLAPSING GN / SLE in A Young Girl 1 day ago

Agree with treatment but prognosis is not good. ------------------------------ Roger Rodby MD, FASN Professor of Medicine Rush University Medical C...

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RE: COLLAPSING GN / SLE in A Young Girl 1 day ago

What did chest CT show? The SARS -COV-2 tests might be “false negative”. Do you gave a ferritin/Il6level? This might be Collaoading FSGS superimpos...

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RE: Membranous/RVT 1 day ago

If the MN has already caused RVT necessitating anticoagulation, the regimen that is likely to induce remission faster should be preferred. Dr. Glas...

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RE: COLLAPSING GN / SLE in A Young Girl 1 day ago

Treatment : MMF -250 mg bid from 11 yrs age /plaquanil Thus admission - 9/20 - Pulse steroids -followed by prednisone 60 since 9/ 10/20 MMF WAS INC...

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RE: Nephrolithiasis in a 2 year old boy - Dent's Disease? 1 day ago

Thanks Dr. Samsonov for the clarification.  Questions to all: 1. If this is not Dent's, what are the other diagnostic possibilities? 2. What is y...

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