RE: nocturnal polyuria 45 minutes ago

With an eGFR of 57ml/min/1.73m2 and CKD 3A, a3 I would not be surprised if her response to exogenous AVP would be impaired. My guess is that when f...

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RE: nocturnal polyuria 1 hour ago

"urine microalbumin/cr" ratio is the same as an urine ACR "albumin creatinine ratio" you just need to make sure you understand the units, typically...

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RE: nocturnal polyuria 2 hours ago

Dr Venkat: A clarification (if I may): U.microalb/Cr ratio or U.alb/Cr ratio v. U.protein/Cr ratio as I understood is a helpful tool to differentia...

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RE: nocturnal polyuria 5 hours ago

2 Liters of urine a day doenst really qualifies her for polyuria, unless she is small, but I do not deny she has a concentration defect based on sy...

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RE: nocturnal polyuria 6 hours ago

Thank you very much for your reply. The patient's current serum sodium concentration is 145 mmol/L ------------------------------ Zineb Taaam MD ...

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RE: nocturnal polyuria 6 hours ago

I assume that her SNa is normal and it is reassuring that her fluid intake is not high. Intranasal or oral desmopressin has been used in both men a...

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treatment of C3GN after developing meningococcal infection with iptacopan 6 hours ago

Greetings, I was hoping to get your expert opinion on a patient of mine: 22 year old female with C3 GN diagnosed on biopsy in 2019. Her complemen...

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RE: nocturnal polyuria 8 hours ago

Thank you very much for your response. The proteinuria is predominantly composed of albumin. Initially, she only had microalbuminuria, but it has ...

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RE: Transplant Case- can recurrent Ig A in transplant patient present without proteinuria and midly low C3 and more significant lower C4. 8 hours ago

Dr Saja pt only on MMF not in CNI --------------------------------- Shahzad Safdar MD Mt. Auburn Nephrology, Inc. Cincinnati OH (513) 841-0222 ...

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RE: Transplant Case- can recurrent Ig A in transplant patient present without proteinuria and midly low C3 and more significant lower C4. 9 hours ago

I can see she had Chronic allograft dysfunction since 2023, with almost the same GFR trend, which I don't think is related to the recurrence of IgA...

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RE: SLE and HUS 9 hours ago

There is no TMA and no reason to consider Complement inhibition. I have no experience treating monogenic LN- until now, I have never seen a case. I...

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RE: SLE and HUS 11 hours ago

Thank you for your emailYes prof i would agree with you may be too late to decide about trying very costly therapy with this recent biopsy But woul...

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RE: SLE and HUS 12 hours ago

Thank all for your active and informative contribution Actullay i put this case for discussion based on few things dose not fit classical lupus ...

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RE: SLE and HUS 15 hours ago

This recent kidney biopsy (June 8, 2026) shows no evidence at all of a Chronic TMA - so the suggestion for Eculizumab therapy can no longer be just...

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RE: SLE and HUS 17 hours ago

------------------------------ Saja Mohammed MD, MBChB, MS Doctor SQUH Muscat ------------------------------ Files Attached DocumentRE: SLE a...

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RE: SLE and HUS 17 hours ago

She needs Eculizumab (or Iptacopan) now. I agree with Dr. Rodby. . I think it is reasonable to assume that the renal limited TMA is C-dependent. An...

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RE: SLE and HUS 17 hours ago

Dear prof RichardThank you for your emailI need to know from your experience such mutation in CFHR which is related to CFH and sometimes associated...

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RE: SLE and HUS 18 hours ago

The simplest explanation is that she may have had LN in the past but not now. The problem now is renal limited TMA -----------------------------...

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RE: SLE and HUS 20 hours ago

"The initial C3 level was 0.3, then 0.8, and 0.89 until 2021, then normal." Drs. Glassock and Rodby: How do you interpret the gradual normalizati...

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RE: nocturnal polyuria 21 hours ago

Since 24hr urine volume is only around 2.0 L with nocturnal polyuria, it may be informative to check urine specific gravity/Uosm of separate daytim...

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RE: Determining kidney function from DCD graft with prolonged cold ischaemia time. 21 hours ago

" if uncertainty exists, then do a transplant kidney biopsy"- AGREE! !!!!!!!! assuming no significant contraindication i.e. anticoagulants or bleed...

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RE: nocturnal polyuria 21 hours ago

The eGFR of 57ml/min/1.73m2 confirms substantial loss of kidney function. What is the patients Blood Pressure, Hemoglobin and serum uric acid, and ...

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RE: Determining kidney function from DCD graft with prolonged cold ischaemia time. 21 hours ago

Bottom line- if uncertainty exists, then do a transplant kidney biopsy . This case is a good example of the truths in this adage. --------------...

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RE: nocturnal polyuria 22 hours ago

Is the protenuria glomerular or tubular? Have you done UAlb/Cr and UPr/Cr on same sample of urine? Serum albumin level? -------------------------...

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RE: Determining kidney function from DCD graft with prolonged cold ischaemia time. 22 hours ago

Alemtuzumab was initially thought to be such a powerfull induction agent that tacrolimus monotherapy may suffice. However, subsequent experience ha...

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nocturnal polyuria 22 hours ago

Hello everyone, Thank you for the opportunity to present this case for discussion. a 22-year-old patient born to a non-consanguineous marriage, w...

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RE: Case of intermittent Hyokalaemia with preserved kidney function 1 day ago

The "intermittent " hypokalemia appears real. I assume that the serum Mg is in mMol/L -is this correct. ? Did you ever measure a serum aldosterone ...

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RE: Determining kidney function from DCD graft with prolonged cold ischaemia time. 1 day ago

The iBox is available as an online calculator (www.paristransplantgroup.org) and can be computed at any time post-transplant, typically at protocol...

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RE: SLE and HUS 1 day ago

I agree with Dt. Rodby. ------------------------------ Richard Glassock MD, FASN Emeritus Professor Geffen School of Medicine at UCLA Laguna Wood...

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RE: Determining kidney function from DCD graft with prolonged cold ischaemia time. 1 day ago

Hello Dr. Soobadar, Thank you for sharing this interesting case. Although there is no perfect method to accurately predict post-transplan...

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RE: Case of intermittent Hyokalaemia with preserved kidney function 1 day ago

Urine pH 8.5 is never "normal" and represents infection or renal response to hyperventilation or intake of base, citrate, NaHCo3 etc. You say he...

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RE: Doac Use In pD 1 day ago

thanks prof rodby and prof glassock ------------------------------ Muhammad Soobadar MBChB UK ------------------------------

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RE: Doac Use In pD 1 day ago

doac for non valvular af doac for VTE prophylaxis Doac for VTE Treatment and all above for PD patients ------------------------------ Muhamma...

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RE: Case of intermittent Hyokalaemia with preserved kidney function 1 day ago

clinic potassium is normal, thyroid function is normal any thoughts ? no medication or OTC ------------------------------ Muhammad Soobadar...

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RE: Case of intermittent Hyokalaemia with preserved kidney function 1 day ago

blood and urine test ------------------------------ Muhammad Soobadar MBChB UK ------------------------------ Files Attached DocumentRE: Case of...

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Case of intermittent Hyokalaemia with preserved kidney function 1 day ago

44 female DIAGNOSES: Uterine fibroid Migraine Iron deficiency anaemia Previous elective Caesarian delivery Previous appendicectomy REASON...

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RE: Determining kidney function from DCD graft with prolonged cold ischaemia time. 1 day ago

DSA not done . we do not use cf DNA? Urine acr 20 mg/mmol ------------------------------ Muhammad Soobadar MBChB UK ----------------------...

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RE: SLE and HUS 1 day ago

As both Dr Glassock and I have pointed out, this is a presentation of aHUS and this is supported by the biopsy, and whatever lupus she may have thi...

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RE: SLE and HUS 1 day ago

Thank prof Richard Glassock As her clinical presentation and initial response to systemic lupus erythematosus (SLE) and lupus nephritis and...

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RE: SLE and HUS 1 day ago

Thank you, Dr Emilio her initial presentation was back to late 2015/2016 with sever auric AKI supported with HD for 3 months and treated on the...

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RE: Help me make sense of this 24 hr urine study for stones. 1 day ago

Thanks for the follow up information from the CT scan. It is not uncommon for a patient to have both Ca and uric acid stones. I would use sodium al...

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RE: SLE and HUS 1 day ago

I am quite confused. You say that the kidney biopsy shiws no findings of LN, yer she has a homozygous mutation of a gene that causes LN and she is ...

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RE: Determining kidney function from DCD graft with prolonged cold ischaemia time. 1 day ago

What is current serum creatinine ? UPC ? DSA? DD-cfDNA? ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KPCOP EC [Past Med...

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RE: SLE and HUS 1 day ago

I think this patient needs eculizumab. ------------------------------ Roger Rodby MD, FASN Professor of Medicine Rush University Nephrolog...

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RE: SLE and HUS 1 day ago

Dear Saja, I have seen cases with Both aHUS and SLE, you know lupus can trigger aHUS, and you are right, should always investigate for aHUS in a lu...

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RE: Doac Use In pD 1 day ago

The key issue is "for what indication" . Please clarify your question and make it more precise. The role of DOAC in management of embolism risk in ...

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RE: Transplant Case- can recurrent Ig A in transplant patient present without proteinuria and midly low C3 and more significant lower C4. 1 day ago

In my opinion, the evidence for recurrent IgAN is weak, and immunoperoxidase staining and EM ot the transplant biopsy suggests that something else ...

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Determining kidney function from DCD graft with prolonged cold ischaemia time. 1 day ago

60 M who had a DCD renal transplant on 26/02. HLA mismatch of 1:0:1. He required one session of HD post transplant on 28/02. Had a long CIT of 24hr...

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RE: Transplant Case- can recurrent Ig A in transplant patient present without proteinuria and midly low C3 and more significant lower C4. 1 day ago

urine dipstick no microscopic haematuria ------------------------------ Muhammad Soobadar MBChB UK ------------------------------

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RE: Transplant Case- can recurrent Ig A in transplant patient present without proteinuria and midly low C3 and more significant lower C4. 1 day ago

on MMF single therapy and now anaemic too ------------------------------ Muhammad Soobadar MBChB UK ------------------------------

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