RE: Follow up 3 hours ago

Dr. Grimm thank you so very much for correcting my post on open evidence AI regarding complication rates between native kidneys. I also went back a...

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RE: Follow up 4 hours ago

@Paul Grimm There is something strange about some of the findings of the study you referred to: 1.It found a greater risk of major complications ...

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RE: Lithium Nephropathy 5 hours ago

The patient has substantial differences in size between the two kidneys. This is unusual in lithium induced nephropathy. think of additional path...

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RE: ANCA vasculitis with AIN 5 hours ago

Dr. Glassock: Since SCr has plateaued at 3.7 mg for 3 days and the biopsy does not show any necrosis or crescents in glomeruli, I would follow-up t...

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RE: ANCA vasculitis with AIN 7 hours ago

I would start steroids , and wait for the PR3 and MPO before starting Rituximab . --------------------------------- Dr. Hormaz Dastoor. MD, MSc, ...

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RE: ANCA vasculitis with AIN 7 hours ago

Dr. Dastoor- would you treat this patient with Steroifs and RTX now based on the information available? ------------------------------ Richard Gl...

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RE: ANCA vasculitis with AIN 8 hours ago

Is c- Anca positive with infections , or is it more likely to be a positive p- Anca with infections, drugs etc ?? -------------------------------...

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RE: Lithium Nephropathy 15 hours ago

Dr Tirolien: Reviewed your Pt's case history. I have another idea (not disregarding the tole of Ch Lithium nephropathy in the slightest). I realize...

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RE: Follow up 15 hours ago

Hi. This underscores why you must check original references when using AI. Dr. Lerman's AI report interpreted the reference exactly wrong. I fo...

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RE: ANCA vasculitis with AIN 16 hours ago

Dr. Venkat. Endocapillary hypercellularity and mesangial expansion present . I am not sure the IF can be interpreted and no EM done. If the anti-MP...

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RE: ANCA vasculitis with AIN 1 day ago

Dr. Venkat, there is no EM attempted on paraffin sections . ------------------------------ Pongstorn Pitiranggon MD Pee Dee Nephrology Florence S...

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RE: Follow up 1 day ago

Interesting, I can only report that in my 40 years of clinical nephrology and transplant nephrology I almost never biopsy the left native kidney wh...

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RE: Canine amyloidosis treatment options 1 day ago

Thanks to all for sharing your thoughts. The dog's owner decided to go with chlorambucil since we don't have safety data on tocilizumab. I'll updat...

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RE: Follow up 1 day ago

I am confused because the left kidney is usually chosen for percuutaneous biopsy. Google AI says: "In a percutaneous kidney biopsy, the left kid...

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RE: Follow up 1 day ago

I mistakenly did not state right kidney in my consultation to IR. They had never done a left kidney biopsy unless there was a specific reason to av...

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RE: Follow up 1 day ago

Dr. Rodby can you update us on the training of current nephrology fellows in performing percutaneous renal biopsies on native kidneys and transplan...

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RE: Follow up 1 day ago

I am curious as to why the left kidney was biopsied versus the right kidney. I'm also a little curious as to why shock from a lacerated spleen woul...

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RE: Lithium Nephropathy 1 day ago

I have seen many patients that had early Li nephropathy that were successfully changed to one of the agents Dr Venkat mentioned, especially valproa...

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RE: ANCA vasculitis with AIN 1 day ago

Dr. Glassock: Regarding the possibility of IRGN, I noted that immunofluorescence was negative in glomeruli. However, IMF, however, was performed on...

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RE: Lithium Nephropathy 1 day ago

Alternatives to lithium in treating bipolar disorders include anticonvulsants (valproate, carbamazepine, lamotrigine) and atypical antipsychotics (...

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Lithium Nephropathy 1 day ago

Could you please offer your help and cooperation on this difficult case? Today, during a follow-up consultation, I am seeing a 66-year-old female...

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RE: ANCA vasculitis with AIN 1 day ago

Thank you Drs. Venkat and Glassock. Yes, I am awaiting anti PR3 and MPO. Blood cultures have been negative thus far. Cardiologist and pulmonologist...

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RE: ANCA vasculitis with AIN 1 day ago

The high RF, leucocytosis and low titer ANCA are more suggestive of IRGN than a Vasculitis. I might wait until anti-MPO and anti-PR3 are available ...

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RE: ANCA vasculitis with AIN 1 day ago

" C-ANCA positive 1:40, P-ANCA negative" PR3 and MPO antibody results? BNP results? ------------------------------ K.K. Venkat MD Troy MI (248)...

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ANCA vasculitis with AIN 1 day ago

I like to get opinions from the community. An 82 y/o w/f with hypertension was admitted on 3/14/26 for generalized weakness and body aches for wh...

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RE: Follow up 1 day ago

Regarding the adequacy/safety of kidney biopsy by a nephrologist vs IR, please see following references: https://pmc.ncbi.nlm.nih.gov/articles/PMC...

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RE: AAV ? 1 day ago

Dr. Taam was a lung diffusion test (DLCO) performed? thanks ------------------------------ Emilio Venturelli MD Scuola di specializzazione i...

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RE: AAV ? 1 day ago

As pointed out by Dr. Glassock, lung involvement dominates in anti-synthetase syndrome. Also, unlike SLE, nephritis and malar rash are uncommon in ...

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RE: Follow up 1 day ago

Many private hospital renal docs have interventional radiology doing renal biopsies There seems to be many more complications Most of us don’t have...

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RE: Follow up 2 days ago

Interventional radiology biopsied the left kidney!??? 3 days later, went into shock. Lacerated spleen. They tried to convince me splenic laceration...

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RE: AAV ? 2 days ago

Hematuria persists. CRP is 10 mg/L. Complement levels (C3 and C4) are within the normal range (not consumed), and anti–dsDNA antibodies are negati...

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RE: AAV ? 2 days ago

Without any signs of pulmonary inolvement it would be very difficult to diagnosis an "antisynthtase syndrome" in this case, in my opinion ------...

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RE: AAV ? 2 days ago

Is hematuria persisting? Sedimentation rate/CRP? C3/C4 and anti-ds-DNAab trend?Has ANCA become negative? Since SCr has improved only from 3.1 mg....

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RE: Follow up 2 days ago

Thanks for sharing biopsy- what was reason for splenectomy ? Not optimistic for recovery of function . Would not continue IS especially if tolerati...

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RE: AAV ? 2 days ago

Follow-up We would like to provide an update on the patient's clinical course. The patient received rituximab (1 g at Day 0 and Day 14), along w...

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RE: Follow up 2 days ago

80 and remains on dialysis? I would taper everything off except perhaps follow up dose of rituximab. I would check CD 19 first and if suppressed ...

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RE: Is Hypertonic Saline appropriate here 2 days ago

I would first treat the Hyponatremia with Hypertonic saline and delay treatment of Hyperglycemia by 24 hours to avoid over correction of Hyponatrem...

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RE: Follow up 3 days ago

I would treat this patient as a case of combined ANCA and anti-GBM disease. Some sort of maintenance therapy (RTX) may be required to prevent a rel...

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RE: Distal RTA , COLA and Sibnayal 3 days ago

Dr Dastoor – very interesting patient. There is a case report from Japan (attached) that describes a patient with lysinuric protein intolerance w...

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RE: Follow up 3 days ago

28 glomeruli in specimen 11 globally sclerotic 13 of 17 showed segmental fibrinoid necrosis with cellular crescents. several crescents contained...

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RE: Canine amyloidosis treatment options 3 days ago

Dr. Foster could you share your email address off-line to me? My email is MJL 972@aol.com I would like to ask you a question off-line. ----------...

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RE: Follow up 3 days ago

Can you reshare biopsy report unidentified? ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KPCOP EC [Past Medical Directo...

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RE: Canine amyloidosis treatment options 3 days ago

The pathology sounds like AA with the nonspecific trapping of IgG. Immunohistochemistry is very accurate for AA so I would try that first. I actual...

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RE: Membranous Nephropathy with Rapid Progression 3 days ago

We can have ANCA vasculitis GN without microscopic hematuria. We had a patient with AKI , p ANCA and cANCA negative , anti proteinase 3 positive , ...

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RE: Follow up 3 days ago

Is she is a cigarette smoker? If no, risk of pulmonary hemorrhage from anti-GBM antibody will be low. ANCA is already negative. Given her age and m...

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Follow up 3 days ago

Last month I presented a case that continues to present difficult choices. I summarize 80 year old female presented with 1 gram of proteinuria, h...

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RE: Distal RTA , COLA and Sibnayal 3 days ago

Distal RTA was diagnosed based on clinical findings of hypokalemia , urine pH , failure to acidify urine with furosemide , non anion gap acidosis ,...

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RE: Distal RTA , COLA and Sibnayal 3 days ago

What is the significance of Lysine and Arginine excretion in the urine with normal Po4, glucose, Cystine and ornithine . Would it suggest the possi...

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RE: Novel COL4A3 Variant and Kidney Transplantation Wednesday, March 18 @ 10:00 AM

What you have is a missense variant which is not X linked and is not even a definitely pathogenic variant. So I would think the risk of post transp...

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RE: Novel COL4A3 Variant and Kidney Transplantation Wednesday, March 18 @ 9:52 AM

Regarding risk of anti-GBM antibody RPGN after kidney transplantation - from Google AI: " The risk of developing anti-GBM RPGN (rapidly progres...

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