RE: PD and Crohn's disease 43 minutes ago

When Crohn's disease is in a long-time remission and there are no indications for the presence of adhesions, I see no reason not to try PD when the...

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RE: Management of a patient with history of pANCA positive vasculitis in clinical remission, with increasing Myeloperoxidase Ab titers 6 hours ago

Dr. Rodby raises some important issues for which we do not have answers (as in evidence) but we do have opinions ( which differ quite a bit) Herei...

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RE: Tablo/Outset dialysate flow rates of 300 7 hours ago

Great discussion on Tablo. Is the machine available for purchase on an individual basis, and if so what is the approx price? And any plans that the...

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RE: Intradialytic Hypotension with Interdialytic Hypertension 7 hours ago

And one more point you made was regarding the lack of symptoms for one month when he traveled. I would suggest enquiring about the dialysate compos...

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RE: Intradialytic Hypotension with Interdialytic Hypertension 7 hours ago

And one more point you made was regarding the lack of symptoms for one month when he traveled. I would suggest enquiring about the dialysate compos...

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RE: Intradialytic Hypotension with Interdialytic Hypertension 7 hours ago

Agree with Dr. Venkat that this is most likely renin defendant mechanism. I have similar case of an elderly thin patient on HHD who developed sever...

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RE: Tablo/Outset dialysate flow rates of 300 8 hours ago

Well, welcome to the club. There are enough of us still around to remember when someone sat with each patient on dialysis. and staffing ratios were...

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RE: Tablo/Outset dialysate flow rates of 300 8 hours ago

Yes, I too cut my teeth om the Baxter twin coil system that looked like a large washing machine on wheels. Remember, it had a mixer to constantly s...

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RE: Tablo/Outset dialysate flow rates of 300 8 hours ago

Agree with Dr. Goldfarb and Dr. Teixeira's comments. I have no experience with REDY (before my time) but plenty with Tablo! both inpatient setting ...

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RE: PD and Crohn's disease 8 hours ago

attached "Prior to the procedure, the patient is interviewed and examined to determine if there are any potential contra- indications to PD cathet...

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RE: Tablo/Outset dialysate flow rates of 300 9 hours ago

I have no vested interests, but which (Tablo or NxStage ) is a more adaptable machine for an inpatient dialysis service in COVID era.-portability, ...

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RE: Tablo/Outset dialysate flow rates of 300 9 hours ago

But are you a member of the REDY OFDC? ------------------------------ Roger Rodby MD, FASN Professor of Medicine Rush University Medical Center Ch...

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RE: Management of a patient with history of pANCA positive vasculitis in clinical remission, with increasing Myeloperoxidase Ab titers 9 hours ago

Dr Glassock, So if you had a patient with biopsy proven ANCA associated glomerulonephritis, and the patient went into both clinical and serologic r...

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RE: Tablo/Outset dialysate flow rates of 300 9 hours ago

Roger - Tablo is now approved for 24h. Then you change the cartridge. ------------------------------ David S. Goldfarb MD, FASN Professor of Medi...

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RE: Tablo/Outset dialysate flow rates of 300 9 hours ago

I have no experience with TABLO but a LOT with NxStage. I have no financial interest but am on NxStage scientific advisory board. One thing I bel...

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RE: Tablo/Outset dialysate flow rates of 300 11 hours ago

Great historical vignettes. I cut my dialysis teeth on the Baxter TwinCoil 100L stainless steel tank with self mixed (individualized) electrolytes ...

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RE: Management of a patient with history of pANCA positive vasculitis in clinical remission, with increasing Myeloperoxidase Ab titers 11 hours ago

Third opinion. I follow Dr. Venkat and only treat clinical relapse in anti-MPO SVV. I am not convinced that assessing CD19 B cell levels will be a ...

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RE: Management of a patient with history of pANCA positive vasculitis in clinical remission, with increasing Myeloperoxidase Ab titers 11 hours ago

See attached, a fourfold increase in MPO or PR3 is most predictive of clinical relapse. (KI 03 Niles)  I use this, unless there are clinical indica...

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RE: Management of a patient with history of pANCA positive vasculitis in clinical remission, with increasing Myeloperoxidase Ab titers 11 hours ago

Sed rate, CRP, current CD19/20 cell count? Given lower risk of clinical relapse with MPO-ANCA and lack of hematuria, my approach would be monitor c...

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RE: Tablo/Outset dialysate flow rates of 300 12 hours ago

Remember the REDY system well from my 1976-1978 nephrology fellowship. Rapid saturation of limited quantity of generated dialysate by removed uremi...

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RE: Tablo/Outset dialysate flow rates of 300 12 hours ago

Yes indeed. We use it at Thomas Jefferson Univ Hospital. Its main advantage was regeneration of the dialysate. Back then we did not worry much abou...

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RE: Tablo/Outset dialysate flow rates of 300 12 hours ago

Correct. The regeneration of dialysate In hemodialysis system (REDY). ------------------------------ Mario Rubin, M.D. Houston TX (713) 252-5539 -...

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RE: Tablo/Outset dialysate flow rates of 300 12 hours ago

Correct! ------------------------------ Mario Rubin, M.D. Houston TX (713) 252-5539 ------------------------------

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Management of a patient with history of pANCA positive vasculitis in clinical remission, with increasing Myeloperoxidase Ab titers 12 hours ago

I am seeing a 25-year-old woman who was diagnosed to have glomerulonephritis from ANCA vasculitis in 2018. Her serum Cr in 2018 was 1.4. Urine Alb/...

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RE: Tablo/Outset dialysate flow rates of 300 13 hours ago

REDY. I only used one a couple of times. The Baxter RSP was also pretty portable (but bulky), made obsolete by the development of the Hollow Fiber ...

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RE: Membranous nephropathy follow up 13 hours ago

Thanks , Sonali Sent from my iPhone

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RE: Tablo/Outset dialysate flow rates of 300 13 hours ago

Looks similar to the Reddy (sp?) machines we used sometimes —- mainly with Met alkalosis (if memory serves). --------------------------------- Ell...

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RE: Tablo/Outset dialysate flow rates of 300 13 hours ago

It did not reproduce. Let's try again! ------------------------------ Mario Rubin, M.D. Houston TX (713) 252-5539 ----------------------...

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RE: A young patient with diffuse alveolar hemorrhage and renal impairment 14 hours ago

Did the patient receive COVID19 vaccine, especially an Adenovirus based one? What about complement blockade to put off the fire first, then go aft...

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RE: Membranous nephropathy follow up 14 hours ago

With the excellent immunological response, I would wait for the clinical response to catch up. No need to change therapy right now, IMO. ---------...

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RE: PD and Crohn's disease 14 hours ago

Thanks Dr Shah, I did.  Asked in case our community members have a personal opinion/experience. ------------------------------ [V] [Melnikov] [MD,...

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RE: Membranous nephropathy follow up 14 hours ago

I had posted about the patient with membranous nephropathy few months back Primary MN with + PLA2R ( tissue stain +) + antiPLA2R IV Rituxan : 1 gm ...

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RE: Tablo/Outset dialysate flow rates of 300 14 hours ago

A short piece of portable dialysis machine history. As a fellow at Georgetown in 1979 this is the machine we used in the patient's room. Do any of ...

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RE: PD and Crohn's disease 16 hours ago

Please see a similar question answered on the ISPD Q and A page - see screenshot and link below. https://ispd.org/question/who-has-experience-w...

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RE: Tablo/Outset dialysate flow rates of 300 16 hours ago

Thank you David Anatole(Tony) Sent from Outlook

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RE: Tablo/Outset dialysate flow rates of 300 17 hours ago

Tony, I have no personal experience with NxStage but I'm a Tablo fan since the start of the pandemic. I have no financial relationship with them. B...

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PD and Crohn's disease 17 hours ago

28 yo male with advance CKD due to IgA nephropathy needs initiation of RRT. He has Crohn's disease in remission. No abdominal surgeries. I am going...

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RE: RAASi in Peritoneal Dialysis 18 hours ago

We use ACEi/ ARB ( prefer due to less side effect) in our PD patient with arterial HTN. We have not noticed any significant drop in RRF in those pa...

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RE: Intradialytic Hypotension with Interdialytic Hypertension 20 hours ago

I have seen 2 definitions of IDH in this discussion. A MAP decrease of > 20 mm Hg and a systolic pressure < 90  mm HG. Symptomatic in both cases. W...

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RE: A young patient with diffuse alveolar hemorrhage and renal impairment 20 hours ago

Dear AllI agree with Prof Hayden, Use of IV IG in combination with Plex may be helpful as an immunomodulator.The other remote possibility could be ...

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RE: Tablo/Outset dialysate flow rates of 300 20 hours ago

I have been out of Clin Practice for almost 6.5 years. We used the NxStage system back then and I never heard of Tablo. Looking at the internet, th...

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RE: Intradialytic Hypotension with Interdialytic Hypertension 20 hours ago

What is the average volume of ultrafiltration per dialysis session and does post-dialysis hypertension correlate with intradialytic weight loss? If...

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RE: RAASi in Peritoneal Dialysis 21 hours ago

The increase in small solute transfer is not a simple A-11 effect, because it also does not occur using normal pH, low GDP solutions as we showed r...

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RE: Intradialytic Hypotension with Interdialytic Hypertension 22 hours ago

Dr Dastoor, what is the dialysate Na you used and UF (ml/kg/hr)? --------------------------------- Hayder Aledan MD, FASN Assistant Professor Basr...

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RE: RAASi in Peritoneal Dialysis 1 day ago

Some resources I use to justify the practice outlined above. An ISPD presentation by @Joanne Bargman and the ISPD recommendations in a paper by...

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RE: RAASi in Peritoneal Dialysis 1 day ago

I regularly use RAASi as first choice in patients who need anti HTN medications and have urine output >250 ml/d (rule of thumb for some residual fu...

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RE: RAASi in Peritoneal Dialysis 1 day ago

I have used ACEi/ARBs in most patients on PD with RRF. They not only helps in controlling BP, but also have other beneficial effects like in other ...

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RE: A young patient with diffuse alveolar hemorrhage and renal impairment 1 day ago

Too bad. This is definitely not medical progress. Single breath CO uptake May be the best test available to distinguish pulmonary edema from DAH- B...

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RE: A young patient with diffuse alveolar hemorrhage and renal impairment 1 day ago

Also happens in mine --------------------------------- Bajinder Reen MD Brampton ON (905) 453-0821 ---------------------------------

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RE: Tablo/Outset dialysate flow rates of 300 1 day ago

Completely agree with Dr. Teixera's detailed response. We have at least 2 Tablos set up in our chronic unit now in order to keep everyone fresh on ...

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