RE: Nephrotic syndrome, timing of the biopsy 47 minutes ago

CANADA HAS SOME FUNNY RULES Each province has to manage the Government allotment. Agree it makes a difference whether patient has MCD or MGN Mayb...

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RE: Nephrotic syndrome, timing of the biopsy 4 hours ago

Agree with Dr Glassock, depending on how far away the biopsy is (ASAP IMO) a bit of tac and I would cut steroids until path available. This is a bi...

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RE: Minimal change disease 10 hours ago

Interesting. Have you subjected this regimen to a RCT.? ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 --...

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RE: Nephrotic syndrome, timing of the biopsy 10 hours ago

Stupid rule. Government practicing medicine. bad idea. But Tac would probably be better than steroid monotherapy. Just an opinion. ---------------...

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RE: Membrane Vs Centrifuge Plasma Exchange 10 hours ago

Use plasma IgG level (if FFP is not used as replacement fluid.) after accounting fir refilling rate. The two methods are quite comparable fir remov...

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Membrane Vs Centrifuge Plasma Exchange 11 hours ago

When comparing membrane vs Centrifuge plasma exchange, is there any idea about biomarker we can use to measure clearance or plasma removal efficien...

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RE: Nephrotic syndrome, timing of the biopsy 11 hours ago

thank you Dr. Glassock, Ritux is not available for us without biopsy - would you use Tacrolimus until we can get Ritux? -------------------...

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RE: Minimal change disease 12 hours ago

Hello Drs. In case of cramps on high dose of steroids I give Potassium tablets (check GFR), Vit-D+ Ca and cramps resolve. ------------------------...

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RE: Minimal change disease 15 hours ago

Despite loss of Vitamin D bound to protein in the urine in NS, a symptomatic decline in ionized calcium levels is very rare in NS. ---------------...

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RE: Nephrotic syndrome, timing of the biopsy 15 hours ago

I assume the PE are recent and not remote from the onset of NS. MCD and MN are the two major diagnostic possibilities. Stopping NOAC probably not a...

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RE: Minimal change disease 16 hours ago

Would like to know his Ca++ Mg++ levels - Proteinuria related Mg drag - - > leading to Hypocalcemia - Steroid related decreased intestinal Ca absor...

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RE: Minimal change disease 19 hours ago

Thank you Dr Balan, I am going to discuss this with them! ------------------------------ Bhavika Gandhi MD Nephrology Fellow Baylor Scott and Whit...

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RE: Minimal change disease 19 hours ago

Thank you Dr Rodby! ------------------------------ Bhavika Gandhi MD Nephrology Fellow Baylor Scott and White Bhavika[LastN[CompanyName] -------...

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Nephrotic syndrome, timing of the biopsy 20 hours ago

Hello, Would appreciate some advise about timing of biopsy and future treatment: I have a 31 year old female, admitted with nephrotic syndrome, a...

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RE: Advise about a patient with a new diagnosis of GN. 21 hours ago

I was more focused on the EM findings. The Haas and Eustace study clearly shows that mesangial ED deposits by EM are fairly common in typical antiP...

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RE: Advise about a patient with a new diagnosis of GN. 23 hours ago

Dr Glassock, while IC deposits can occur in pauci-immune GN, Haas paper is not clear on description of isolated C3 deposits. This paper https://pub...

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RE: Advise about a patient with a new diagnosis of GN. 23 hours ago

See Haas And Eustace - Kidney Int 2004; 65: 2145-2152. IC deposits by EM (especially in ) can be seen in "Pauci Immune" Necrotizing and Crescentic ...

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RE: Advise about a patient with a new diagnosis of GN. 23 hours ago

These findings are consistent with an anti-PR3 associated granulomatous Polyangiitis. The current treatment of choice is RTX, or combinations of RT...

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RE: Advise about a patient with a new diagnosis of GN. 1 day ago

Infection related GN appears more likely of the three differentials to me. Presence of numerous electron dense mesangial deposits, is inconsistent ...

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Advise about a patient with a new diagnosis of GN. 1 day ago

Dear ASN members I would like to discuss a case and get your opinion about diagnosis and management. I have a 35 years old male who was in excellen...

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RE: ANCA Vasculitis in peritoneal dialysis 1 day ago

Despite being on dialysis , l have seen flares of ANCA vasculitis with typical lung involvement in patients still making urine . is this patient...

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RE: New Website: AGS/AGING Learning Collaborative 1 day ago

I attended the first webinar. Definitely a useful resource for those selecting outcomes for their studies. More broadly, this collaborative is real...

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RE: False positive / equocal anti gbm 1 day ago

Dr Cohney So was I and taught fellows to do same. But if Muscle mass is same, a plot of GFR vs time should give the same trend. The difference is ...

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ARPKD, 1 day ago

Is there any data regarding validation of MAYO clinic ADPKD calculator and / or use of Tolvaptan in ARPKD patients? I did find an ongoing study wi...

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RE: A 20 years boy with hemoptysis 1 day ago

Thank you very much Kidney size normal with intact CM differentiation , previous creatinine not available . Chest improving ,Pulmonologist opinion...

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RE: False positive / equocal anti gbm 1 day ago

In regards to Dr Glassocks comments about rate of rise of creatinine etc was always a great believer in plotting 1/serum creatinine to see if there...

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RE: A 20 years boy with hemoptysis 1 day ago

Thanks for providing all the information I can see a comment about the upper pole of kidneys but havent seen a comment about kidney size, corticom...

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RE: A 20 years boy with hemoptysis 1 day ago

Thank you All for great feedback Dr Glassock ,Dr Rhodby ,Dr shlomo, with your great feedback near to final diagnosis . Regards Dr Abdul Fatah sark...

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RE: A 20 years boy with hemoptysis 1 day ago

Dr shlomo ,Dr Glassock CT attached Renal biopsy tomorrow. ------------------------------ Abdul Sarki MBBS resident Diaverum Karachi 00927...

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RE: Permissive Hypernatremia in a CRRT patient 1 day ago

I prefer adding post-filter 3% saline infusion to achieve higher sodium levels while on CRRT without manipulating the dialyzate bags. Dr Yessayan a...

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RE: Minimal change disease 1 day ago

last resort for cramps Tonic water has a bit of quinine nothing like the dose that took quinine off the market bc of of Torsade "Tonic water cont...

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RE: ANCA Vasculitis in peritoneal dialysis 1 day ago

Dr Venkat, His hemoglobin dropped initially down to 6.9. He received one unit of PRBCs. He has been stable over the past 48 hours. His hemoptysis h...

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RE: Minimal change disease 1 day ago

Since cramping is a major adverse effect in this patient, if a CNI is chosen for further therapy, cyclosporine may be a better option. Cramps can b...

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RE: ANCA Vasculitis in peritoneal dialysis 1 day ago

What is the hemoglobin/hematocrit trend? This will give an idea about severity of pulmonary hemorrhage. If severe, PLEX may have to be considered. ...

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National O'Brien Center Kidney Seminars (NOCKS) 1 day ago

Please join us for the next NOCKS on Friday February 3rd hosted by UAB. Please Presentations will be held from 11:30 AM - 12:30 PM CT followed...

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National O'Brien Center Kidney Seminars (NOCKS) 1 day ago

Please join us for the next NOCKS on Friday February 3rd hosted by UAB. Please Presentations will be held from 11:30 AM - 12:30 PM CT followed by...

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Kidney Biopsies in Mice 1 day ago

Dear Colleagues, Happy 2023! I wonder if any of you have a protocol for performing kidney biopsies in mice in order to follow disease progression ...

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RE: ANCA Vasculitis in peritoneal dialysis 1 day ago

Thank you both for the responses. Dr Glassock, I do not have a prior anti-PR3 lvl. I am trying to reach his nephrologist to see if she has a prio...

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RE: Permissive Hypernatremia in a CRRT patient 1 day ago

If pharmacy refused to modify replacement /dialysate fluid sodium concentration. You can use online CRRT with high dialysate sodium as described he...

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RE: ANCA Vasculitis in peritoneal dialysis 1 day ago

Clinically this appears to be a re-exacerbation/flare of his ANCA vasculitis which is unusual in ESRD. Agree. GPA is much more likely to relapse t...

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RE: ANCA Vasculitis in peritoneal dialysis 1 day ago

Do you have an anti-PR3 antibody level before this episode when the patients was stable on PD?Low grade Positive ANCA can be observed in 15-20% of ...

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ANCA Vasculitis in peritoneal dialysis 1 day ago

I have a very delightful 74y.o. male with a history of granulomatosis with polyangiitis which resulted in ESRD for which he has been on peritoneal ...

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New Website: AGS/AGING Learning Collaborative 2 days ago

The American Society of Nephrology is pleased to share that the AGS/AGING LEARNING Collaborative has launched its website and published the first t...

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RE: Minimal change disease 2 days ago

I agree with Dr. Balan. This patient is behaving as Primary FSGS, not MCD, so aCNI would be the next step. But nephrotoxicity would be a big concer...

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RE: Minimal change disease 2 days ago

Cramps are a real pain for some patients on steroids. I would suggest checking vitamin D levels and correcting if low more out of hope than convict...

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RE: Minimal change disease 2 days ago

🙏🙏🙏 thank you. In that case should I be doing a fast taper on steroids and start on high dose tacrolimus? I was trying to do that but my patient...

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RE: Hiatal/Diaphragmatic hernia a contraindication for PD? 2 days ago

Anything that increases ip pressure will increase complaints of a diaphragmatic hernia, but it should be appreciated that on average ip pressure wi...

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RE: Kidney transplant dysfunction 2 days ago

No clear cut diagnosis/answers The practical problems Impaired renal function without apparent parnchymal pathology Potential issues with cyt...

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RE: Kidney biopsy in a patient on clopidogrel 2 days ago

Obviously, need to speak to the cardiologists - different views depending on particular lesions/position/complexity etc - if renal function is ok...

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RE: Minimal change disease 2 days ago

If misery loves company, I can share similar experiences of unexplained muscular cramps in nephrotic patients treated with steroids. I was never ab...

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