RE: chronic hyponatremia 2 hours ago

This patient represents an interesting problem - patients with asymptomatic hyponatremia for many years. I recently had a similar patient although ...

View Discussion

RE: ADPKD 3 hours ago

She found this information while she was doing a google search on treatment for ADPKD- “NIR therapy appears to counteract damage induced by the pro...

View Discussion

Lupus nephritis vs IgA nephritis 3 hours ago

41 Y female with 3 months of leg edema 2+ and elevated cr 1.7 from 1.0 with urine pr/cr >4 gm, alb/cr>3 gm, negative hepatitis panel, normal ANA, n...

View Discussion

ADPKD 4 hours ago

Would Like to ask the community on any data regarding near infrared light therapy for ADPKD I have a 44 year old patient with hx of ADPKD, mom on D...

View Discussion

RE: Dialysis for Gadolinium Removal in patient with stage IV CKD 4 hours ago

We have to options ;if gadolinium studies are mandatory, dialysis and avoidance of group I gadolinium substances and both are applicable in patient...

View Discussion

RE: Dialysis for Gadolinium Removal in patient with stage IV CKD 6 hours ago

​In addition to patients with advanced CKD or those with ESRD on dialysis, another population of concern are patients with AKI, where GFR can be se...

View Discussion

RE: Membraneous nephropathy case 12 hours ago

I am not sure that 45RU/ml is meaningfully different from 40RU/ml, but the values are not falling -  so I would give another dose of RTX now or swi...

View Discussion

RE: When to dialyze? 13 hours ago

Sir, there was some issue with lactate and it was not available.. creat was the 1.8 mg/dL.. normal baseline rft.. she had aki during recent admissi...

View Discussion

RE: Membraneous nephropathy case 15 hours ago

As it is rising I woukd give the rituxan now, not waiting the arbitrary 6 months. another option would be Obinutuzumab. ---------------------------...

View Discussion

RE: RITUXIMAB therapy. 15 hours ago

So this is PLA2R positive MGN. Then the histology questions I asked are pretty much moot. One of the best features about PLA2R MGN is the ability t...

View Discussion

RE: chronic hyponatremia 15 hours ago

she has a mild dilution defect (SiADH) but the fairly dilute urine is more compatible with a tea and toast hyponatremia. If I had no other informat...

View Discussion

RE: RITUXIMAB therapy. 17 hours ago

Thank you Dr.

View Discussion

RE: RITUXIMAB therapy. 17 hours ago

Unfortunately I don’t have yet Electron Microscopy, here in Monterrey, Mexico, the hospital send the sample to USA, we are still waiting for the re...

View Discussion

RE: Chronic Active Antibody Mediated Rejection 17 hours ago

Can you share the evidence for its benefit in this situation. Thank you --------------------------------- Wael Jebur MD, FASN drwaellatif@hotmail.c...

View Discussion

chronic hyponatremia 18 hours ago

​I have a 70 years old lady with persistent hyponatremia with serum Na about 120 mmol/L, for at least 6 years. Medical history includes diabetes, h...

View Discussion

RE: Hyperparathyroidism with negative imaging 18 hours ago

I agree with the above comments, other information to consider.  In addition to Denosumab, chronic bisphosphonate use can also result in increase i...

View Discussion

RE: Patient with multiple episodes of angioedema on dialysis 19 hours ago

If these episodes are truly angioedema due to an IgE mediated hypersensitivity to some component of the tubing or dialysis cartridge it should not ...

View Discussion

RE: Membraneous nephropathy case 20 hours ago

PLA2r returned at 45 --------------------------------- Edgard Wehbe MD, FASN Wichita Nephrology Group Wichita KS (316) 993-6580 -------------------...

View Discussion

RE: RITUXIMAB therapy. 20 hours ago

I would monitor the anti-PLA2R levels (by ELISA, not IIF) every 1-2 months for 6 months at least ) if initially positive. Sent from my iPhone

View Discussion

RE: RITUXIMAB therapy. 20 hours ago

Was the IF Full house? Were there mesangial deposits or just sub epi? Do you have the Serum PLA2R? --------------------------------- Roger Rodby MD...

View Discussion

RE: RITUXIMAB therapy. 22 hours ago

Hi Dr. Rodby, yes I asked for all the immunological panel, I repeated the ANAs twice, negative, and anti DNAdc, anti-Smith, were negative, C3 and ...

View Discussion

RE: Patient with multiple episodes of angioedema on dialysis 22 hours ago

Additional questions/thoughts: Usual accompaniment of pruritus would favour histamine- rather than bradykinin-mediated. Do you have levels of trypt...

View Discussion

RE: When to dialyze? 22 hours ago

Curious what was Lactate and creatinine? ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] [Medical Director Kidney Pancreas Trans...

View Discussion

RE: Patient with multiple episodes of angioedema on dialysis 23 hours ago

''He developed angioedema with each of these dialyzers within a few months of using them and in spite of premedication with IV solumedrol, benadryl...

View Discussion

RE: RITUXIMAB therapy. 23 hours ago

Do you have PLA2R staining of the biopsy or serum PLA2R Ab testing?  A young woman I'd be thinking lupus. AN etc? While on therapy I check it at le...

View Discussion

RE: RITUXIMAB therapy. 23 hours ago

Hi Dr. Glassock, I`m Allina Flores from Mexico, how often is appropriate to ask for anti PLA2R, I got a female 36y old patient , with history of NS...

View Discussion

RE: Stones - RTA 23 hours ago

Thank you all for weighing in. I will keep you posted. I do appreciate you taking out time to help all of us with expertise. ----------------------...

View Discussion

RE: Steroid dependent FSGS 1 day ago

After agreeing that Rituxan is a next step. In case  you do not get a good response, you might need to go to CYC.  Would not give MFM longer time. ...

View Discussion

RE: Patient with multiple episodes of angioedema on dialysis 1 day ago

I believe each of these dialyzers have had anaphylactic reactions reported and many have cross-reactivity, but clearly you have to eliminate EO fro...

View Discussion

Patient with multiple episodes of angioedema on dialysis 1 day ago

​We have a 73 year old patient with HTN, COPD, hepatitis C ( treated) , supraglottic carcinoma, S/P supraglottic laryngectomy in 2013, NSTEMI, ESRD...

View Discussion

RE: 59 year female with ckd with high titer ds DNA and ear of 82 1 day ago

I agree- the intent of my comments concerned the active use of specific therapies, such as immunosuppressants. Maximally tolerated conservative t...

View Discussion

RE: Stones - RTA 1 day ago

Thanks. For the record, LAMA-2 is a biomarker discovered in a proteomic analysis. Unclear specificity and sensitivity. Its relationship to MSK is o...

View Discussion

RE: 59 year female with ckd with high titer ds DNA and ear of 82 1 day ago

I agree, very nice summary by Dr Glassock of a nuanced issue, thank you, but I take minor exception to:  "...nihilists to let nature take its cours...

View Discussion

RE: 59 year female with ckd with high titer ds DNA and ear of 82 1 day ago

Thanks Dr. Glassock. That is a very concise and very correct statement regarding this common conundrum. ------------------------------ K.K. Venkat ...

View Discussion

RE: Stones - RTA 1 day ago

David, thanks. That’s exactly why I cautiously prefaced my query. Perhaps the evidentiary basis for urine LAMA-2 or the like will grow bypassing th...

View Discussion

RE: Steroid dependent FSGS 1 day ago

I also think that RTX would be a good choice in this patient assuming that the remissions in the past with steroids were complete and the patient i...

View Discussion

RE: Twitter Chat Summary - Ask the Editor-in-Chief 1 day ago

Thanks, Kelly, for the excellent recap of the Twitter chat. I was delighted with the enthusiasm about Kidney360, and look forward to receiving manu...

View Discussion

Twitter Chat Summary - Ask the Editor-in-Chief 1 day ago

#AskASN Twitter chat, November 19, 2019  Last night's #AskASN Twitter chat featured Dr. Michael Allon ( @MikeAllonK360 ), Editor-in-Chief of Kidne...

View Discussion

RE: Stones - RTA 1 day ago

@David Goldfarb   Thank you for this information ------------------------------ Mario Rubin, M.D. Houston TX (713) 252-5539 -----------------------...

View Discussion

RE: Stones - RTA 1 day ago

Oded, MSK is ruled out by a contrast study, and I agree that 1) it's in the differential diagnosis but 2) is not really known to cause significant ...

View Discussion

RE: Stones - RTA 1 day ago

Sadly, the Rare Kidney Stone Consortium is not genotyping at the moment due to a loss of our NIDDK funding. What can I say? Currently Alnylam has a...

View Discussion

RE: Dialysis for Gadolinium Removal in patient with stage IV CKD 1 day ago

Osteomyelitis needs gadolinium with contrast.eGFR value from 15 to 29 ml/min with already functioning dialysis access could make dialysis of concer...

View Discussion

RE: Stones - RTA 1 day ago

Although usually benign & not routinely screened for, was MSK ever ruled out? --------------------------------- Oded Friedman ---------------------...

View Discussion

RE: Stones - RTA 1 day ago

@John Asplin Thank you John for your input. Do you happen to know which center specializes in genetic testing for NC? If my memory serves me right,...

View Discussion

RE: Stones - RTA 1 day ago

As for the question about progressive CaP precipitation from alkalinization, this is still controversial in the kidney stone community. Certainly r...

View Discussion

RE: Dialysis for Gadolinium Removal in patient with stage IV CKD 1 day ago

This remains a very controversial topic. The American College of Radiology and other Radiology associations do not believe that NSF with the newer ...

View Discussion

RE: Dialysis for Gadolinium Removal in patient with stage IV CKD 1 day ago

Having seen several patients with post Gd NSF in the days when this was first recognized, it is severe, life threatening complication and not somet...

View Discussion

RE: Chronic Active Antibody Mediated Rejection 1 day ago

Does this pa ------------------------------ Hani Wadei MD, FASN Associate Professor of Medicine Mayo Clinic Jacksonville FL (904) 956-3259 --------...

View Discussion

RE: Chronic Active Antibody Mediated Rejection 1 day ago

I totally agree with you Dr. Venkat, There is no consensus about the benefit of the aggressive approach . ------------------------------ Wael Jebur...

View Discussion

RE: Steroid dependent FSGS 1 day ago

Since she was very steroid responsive I'd be inclined to go with Rituxan (1 gm twice over two weeks) I'd probably keep the mmf on for a few weeks a...

View Discussion