RE: finerinoneh 1 hour ago

In a diabetic with SBP of 120 mmHg in the sitting position I would check BP during orthostasis. Orthostatic hypotension in these patients could gen...

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RE: A difficult case of IgAN 2 hours ago

You can also send paraffin tissue to Dr. Sethi at the Mayo Clinic for Laser dissection /Mass spectrometry, which should give definitive answers to ...

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RE: ?Mitochondrial disorder 3 hours ago

Thank you. ------------------------------ M Kaisar Nephrologist Brisbane ------------------------------

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RE: ?Mitochondrial disorder 3 hours ago

I had a MELAS syndrome long ago that was very severe and present when not under stress, but asking this "mitochondrial mutation that causes lactic ...

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RE: ?Mitochondrial disorder 4 hours ago

I agree that with this history and repeated episodes of HAGMA and hypokalemia a genetic mitochondrial cytopathy they should be considered. (See the...

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RE: A difficult case of IgAN 4 hours ago

Unfortunately I dont think we have access to those stains, Dr Glassock. But I will check with our pathologist if any of that is possible --------...

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RE: A difficult case of IgAN 4 hours ago

Thanks. I better understand your choice of CYC, it hard to say that this is RPGZN with inky C1 crescents. Any chance you can study the biopsies for...

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RE: A difficult case of IgAN 4 hours ago

Thank you, Dr Glassock! I did notice the absence of light chains, but didnt think a paraprotein-mediated aetiology was likely at his age, so didn't...

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?Mitochondrial disorder 6 hours ago

I would appreciate any input for the case below.. Thank you. Recent reviewed a young lady whom previously had been diagnosed with type 1 RTA t...

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RE: finerinoneh 6 hours ago

Thank you. As you mentioned data from https://pmc.ncbi.nlm.nih.gov/articles/PMC10278789/#s3 Mainly black females were the ones with stage 4 CKD i...

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RE: finerinoneh 6 hours ago

Thank you for your reply. The patient BP is around 120+ systolic. He is diabetic again well controlled. ------------------------------ M...

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RE: finerinoneh 6 hours ago

Thank you for your reply. Only data I could find was indirect : https://jamanetwork.com/journals/jama/fullarticle/2432163 and subgroup analysi...

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RE: A difficult case of IgAN 7 hours ago

This is a very atypical presentation and pathology for classical IgAN.. The lack of light chain deposits and the MPGN features features make me thi...

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A difficult case of IgAN 9 hours ago

We recently had a patient with IgAN who has been particularly difficult to treat. Would be grateful for advice on what to do next: 19/M, who prese...

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RE: finerinoneh 1 day ago

To reframe your question is that you use Finerenone per trials for CKD patient with an entry eGFR > 25 ml/min but now the eGFR is drift below 25 ml...

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RE: finerinoneh 1 day ago

The FIDELIO DKD trial included diabetic patients with rGFR down to 25 mL/min/1.73 m², but did not establish efficacy below that threshold. Your p...

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RE: are foamy cells in kidney biopsy synonymous with fabry disease? 1 day ago

Thanks prof glassock. Very helpful as usual . Proposed donor excluded. Albumin in donor 33 slightly below normal ( not sure of genetic fsgs can ...

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RE: Proteinuria 1 day ago

How tall is she? 9.5 cm kidney could be small for tall person. Zoledronic might be innocent by stander. If she has FSGS, which is expected, will be...

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RE: Urine Sodium In Hyponatremia 1 day ago

"My main question is that if we assume any patient , is volume depleted , will his Urine Na reflect his volume depleted status ie low Una or will h...

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RE: Proteinuria 1 day ago

Thank you very much for your advice. ------------------------------ Soroush Shojai MD Associate Professor University of Alberta Edmonton AB 0044...

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RE: Proteinuria 1 day ago

Thank you for your advice. We haven't repeated her US recently but her kidney was 9.5 Cm on the latest US. I am not aware of her birth eight but ...

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RE: Proteinuria 1 day ago

The other symptoms reported are consistent with zoledronic acid induced systemic inflammation, a well reported phenomenon, and I wouldn't necessari...

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RE: Proteinuria 1 day ago

Yes her serum Albumin is normal and she doesn't have any oedema. Thank you very much for your advice. ------------------------------ Soroush S...

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RE: Proteinuria 1 day ago

Thank you for your advice. I agree ATIN is a possibility and it was discussed among our team. However, the consensus was even if the biopsy shows A...

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RE: Proteinuria 1 day ago

Hi Thank you for your reply. She doesn't have any glycosuria. ------------------------------ Soroush Shojai MD Associate Professor University ...

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RE: Proteinuria 1 day ago

Reviewed labs - could follow for now on present meds- reserve biopsy if eGFR decreases or becomes nephrotic ( serum albumin normal if read table co...

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RE: Urine Sodium In Hyponatremia 1 day ago

I completely agree with Dr. R. Rodby. This is not salt wasting nephropathy, but typical SIADH. Hence the use of the 2 % saline just allowed the ser...

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RE: MCD-IgA nephropathy 1 day ago

Ok- good luck keep us informed ! ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KPCOP EC [Past Medical Director Kidney Pa...

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RE: Are International Kidney Disease Guidelines Equally Applicable Across Different Healthcare Settings? 1 day ago

I do not have any good answers to your questions. guideline writers try to take into account the global heterogeneity of availability of drugs to t...

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RE: finerinoneh 1 day ago

I can't find any published information that answers your question. We will gave to rely on the opinion of someone who has experience with treating ...

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RE: MCD-IgA nephropathy 1 day ago

He's been on it for a while, I stopped it during this last visit. I am planning to start tapering steroids by next 2 weeks. He does have some ste...

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RE: MCD-IgA nephropathy 1 day ago

"He takes hydralazine, hydrochlorothiazide, bumex and metformin." suspect rash not steroids but agree with referred to dermatology for possible s...

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RE: Proteinuria 1 day ago

Pamidronate is associated with FSGS while zolindronte is associated with ATI. Solitary kidney is not an absolute CI for kidney biopsy so I would pr...

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RE: Proteinuria 1 day ago

any glucosuria present on UA ? --------------------------------- Edgard Wehbe MD, FASN Wichita Nephrology Group Wichita KS (316) 993-6580 ----...

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RE: Lupus nephritis - Renal Limited TMA - Complement mediated CAPS 1 day ago

Agree with Dr. Glassock and i think all lesions can be explained by LN even the TMA so my plan to wait for OBI plus SOC (MMF and PRD) to work befor...

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RE: Lupus nephritis - Renal Limited TMA - Complement mediated CAPS 1 day ago

Thanks It is a complicated case of a patient presenting with 2 major thrombotic events . His biopsy shows class 4 lupus Nephritis There is a sug...

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RE: Proteinuria 2 days ago

What is the size of the solitary Kidney by US ? Do you happen to kniw her birth weight?. What is her systolic BP and ABOM (nocturnal dipping) ?. Wh...

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RE: Lupus nephritis - Renal Limited TMA - Complement mediated CAPS 2 days ago

Dr-Dastoor- Given the findings in this complex case of LN, I have difficulty understanding the rationale for using anti -C5 MoAb -can you succinc...

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RE: Lupus nephritis - Renal Limited TMA - Complement mediated CAPS 2 days ago

Genetic testing done Obi given last night Eculizimab planned for tomorrow, Ravulizumab as an outpatient --------------------------------- Dr. Ho...

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RE: are foamy cells in kidney biopsy synonymous with fabry disease? 2 days ago

I would do genetic studies for Alport and Fabry Disease on potential donor and intended recipient in this case. Interstitial foam cels are abnormal...

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Proteinuria 2 days ago

I would like to ask my colleagues' opinion on this patient. 61 years old female with solitary kidney ( Donated her kidney 12 years ago), presente...

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RE: MCD-IgA nephropathy 2 days ago

he does have microscopic hematuria, persistently 17-26 RBCs on UA. ------------------------------ Sarah Al Zoubi MD John Stroger Hospital of Cook...

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RE: MCD-IgA nephropathy 2 days ago

He takes hydralazine, hydrochlorothiazide, bumex and metformin. I think it is more drug eruption from steroids. he was referred to dermatology fo...

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RE: Urine Sodium In Hyponatremia 2 days ago

On 28th October his Pna was 118 . He was placed on 2% saline for 24 hours . His Una was 160 and Uosm was 550 while on 2% saline . On 29th October ...

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RE: Urine Sodium In Hyponatremia 2 days ago

"His serum creatinine is 28 umol/l or 0.4 mg/dl, urea is 4 mmol/l ( 12 mg/dl) uric acid 72 umol/L" Dr. Dastoor: Were these the presenting values be...

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RE: are foamy cells in kidney biopsy synonymous with fabry disease? 2 days ago

should i check for Fabry disease? ------------------------------ Muhammad Soobadar MBChB UK ------------------------------

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are foamy cells in kidney biopsy synonymous with fabry disease? 2 days ago

59 F coming foward to be considered as live donor for nephew PMH: 3 previous C sections - one under GA and 2 under spinal : Nil issues Frozen ...

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RE: Urine Sodium In Hyponatremia 2 days ago

exactly why a measured urine sodium assuming no diuretics for several days would have been informative ------------------------------ [Mark] [Ler...

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RE: Urine Sodium In Hyponatremia 2 days ago

I attached the aforementioned article about the value of the Una over the physical exam for euvolemia v hypovolemia in HypoNa. TO me this is a clas...

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RE: Urine Sodium In Hyponatremia 2 days ago

Was urine sodium measured when pNA was 118? ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KPCOP EC [Past Medical Directo...

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