RE: Reccurent Post infections GN 2 hours ago

Good question. No good answer. The best study was done in 1992 by Meri et al (J exp Med1992; 175; 939-950) where a 1:1 mixing of patient plasma wit...

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RE: Reccurent Post infections GN 4 hours ago

Thank you for for the insight @Richard Glassock the low c4 was only the 3rd episode which normalise quickly. Her renal function is normal now desp...

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RE: Reccurent Post infections GN 4 hours ago

1. Was ASO elevation present during second and third episodes also? the ASO titre was high for first and third episode. Complements C3 and c4 was l...

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RE: Reccurent Post infections GN 6 hours ago

Several observations makes frequent, recurrent ASPGN unlikely. 1) the number of species of streptococci that have nephritogenic potential is limite...

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RE: AR alprt carrier COL4A4 6 hours ago

I have a few comments on Dr. Robdby's very nice analysis of COLIV a4 genetics, which should be complementary to his remarks. A "Carrier" state in t...

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RE: Reccurent Post infections GN 6 hours ago

Can't think of diagnostic possibility other than recurrent infection-associated GN given low complements and sub-epithelial humps. Thankfully, rena...

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RE: A Case of Resistant Hyperkalemia 10 hours ago

Fascinating. Just saw an almost identical case today. Normal renal function, k between 5 and 5.7 for years. Not as elevated as your case, but still...

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RE: Suspected Hyper-Aldo Confirmatory test ??? 10 hours ago

I agree with Dr. Rodby and Dr. Lerman's suggestion to check plasma renin and aldosterone anyway. If the renin is suppressed (PRA [More]

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RE: AR alprt carrier COL4A4 12 hours ago

Thanks Professor ------------------------------ Kevin Mitchell MBBS Bosie ID ------------------------------

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Reccurent Post infections GN 12 hours ago

Dear All I would be grateful if you could give me some insight on this 61 year old interesting lady who is under my care recently She is present...

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RE: AR alprt carrier COL4A4 13 hours ago

the COL4A4 recessive carrier (heterozygote) may represent the carrier state of autosomal recessive Alport disease which may also be the genetics o...

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RE: AR alprt carrier COL4A4 16 hours ago

Appreciate the help. Will follow his hematuria was 50 RBCs previously and check renal function multiple ways. --------------------------...

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RE: AR alprt carrier COL4A4 16 hours ago

I need to add that a detailed examination of the urine and urinary sediment should be carried out on all available first degree relatives of the pa...

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RE: AR alprt carrier COL4A4 16 hours ago

Repeat the serum creatinine level and determine the urine red cell excretion rate and quantitative albuminuria. Is he robust and muscular . Do you ...

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RE: Peritoneal dialysis power flush 17 hours ago

Agree with the points that Dr. Alvarez makes – one additional comment: a 60 ml syringe does NOT provide a power flush, rather a volume flush. – The...

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AR alprt carrier COL4A4 17 hours ago

New patient referred mid 20's male whom is a carrier of COL4A4 recessive. Wife had miscarriage and discovered with testing. Checking for protein...

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RE: Suspected Hyper-Aldo Confirmatory test ??? 18 hours ago

I would also recommend getting renin and Aldo levels, despite being on these medications. Other than beta blockers and high-dose Aldactone wouldn't...

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RE: Peritoneal dialysis power flush 1 day ago

Dear all In our center managed such patients either with rapid wash or irrigation with normal saline with heparin or by using gaid wire all last st...

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RE: TMA in Kidney Transplant Recipient 1 day ago

Dr Venkat, BP is very well controlled. Thanks Dr Cohney for detailed reply. COVID and respiratory virus panel was negative except for RhinoV. Patie...

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RE: Suspected Hyper-Aldo Confirmatory test ??? 1 day ago

If only there were an easy way to work this up. so many meds make renin and aldo hard to interpret, but I would still get renin and aldo, if both l...

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RE: TMA in Kidney Transplant Recipient 1 day ago

If I understand correctly Kidney likely not salvageable - or at least it would only be putting off the inevitable for a short time Unclear as ...

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Suspected Hyper-Aldo Confirmatory test ??? 1 day ago

A 45-year-old male with history of longstanding resistant hypertension. Medication: Amlodipine 10 mg daily Losartan 100 mg daily Spironolactone ...

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RE: TMA in Kidney Transplant Recipient 1 day ago

Is BP well controlled? May be hypertension related TMA . ------------------------------ K.K. Venkat MD Troy MI (248) 420 7798 --------------------...

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Open Forum Digest for Wednesday December 7, 2022 1 day ago

On Wed, Dec 7, 2022, at 7:23 AM, American Society of Nephrology wrote: 1 announcement, 1 new thread and 21 replies from 13 authors in the "Open For...

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RE: Peritoneal dialysis power flush 1 day ago

Regardless of When the PD Catheter was placed a KUB to determine position. If it was recently placed it is usually due to Migration or Omental wrap...

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NIH-funded training grant post-doctoral fellowships at UAB 1 day ago

RFA for postdoctoral positions in Interdisciplinary Training in Kidney-Related research at the University of Alabama at Birmingham – 2023. Applic...

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RE: Hemodialysis Filter Discard 1 day ago

Agree with Dr Glassock. What was the Hb pre-ESA therapy? A "hyper-response" to a Hb of 14 g/dL indicates extreme sensitivity and he might need a s...

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RE: TMA in Kidney Transplant Recipient 1 day ago

Why no a transplant nephrectomy.? ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ------------------------...

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TMA in Kidney Transplant Recipient 1 day ago

Dear Community: 20 yr old, primary kidney disease; renal dysplasia. Live related Kidney Tx 7 years ago, maintenace Pred, MMF, Tac. May 2022, graft ...

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RE: Hemodialysis Filter Discard 1 day ago

would be interested to know what hgb was prior to initiating esa. ------------------------------ Brian Michel MD Haddon Renal Medical Specialists ...

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RE: Peritoneal dialysis power flush 1 day ago

When a PD catheter is not functioning well, I would check its position first by a plain abdominal X-ray. Only when its position looks ok, the possi...

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RE: When to consider kidney biopsy for proteinuria that is associated with HELLP 2 days ago

Thank you all for your input ------------------------------ Rehab Albakr MD Nephrologist ------------------------------

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Peritoneal dialysis power flush 2 days ago

Interested in opinions regarding managing pd cath malfunction (not draining/slow flow) most clinics usually perform a "power flush" using a 60 ml s...

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RE: nedd help with IgA pt 2 days ago

Thanks so much. I was unaware of this tool and can see it will be very helpful in coming up with a plan. I don’t have all the exact data in front o...

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RE: nedd help with IgA pt 2 days ago

Good question. Unfortunately, the hypothesis you articulate has never been adequately studied in IgAN. Fundamentally, it is a trade off between und...

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RE: When to consider kidney biopsy for proteinuria that is associated with HELLP 2 days ago

Concur with waiting a while longer. ------------------------------ John Mellas MD Nephrology and Hypertension Specialists St Louis MO 3145372356 -...

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RE: nedd help with IgA pt 2 days ago

I should explain that one more factor in my considering more aggressive initial treatment is the patient's age-35. Over the past couple of years I ...

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RE: Suspected minimal change disease 2 days ago

Thanks so much for the info Dr. Glassock!! ------------------------------ James Matera DO Sr. VP of Medical Affairs/CMO CentraState Medical Center...

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RE: Suspected minimal change disease 2 days ago

See Pankhurst , et al NDT 2006;21:64-69 concerning incidentalomas on kidney biopsy. Bottom line, if you can't see it with imaging, surveillance onl...

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RE: Suspected minimal change disease 2 days ago

Thank you everyone. Will report back once the mammogram is resulted. ------------------------------ Louis Spiegel MD ------------------------------

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RE: Lupus Nephritis - now w change of class 2 days ago

Sounds like active LN, probably Class III/IV a/c. I am not convinced that a repeat kidney biopsy is needed. But she probably needs "re-induction " ...

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RE: Thymoma And Minimal Change 2 days ago

A specific role for T-cells in the pathogenesis of the pattern of injury lesion we have descriptively labeled as "Minimal Change Disease " is large...

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RE: When to consider kidney biopsy for proteinuria that is associated with HELLP 2 days ago

I agree with Dr. Glassock; I would definitely wait. It can take several months for proteinuria to disappear after severe preeclampsia/eclampsia - u...

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RE: Hemodialysis Filter Discard 2 days ago

No epo requirement is observed in number of dialysis patients. We always jump to r/o RCC. The reality that only small fraction of RCC express eryth...

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RE: Thymoma And Minimal Change 2 days ago

I recall work of french groups linking minimal change disease to T-lymphocytes. Will ATG be of value in such situation? --------------------------...

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RE: Suspected minimal change disease 2 days ago

No CYC, did relapse with steroids x 2, so got MMF and full remission after 4 months. ------------------------------ James Matera DO Sr. VP of Medi...

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RE: Suspected minimal change disease 2 days ago

Interesting finding-, co-incidental or causal. Difficult to be sure. What was the original treatment regimen for MCD?Did he receive any CYC? -----...

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RE: Lupus Nephritis - now w change of class 2 days ago

please refer to the history above i will summarize briefly - this is a 22yr old AA girl w bx proven pure Class V (last year) - did well on mmf, raa...

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RE: CKD after unilateral nephrectomy 2 days ago

Most standard 40 year old donors should have a baseline GFR > 90cc/min/1.73m2 and have a normal creatinine 6 months post unilateral nephrectomy. Th...

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RE: Recurrent treatment resistant FSGS that is TPE dependent 2 days ago

I agree- In fact, treatment of recurrent FSGS has been shown to be much less successful when PLEX (or Lipid Apheresis ) is begun AFTER well develop...

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