Diagnostic dilemma/ LCAT??? 1 hour ago

42 years old male , textile worker , no prior co morbidities, (1 paternal uncle in family was diagnosed ckd at the age of 60 years) Had body swel...

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RE: diagnosis? 1 hour ago

I believe that the urinary citrate excretion increase with K Citrate, K Acetate, K bicarb due the alkalinization effect . If metabolic alkalosis is...

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RE: diagnosis? 1 hour ago

With genetic testing more readily available we now see more and more cases of late Onset type II Barrters. One of our cases Here. Hyperparathyroi...

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RE: Refractory membranous Nephropathy 1 hour ago

Dr. Dastoor. Can you explain to me why you think that further iS therapy is indicated despite a complete immunological remission (anti-PLA2R antibo...

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RE: Refractory membranous Nephropathy 2 hours ago

Her biopsy was done in Sept 2025 , and I don't think there is a need for another biopsy. The biopsy does not show evidence of any other disease lik...

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RE: Refractory membranous Nephropathy 3 hours ago

Interesting case. The commonly used definition of treatment Refractory MN has not been met in thus case. She has developed a complete immunological...

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RE: Refractory membranous Nephropathy 3 hours ago

Dual pathology also possible with non immune cause of proteinuria and MN --------------------------------- Muhammad Soobadar MBChB UK -----------...

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RE: Refractory membranous Nephropathy 3 hours ago

Thanks for case humble opinion 1. Would you consider that this patient still has kidney PlA2r positivity driving her disease I don’t think so as...

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RE: diagnosis? 3 hours ago

Thanku so much for correction. I will switch it to kcl . I wish i could get genetic studies , unfortunately not available in Pakistan. Is there any...

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Refractory membranous Nephropathy 4 hours ago

This is a case referred to me , from a colleague , who was initially antiPlA2R positive , but has been negative since 2023 . Despite serum antiPlA2...

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RE: Serum Ig A Level In Ig A Nephropathy / Vasculitis 4 hours ago

Thanks What about km55( mentioned by prof glassock in previous post) can it be used as diagnostic tool and as marker for IS? -----------------...

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RE: Newly Diagnosed Anca Vascultis 4 hours ago

Thanks prof rodby Yes it fits with description mentioned Very educational @ prof rodby / @ prof glassock / any colleagues I wonder iRGN with...

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RE: IgA Nephropathy 4 hours ago

Thanks prof glassock . I got the point . Thanks prof dastoor for update Will await 24hr urine sodium @ prof dastoor / prof glassock would you s...

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RE: diagnosis? 4 hours ago

@John Asplin ------------------------------ Roger Rodby MD, FASN Professor of Medicine Rush University Nephrology Associates Chicago IL (773) 505...

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RE: Interpretation Of Mainritsan 2 4 hours ago

Steroid weaning I mean not relapse Thanks --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Interpretation Of Mainritsan 2 4 hours ago

Thanks prof glassock . Prof rodby and prof dastoor I would induce with 2cyclo pulse with 2 rituxan dose and avacopan and plex if creatine >3 and s...

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RE: diagnosis? 5 hours ago

The published literature on Bartter Syndrome suggests that K Citrate should be avoided as it aggravates the metabolic alkalosis. The calcification ...

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RE: Newly Diagnosed Anca Vascultis 5 hours ago

Check out this case of IRGN https://www.ajkd.org/action/showPdf?pii=S0272-6386%2825%2901109-6 Gemella morbillorum yet another rare organism for ...

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RE: Interpretation Of Mainritsan 2 5 hours ago

"Would you use fixed dose or tailored RTX regimens for maintenance of remission in ANCA Vasculitis, or do you have no preference for the dosing reg...

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RE: diagnosis? 6 hours ago

Sir I am surprised why you are in favour of kcl over potassium citrate. His urinary citrate is low, won't it be of any help ? Yahoo Mail: Search, ...

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RE: diagnosis? 6 hours ago

Sir this is 24 hours result , means total in 24 hours. This was done when his serum level was 2.2 and urine is too diluted , so only 72 in 24 hours...

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RE: diagnosis? 7 hours ago

Dr. Syed , can u clarify the u clarify the Urine potassium results ... It says 72... Is that 72 mg total in the 8 liters of urine or is it 72 mg /l...

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RE: diagnosis? 8 hours ago

He is already on potassium citrate 15 mg tid Yahoo Mail: Search, organise, conquer

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RE: diagnosis? 9 hours ago

The patient has significant nephrocalcinosis on US KUB Urine citrate levels are low This will probably promote more nephrocalcinosis . Hence I t...

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RE: diagnosis? 9 hours ago

Due to metabolic alkalosis K Citrate would be unwise- KCl is best. The PTH and 1,25 Dihydroxy Vitamin D levels are consistent with Bartter syndrome...

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RE: IgA Nephropathy 11 hours ago

Sure I will have to do it next month when the patient returns . In the meantime will make a submission for ET1 - Atrasentan . -------------------...

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RE: diagnosis? 11 hours ago

I have used K citrate, Spironolactone/ Amilirolide and ACEi in the past , and if needed I would escalate or switch to NSAID . Am not too comfortabl...

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RE: Interpretation Of Mainritsan 2 11 hours ago

For the majority of patients I use a q6 monthly dosing schedule . It's more predictable for myself and the patients . A few have had serious life...

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RE: diagnosis? 13 hours ago

His PTH is raised , calcium is normal and PO4 is low - am not convinced it is sex hyperPTH. With Creatinine of 1.4 mg/dl , his eGFr is > 60 ml/min ...

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RE: IgA Nephropathy 14 hours ago

Dr. Dastoor - Please let us know what the 24 hour urine Sodium excretion is in this case when the results return- is a key point in management...

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RE: Interpretation Of Mainritsan 2 14 hours ago

Drs. Soodabar, Dastoor and Rodby Would you use fixed dose or tailored RTX regimens for maintenance of remission in ANCA Vasculitis, or do you...

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RE: diagnosis? 14 hours ago

Drs. Mellas, Dastoor and Rodby- would you treat this patient with NSAID and careful monitoring? Just curious. ------------------------------ Rich...

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RE: diagnosis? 19 hours ago

Thanks, Dr. Rodby. Apparently , the Bartter Syndrome (Type 3; The Classic form) can present in Adults between 20 and 40 years of age. ---------...

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RE: diagnosis? 21 hours ago

yes that age at presentation must be rare but the degree of neprhocalcinosis and severity of presentation makes me think this has been going on a...

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RE: Interpretation Of Mainritsan 2 23 hours ago

I 100% agree with Dr. Rodby that the MAINRITSAN -II trial was underpowered to examine AE occurring with the the regimens . The trial was powered fo...

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RE: diagnosis? 23 hours ago

Thanks- Dr. Rodby- Do you have an opinion as to whether this case is an acquired form or a congenital form of Bartter Syndrome. Hopefully, the gene...

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RE: diagnosis? 23 hours ago

"To all- does a normal serum Magnesium favor a diagnisis of Dent Disease or acquired non-genetic Bartter syndrome. ?" I say no, hypoMg is much mo...

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RE: Interpretation Of Mainritsan 2 23 hours ago

"There is a difference between relapse in fixed regime dosing vs tailored infusion regime . Could colleague explain why they say" The only way th...

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RE: Interpretation Of Mainritsan 2 1 day ago

The Adverse events were numerically higher in the fixed dose arm combated to the tailored dose arm but tgus difference was not stistically signific...

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RE: diagnosis? 1 day ago

CT chest is due on Monday Yahoo Mail: Search, organise, conquer

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RE: IgA Nephropathy 1 day ago

Possible, but not glomerular hypertrophy not seen in kidney biopsy. Hard to prove without knowing nephron #..I don't disagree with early therapy, b...

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RE: Newly Diagnosed Anca Vascultis 1 day ago

Yes. RF = Rheumatoid Factor. ANA= antinuclear antibody ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 -...

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RE: diagnosis? 1 day ago

These findings indicate an inappropriate increase in 1-hydroxlase Vitamin D activity- seen in Bartter syndrome and in Sarcoidosis. Have you done a ...

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RE: diagnosis? 1 day ago

The serum calcium is normal because of secondary hyperparathyroidism!!! ------------------------------ Richard Glassock MD, FASN Laguna Woods CA...

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RE: diagnosis? 1 day ago

If this is Bartter syndrome, then NSAID are indicated with careful monitoring. ------------------------------ Richard Glassock MD, FASN Laguna W...

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RE: diagnosis? 1 day ago

To all- does a normal serum Magnesium favor a diagnisis of Dent Disease or acquired non-genetic Bartter syndrome. ? ---------------------------...

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RE: diagnosis? 1 day ago

Is this a spot or 24 hour. He is polyuria so spot values will be liw- I assume that this is in mmol. ------------------------------ Richard Glass...

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RE: diagnosis? 1 day ago

His repeat labs today showed low 25oh VIT d only 8.9 and 1-25oh VIT d was high 1 week back,,, Why? Yahoo Mail: Search, organise, conquer

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RE: diagnosis? 1 day ago

The thread mention that elevated PTH is due to Hypercalicuria . However the patients serum calcium is normal .... Would that still cause Hyper- PTH...

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RE: Newly Diagnosed Anca Vascultis 1 day ago

Thanks prof glassock You mean Ana + ve with RF Positivity and low complement ? --------------------------------- Muhammad Soobadar MBChB UK ---...

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