RE: Acute Antibody Rejection With Mild Biopsy Findings 10 minutes ago

Before lowering tacrolimus dose/levels in such cases, tests such as DSA, cf-dd-DNA and follow-up biopsy should ideally be done to exclude evolving ...

View Discussion

RE: PGNMID with no MGUS 2 hours ago

80-year-old with EF of 15% and eGFR of 15-19 ml/min. Rituximab and daratumumab may be of questionable benefit and risky. How much did SCr/eGFR, UPr...

View Discussion

RE: PGNMID with no MGUS 3 hours ago

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

View Discussion

RE: PGNMID with no MGUS 3 hours ago

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

View Discussion

RE: Acute Antibody Rejection With Mild Biopsy Findings 3 hours ago

Thank you for your input, I'll keep that in mind. and if you're interested I can share any new cases with few changes in transplant biopsy withou...

View Discussion

cresenteric Ig A case 3 hours ago

60 y male pmhx of BPH PTSD, alcohol abuse admitted with SoB , new onset HTN and elevated cr 2. New onset lower ext edema for 3 weeks. Cola colored ...

View Discussion

RE: Acute Antibody Rejection With Mild Biopsy Findings 4 hours ago

After steroid blouse SCR 146, now 135 micromols post PLEX + IVIG. No significant change yet. If after another 2 weeks no significant change in SCr,...

View Discussion

Nephrolithiasis and Osteoporosis 4 hours ago

Hi everyone, I have a 31 year old with CaPO4 kidney stones, nephrocalcinosis and osteoporosis. Serum Ca, Phos and PTH normal. Urine PH on spot samp...

View Discussion

RE: Acute Antibody Rejection With Mild Biopsy Findings 4 hours ago

Thank you for your answers, The patient received 5 sessions of PLEX, and 5 doses of IVIG (total of 90grams). Her tacrolimus level was 9 and 8 in 2...

View Discussion

RE: PGNMID with no MGUS 5 hours ago

I agree with Dr. Rodby, that Daratumumab may be the preferred initial therapy in this patient, due to high response rate and freedom from a risk of...

View Discussion

RE: Canine hyponatremia, proteinuria and some urine clearance calculations 5 hours ago

Would this help quide fluid restriction • Insensible losses (not readily measured losses from respiratory evaporation and the passage of norm...

View Discussion

RE: Canine hyponatremia, proteinuria and some urine clearance calculations 5 hours ago

I dont know about fluid restriction in an animal that cannot express thirst. I would prefer treating it with an increase in solute intake. I wond...

View Discussion

RE: PGNMID with no MGUS 5 hours ago

If you could use daratumumab I think it has the best response rate. see attached also this https://scholar.google.com/s...

View Discussion

RE: PGNMID with no MGUS 7 hours ago

A word of caution. RTX has rarely been associated with a cardiomyopathy. I have no idea if this risk is enhanced by a prior drug induced cardiomyop...

View Discussion

RE: PGNMID with no MGUS 8 hours ago

In PGNMID without an identified clone, the initial preferred therapy is RTX, 1000mg X2 one or two weeks apart, and a repeat dose of 1000mg at 6 mon...

View Discussion

PGNMID with no MGUS 14 hours ago

Hello all I have a 80 yo patient with PMHx of breast Ca treated with doxorubicin who first came to me for AKI and anasarca. She was found to ...

View Discussion

RE: IgA nephropathy with ANCA vasulitis 17 hours ago

"Its a tough one but i am prefering over treating - will decide with patient." Please do post serial SCr levels before and after treatment. ---...

View Discussion

RE: IgA nephropathy with ANCA vasulitis 17 hours ago

Only have a couple of lab readings (only recent AKI) so not sure if there will be some improvement in his kidney function to see serial readings. ...

View Discussion

RE: Canine hyponatremia, proteinuria and some urine clearance calculations 19 hours ago

"one thought is to restrict water and follow serum sodium and urine osmolality" from my earlier post " here is the reference -https://doi.org/...

View Discussion

RE: IgA nephropathy with ANCA vasulitis 20 hours ago

Dr. Rodby said it very well. There are a lot of nuances in cases like this that can be interpreted in various ways. For example, the 56% global Glo...

View Discussion

RE: Canine hyponatremia, proteinuria and some urine clearance calculations 20 hours ago

Yes- this hereditary nephropathy is Alport. Affected males die pretty fast. Females usually show azotemia around age 5 or so. Kidney biopsy has b...

View Discussion

RE: Canine hyponatremia, proteinuria and some urine clearance calculations 21 hours ago

well this doesn't sound (no pun intended) like Alport anyway. What diseases do English Cocker Spaniels get that cause nephrotic range proteinuri...

View Discussion

RE: Canine hyponatremia, proteinuria and some urine clearance calculations 21 hours ago

Urine uric acid was not performed. Most dogs have very low uric acid concentrations in urine due to uric oxidase activity, which humans lost along ...

View Discussion

RE: Canine hyponatremia, proteinuria and some urine clearance calculations 22 hours ago

We have very minimal genetic testing available. We can test for mutations in nephrin that are associated with podocytopathy (not ICGN) in soft coat...

View Discussion

RE: Canine hyponatremia, proteinuria and some urine clearance calculations 23 hours ago

I know you do renal biopsies on dogs, but is genetic testing even available? Are there any nephrotic/blind syndromes in dogs? ---------------...

View Discussion

RE: IgA nephropathy with ANCA vasulitis 1 day ago

I am trying to be practical, lots of glomerular sclerosis, with fibrocellular crescents, and while there is clearly IgAN, i do not want to take the...

View Discussion

RE: IgA nephropathy with ANCA vasulitis 1 day ago

Dr. Rodby- interesting that you would select a "PEXIVAS " protocol for this patient. I presume that you did not mean to use PLEX in this patient. A...

View Discussion

RE: Canine hyponatremia, proteinuria and some urine clearance calculations 1 day ago

"Chemistry: Na 128 (L), Cl 96 (L), rest WNL" BUN and SCr are normal, doesn't this make euvolemic hyponatremia (such as SIADH) more likely and vol...

View Discussion

RE: Bile nephrosis with normal creatinine 1 day ago

A while ago , I saw a patient with a normal serum creatinine, oliguria and a serum Total Bilirubin of >40mg /dL due to fulminant Acute Hepatitis A....

View Discussion

RE: Canine hyponatremia, proteinuria and some urine clearance calculations 1 day ago

I think the core of this case is the presence of Nephrotic syndrome and blindness. Would do a kidney biopsy (with IF and EM) and / or genetic testi...

View Discussion

RE: Canine hyponatremia, proteinuria and some urine clearance calculations 1 day ago

electrolyte free water clearance is more correct than solute free water clearances and in one study of normal subjects was positive until urinary o...

View Discussion

RE: Canine hyponatremia, proteinuria and some urine clearance calculations 1 day ago

Twitter question: "Consult on 9 yr dog with 2yrs of neuro signs and 2 months of hypoNa. UNa 45 UK 42 Uosm 322, UPC 5.4. PNa 128 POsm 268. Was asked...

View Discussion

RE: IgA nephropathy with ANCA vasulitis 1 day ago

Is this patient a diabetic as small number of crescents can be present in diabetic. Which has no prognostic value --------------------------------...

View Discussion

Canine hyponatremia, proteinuria and some urine clearance calculations 1 day ago

Hello everyone, Would appreciate any thoughts you may have on this consult. I haven't seen the patient, but this was the information sent to me: ...

View Discussion

RE: IgA nephropathy with ANCA vasulitis 1 day ago

Lots of chronicity , but a relatively small sample. Clearly long standing IgAN. Does the urine sediment contains RBC casts and acanthocytes? What i...

View Discussion

RE: IgA nephropathy with ANCA vasulitis 1 day ago

"B/G of obesity, Asthma, Gout, HTN." Dr. Rodby: I agree with you that it is difficult to decide whether ANCA-associated crescentic GN is a pathog...

View Discussion

RE: Bile nephrosis with normal creatinine 1 day ago

I'm curious as to the indication for dialysis. While various albumin based forms of dialysis (MARS, SPAD) or a system like PROMETEUS can remove bil...

View Discussion

RE: IgA nephropathy with ANCA vasulitis 1 day ago

Please repost with the patient's name blocked, we can still see it in several places. I would be careful not to make a treatment decision base...

View Discussion

RE: IgA nephropathy with ANCA vasulitis 1 day ago

Has mild AKI (eGFR 50 ml) resolved? Did he have gross hematuria? UPr trend? ------------------------------ K.K. Venkat MD Troy MI (248) 420 7798 ...

View Discussion

IgA nephropathy with ANCA vasulitis 1 day ago

54 year old presented with mild AKI (eGFR dropped to 50 from a baseline > 90). B/G of obesity, Asthma, Gout, HTN. work up because of active urine...

View Discussion

RE: Bile nephrosis with normal creatinine 2 days ago

My apologies to Juan Carlos. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ------------------------------

View Discussion

RE: Bile nephrosis with normal creatinine 2 days ago

Patients such as yours can have many etiologies of AKI, Hepatorenal syndrome, ATN, and the vague condition of bile cast nephropathy , a diagnosis s...

View Discussion

RE: Renal Biopsy In Lupus Nephritis With Thrombocytopenia 2 days ago

Cylophosphamid given after PRES finding by imaging --------------------------------- Mohamed Mahmoud MBBS NEPHROLOGIST MOH KUWAIT 00965 513777...

View Discussion

RE: Renal Biopsy In Lupus Nephritis With Thrombocytopenia 2 days ago

Does anyone think that the cyclophosphamide given could be a cause of PRES? Not sure how you would be able to tell. -----------------------------...

View Discussion

RE: Bile nephrosis with normal creatinine 2 days ago

Juan Carlos Velez (Ochsner Clinic) is one of the world's experts on BCN. ------------------------------ John Schwartz MD Dallas Nephrology Assoc...

View Discussion

RE: Belimumab Vs Retuximab In Lupus Nephritis 2 days ago

Yes ,till now the question is not answered. We need more studies on large number if patients for long periods --------------------------------- N...

View Discussion

RE: Treatment Of Anti Gbm And Anca Disease 2 days ago

With such a very high anti-GBM level, I think I would add PLEX, at least until the findings on kidney biopsy are available (% normal glomeruli). If...

View Discussion

RE: Treatment Of Anti Gbm And Anca Disease 2 days ago

Pulsed --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

View Discussion

RE: Treatment Of Anti Gbm And Anca Disease 2 days ago

Hi the team have pushed him and given him cyclophosphamide but no plex due to Anuria. He will have rituximab too . Has tunelled line over weekend ...

View Discussion

RE: Bile nephrosis with normal creatinine 2 days ago

Bile cast Nephropathy, cholemic nephrosis, bile nephrosis and Icteric Nephropathy are different names for same, typically underdiagnosed entity wit...

View Discussion