RE: Secondary hypertension Work up 57 minutes ago

the usual nightmare of working up for primary hyperaldo.  I'm not impressed by either the renin or aldo, But he does have hypoK and a metabolic alk...

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RE: Secondary hypertension Work up 2 hours ago

thanks. I was thinking about CTA too, but his Cr is high. I understand our rethinking regarding contrast induced nephropathy, but I don't think he ...

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RE: Secondary hypertension Work up 2 hours ago

Suspect renin and aldosterone levels on multiple drugs especially Lisinopril will be hard to interpret so if you really believe he is adherent (I r...

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RE: Secondary hypertension Work up 2 hours ago

I just saw him for the first time. Those studies were done a couple of months ago as in-patient when he was admitted for 'stroke rule out'. I am no...

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RE: help with patient with adpkd 2 hours ago

So agree that decision regarding preemptive nephrectomy with possible need for dialysis vs simultaneous native nephrectomy should be coordinated wi...

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RE: NS in a patient of psoriasis 4 hours ago

Some patients who do not respond to tacrolimus do respond to cyclosporine. This is mostly in children and experience in adults would be more guarde...

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RE: A case of rpgn 4 hours ago

What is the patients HIV/HCV/HBV status? Do you have any EM Studies? Without crescents this is not RPGN. Could be infection related GN. Sent from m...

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RE: A case of rpgn 5 hours ago

Initially I thought you were going to allude to a thrombotic microangiopathy given the high blood pressure.   But then I read the biopsy and saw 2+...

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RE: NS in a patient of psoriasis 5 hours ago

Before subjecting the patient to another biopsy, detailed reevaluation of the first biopsy by an experienced renal pathologist is warranted. Also, ...

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RE: Renal cysts and Erthryocytosis 5 hours ago

There is a large experience of using an ACE-I or ARB to treat post-renal transplant erythrocytosis which is attributed mostly to continued EPO prod...

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RE: Renal cysts and Erthryocytosis 6 hours ago

Thanks for all this input! I'm pulling the imaging reports but he was told quite clearly they were simple cysts.  Of course, if complex, I would ch...

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RE: Graft Dysfunction ? TMA 6 hours ago

We had a patient once who was treated elsewhere and had TMA on biopsy done for graft dysfunction. Creatinine was around 2.5 to 3 for about 2-3 mont...

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RE: Pregnant patient with Liddle syndrome 6 hours ago

Does family history reveal autosomal dominance for hypertension? In addition to amiloride for hypertension should gene analysis be done? ----------...

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A case of rpgn 6 hours ago

21 yr male, presented with recent onset of hypertension with renal impairment. No significant clue in history suggestive of any specific disorder. ...

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RE: Crescentic IgA Nephropathy 6 hours ago

Sorry. Meant advisable not available. ------------------------------ K.K. Venkat MD Troy MI (248) 420 7798 ------------------------------

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RE: help with patient with adpkd 6 hours ago

Up to 6 months of pretransplant dialysis is probably same as a preemptive transplant in terms of long-term post-transplant outcomes. The choice of ...

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RE: Secondary hypertension Work up 6 hours ago

I am always skeptical of adherence in pts with poorly controlled HTN on multiple antihypertensive agents. Brief hospitalization usually will clarif...

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RE: Renal cysts and Erthryocytosis 6 hours ago

The question of whether a cyst or many cysts (as in polycystic kidneys) are associated with increased renal erythropoietin production has long been...

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RE: Hypokalemia In A Young Woman. 6 hours ago

Which urine sample was chloride 41? ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] [Past Medical Director Kidney Pancreas Trans...

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RE: NS in a patient of psoriasis 6 hours ago

In general, both CYC and RTX gave little effect in steroid unresponsive FSGS. It woukd help to have a report on the LM, IF, EM findings. Sent from ...

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RE: excess urine output of uncerain etiology 6 hours ago

If the “spot” uOSM is representative of a 3.2L daily urine volume, then tge daily OSM excretion rate is about 1000mOSM- and tge polyuria us largely...

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RE: NS in a patient of psoriasis 6 hours ago

I assume mtx has been stopped? Steroid resistant NS thought to be MCD ( but may be FSGS). This degree of nephrosis makes me think this is primary f...

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RE: excess urine output of uncerain etiology 7 hours ago

Yesterday, osmolarity on the blood 292, osmolarity on the urine spot 31 4 Mosm/L ------------------------------ Sadeem Ali MD Bridgeport WV (612) 8...

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RE: NS in a patient of psoriasis 9 hours ago

I wonder if the lack of response to cyclophosphamide is due to the GN being secondary (and perhaps the pathologic finding of minimal change disease...

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RE: Renal cysts and Erthryocytosis 9 hours ago

Is this a simple cyst or is there complexity as per the Bosniak grading criteria? ------------------------------ Tejas Desai, MD Founder, NOD Analy...

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RE: Secondary hypertension Work up 9 hours ago

Can you tell us the unit of measurement of both plasma renin and aldosterone? --------------------------------- Hayder Aledan MD, FASN Assistant Pr...

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NS in a patient of psoriasis 9 hours ago

Good afternoon all Greetings from Delhi, India I need a whole hearted opinion on a difficult to manage NS  She is a 46y known case of Psoriasis man...

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RE: Renal cysts and Erthryocytosis 12 hours ago

Very good question. The phenomenon of simple kidney cyst “induced” polycythemia is so rare that few have any experience. But a very high plasma ery...

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Renal cysts and Erthryocytosis 14 hours ago

I have a patient with secondary polycythemia, normal renal function, and evidence of previously diagnosed simple cysts.  The largest was only 4-5 c...

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RE: Secondary hypertension Work up 17 hours ago

Were the plasma renin activity (PRA) and aldosterone level obtained while patient was taking lisinopril? The "normal" PRA might actually have been ...

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RE: Secondary hypertension Work up 18 hours ago

Aldo 17. Sorry, there was a typo, aldosterone was auto-corrected to testosterone. ------------------------------ Abdul Wali Nuristani, MD Sacrament...

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RE: Secondary hypertension Work up 19 hours ago

What was the Aldo associated with that renin? --------------------------------- Roger Rodby MD, FASN Professor of Medicine Rush University Medical ...

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RE: Secondary hypertension Work up 19 hours ago

He reports being very adherent and takes all his meds on time. Don't have 24 hr BP monitoring, but trying to get it. ------------------------------...

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RE: Pregnant patient with Liddle syndrome 19 hours ago

https://www.researchgate.net/publication/315173150_Management_of_Liddle_Syndrome_in_Pregnancy_A_Case_Report_and_Literature_Review https://www.hinda...

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RE: Secondary hypertension Work up 19 hours ago

Sorry, forgot to mention, he used to be on furosemide and HCTZ, but stopped taking it, presumably due to hypokalemia, but he was not sure about it....

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Pregnant patient with Liddle syndrome 19 hours ago

25 yr pregnant female with 14 week gestation with diagnosis of HTN at age 18 yrs and clinical diagnosis of Liddle syndrome in the setting of HTN, h...

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RE: Secondary hypertension Work up 20 hours ago

Compliance issues? Any 24 hour ambulatory BP monitoring? Sent from my iPad

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RE: Secondary hypertension Work up 20 hours ago

True definition of resistant hypertension is requiring three or more antihypertensives including at least one diuretic and ruling out non-adherence...

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RE: excess urine output of uncerain etiology 21 hours ago

Urea, Na and K mmol in the total 3.2 L collection ------------------------------ Sadeem Ali MD Bridgeport WV (612) 865-9067 -----------------------...

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RE: Creatinine increase w exemestane 21 hours ago

If true as I haven’t previously come across this observation, could it simply reflect increased muscle mass from a higher androgen-to-estrogen rati...

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RE: Hypokalemia In A Young Woman. 21 hours ago

Urine chloride 41 24hr urine for cortisol and cortisone are pending. Did order Urine screen for diuretics as well. Appreciate your input. ---------...

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Creatinine increase w exemestane 22 hours ago

Do we know the mechanism of increase in creatinine with  exemestane, an aromatase inhibitor? ------------------------------ Denise Ricker MD East B...

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Secondary hypertension Work up 23 hours ago

52 Y.O. obese male with history of un-controlled hypertension since his 20s. Strong family history, his father at young age and other paternal rela...

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RE: Tablo Machine For Impatient Dialysis 23 hours ago

Dave, thanks for the summary of your outstanding experience. I attached our abstract from the ASN which we're currently writing up. We've been very...

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RE: Hypokalemia In A Young Woman. 1 day ago

I agree.  Liddle Syndrome is possible, but we should see Autosomal Dominant inheritance. ------------------------------ Richard Glassock MD, FASN E...

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RE: Graft Dysfunction ? TMA 1 day ago

Thanks Dr Venkat and Dr Lerman for your insightful analysis and guidance. I am grateful and will update you on the course. Sincere regards --------...

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RE: Hypokalemia In A Young Woman. 1 day ago

If she has low renin and low aldosterone in the absence of pharmacologic interference, I would contact the Lifton Laboratory at Rockefeller And get...

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RE: Hypokalemia In A Young Woman. 1 day ago

From the reference I posted above “Of interest, while urine sodium (Na +) and chloride (Cl −) excretions were high and coupled (urine Na +/Cl − rat...

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RE: Hypokalemia In A Young Woman. 1 day ago

Dr Lerman, her bicarbonate is normal. would you still worry about a RTA? ------------------------------ Priyanka Khatri MBBS, MRCP Associate Consul...

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RE: Hypokalemia In A Young Woman. 1 day ago

the 2 urine K values are very different . wondering if a 24 hour urine collection will be more helpful in determining renal vs extra renal causes -...

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