RE: EuroLupus Protocol in patient with eGFR 20 3 hours ago

Thank you Dr Nauman and Dr Venkat for your input ------------------------------ Siev Hong Lor PharmD Pharmacist Liverpool Hospital, NSW E: honglo...

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RE: A Philosophical Question 6 hours ago

"AI will ruin the soul of Nephrology"!! . Well, if it is any consolation , we won't be alone in purgatory. But, if we are very careful , we can tam...

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RE: A Philosophical Question 7 hours ago

Positives & Negatives Genetic testing opened a huge new perspective in diagnostic projections for current and future kidney problems. Better...

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RE: Renal Artery stenosis 8 hours ago

Would not waste time STOP Humira STOP Ozempic Call the surgeon > go for as NAUMAN suggested START Isosorbide Dinitrate 10 bid START Fish oil...

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RE: Renal Artery stenosis 12 hours ago

I think a severe RAS which is collateralized may be a reflection of a more chronically hypoxic kidney than if not. While collateralization may prot...

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RE: Tough GN case 14 hours ago

Noted, agree, we are pursuing the biopsy, and good point about recurrence potential s/p txplt. Thank you! ------------------------------ Jeffrey ...

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RE: Tough GN case 14 hours ago

With 9-10 cm kidneys by US I would probably do a kidney biopsy anyway, (if not contraindicated) to put the final nail on the futility issue. And to...

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RE: Renal Artery stenosis 14 hours ago

I think I am in the Klein/Campese camp on this case. I would adopt an aggressive conservative , non-surgical management. At least for now. I doubt ...

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RE: Renal Artery stenosis 14 hours ago

In this case, the risk benefit ratio for intervention is too high. Given the presence of diabetes and severe and diffuse atherosclerosis, the ris...

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RE: Renal Artery stenosis 14 hours ago

Dr. Hirsch: I agree with you that good collaterals supplying the left kidney can explain the maintained renal function despite the 90% RAS, atrophi...

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RE: Renal Artery stenosis 17 hours ago

I must respectively disagree . I think stenting is extremely high risk and though I agree with Dr Rodby that dialysis may be inevitable, until the ...

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RE: Renal Artery stenosis 17 hours ago

Dr Venkat, The angiogram might also show evidence of good collaterals (or not). That is possibly inferred by the Cr of 1.2 to 1.5 despite severe bi...

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RE: A Philosophical Question 17 hours ago

I would add to the many advances cited, progress in preventing progression of CKD to ESRD, which is one of our most important goals, if not the mos...

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RE: Tough GN case 17 hours ago

Thank you for the additional thoughts, Dr. Glassock. I agree, endocarditis going on 2 years does seem unlikely, particularly in the absence of F/...

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RE: Tough GN case 17 hours ago

Thanks for the thoughts. Her ultrasound findings: RIGHT KIDNEY: 9.4 cm long. Cortex is thin and mildly echogenic. No mass, stone, or obstruction ...

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RE: A Philosophical Question 20 hours ago

Yes, science of nephrology and treatment options for kidney diseases have advanced tremendously. If only the socio-economic problems, delayed nephr...

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RE: EuroLupus Protocol in patient with eGFR 20 20 hours ago

Agree with Dr. Nauman regarding cyclophosphamide dose in your patient with eGFR of 20 ml/min. Regarding "excluding preexisting chronic renal failur...

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RE: Renal Artery stenosis 20 hours ago

Agree with Dr. Rodby that stenting of left renal artery is justified despite the absence of the generally accepted indications (flash pulmonary ede...

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RE: Renal Artery stenosis 23 hours ago

24% function in right kidney is about 9 ml/min of GFR. How about stunting in left and auto-transplantation for right kidney. -------------------...

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RE: EuroLupus Protocol in patient with eGFR 20 23 hours ago

I have used 500mg every 2 weeks and have not reduced the dose in lower GFR. My understanding is Cyclophosphamide AUC is equivalent for a given dose...

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EuroLupus Protocol in patient with eGFR 20 1 day ago

Hi all, Can I please find out your experience / practice in treating patient with Lupus Nephritis Class III / IV with IV cyclophosphamide? Loo...

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RE: Memb gn with diabetic nephropathy 1 day ago

Absolutely no data on efficacy and safety of RTX for PLA2R+ MN in this situation, but with a falling anti-PLA2R antibody level and the severe super...

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RE: Tough GN case 1 day ago

Rarely Endocarditis causing CKD can evolve over many months. Admittedly two years would be unlikely but I have seen patients with slowly evolving C...

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RE: Tough GN case 1 day ago

Kidney ultrasound findings (size/echogenicity:cortical thickness? Was anti-GBM antibody negative? I expect the biopsy will show advanced glomerulos...

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Memb gn with diabetic nephropathy 1 day ago

69 year old male with history of spinal cord injury, cervical myelopathy with chronic pain, chronic suprapubic catheter, neuropathy, T2DM, HLD, HTN...

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RE: Tough GN case 1 day ago

Thanks for the clarification. Get Outlook for iOS Confidentiality Notice: This electronic message, including any and all attachments hereto, is ...

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RE: starting spironolactone when cystatin C based GFR 21 (cirrhosis) but creatinind based 41 1 day ago

Agree with others' comments, particularly in that Cystatin C may be more accurate than eGFR in setting of cirrhosis which is commonly associated w/...

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RE: Tough GN case 1 day ago

Cardiac echo because of a concern over endocarditis. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ----...

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RE: starting spironolactone when cystatin C based GFR 21 (cirrhosis) but creatinind based 41 1 day ago

Which is the ratio Cys C/ Creat.The dissociation between biomarkers could be related to sarcopenia(multi-comorbilities)?In this case, wouldn't it b...

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RE: Tough GN case 1 day ago

Thank you for the help, Dr. Glassock. Complements (C3 and C4) are entirely normal. Did not do RF, FLC or echo--I take it I should check those? ...

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RE: Tough GN case 1 day ago

What is the C3/C4. rheumatoid factor, FLC, echocardiogram? This could be one of many things, PGNMID , Fibrillary GN,IRGN, etc. you need a good kidn...

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RE: A Philosophical Question 1 day ago

I just celebrated 25 years of practicing nephrology. Nephrology is better and more exciting than ever. Plenty of great science being translated in ...

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RE: Renal Artery stenosis 1 day ago

dm well controlled on Ozempic A1c 6. No protein uria. Only on Lisinopril hctz and amlodipine. systolic 110-130 Thank you -------------...

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RE: Tough GN case 1 day ago

Thank you for the prompt feedback, Dr. Rodby. Yes, apologies for not mentioning it, but urine is consistently positive for hematuria. I don't h...

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RE: Renal Artery stenosis 1 day ago

Creatinine 1.2-1.5 I would not bother with renal vein renins, I would not expect BP to get better, or get her off medication. But the writi...

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RE: Tough GN case 1 day ago

P-ANCA 1:160, do you have Elisa, this 1:160 may ne an atypical ANCA and may not mean anything Any hematuria? PLA2R? immunofixation? Statin doi...

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Tough GN case 1 day ago

I would greatly appreciate feedback on this case. 59 yoF with advancing CKD (developing over [More]

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RE: Renal Artery stenosis 1 day ago

Can we assume no flash pulmonary edema.? The main issue is whether stenting the L kidney will lead to better preservation of overall kidney functio...

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RE: dsDNA + and GBM + 1 day ago

Yes, understood. But false positive results with the commercial ELISA antiGBM tests are very uncommon. Anemia (typically iron deficient and microcy...

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RE: dsDNA + and GBM + 1 day ago

agree, but sometimes we have false positive antibody tests as well. ------------------------------ Teri Jo Mauch, MD, PhD, FASN, FAAP Professor ...

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RE: dsDNA + and GBM + 1 day ago

Positive anti-GBM antibodies would not be expected in aHUS. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-88...

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RE: A case of nephrocalcinosis 1 day ago

Thank you so much, Dr.Asplin. I am looking forward to meeting you in the upcoming ASN! ------------------------------ Abdallah Qasim MBBS Neph...

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RE: C3GN with C1q deposit 1 day ago

"Echo - EF 50-55%, no RWMA, mild MR, grade II TR and PASP 58mmHg." Dr. Ahmad: PASP is moderately high. Was the pulmonary capillary wedge pressure e...

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RE: dsDNA + and GBM + 1 day ago

Yes oral cyc 0.5mg/kg/day Yes he was taking allopurinol for years and it was sttopped normal lda, normal platelets not dropping thank you ...

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Renal Artery stenosis 1 day ago

53 year f with HTN Diastolic Dys RA on Humira, s/p Carotid endarterectomy and Multiple peripheral stents with atrophic right kidney 6.7cm with 24% ...

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RE: dsDNA + and GBM + 1 day ago

Regarding your new case of nephritic syndrome: the hemoglobin has fallen; did platelets also drop? Is LDH normal? Atypical HUS can present at any a...

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RE: A Philosophical Question 1 day ago

Even in dialysis hemodiafiltration seems to be much better. The 3H trial showed children actually grew on dialysis, only seen before with transplan...

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RE: dsDNA + and GBM + 1 day ago

Are you giving CYC in reduced doses as welll? Is the patient on hydralazine or allopurinol? If so, they should be stopped. ----------------------...

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RE: Budenoside for IgA Nephropathy 1 day ago

Without direct comparator trials how can you confidently conclude that TRF Budesonide is safer than Moderate doses of oral systemic stetoids? ---...

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RE: Budenoside for IgA Nephropathy 1 day ago

Dr. Jebur, though proteinuria is not great end point due to the multiple factors affecting protein filtration and uptake, it is the only thing we c...

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