RE: Fibronectin glomerulopath 32 minutes ago

EM reports non conclusive - Focal effacement of foot processes of visceral epithelial cells is noted (about 35-40%). Mesangial matrix appears mar...

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RE: A Case of Extreme Persistent Polyuria After Obstructive Uropathy 2 hours ago

This appears to be a mixed diuresis, but it is predominantly solute-driven at this stage, largely fueled by the ongoing intravenous fluid replaceme...

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RE: A Case of Extreme Persistent Polyuria After Obstructive Uropathy 2 hours ago

Most of the time this is due to 'chasing' the urine output. I note that you have reduced the replacement fluid to 70 percent but I believe that is ...

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Membranous Nephropathy Clinical Case 5 hours ago

Hello, I want to share with you this case. 54yo male, dyslipidemia, coronary artery disease with Angioplasty-Stent 2019, FE 73%. Diagnosed MN...

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A Case of Extreme Persistent Polyuria After Obstructive Uropathy 12 hours ago

I have two patients with a very similar clinical presentation. The first is a 55-year-old male with chronic obstructive uropathy secondary to ben...

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RE: Debating taking boards, what rec's would you have for study materials/Courses? 17 hours ago

If you took the ASN's board review course you should have a data bank of > 500 practice questions, hundreds of "Pearls" and hundreds of Flash cards...

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Debating taking boards, what rec's would you have for study materials/Courses? 23 hours ago

Hi all! I'm debating taking the boards and unenrolling from LKA, what recomendations would you have in terms of study materials? I've taken the A...

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RE: Dual Vascultis / Sle 23 hours ago

What about the anti-GBM titer? The biopsy will confirm the diagnosis and guide treatment in this old-age patient with low GFR ----------...

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RE: Dual Vascultis / Sle 1 day ago

Double positive ANCA ANA is not that unusual, ANCA in the presence of lupus worsens prognosis a bit but I dont care what you call this. It total...

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RE: Dual Vascultis / Sle 2 days ago

Thanks prof glassock --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Dual Vascultis / Sle 2 days ago

This means that the ELISA was probably a false + ------------------------------ Richard Glassock MD, FASN Emeritus Professor Geffen School of Med...

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RE: Dual Vascultis / Sle 2 days ago

@ prof glassock ? --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Intersting case-Need your opinion 2 days ago

Thanks for case I have sent uk checklist for ahus How long would complement antibodies and complement genertiv test take From what prof glassock ...

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RE: Intersting case-Need your opinion 2 days ago

https://www.atypicalhus.co.uk/wp-content/uploads/2023/04/National-aHUS-Service_diagnostic-checklist-v11.04.2023.docx -----------------------------...

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RE: hemodialysis ascites 2 days ago

Thanks Dr Glassock; I value your analysis more than AI-Claude. However I don't think your AI knows the difference between "a definition" and "a dis...

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RE: hemodialysis ascites 3 days ago

This indicate different serosal environment and different cells residence. Pericardial tissue has sparse cells and the pericarditis in uremia is du...

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RE: hemodialysis ascites 3 days ago

uremic pericarditis can have a predominance of neutrophils. why would a uremic peritonits be different? --------------------------------- J Gunne...

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RE: Help me make sense of this 24 hr urine study for stones. 3 days ago

Hi Dr Anand, I think that is a very good question. I believe the difference is that citrate is trivalent and has two carboxyl groups with much...

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RE: hemodialysis ascites 3 days ago

Resolution of ascites with increasing UF plus water and salt restriction is both diagnostic and therapeutic for nephrogenic ascites. I tend to dis...

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RE: hemodialysis ascites 3 days ago

His serum albumin 3.1. His fluid LDH 242, glucose 114. Cytology x2 neg on the fluid though this is low sensitivity. EGD AND Colonoscopy neg. I have...

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RE: hemodialysis ascites 3 days ago

The fact that these patients typically have inflammatory indicators in the ascites, especially with a monocyte predominance says this is not just a...

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RE: hemodialysis ascites 3 days ago

Dr. Salman. Both my AI assistant (Claude) and I respectfully disagree with your "blanket" statement about "Nephrogenic Ascites " "A normal free a...

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RE: hemodialysis ascites 3 days ago

Quick literature review showed that in only 15% of cases (138 cases mentioned), an underlying causes were identified after extensive workup and the...

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RE: hemodialysis ascites 3 days ago

There is no Nephrogenic Ascites. It is in fact the result of "increased right sided venous blood pressure returning to the heart" causing very co...

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RE: Help me make sense of this 24 hr urine study for stones. 3 days ago

@John Asplin Dr. Asplin if I can ask a dumb question. This is in connection with the bicarbonate vs citrate’s effect on urine pH. Both bicarbonat...

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RE: A 19-Year-Old Male with Frank Hematuria, Proteinuria, and Weak Anti-GBM Positivity 3 days ago

I think this comment was added to the wrong thread. ------------------------------ Richard Glassock MD, FASN Emeritus Professor Geffen School of ...

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RE: hemodialysis ascites 3 days ago

If the Neutrophil Count in the ascitic fluid is > 250/ cumm then the likelihood that this is "Nephrogenic Ascites” diminishes greatly.Good point ma...

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RE: A 19-Year-Old Male with Frank Hematuria, Proteinuria, and Weak Anti-GBM Positivity 3 days ago

Here are the key studies relevant to the forum discussion on **EPO/ESA and tumor growth**: --- ## 1. Meningiomas & EPO Receptors (Most Directly Rel...

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RE: hemodialysis ascites 3 days ago

What was the differential (WBC) of the peritoneal cell count? DAA typically has predominant monocytes. His story of poor dialysis adherence fi...

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RE: hemodialysis ascites 3 days ago

What is the serum albumin -ascites albumin gradient? What is the ascites fluid LDH and glucose.? While "Nephrogenic ascites " has typical biochemic...

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hemodialysis ascites 3 days ago

I have a 40yo patient who was discharged from the local clinics for dangerous behavior 4 years ago. He would come to the hospital every 3 months fo...

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RE: Help me make sense of this 24 hr urine study for stones. 3 days ago

Dr Ali, Thanks for providing the additional clinical information and for tracking down earlier 24 hr urine results. The panels are done in variou...

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RE: Intersting case-Need your opinion Monday, June 1 @ 7:54 PM

Dear Saja, all viral screen negative, nil features of scleroderma , genetic test sent-results awaited Thank you -----------------------------...

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RE: Gross hematuria in a patient with failed renal allograft Monday, June 1 @ 7:26 PM

Dr. JOSHI- I referenced the same article as above in my post above -despite the article I have never seen more than a few significant complications...

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RE: Help me make sense of this 24 hr urine study for stones. Monday, June 1 @ 6:46 PM

Dr. Asplin, Thank you for your response. To answer your questions : I am attaching two more 24 hr urines which were done prior to starting ...

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RE: A 19-Year-Old Male with Frank Hematuria, Proteinuria, and Weak Anti-GBM Positivity Monday, June 1 @ 3:06 PM

Dr. Rodby personally given the normal and apparently stable kidney function in this case, I personally would not start empiric steroid for the ne...

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RE: Erythropoetin and meningioma Monday, June 1 @ 12:26 PM

According to Claude (my AI assistant) -aggravation of meningioma growth by exogenous EPO is plausible (from in vitro studies) but unproven in ESRD....

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RE: Erythropoetin and meningioma Monday, June 1 @ 11:35 AM

We find that typically when it comes to ESA use in patients with cancer , our oncology colleagues usually give us the go ahead. A meningioma ...

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RE: Gross hematuria in a patient with failed renal allograft Monday, June 1 @ 11:11 AM

@Amit Joshi "Thank you Dr. Rodby, That's concern I had, but came across this article when learning about it. " Thanks for attaching the a...

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Erythropoetin and meningioma Monday, June 1 @ 11:11 AM

This one is for all the EPO experts out there; Are you aware of any risk of accelerating meningioma growth in a dialysis patient treated with ery...

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RE: Gross hematuria in a patient with failed renal allograft Monday, June 1 @ 12:51 AM

For what it is worth (not a great deal) , I agree with Dr. . Lerman. This a failed kidney transplant due to non-compliance. Better to do a transpla...

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RE: Gross hematuria in a patient with failed renal allograft Sunday, May 31 @ 8:24 PM

Thanks Dr. Rubin very interesting and educational to have your vascular radiologist's opinion of the angiogram. my final vote is going to favor n...

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RE: Gross hematuria in a patient with failed renal allograft Sunday, May 31 @ 6:48 PM

The following is what our vascular radiologist thinks: " it's hard for me to tell on 1 image. maybe there js some extrav along the capsule but i ...

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RE: Effect Of Plasma Exchange On Complement (c3,c4) Sunday, May 31 @ 5:57 PM

This a complex question. We usually do not do PLEX in normal subject and some indication will have complement activation and consumption process as...

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RE: A 19-Year-Old Male with Frank Hematuria, Proteinuria, and Weak Anti-GBM Positivity Sunday, May 31 @ 5:18 PM

Wait for the biopsy LM and IF report. Will EM also be available? With NS, I would consider RTX as well , but the splenomegaly still troubles me. An...

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RE: Gross hematuria in a patient with failed renal allograft Sunday, May 31 @ 4:58 PM

I have attached the most often cited paper (NO RCTs are available on this topic) which concluded that there is a lower morbi-mortality with coil em...

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RE: Gross hematuria in a patient with failed renal allograft Sunday, May 31 @ 4:42 PM

Be careful and do not make decisions on the basis of a single center (the surgical and radiological skills are unique to that center), retrospectiv...

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RE: Gross hematuria in a patient with failed renal allograft Sunday, May 31 @ 4:36 PM

@Amit Joshi Slide # 3 appears to show a scarcity of blood vessels in the lower pole with some vascular blushes (see below)? It gives the appearan...

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RE: Gross hematuria in a patient with failed renal allograft Sunday, May 31 @ 4:30 PM

Thank you Dr. Rodby, That's concern I had, but came across this article when learning about it. ------------------------------ Amit Joshi Chica...

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RE: Gross hematuria in a patient with failed renal allograft Sunday, May 31 @ 4:24 PM

Ok, will update once I have more information. Thank you! ------------------------------ Amit Joshi Chicago IL ------------------------------

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