Renal Transplant Biopsy 54 minutes ago

I have a renal transplant patient transplanted 7 years ago . Primary disease unknown . Had rejection first month of transplant . Kidney function ...

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RE: Target Weight In New HD Starter 1 hour ago

My vintage in dialysis therapy for ESKD was when "probing dry weight" by aggressive ultrafiltration was the rule. We did believe, very passionately...

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RE: Denosumab in Chronic kidney disease patients 1 hour ago

Thanks. Like Dr. Sprague , I do not believe that Denosumab is contra-indicated in advanced CKD, but case selection and monitoring are very importan...

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RE: Target Weight In New HD Starter 3 hours ago

The French have more culture than we. They even wine and dine during HD in Tassin. In a review I recently submitted, my co-authors took issue that ...

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RE: Target Weight In New HD Starter 3 hours ago

Attached is an excellent review on the topic of dry weight by @Jennifer Flythe. My two cents on this: "All" ESKD patients with HTN are overloa...

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RE: Hypertension in athletic healthy patient 3 hours ago

Totally agree with you Had to set and read through the articles process all that talk to him we both agreed to go with confirmation test...

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RE: Hypertension in athletic healthy patient 4 hours ago

"I will try to convince him to go for CT abdomen (it was a huge win to get him to do his labs) " I think you have answered the debate on wheth...

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RE: Denosumab in Chronic kidney disease patients 4 hours ago

..dose reduction of Prolia (from the standard of 60mg SQ qmonthly) theoretically, wouldn’t work, since the monoclonal agent is not renally cleared....

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RE: Denosumab in Chronic kidney disease patients 5 hours ago

Dr. Malluche and his group at the University of Kentucky might be able to provide us with insight if the service is still active. They received a h...

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RE: membranous with excellent but not 100% response 5 hours ago

Good choice. . It does take time for the kidney manifestations to resolve after immunotherapy. SLE is another disorder that takes time for the urin...

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RE: Steroids before a renal biopsy 5 hours ago

Interesting discussion. I too think this is drug induced. I presume patient is in the ICU? I would use steroids ad depending on the results requ...

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RE: Steroids before a renal biopsy 5 hours ago

@Richard Glassock I appreciate your concern. My own feeling is that with this degree of renal dysfunction we must put in early, aggressive effort...

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RE: Timeline to use a new AV graft 5 hours ago

I think a lot of education is needed. There is "value" in doing things right.Can it be applied to the Vascular access? Both AVF and AVG can devel...

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RE: membranous with excellent but not 100% response 5 hours ago

Thanks guys, I will do nothing (but watch) ------------------------------ Sheldon Hirsch MD Lakeside Nephrology Wilmette IL (312) 986-0110 ------...

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RE: Steroids before a renal biopsy 6 hours ago

I was also putting my bet on hydralazine! ------------------------------ Lynn Cornell MD, FASN Mayo Clinic Rochester MN (507) 538-4356 ----------...

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RE: Steroids before a renal biopsy 6 hours ago

Agreed- but I am not convinced about the need for PLEX and its use will also increase the risk of a serious infection. --------------------------...

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RE: Denosumab in Chronic kidney disease patients 6 hours ago

Excellent summary by Professor Glassock, I could not have stated it better. we have to be real careful in patients with advanced CKD stage 4/5 and ...

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RE: Steroids before a renal biopsy 6 hours ago

I think I will paraphrase Dr Rodby. PLEX and pulse steroids, PEXIVAS be damned. This is DAH unless proved otherwise. If there is sputum you can che...

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RE: Clinical trials for patients with Familial FSGS 7 hours ago

An excellent resource is NephCure's clinical trials gateway. https://kidneyhealthgateway.com/trials-research/ While not specific to NPHS2 it does...

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RE: Denosumab in Chronic kidney disease patients 10 hours ago

Because of concerns about overall efficacy (fracture prevention) and safety if Denosumab in Advanced CKD (especially categories 4, 5 and 5 D) use o...

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RE: Denosumab in Chronic kidney disease patients 11 hours ago

Thank you very much for your reply's. Alkaline phosphatase was within normal range , no bone alkaline phosphatase was not requested. DEXA scan ...

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RE: Denosumab in Chronic kidney disease patients 14 hours ago

Thanks, Drs. Venkat and Sprague. Dr. Jebur, have we answered your questions with sufficient clarity ? ------------------------------ Richard Glas...

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RE: membranous with excellent but not 100% response 16 hours ago

"The usual thinking about this is that the negative serum PLA2R means that immunologic activity has resolved and that the remnant proteinuria is du...

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RE: Steroids before a renal biopsy 16 hours ago

Dr Glassock's questions are all important but I will opine in an answer void. It may sound like I am being flippant, or disrespectful with my bet...

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RE: Denosumab in Chronic kidney disease patients 16 hours ago

It is a tough question, but as pointed out by Professor Glassock a diagnosis of osteoporosis can not be made in a patient with advanced CKD and sol...

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RE: Timeline to use a new AV graft 17 hours ago

Thanks to all for this highly educational and enlightening series of posts. The thread should be read by all vascular surgeons performing AVF and A...

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RE: Clinical trials for patients with Familial FSGS 17 hours ago

Thanks. Good luck with the ACTION3 trial in patients with Primary and Genetic FSGS lesions. previously, the Lumina-1 trial of CCX140 (an orally eff...

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RE: Timeline to use a new AV graft 17 hours ago

You are asking for data that does not exist. Medicine is more than numbers. There are many predictors of AVF maturation. For AVG, less so. The ar...

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RE: Steroids before a renal biopsy 19 hours ago

What are the C3/C4 levels? What do's the urine sediment exam show? Have you attempted to detect cryoglobulins in serum? . what is the HCV and HBV s...

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RE: membranous with excellent but not 100% response 19 hours ago

An immunological remission in PLA2R related MN is defined as a negative serum IFA test or and ELISA of [More]

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RE: Timeline to use a new AV graft 20 hours ago

I have attached a number of summaries of papers published in the past few years. They talk about what happens to cardiac remodeling when an AV Acce...

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RE: Timeline to use a new AV graft 21 hours ago

If patient is volume-overloaded, low EF may improve after adequate ultrafiltration and volume optimization. "Uremic cardiomyopathy" may be another ...

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RE: Denosumab in Chronic kidney disease patients 21 hours ago

Stage-4 CKD with calcium on high normal side (10 mg/dl) and PTH of only 70 despite phosphate of 5.0 mg/dl suggests possibility of adynamic bone dis...

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RE: Timeline to use a new AV graft 1 day ago

Thank you Dr. Wasse I need your opinion and experiences for optimal time to use AVG Minimal EF% that allow to do AVG --------------------------...

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Steroids before a renal biopsy 1 day ago

Hello everyone I have a patient,77 year old caucasian lady, who has AKI, proteinuria and hematuria and is currently inpatient. Her serologies ...

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membranous with excellent but not 100% response 1 day ago

53 yo white male with no medical history developed nephrosis (6 gms, alb 2.9) with normal GFR about 18 months ago. Extensive serology negative exce...

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RE: Timeline to use a new AV graft 1 day ago

A few points, IMO, worth emphasizing: --As Dr Besarab aptly notes, there are significant differences between grafts and fistulas and between uppe...

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RE: Timeline to use a new AV graft 1 day ago

Monnie You always could say it in a few words where as I always need a page Well Said. The issue of adequate training of surgeons ...

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RE: Hypertension in athletic healthy patient 1 day ago

I frankly believe it is a good test but it takes 6-8 weeks to see the effect on serum K adf BP. Men hate it because of the gynecomastia. Oddly I ha...

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RE: Clinical trials for patients with Familial FSGS 1 day ago

thank you for the correction Dr Glassock you are correct, the ACTION3 study is the proper name of the trial (DIMERIX is the company) yes, we, a...

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RE: Clinical trials for patients with Familial FSGS 1 day ago

Many thanks for your post . i assume you are referring to the ACTION3 international trial of DMX-200 (a CCR2 receptor antagonist.) Like the recentl...

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RE: Timeline to use a new AV graft 1 day ago

No, it does not.

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RE: Timeline to use a new AV graft 1 day ago

Good response Dr. Wasse. Does any data exist concerning the effect of a forearm AVG on hospitalizations for CHF (or CV mortality) in hemo- dialysis...

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RE: Clinical trials for patients with Familial FSGS 1 day ago

Hello Dr Karimi yes, the DIMERIX study is currently enrolling patients with genetic FSGS (although, not specific to NPHS2). Based on what you hav...

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RE: Timeline to use a new AV graft 1 day ago

Several excellent points have been made already, but please indicate whether the patient is on already dialysis, and whether this may be the reason...

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RE: Denosumab in Chronic kidney disease patients 1 day ago

Tough question. Bottom line- do not trust a "diagnosis" of osteoporosis made by DEXA scansonly in zny patidnt with advanced CKD. Adding serum bioma...

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RE: Hypertension in athletic healthy patient 1 day ago

Thank you for the article and the input. Let me see if he is interested in doing more blood work (post- salt load) and a CT ---------------------...

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RE: Hypertension in athletic healthy patient 1 day ago

Thanks for sharing! ------------------------------ Sarah Aloudat ------------------------------

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RE: Hypertension in athletic healthy patient 1 day ago

The Melby test- you previously suggested I treat one of my patients with HTNsive crisis (Stroke, ESRD), He was 49 when we started Spironolactone...

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RE: Hypertension in athletic healthy patient 1 day ago

Thank you, this is very important, I have couple of patients in this program, one is screaming a hyperaldo (her K is low, Na is high and HCO3 is...

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