RE: PD and Crohn's disease 41 minutes ago

Please see a similar question answered on the ISPD Q and A page - see screenshot and link below. https://ispd.org/question/who-has-experience-w...

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RE: Tablo/Outset dialysate flow rates of 300 54 minutes ago

Thank you David Anatole(Tony) Sent from Outlook

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RE: Tablo/Outset dialysate flow rates of 300 1 hour ago

Tony, I have no personal experience with NxStage but I'm a Tablo fan since the start of the pandemic. I have no financial relationship with them. B...

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PD and Crohn's disease 1 hour ago

28 yo male with advance CKD due to IgA nephropathy needs initiation of RRT. He has Crohn's disease in remission. No abdominal surgeries. I am going...

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RE: RAASi in Peritoneal Dialysis 2 hours ago

We use ACEi/ ARB ( prefer due to less side effect) in our PD patient with arterial HTN. We have not noticed any significant drop in RRF in those pa...

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RE: Intradialytic Hypotension with Interdialytic Hypertension 4 hours ago

I have seen 2 definitions of IDH in this discussion. A MAP decrease of > 20 mm Hg and a systolic pressure < 90  mm HG. Symptomatic in both cases. W...

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RE: A young patient with diffuse alveolar hemorrhage and renal impairment 4 hours ago

Dear AllI agree with Prof Hayden, Use of IV IG in combination with Plex may be helpful as an immunomodulator.The other remote possibility could be ...

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RE: Tablo/Outset dialysate flow rates of 300 4 hours ago

I have been out of Clin Practice for almost 6.5 years. We used the NxStage system back then and I never heard of Tablo. Looking at the internet, th...

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RE: Intradialytic Hypotension with Interdialytic Hypertension 4 hours ago

What is the average volume of ultrafiltration per dialysis session and does post-dialysis hypertension correlate with intradialytic weight loss? If...

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RE: RAASi in Peritoneal Dialysis 5 hours ago

The increase in small solute transfer is not a simple A-11 effect, because it also does not occur using normal pH, low GDP solutions as we showed r...

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RE: Intradialytic Hypotension with Interdialytic Hypertension 6 hours ago

Dr Dastoor, what is the dialysate Na you used and UF (ml/kg/hr)? --------------------------------- Hayder Aledan MD, FASN Assistant Professor Basr...

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RE: RAASi in Peritoneal Dialysis 15 hours ago

Some resources I use to justify the practice outlined above. An ISPD presentation by @Joanne Bargman and the ISPD recommendations in a paper by...

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RE: RAASi in Peritoneal Dialysis 16 hours ago

I regularly use RAASi as first choice in patients who need anti HTN medications and have urine output >250 ml/d (rule of thumb for some residual fu...

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RE: RAASi in Peritoneal Dialysis 16 hours ago

I have used ACEi/ARBs in most patients on PD with RRF. They not only helps in controlling BP, but also have other beneficial effects like in other ...

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RE: A young patient with diffuse alveolar hemorrhage and renal impairment 19 hours ago

Too bad. This is definitely not medical progress. Single breath CO uptake May be the best test available to distinguish pulmonary edema from DAH- B...

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RE: A young patient with diffuse alveolar hemorrhage and renal impairment 20 hours ago

Also happens in mine --------------------------------- Bajinder Reen MD Brampton ON (905) 453-0821 ---------------------------------

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RE: Tablo/Outset dialysate flow rates of 300 20 hours ago

Completely agree with Dr. Teixera's detailed response. We have at least 2 Tablos set up in our chronic unit now in order to keep everyone fresh on ...

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RE: ? Amyloid,? MGRS 20 hours ago

Dr. Ahmad: Can you please provide a further update? What is the current SCr and UPr/Cr? Is the patient off steroids yet? -------------------------...

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RE: A young patient with diffuse alveolar hemorrhage and renal impairment 21 hours ago

Amazing!! Is this true at many other hospitals? --------------------------------- Richard Glassock MD, FASN Emeritus Professor David Geffen Sch...

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RE: A young patient with diffuse alveolar hemorrhage and renal impairment 22 hours ago

“A single breath carbon monoxide uptake test (pulmonary diffusing capacity- a standard test in most pulmonary function laboratories) can often dist...

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RE: IgA nephropathy clinical trial 1 day ago

A good source for locating glomerular disease trials is NephCure Kidney International's www.kidneyhealthgateway.com site. The organization maintain...

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RE: A young patient with diffuse alveolar hemorrhage and renal impairment 1 day ago

I would be surprised if Caplacizumab was available, but Dr. Leung makes a good point about PLEX (with FFP replacement) Resistant TTP (due to ADAMTS...

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RE: Tablo/Outset dialysate flow rates of 300 1 day ago

Hello Dr. Pohlman-- Full disclosure  -- I have done a bit of consulting for Outset, but I will give you my honest appraisal of the Qd issue with T...

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RE: Tablo/Outset dialysate flow rates of 300 1 day ago

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RE: IgA nephropathy clinical trial 1 day ago

I believe Brad Rovin is a PI in an Astra Zeneca sponsored trial. ------------------------------ John Mellas MD Nephrology and Hypertension Special...

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RE: Paxlovid treatment in dialysis patients 1 day ago

I don't have any experience but in general agree with Dr. Glassock's points further up the thread. From a pharmacokinetics and toxicity standpoint ...

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RE: A young patient with diffuse alveolar hemorrhage and renal impairment 1 day ago

Any history of quinine exposure?  Was this the first occurrence?  There is a congenital form Upshaw-Shulman syndrome which present early in life.  ...

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RE: Intradialytic Hypotension with Interdialytic Hypertension 1 day ago

As a follow up , this patient is still having a lot of trouble managing his BP. In summary he is 36 year old Spanish Gentleman , from Majorca He is...

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RE: A young patient with diffuse alveolar hemorrhage and renal impairment 1 day ago

My point is that pulmonary venous congestion may be the cause (or at least contributing factor) in patient dyspnea and may even cause blood tinged ...

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RE: A young patient with diffuse alveolar hemorrhage and renal impairment 1 day ago

Haptoglobin level? ------------------------------ K.K. Venkat MD Troy MI (248) 420 7798 ------------------------------

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RE: RAASi in Peritoneal Dialysis 1 day ago

Dr. Krediet has conducted studies addressing this question and perhaps he can comment. I personally see no reason to avoid RASi inhibitors in PD pa...

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RE: A young patient with diffuse alveolar hemorrhage and renal impairment 1 day ago

In absence of availability of ADAMTS13 high plasmic score favours TTP altho not diagnostic Any drug history as suggested by DrGlassock ----------...

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RE: A young patient with diffuse alveolar hemorrhage and renal impairment 1 day ago

No improvement in ldh and platelet ...remained static even after 5 sessions of Plex Patient is oliganuric ....on alternate day dialysis Plasmic sco...

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RE: A young patient with diffuse alveolar hemorrhage and renal impairment 1 day ago

Markedly reduced GFR makes HUS more likely than TTP. TTP can't be excluded without ADAMTS13 activity level. PLEX with FFP is the standard of care t...

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RE: RAASi in Peritoneal Dialysis 1 day ago

RAASi inhibits TGF beta, a mediator of fibrosis , which may be how time on PD increases small solid transport and makes a patient “higher perm” and...

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RE: A young patient with diffuse alveolar hemorrhage and renal impairment 1 day ago

I know this is a very rare disease,outside of the Southern US, but if there is any history of drug abuse, you might want to consider Opana  (extend...

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RE: RAASi in Peritoneal Dialysis 1 day ago

I would add this meta-analysis which also favor the use of RAASi to preserve RRT in PD patients. --------------------------------- Hayder Aledan M...

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RE: Paxlovid treatment in dialysis patients 1 day ago

Hard to use a drug of marginal efficacy,when the manufacturer says not to use it. ------------------------------ Richard Glassock MD, FASN Emeritu...

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RE: A young patient with diffuse alveolar hemorrhage and renal impairment 1 day ago

Sorry QXMD --------------------------------- Bajinder Reen MD Brampton ON (905) 453-0821 ---------------------------------

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RE: A young patient with diffuse alveolar hemorrhage and renal impairment 1 day ago

Remember, if this is TTP you should be using FFP as replacement fluid. ------------------------------ Richard Glassock MD, FASN Emeritus Professor...

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RE: A young patient with diffuse alveolar hemorrhage and renal impairment 1 day ago

If plasmic score low consider Ahus --------------------------------- Bajinder Reen MD Brampton ON (905) 453-0821 ---------------------------------

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RE: RAASi in Peritoneal Dialysis 1 day ago

In contrast with some other studies, we found no positive effect of A-11 inhibitors on the time course of residual GFR in 452 incident PD patients,...

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RE: Paxlovid treatment in dialysis patients 1 day ago

thanks Dr Glassock Patients with severe CKD are it increased risk of severe disease  of COVID 19 and no published data regarding the use of Paxlovi...

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RE: A young patient with diffuse alveolar hemorrhage and renal impairment 1 day ago

I agree with Dr Aledan Calculate plasmic score Looks like high looks. Go to App Store Download QxD and look for plasmic score if high treat ad TTP ...

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RE: A young patient with diffuse alveolar hemorrhage and renal impairment 1 day ago

Given these lab values, the most probable diagnosis is TTP/HUS and in severe cases refractory to steroids and plasmapheresis, RTX may be used. Unfo...

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RE: A young patient with diffuse alveolar hemorrhage and renal impairment 1 day ago

Histoplasmosis? ------------------------------ Peter Mathieson MBBS, PhD Principal & Hon Professor of Medicine University of Edinburgh Edinburgh 4...

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RE: A young patient with diffuse alveolar hemorrhage and renal impairment 1 day ago

Echo -55% EF Wat about giving immunoglobulins ? ------------------------------ Batool Butt MBBS Doctor Hospital Islamabad 03335570895 ------------...

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RE: A young patient with diffuse alveolar hemorrhage and renal impairment 1 day ago

Blood culture no growth Lupus anticoagulant and anticardiolipin antibodies and other autoimmune and vasculitic screening(ana,anca antigbm and compl...

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RE: A young patient with diffuse alveolar hemorrhage and renal impairment 1 day ago

What about ADAMS TS13? (TTP) Anti phospholipid antibodies? (APA) Catastrophic APA can have Microangiopathic hemolytic anemia (MAHA) and diffuse pu...

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A young patient with diffuse alveolar hemorrhage and renal impairment 1 day ago

A 15 yr male transferred from another hospital with anemia ,thrombocytopenia and renal impairment -02 sessions of hemodialysis done there. At the t...

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