High PLA2R and minimal proteinuria 17 minutes ago

Hello  Will appreciate help to address management plan for a patient  52 yrs old Gentleman who accidentally found to have protein ++ on dipstick wo...

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RE: Post transplant immunosuppressive therapy in covid pt 35 minutes ago

Doubt any set guidelines- suspect many programs slowly resume MMF and/or Tac after clinical recovery and conversion to negative RT-PCR ------------...

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RE: Unexplained Proteinuria 1 hour ago

Could this be hemorrhagic cystitis such as caused by adenovirus ------------------------------ [Dr Ravindra Attur] [Prabhu] [Professor HoU] [KMC Ma...

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RE: Unexplained Proteinuria 2 hours ago

“UPEP Interpretation MILD PROTEINURIA IN SELECTIVE PATTERN.” Mild suggests it was done later in the course of events when proteinuria and hematuria...

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RE: Uremic vs non-uremic preicarditis 2 hours ago

Agree . For patients with large effusion or tamponade .drainage is required. In mild to moderate effusion we can sometimes do with aggressive dialy...

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RE: Unexplained Proteinuria 2 hours ago

"SPEP/UPEP showing moderate proteinuria in selective pattern with decreased alhpa one, alpha two, beta and gamma globulins, however, serum immunofi...

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RE: Uremic vs non-uremic preicarditis 2 hours ago

A very sensible comment of Dr Rudnick,i mmediate drainage rather than a a more conservative approach of aggressive   hemodialysis, is our clinical ...

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RE: Unexplained Proteinuria 3 hours ago

UPEP showed:  Albumin  82.5%  Alpha 1 Globulin,  3.1%   Alpha 2 Globulin,  6.9 %   Beta Globulin, 6.4 %   Gamma Globulin, 1.1%  UPEP Interpretation...

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RE: Unexplained Proteinuria 3 hours ago

Interesting ------------------------------ Ghansham Das MD Syracuse NY ------------------------------

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RE: Unexplained Proteinuria 3 hours ago

Thanks for the clarification. An episode of self-limited infection related GN super-imposed on TBMN ight be the best explanation, but the EM studie...

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RE: Uremic vs non-uremic preicarditis 3 hours ago

I believe it's important to distinguish between pericardial effusions  which are a very late manifestation of uremia versus pericardial effusion's ...

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RE: Unexplained Proteinuria 3 hours ago

Being an Occam-phile but able to reluctantly accept  Hickam     https://radiopaedia.org/articles/hickams-dictum?lang=us,  I suppose this patient co...

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RE: Unexplained Proteinuria 3 hours ago

her albumin was 3.2g/dl on the day when her UPCR was 13.03mg/mg. ------------------------------ Ghansham Das MD Syracuse NY -----------------------...

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RE: Unexplained Proteinuria 3 hours ago

Sorry it's all mg/mg ------------------------------ Ghansham Das MD Syracuse NY ------------------------------

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RE: Unexplained Proteinuria 4 hours ago

If the estimation of proteinuria was done during period of gross hematuria it can be misleading. We had a similar case, gross heamturia, nephrotic ...

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RE: Unexplained Proteinuria 4 hours ago

UPCR is not reported as mg/dL - please clarify the next to last sentence in your original report. What pattern of proteinuria was seen in the UPEP?...

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RE: Unexplained Proteinuria 4 hours ago

I rechecked it. It's 13.03mg/mg ------------------------------ Ghansham Das MD Syracuse NY ------------------------------

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RE: Unexplained Proteinuria 5 hours ago

Nephrotic range proteinuria with intact foot processes is a severe mismatch. As Dr. Rodby says- it does not compute. Sent from my iPad

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RE: Unexplained Proteinuria 5 hours ago

Something is off. You reported proteinuria in mg/mg. Are you sure it wasn’t mg/g? --------------------------------- Roger Rodby MD, FASN Professor ...

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RE: Unexplained Proteinuria 5 hours ago

EM showed generally intact podocytes. No significant foot process fusion. ------------------------------ Ghansham Das MD Syracuse NY --------------...

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RE: Unexplained Proteinuria 6 hours ago

Explaining the high grade proteinuria and thin basement membranes on hyper filtration is a stretch (no pun intended) . The Hematuria could be TBMD ...

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RE: Converting albumin / creatinine ratio to approximate g/day 14 hours ago

Thank you all for the resources / assistance, it has been much appreciated. ------------------------------ Justin Davis MBBS Nephrology Registrar T...

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Unexplained Proteinuria 16 hours ago

A 69-year-old female with a past medical history of depression/anxiety, migraine, herpes zoster infection, SIADH, hypothyroidism readmitted to the ...

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RE: Converting albumin / creatinine ratio to approximate g/day 20 hours ago

I agree with Dr. Venkat. There is often some useful information in examining the ratio of UACR and UPCR. Sent from my iPad

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RE: Converting albumin / creatinine ratio to approximate g/day 21 hours ago

Another thing to be aware of when assuming ~ 70% albumin content of total protein in urine to convert UAlb/Cr to UPr/Cr is the possibility that in ...

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RE: Uremic vs non-uremic preicarditis 1 day ago

For what it is worth... I once had a case of tamponade (clear diastolic collapse) with hypertension! The patient was tachycardic and I suppose had ...

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RE: Converting albumin / creatinine ratio to approximate g/day 1 day ago

We recently looked at ACR in patients with AL amyloidosis.​  The correlation was extremely good.  However, it is slightly different whether the pro...

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RE: Uremic vs non-uremic preicarditis 1 day ago

In my opinion the most important issue is the pericardial effusion causing hemodynamic instability. Tamponade - are there signs of cardiogenic shoc...

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RE: Unusual case of proteinuria 1 day ago

As i promised- here is the final version of the case (attached) ------------------------------ [Amaresh] [Vanga] [MD] [Virginia Beach, VA] --------...

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RE: Need help with interesting electrolyte abnormality case 1 day ago

His calcium in rest of labs are ok and never was an issue again. on further poking, he does admit to the fact that he was having issues with freque...

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RE: Converting albumin / creatinine ratio to approximate g/day 1 day ago

The issue of converting UACR to UPCR values makes the rate of creatinine excretion not very relevant as the errors introduced by varying creatinine...

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RE: Converting albumin / creatinine ratio to approximate g/day 1 day ago

I agree that longitudinal changes in UPCR are more important than a single test. The issue of conversion values for UPCR to UACR have been made mor...

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RE: Converting albumin / creatinine ratio to approximate g/day 1 day ago

This is from Roger's paper and I believe is well said and important: [More]

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RE: Converting albumin / creatinine ratio to approximate g/day 1 day ago

Dr. Rodby: Thanks for posting the full article link to your very useful AJKD paper. I wish to reemphasize the following points (some of which you m...

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RE: allograft dysfunction and nephrotic syndrome 1 day ago

2020DOI:https://doi.org/10.1016/j.kint.2020.10.004 This series from NY was 40% without symptoms --------------------------------- [Mark] [Lerman] [...

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RE: Converting albumin / creatinine ratio to approximate g/day 1 day ago

As Dr. Rodby points out the fraction of total protein in the urine that is albumin (Immuno reactive, un degraded ) is about 60-70% in glomerular pr...

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RE: Converting albumin / creatinine ratio to approximate g/day 1 day ago

Conversion of Urine Protein-Creatinine Ratio or Urine Dipstick Protein to Urine Albumin-Creatinine Ratio for Use in Chronic Kidney Disease Screenin...

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RE: Need help with interesting electrolyte abnormality case 1 day ago

Pure speculation. ------------------------------ John Mellas MD Nephrology and Hypertension Specialists St Louis MO 3145372356 --------------------...

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RE: Severe anemia and thoracic pain on HD patient 1 day ago

patient with hypercalcemia, anemia,skull xray showed lytics lesions    m.myeloma in top of list dr Halima fedail physician  nephrologist khartoum s...

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RE: Difficult to control hypertension with one kidney and AAA 1 day ago

We have authorized the patient to get MRA from an outside institute because it's not done in our Institute at present . ---------------------------...

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RE: Converting albumin / creatinine ratio to approximate g/day 1 day ago

Most glomerular proteinuria is about 60% albuminuria. So you can divide ACR by 0.6 to get an equivalent PCR. Using mg/g or g/g is roughly translate...

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RE: Uremic vs non-uremic preicarditis 1 day ago

Thanks Dr Bansal. we do echo before AVF creation to know the baseline Cardiac status. ------------------------------ Mustafa Ahmad MD, FASN Consult...

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RE: allograft dysfunction and nephrotic syndrome 1 day ago

Around 30 percent of the transplant patients who developed COVID were completely asymptomatic in our series. A few of them developed cough later on...

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RE: Need help with interesting electrolyte abnormality case 1 day ago

Thanks- is this speculation or is the supposition based on data? Sent from my iPad

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Converting albumin / creatinine ratio to approximate g/day 1 day ago

Hi all; Does anyone have a good resource / algorithm to convert an albumin / creatinine ratio to an approximate g/day equivalent? I find it...

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RE: Autoimmune event on Belatacept 1 day ago

Thank you Dr. Glassock and Dr. Rodby. ------------------------------ Pooja Sanghi MBBS,FRACP(Nephrology) Transplant Nephrology Fellowship(USA) Gold...

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Post transplant immunosuppressive therapy in covid pt 1 day ago

Respected Faculty Request your advice when to restart antimetabolites in covid recovered post transplant patient. Are there any recommendations/ gu...

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RE: Uremic vs non-uremic preicarditis 1 day ago

Dear Mustafa, we do routine echo in all patients who are admitted with CKD 5, not only for pericardial effusion but for overall cardiac and volume ...

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RE: Autoimmune event on Belatacept 1 day ago

CTLA 4 inhibitors do not cause Sarcoid-like lesions in humans as far as I know. To my understanding none of the Auto-immune phenomena see with ICPI...

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RE: Autoimmune event on Belatacept 1 day ago

Thank you, Dr. Glassock for your very helpful comment. Highly appreciate. I was wanting to know the mechanisms of sarcoid-like lesions induced by C...

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