RE: proteinuria ? cause 4 hours ago

Thanks for the prompt replyFirst kidney biopsy from right was inadequate sampleSecond biopsy from left and is hydronephrotic .stent was removed few...

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RE: Puzzling Case of Post-Transplant Proteinuria 4 hours ago

There are multiple urine tests over the past several months consistently showing very high UAlb/Cr and UPr/Cr ratios. Urine protein electrophoresis...

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RE: proteinuria ? cause 4 hours ago

Was the biopsy of the left or right kidney.? Any hematuria or acanthocyturia by urinalysis (red cell casts in tubules) ? Any family history of kidn...

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proteinuria ? cause 6 hours ago

77 years old female with history of chronic hydronephrosis on the left. Cystoscopy and stents ×3. Noted to have scarring of the ureter in May 2025....

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RE: Somewhat suppressed aldo, Primary aldosteronism or not? 7 hours ago

Renin is not suppressed in Obesity related hyperaldosteronism 10.1093/ckj/sfaf218 Regardless treatment is medical IMO -----------------------...

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RE: Resistant Rejection 7 hours ago

Good morning Interesting case. Given the lack of response to steroids and thymoglobulin, I would question whether the persistent inflammation re...

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RE: Puzzling Case of Post-Transplant Proteinuria 8 hours ago

if urine is non-milky and confident patient provided urine with normal TG level then Chyluria very unlikely. would get urine electrophoresis again ...

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RE: Resistant Rejection 8 hours ago

DSA?- positive or negative is necessary to classify this mixed rejection t-cell + ABMR -which has important implications for prognosis and addition...

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Resistant Rejection 10 hours ago

Clinical History A 37-year-old woman with a history of systemic lupus erythematosus (SLE), diagnosed in 2009, has a significant obstetric history ...

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RE: Puzzling Case of Post-Transplant Proteinuria 13 hours ago

According to Claude, a normal TG level in a single urine specimen does not rule out Chyluria. He recommends an oral fat challenge test, similar to ...

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RE: Puzzling Case of Post-Transplant Proteinuria 13 hours ago

Could this be a lab error? Unlikely, I admit. ------------------------------ Richard Glassock MD, FASN Emeritus Professor Geffen School of Medic...

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RE: Puzzling Case of Post-Transplant Proteinuria 15 hours ago

What is serum creatinine? were 24 hr urine albumin and protein and creatinine done? ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,...

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RE: Puzzling Case of Post-Transplant Proteinuria 18 hours ago

My AI search was from Claude and it gave different results than yours, this ocurrs fairly commonly, in my experience. It matters how you ask the qu...

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RE: Puzzling Case of Post-Transplant Proteinuria 18 hours ago

Dr. Glassock: My AI search was done using Google Gemini. Unfortunately, the outside pathology lab which reported on the 2 kidney biopsies, did not ...

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RE: Metabolic alkalosis, high urine Chloride, new diagnosis of metastatic lung cancer 19 hours ago

Just spironolactone at discharge to try to counteract the mineralocorticoid effects. The confirmatory tests (urine cortisol) resulted only recently...

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RE: PGNMID case -Request help 20 hours ago

If this is IgG 3 kappa + IC-MPGN then there is a 70% chance that this is a monotypic PGN and a10% chance that this is a monoclonal PGN- withe 20% u...

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RE: PGNMID case -Request help 21 hours ago

Hi Dr Glassock, thank you for the response and the article. IgG subtyping was sent out to UCLA or Cedars path and showed staining for IgG3 heavy ch...

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RE: PGNMID case -Request help 21 hours ago

Do you have IgG3 subclass staining? IgG subclass staining is positive for IgG3 only, this is likely to be monotypic PGN,with no monoclonal IgG pres...

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PGNMID case -Request help 23 hours ago

Hello I would like to request help from our experts with this case. 41-year-old Caucasian female who presented in June 2023 with AKI and severe nep...

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RE: Metabolic alkalosis, high urine Chloride, new diagnosis of metastatic lung cancer 1 day ago

Thanks for the FU. What therapy did you choose for presumed ectopic ACTH syndrome? ------------------------------ Richard Glassock MD, FASN Eme...

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RE: Metabolic alkalosis, high urine Chloride, new diagnosis of metastatic lung cancer 1 day ago

I wanted to give an update on her 24 hr urine cortisol (this pt with new lung cancer, metabolic alkalosis and hypokalemia) The 24 hr urine cortis...

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RE: Somewhat suppressed aldo, Primary aldosteronism or not? 1 day ago

I agree with Dr. Rodby's suggestion to "call it a day" and treat this patient medically as a case of "presumed" PHA without any further testing.. ...

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RE: Puzzling Case of Post-Transplant Proteinuria 1 day ago

"Mild" GBM thickening in the second kidney biopsy, can we have some morphometric GBM thickness in the first and secondtransplant. biopsies. Also do...

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RE: Somewhat suppressed aldo, Primary aldosteronism or not? 1 day ago

This is the problem with diagnosiy PHA, it always seems complicated by meds, overlapping non consistsnt renin Aldo levels. Adrenal vein sampling is...

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RE: Puzzling Case of Post-Transplant Proteinuria 1 day ago

Dr,. Venkat - Which AI did you use for your search? ------------------------------ Richard Glassock MD, FASN Emeritus Professor Geffen School of ...

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RE: Somewhat suppressed aldo, Primary aldosteronism or not? 1 day ago

Dr. Anand- thanks for posting the PodCast - I guess I will have to disagree. In my opinion , the Use of RASI , Beta Blocker and MRA can make it ver...

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RE: Somewhat suppressed aldo, Primary aldosteronism or not? 1 day ago

In patients with suspected primary aldosteronism it is difficult to withhold bp meds esp in cases like mine where the BP was very high. @Richard...

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RE: Puzzling Case of Post-Transplant Proteinuria 1 day ago

Was transplant RAS ruled out? --------------------------------- Oded Friedman ---------------------------------

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RE: Puzzling Case of Post-Transplant Proteinuria 1 day ago

Thanks Dr. Glassock Did an AI search: As you had mentioned, it said that heavy glomerular proteinuria without podocyte effacement can occur in the ...

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RE: Somewhat suppressed aldo, Primary aldosteronism or not? 1 day ago

not an expert on this, not sure, defer to others can say this: agree with Dr Glassock, not sure we can trust the renin and aldo levels here, give...

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RE: Somewhat suppressed aldo, Primary aldosteronism or not? 2 days ago

wouldn't renin levels be normal or elevated? ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KPCOP EC [Past Medical Direct...

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RE: Timing of blood sampling in twice-weekly hemodialysis regimens 2 days ago

In my practice I typically measure CrCl in an ICU patient with AKI where the urine output can be reasonably measured. I ask the ICU nurse to accura...

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RE: Timing of blood sampling in twice-weekly hemodialysis regimens 2 days ago

"With dialysis the SCr falls as does the urine Cr excretion so that the ratio of U x V / S Cr remains rather constant and equal to actual ClCr." ...

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RE: Puzzling Case of Post-Transplant Proteinuria 2 days ago

Dr- Venkat- very unusual case. The lack of a correlation between albuminuria and podocyte FP effacement is well described in the literature. Serum ...

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Puzzling Case of Post-Transplant Proteinuria 2 days ago

I wish to obtain the impressions/recommendations of Forum participants regarding the following patient: Question: How to explain very heavy albumi...

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RE: Timing of blood sampling in twice-weekly hemodialysis regimens 2 days ago

It is fortuitous that ClCr is rather accurate using the standard method of ClCr in AKI or to measure residual kidney function in a patient on dialy...

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RE: Obstructing Urinary Stone 2 days ago

It was a calcium oxalate stone and she has been referred to a urolithiasis expert for a complete evaluation. a repeat US showed that the right side...

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RE: Obstructing Urinary Stone 2 days ago

Dr. Glassock-thanks for follow-up. you may have already addressed but what was stone analysis and workup to avoid additional nephrolithiasis? ---...

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RE: Obstructing Urinary Stone 2 days ago

Dr. Glassock: As I had mentioned previously in this thread, I have consistently noticed an approximate doubling of SCr over the first 24 hrs follow...

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RE: Treatment of membranous nephropathy with microsherular substructure 2 days ago

Thank you very much for taking the time to give me advice Joanne O'Riordan Sent from my iPad

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RE: Severe Hypomagnesemia 2 days ago

Thank you for all the useful comments. Bicarbonate initially was 31 when he also had low K but, with amiloride use both K and Bicarbonate remain no...

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RE: Somewhat suppressed aldo, Primary aldosteronism or not? 2 days ago

@Hormaz Dastoor-thanks for your comments several points spironolactone >100mg/day may not be tolerated in men epleronone is an option if nece...

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RE: Obstructing Urinary Stone 2 days ago

The serum creatinine returned to her usual normal level (0.84mg/dL), approximately one week (or sooner) after laser fragmentation and removal of an...

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RE: Timing of blood sampling in twice-weekly hemodialysis regimens 3 days ago

Luis: I am not sure whether any data exists as to what is a good time to take the blood samples. Proponents of incremental hemodialysis (like Dr Ka...

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RE: Severe Hypomagnesemia 3 days ago

Other ideas or expansions of ones already suggested: (1) Other better tolerated Mg salts [citrate, aspartate, glycinate, gluconate, lactate (see NE...

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RE: recurrent intracerebral hemorrhagic stroke in a young female known case of hypertension VS ANCA associated vasculitis 3 days ago

TThank you, Dr. Mohammed. She has had multiple brain imaging studies, including CT angiography with stroke protocol, MRI, and MR venography. I...

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RE: recurrent intracerebral hemorrhagic stroke in a young female known case of hypertension VS ANCA associated vasculitis 3 days ago

Thanks for case 2023 icb with high bp active urine sediment Was mpo negative then +ve after introduction of hydralazine I am interested to know ...

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RE: another ANCA case 3 days ago

With 500 mg Rituximab , did you check for CD19 depletion. Also did the c- anca ever become negative during therapy or not ?? Guess in refractory ...

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RE: Severe Hypomagnesemia 3 days ago

Magnesium citrate if available has better absorption than the oxide Have u tried sglt2i.. --------------------------------- Dr. Hormaz Dastoor. ...

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RE: another ANCA case 3 days ago

Thank you, Dr. Glassock. ------------------------------ Amit Joshi Chicago IL ------------------------------

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