RE: unusual creat in a rhabdo patient 4 minutes ago

This level of CK is seen in ultramarathoners and frequently they do not have AKI or rise in creatinine.  In presence of normal kidney pushing fluid...

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RE: Piperacillin-tazobactam Vs Amikacin In CKD 19 minutes ago

“In CKD, the single nephron GFR is way up and the amikacin load per nephron should be high and risk damage.” If extended-interval AG dosing is the...

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Minimal Change Disease 37 minutes ago

I have a 50 year old white male with nephrotic syndrome with 11gm of protein. His biopsy in 2017 showed minimal change disease. He was treated with...

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Joubert syndrome secondary to (cc2d2a) homzygous mutatation nephrological associations?? 2 hours ago

Good evening dear doctors, I have encountered an interesting case in the nephrology clinic with my attending physician yesterday. It was a patient ...

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RE: unusual creat in a rhabdo patient 2 hours ago

I think part of that question is--hypothetically--if a normal person with normal kidney function was infused with a ton of (muscle) creatine and CP...

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RE: Exostosin associated membranous nephropathy 3 hours ago

We do not yet know how the identification of the Exostosin + sub-type of MN in patients with auto -immune disease (SLE, Sjogren’s , MCTD, etc) shou...

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RE: unusual creat in a rhabdo patient 4 hours ago

well I suppose so,  a lot of the rhabdo associated AKI is traumatic and then you are almost certainly going to be volume depleted, maybe these heal...

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RE: Exostosin associated membranous nephropathy 4 hours ago

So this is classic exostosin MGN that is autoimmune related like that seen in lupus.  If she had lupus, and this were class 5 and you didnt have ex...

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RE: Reflux Nephropathy ? Superimposed GN 4 hours ago

If urine cleared it is hard to argue for a renal biopsy now. My money is still on IgAN and it will come back and then you can go through this diag...

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RE: Piperacillin-tazobactam Vs Amikacin In CKD 4 hours ago

I agree with using pip/tazo over amikacin but am surprised that you would not expect to see nephrotoxicity in advanced CKD from an aminoglycoside....

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RE: Piperacillin-tazobactam Vs Amikacin In CKD 5 hours ago

I think nephrotoxicity of amikacin is well defined whereas the nephrotoxicity of pip/tazo is mainly in combination with vancomycin and by itself to...

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RE: Reflux Nephropathy ? Superimposed GN 5 hours ago

Her creat at 1.3 mg/dL UA with no protein, trace of blood Protein/creat 200 mg/g creatinine BP: 120/82 No kidney biopsy at this time as it will not...

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RE: Exostosin associated membranous nephropathy 5 hours ago

Albumin is 3.1 ------------------------------ Fariba Zarinetchi MD, FASN Kidney Specialists of South Texas Corpus Christi, TX (361) 887-8451 -----...

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RE: Dataset for de novo DSA in renal transplant recipients? 9 hours ago

Correct. Thank you for bringing them up. I am not surprised to hear about the alleged sensitizing effects of the Covid vaccines and expect to see r...

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RE: Hep B Core Positive And Risk Of Liver Cancer 10 hours ago

I think only in immunosuppressed patient like in our kidney transplant pts or I have another patient who I am giving Rituximab for ANCA vasculitis ...

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RE: Reflux Nephropathy ? Superimposed GN 13 hours ago

Can the right pyelonephritic shrunken kidney be the source of high blood pressure? The shrunken pyelonephritic kidney may cause ischemia  as renal ...

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RE: unusual creat in a rhabdo patient 13 hours ago

So would I be right in saying that even if your CK is greater than 1 000 000, but you are well hydrated , Creatinine can be normal --------------...

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RE: Hep B Core Positive And Risk Of Liver Cancer 15 hours ago

Is Entecavir indicated in HBc antibody positive patients with no clinical evidence of cirrhosis and no circulating HBV genome in the circulation by...

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RE: Exostosin associated membranous nephropathy 15 hours ago

Whatisthebpatidnts serum albumin .  If normal, I would be very conservative.  Probably RASi only.  The Azathioprine is probably accomplishing  very...

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RE: Hep B Core Positive And Risk Of Liver Cancer 16 hours ago

Thanks for everyone’s input. patient does not have evidence NASH or cirrhosis on imaging never had liver biopsy liver function tests are normal ...

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Piperacillin-tazobactam Vs Amikacin In CKD 16 hours ago

Inquiring if there are head to head study as to potential for nephrotoxicity of piperacillin-tazobactam vs amikacin when used as monotherapy. If we...

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Exostosin associated membranous nephropathy 17 hours ago

I have a 40 year female patient, with history of sjogren's, Creat is normal at 0.7 Nephrotic range if proteinuria, in excess of 4 grams a day.  kid...

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RE: Dataset for de novo DSA in renal transplant recipients? 18 hours ago

I have heard of the "molecular mimicry" hypothesis - that certain viral antigens (especially CMV) may have antigenic similarities to human HLA anti...

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RE: Dataset for de novo DSA in renal transplant recipients? 18 hours ago

@Howard Gebel Several viruses have been incriminated as triggers of sensitization but the most notorious one is CMV (see attached). SARS-CoV-2 can...

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RE: Dataset for de novo DSA in renal transplant recipients? 19 hours ago

Just curious, what kind of  viral infections are known to evoke de novo DSA. ------------------------------ Richard Glassock MD, FASN Emeritus Pro...

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RE: Reflux Nephropathy ? Superimposed GN 19 hours ago

She is coming Thursday for follow-up. Awaiting on her repeat lab done late Monday at pcp office. She had cysto and ureterscopy: Both kidney showe...

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RE: Dataset for de novo DSA in renal transplant recipients? 21 hours ago

Actually this phenomenon is not new. For years we have known that patients can get sensitized as a result of previous transplants, blood transfusio...

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RE: Dataset for de novo DSA in renal transplant recipients? 21 hours ago

Wow-!! - that is an eye-opening experience. Thanks for sharing. Post-COVID DSA monitoring certainly seems worthwhile . I suppose the same is the ca...

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RE: Reflux Nephropathy ? Superimposed GN 22 hours ago

Dr. Wehbe: Any updates on your patient? Current SCr, hematuria resolved or not, current UAlb/Cr and/or UPr/Cr and kidney biopsy result (if done)? ...

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RE: Use of IVIG in ABO incompatible desensitisation protocol 23 hours ago

Again this paper for which I reviewed prior to my initial answer raises caution with very high doses vs low dose IVIG . The latter is more commonly...

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RE: unusual creat in a rhabdo patient 1 day ago

"my question is – why is his creatinine not higher with a CK of over 100,000" I would say because he does not have AKI, despite having, what appea...

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RE: Sodium Thiosulfate-PICC or Port 1 day ago

STS appear to be at best adjuvant in these patients.  Aggressive phos control and dialysis is the best.  Vitamin K does not hurt. Low dose bisphosp...

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RE: unusual creat in a rhabdo patient 1 day ago

My marathon runner knew the dangers of salt and water depletion and thus was careful. His wife made sure along the route to provide both and encour...

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RE: Dataset for de novo DSA in renal transplant recipients? 1 day ago

Reached out to Matthew Cooper, MD President, United Network for Organ Sharing (UNOS) who responded this project is in progress. I can tell you my ...

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RE: FSGS- Pull the trigger on Steroids 1 day ago

Just as a followup, i spoke to the patient again today. She is unable to visit me as she lives nearly 300 kms away. However it seems that while sh...

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RE: unusual creat in a rhabdo patient 1 day ago

Thanks- a real classic paper, worth reading again. So the serum creatinine Level in the patient posted is not all that “unusual”, but rather explai...

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RE: unusual creat in a rhabdo patient 1 day ago

excerpts above from attached ------------------------------ Roger Rodby MD, FASN Professor of Medicine Rush University Medical Center Chicago IL ...

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RE: unusual creat in a rhabdo patient 1 day ago

you need more than just myoglobinuria: ------------------------------ Roger Rodby MD, FASN Professor of Medicine Rush University Medical C...

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RE: Hep B Core Positive And Risk Of Liver Cancer 1 day ago

A recent review has clarified the various factors associated with hep B and HCC. https://hrjournal.net/article/view/3851 The direct oncogenic eff...

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RE: Dataset for de novo DSA in renal transplant recipients? 1 day ago

Very interesting question, but how can you evaluate causality from such a data-base? --------------------------------- Richard Glassock MD, FASN ...

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RE: Hep B Core Positive And Risk Of Liver Cancer 1 day ago

So is it cirrhosis that is associated with cancer risk or integration of the viral genome into the host genome that confers the risk, or both? ---...

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RE: unusual creat in a rhabdo patient 1 day ago

Great to learn about this nuance in Rhabdomyolysis. I wonder If the phenomenon is limited to exercise -induced Rhabdomyolysis.. ------------------...

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RE: unusual creat in a rhabdo patient 1 day ago

This patient reminds me of a very similar case some years ago in Texas, a young man in his 20s who had exertional rhabdo from waterskiing on a very...

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RE: Hep B Core Positive And Risk Of Liver Cancer 1 day ago

As I understand, anti HBc patients, in their risk of developing HCC, can be of two types. 1. Those who developed infection with HBV and became ne...

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RE: Dataset for de novo DSA in renal transplant recipients? 1 day ago

I am seeking for number of kidney transplant recipients who developed de novo DSAs in 2020-2021 and their COVID infection status. Thank you ------...

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RE: Dataset for de novo DSA in renal transplant recipients? 1 day ago

What specific data are you seeking? --------------------------------- [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KPCOP EC [Past Medical Director Kidn...

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Dataset for de novo DSA in renal transplant recipients? 1 day ago

Is there any resource for the data of de novo DSAs in kidney transplant recipients in the US? Looked into the UNOS and SRTR websites but could not ...

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RE: unusual creat in a rhabdo patient 1 day ago

Thank you for the input. The gentleman's CK is dropping dramatically and I plan on discharging him tomorrow and digging more into his history If he...

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RE: unusual creat in a rhabdo patient 1 day ago

This reminds me of a patient (actually a Nephrology fellow) I saw in 1978, a long distance runner, who trained hard, and who was evaluated for very...

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RE: unusual creat in a rhabdo patient 1 day ago

Hi Dr. Lautman, As Dr. Rodby intimated, myoglobin per se may not be "nephrotoxic" in that at least animals infused with myoglobin do not develop ...

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