RE: Nephrotic syndrome, timing of the biopsy 1 hour ago

Agree with Dr Glassock, depending on how far away the biopsy is (ASAP IMO) a bit of tac and I would cut steroids until path available. This is a bi...

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RE: Minimal change disease 7 hours ago

Interesting. Have you subjected this regimen to a RCT.? ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 --...

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RE: Nephrotic syndrome, timing of the biopsy 7 hours ago

Stupid rule. Government practicing medicine. bad idea. But Tac would probably be better than steroid monotherapy. Just an opinion. ---------------...

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RE: Membrane Vs Centrifuge Plasma Exchange 7 hours ago

Use plasma IgG level (if FFP is not used as replacement fluid.) after accounting fir refilling rate. The two methods are quite comparable fir remov...

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Membrane Vs Centrifuge Plasma Exchange 8 hours ago

When comparing membrane vs Centrifuge plasma exchange, is there any idea about biomarker we can use to measure clearance or plasma removal efficien...

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RE: Nephrotic syndrome, timing of the biopsy 8 hours ago

thank you Dr. Glassock, Ritux is not available for us without biopsy - would you use Tacrolimus until we can get Ritux? -------------------...

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RE: Minimal change disease 9 hours ago

Hello Drs. In case of cramps on high dose of steroids I give Potassium tablets (check GFR), Vit-D+ Ca and cramps resolve. ------------------------...

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RE: Minimal change disease 12 hours ago

Despite loss of Vitamin D bound to protein in the urine in NS, a symptomatic decline in ionized calcium levels is very rare in NS. ---------------...

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RE: Nephrotic syndrome, timing of the biopsy 12 hours ago

I assume the PE are recent and not remote from the onset of NS. MCD and MN are the two major diagnostic possibilities. Stopping NOAC probably not a...

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RE: Minimal change disease 13 hours ago

Would like to know his Ca++ Mg++ levels - Proteinuria related Mg drag - - > leading to Hypocalcemia - Steroid related decreased intestinal Ca absor...

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RE: Minimal change disease 16 hours ago

Thank you Dr Balan, I am going to discuss this with them! ------------------------------ Bhavika Gandhi MD Nephrology Fellow Baylor Scott and Whit...

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RE: Minimal change disease 16 hours ago

Thank you Dr Rodby! ------------------------------ Bhavika Gandhi MD Nephrology Fellow Baylor Scott and White Bhavika[LastN[CompanyName] -------...

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Nephrotic syndrome, timing of the biopsy 17 hours ago

Hello, Would appreciate some advise about timing of biopsy and future treatment: I have a 31 year old female, admitted with nephrotic syndrome, a...

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RE: Advise about a patient with a new diagnosis of GN. 18 hours ago

I was more focused on the EM findings. The Haas and Eustace study clearly shows that mesangial ED deposits by EM are fairly common in typical antiP...

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RE: Advise about a patient with a new diagnosis of GN. 20 hours ago

Dr Glassock, while IC deposits can occur in pauci-immune GN, Haas paper is not clear on description of isolated C3 deposits. This paper https://pub...

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RE: Advise about a patient with a new diagnosis of GN. 20 hours ago

See Haas And Eustace - Kidney Int 2004; 65: 2145-2152. IC deposits by EM (especially in ) can be seen in "Pauci Immune" Necrotizing and Crescentic ...

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RE: Advise about a patient with a new diagnosis of GN. 20 hours ago

These findings are consistent with an anti-PR3 associated granulomatous Polyangiitis. The current treatment of choice is RTX, or combinations of RT...

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RE: Advise about a patient with a new diagnosis of GN. 21 hours ago

Infection related GN appears more likely of the three differentials to me. Presence of numerous electron dense mesangial deposits, is inconsistent ...

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Advise about a patient with a new diagnosis of GN. 22 hours ago

Dear ASN members I would like to discuss a case and get your opinion about diagnosis and management. I have a 35 years old male who was in excellen...

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RE: ANCA Vasculitis in peritoneal dialysis 22 hours ago

Despite being on dialysis , l have seen flares of ANCA vasculitis with typical lung involvement in patients still making urine . is this patient...

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RE: New Website: AGS/AGING Learning Collaborative 1 day ago

I attended the first webinar. Definitely a useful resource for those selecting outcomes for their studies. More broadly, this collaborative is real...

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RE: False positive / equocal anti gbm 1 day ago

Dr Cohney So was I and taught fellows to do same. But if Muscle mass is same, a plot of GFR vs time should give the same trend. The difference is ...

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ARPKD, 1 day ago

Is there any data regarding validation of MAYO clinic ADPKD calculator and / or use of Tolvaptan in ARPKD patients? I did find an ongoing study wi...

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RE: A 20 years boy with hemoptysis 1 day ago

Thank you very much Kidney size normal with intact CM differentiation , previous creatinine not available . Chest improving ,Pulmonologist opinion...

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RE: False positive / equocal anti gbm 1 day ago

In regards to Dr Glassocks comments about rate of rise of creatinine etc was always a great believer in plotting 1/serum creatinine to see if there...

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RE: A 20 years boy with hemoptysis 1 day ago

Thanks for providing all the information I can see a comment about the upper pole of kidneys but havent seen a comment about kidney size, corticom...

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RE: A 20 years boy with hemoptysis 1 day ago

Thank you All for great feedback Dr Glassock ,Dr Rhodby ,Dr shlomo, with your great feedback near to final diagnosis . Regards Dr Abdul Fatah sark...

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RE: A 20 years boy with hemoptysis 1 day ago

Dr shlomo ,Dr Glassock CT attached Renal biopsy tomorrow. ------------------------------ Abdul Sarki MBBS resident Diaverum Karachi 00927...

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RE: Permissive Hypernatremia in a CRRT patient 1 day ago

I prefer adding post-filter 3% saline infusion to achieve higher sodium levels while on CRRT without manipulating the dialyzate bags. Dr Yessayan a...

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RE: Minimal change disease 1 day ago

last resort for cramps Tonic water has a bit of quinine nothing like the dose that took quinine off the market bc of of Torsade "Tonic water cont...

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RE: ANCA Vasculitis in peritoneal dialysis 1 day ago

Dr Venkat, His hemoglobin dropped initially down to 6.9. He received one unit of PRBCs. He has been stable over the past 48 hours. His hemoptysis h...

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RE: Minimal change disease 1 day ago

Since cramping is a major adverse effect in this patient, if a CNI is chosen for further therapy, cyclosporine may be a better option. Cramps can b...

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RE: ANCA Vasculitis in peritoneal dialysis 1 day ago

What is the hemoglobin/hematocrit trend? This will give an idea about severity of pulmonary hemorrhage. If severe, PLEX may have to be considered. ...

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National O'Brien Center Kidney Seminars (NOCKS) 1 day ago

Please join us for the next NOCKS on Friday February 3rd hosted by UAB. Please Presentations will be held from 11:30 AM - 12:30 PM CT followed...

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National O'Brien Center Kidney Seminars (NOCKS) 1 day ago

Please join us for the next NOCKS on Friday February 3rd hosted by UAB. Please Presentations will be held from 11:30 AM - 12:30 PM CT followed by...

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Kidney Biopsies in Mice 1 day ago

Dear Colleagues, Happy 2023! I wonder if any of you have a protocol for performing kidney biopsies in mice in order to follow disease progression ...

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RE: ANCA Vasculitis in peritoneal dialysis 1 day ago

Thank you both for the responses. Dr Glassock, I do not have a prior anti-PR3 lvl. I am trying to reach his nephrologist to see if she has a prio...

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RE: Permissive Hypernatremia in a CRRT patient 1 day ago

If pharmacy refused to modify replacement /dialysate fluid sodium concentration. You can use online CRRT with high dialysate sodium as described he...

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RE: ANCA Vasculitis in peritoneal dialysis 1 day ago

Clinically this appears to be a re-exacerbation/flare of his ANCA vasculitis which is unusual in ESRD. Agree. GPA is much more likely to relapse t...

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RE: ANCA Vasculitis in peritoneal dialysis 1 day ago

Do you have an anti-PR3 antibody level before this episode when the patients was stable on PD?Low grade Positive ANCA can be observed in 15-20% of ...

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ANCA Vasculitis in peritoneal dialysis 1 day ago

I have a very delightful 74y.o. male with a history of granulomatosis with polyangiitis which resulted in ESRD for which he has been on peritoneal ...

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New Website: AGS/AGING Learning Collaborative 1 day ago

The American Society of Nephrology is pleased to share that the AGS/AGING LEARNING Collaborative has launched its website and published the first t...

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RE: Minimal change disease 1 day ago

I agree with Dr. Balan. This patient is behaving as Primary FSGS, not MCD, so aCNI would be the next step. But nephrotoxicity would be a big concer...

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RE: Minimal change disease 1 day ago

Cramps are a real pain for some patients on steroids. I would suggest checking vitamin D levels and correcting if low more out of hope than convict...

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RE: Minimal change disease 2 days ago

🙏🙏🙏 thank you. In that case should I be doing a fast taper on steroids and start on high dose tacrolimus? I was trying to do that but my patient...

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RE: Hiatal/Diaphragmatic hernia a contraindication for PD? 2 days ago

Anything that increases ip pressure will increase complaints of a diaphragmatic hernia, but it should be appreciated that on average ip pressure wi...

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RE: Kidney transplant dysfunction 2 days ago

No clear cut diagnosis/answers The practical problems Impaired renal function without apparent parnchymal pathology Potential issues with cyt...

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RE: Kidney biopsy in a patient on clopidogrel 2 days ago

Obviously, need to speak to the cardiologists - different views depending on particular lesions/position/complexity etc - if renal function is ok...

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RE: Minimal change disease 2 days ago

If misery loves company, I can share similar experiences of unexplained muscular cramps in nephrotic patients treated with steroids. I was never ab...

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RE: Kidney biopsy in a patient on clopidogrel 2 days ago

there is very little evidence to guide this decision, and as always, risk of bleeding vs. clotting should be considered. IMO, awaiting a full serol...

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