RE: Clinical trials for patients with Familial FSGS 8 minutes ago

The DUPLEX trial of Sparsentan enrolled some Genetic FSGS patients, but unfortunately it had no benefits for eGFR. I know of no clinical trials for...

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Clinical trials for patients with Familial FSGS 1 hour ago

Hello, I have a 27 year old female with familial FSGS (NPHS2) with c.965G>C and c.686G>A variants, both heterozygous. She continues to ha...

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RE: Timeline to use a new AV graft 2 hours ago

A lot of difference of opinion here- is the Vascular Surgeon really "wrong "- his opinion seems conservative and reasonable, under most circumstanc...

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RE: Timeline to use a new AV graft 2 hours ago

As for CHF and AVF, I think that is one of the most overlooked aspects of ESKD treated with AVF. To make my biased point I will upload my enti...

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RE: Timeline to use a new AV graft 2 hours ago

I don't agree with any of the statements except Dr. Rodby . The time to first canulate a n AVG depends on many factors as initially mentioned by...

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RE: Hyponatremia and misdiagnoses in a dog 5 hours ago

Bicarb hasn't been checked since 2022, it was normal at that time: 22 (ref range 13-27). Plan is to recheck it with electrolytes as we begin to tap...

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RE: Timeline to use a new AV graft 5 hours ago

I agree with Dr Hendrix. The surgeon expresses an important concern about AVFs and CHF; however, a fixed rule is rarely a good idea, especially in ...

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RE: Target Weight In New HD Starter 5 hours ago

Dr. Besarab- thanks for your very welcome comments coming from a long experience with handling fluid volume excess in dialysis patients. Your very ...

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RE: Dense deposit disease after kidney transplant and treatment options 5 hours ago

Thanks Dr. Balan. The case under discussion has recurrent DDD in a kidney allograft. Observational Experience with Eculizumab in this situation is ...

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RE: Target Weight In New HD Starter 6 hours ago

I agree that the great majority of incident ESRD patients are not at "ideal Body weight," and have extracellular volume excess. Please see the two-...

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RE: Hyponatremia and misdiagnoses in a dog 6 hours ago

On last analysis, blood glucose was 78 mg/dL and BUN was 18 mg/dL, both within the canine reference range. ------------------------------ JD Fost...

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RE: Timeline to use a new AV graft 6 hours ago

I also agree with the surgeon. A 4 week delay will allow most all of the post-op swelling to resolve making the initial cannulation much easier for...

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RE: Hypertension in athletic healthy patient 7 hours ago

Roger, Thanks for raising these points: I. Are the any clues, eg the degree of Aldo renin ration, absolute level of aldo etc? For instance, renin...

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RE: Dense deposit disease after kidney transplant and treatment options 7 hours ago

@Richard Glassock I am not sure the data on eculizumab is as good in C3GN as in complement mediated HUS. I thought cyclophosphamide for severe ca...

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RE: Dense deposit disease after kidney transplant and treatment options 11 hours ago

Thank you Dr. Glassock for the quick response .Unfortunately no EM report available . We are suspecting this is recurrent DDD after transplant ! It...

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RE: Dense deposit disease after kidney transplant and treatment options 14 hours ago

Do you have EM on any of the pre-transplant native kidney biopsies? De novo DDD post transplant is exceedingly rare . This is missy likely recurren...

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Dense deposit disease after kidney transplant and treatment options 15 hours ago

26-year-old female diagnosed with ESRD in 2015 after she had nephrotic syndrome An initial kidney biopsy done in 2012 for work-up for nephrotic sy...

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RE: Hypertension in athletic healthy patient 19 hours ago

I think the (classic) tip-off to a carcinoma if functional is the co-secretion of multiple hormones; aldo might even be low from excess cortisol, D...

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RE: Target Weight In New HD Starter 22 hours ago

If available, I would use Crit line to estimate dry weight . If not, probe dry weight using conventional signs (BP, symptoms). A 3% weight loss dur...

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RE: Target Weight In New HD Starter 23 hours ago

Thanks prof glassock. You would use crit line in first hd and use that to guide fluid removal and dry weight . And let says new starter to HD has h...

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RE: Timeline to use a new AV graft 1 day ago

I agree with the vascular surgeon. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ----------------------...

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RE: Target Weight In New HD Starter 1 day ago

Nearly all ESKD patients starting dialysis have excess ECFV that cannot readibly be detected by a standard PE. If the systolic BP is elevated and L...

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Target Weight In New HD Starter 1 day ago

Hi for new starters on HD how do we get a target weight ? I examined someone today and in our unit we do BCM. Clinical exam ( chest , jvp , periph...

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RE: Hypertension in athletic healthy patient 1 day ago

@Steven Gorbatkin "3.1 We recommend that all patients with PA undergo adrenal computed tomography (CT) as in the initial study in subtype test...

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RE: Hypertension in athletic healthy patient 1 day ago

I agree with Dr. Hirsch that a further workup may not be helpful for some patients. if a patient has no desire for surgery or other invasive tests ...

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RE: Timeline to use a new AV graft 1 day ago

A lot depends on the type of material used for the graft. Do you know what was used? @Monnie Wasse ------------------------------ Roger Rod...

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Timeline to use a new AV graft 1 day ago

We have a new vascular surgeon in town He wants to wait 4 weeks before using AV graft he has placed He also refuses to place a AV fistula in a pa...

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RE: IgA nephropathy with positive ANCA 1 day ago

With the onslaught of studies and agents for IgAN and so many different clinical and histologic presentations, I think all IgAN treatment decisions...

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RE: IgA nephropathy with positive ANCA 1 day ago

The optimal treatment of "crescentic" disease without RPGN in IgAN (?IgAV) with or without ANCA is one of the great unresolved conundrums in IgAN T...

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RE: IgA nephropathy with positive ANCA 1 day ago

The impact of treating a c2 (finrocellulsr) lesion in IgAN with "stable" , but reduced, kidney function using iS (RTX or other ) is not well unders...

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RE: IgA nephropathy with positive ANCA 1 day ago

I think I would treat the pr3, that level concerns me. I may be treating a lab test alone, a false positive if you will, but I'd rather error on th...

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RE: Renal infarction 1 day ago

Yes.In acute events IR usually evaluate and intervene if feasible by thrombolysis. in cases of smaller branches that are not amenable to interventi...

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RE: IgA nephropathy with positive ANCA 1 day ago

Checking CRP and ESR may help regarding possibility of active vasculitis. Since the initial biopsy in 2018 already showed crescents, it will be imp...

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RE: Renal infarction 1 day ago

Yes (by brain, assume meant head & neck). --------------------------------- Oded Friedman ---------------------------------

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RE: IgA nephropathy with positive ANCA 1 day ago

Can you supply the Oxford -MEST-C score, the urine sediment findings and the current level of urinary protein excretion and aFANA?. We also need to...

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RE: Hyponatremia and misdiagnoses in a dog 1 day ago

A plasma bicarbonate level availabls? ------------------------------ Alejandro Alvarez Ortiz MD Nephrology and Hypertension Specialists St. Louis...

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RE: Renal Biopsy In PAN 1 day ago

Probably not life-threatening. A more conservative approach to therapy may be indicated, and the ANCA titers and kidney biopsy will likely help the...

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RE: Renal infarction 2 days ago

Thank you so much Dr Marwan Abu Minshar . So will the angiogram be helpful ? Who would intervene if something is found ? IR? ------------------...

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IgA nephropathy with positive ANCA 2 days ago

A 34-year-old man with a history of IgA nephropathy, which has been evident since 2018 with crescent formation, was initially treated with a short ...

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RE: Renal Biopsy In PAN 2 days ago

No lung or heart affection or CNS affection , creat 200 --------------------------------- Mohamed Mahmoud MBBS NEPHROLOGIST MOH Egypt 00965 5...

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RE: Renal Biopsy In PAN 2 days ago

Knowing if cystic artery involved in GB (= MVV) vs acanthocytes/RBC casts (= SVV/GN) might help. I’d think therefore to biopsy only if: ANCA neg...

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RE: Renal Biopsy In PAN 2 days ago

What is the current Scr? Any sign of cardiac or lung involvement.? ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949)...

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RE: Renal Biopsy In PAN 2 days ago

This patient CKD base creat. 180 , so this not life threatening organ involvement is that correct ??” --------------------------------- Mohamed Ma...

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RE: Renal Biopsy In PAN 2 days ago

If PAN is confirmed by angiography or kidney biopsy (the latter often shows only non-specific features), the treatment is oral steroids, perhaps co...

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RE: Renal Biopsy In PAN 2 days ago

Thank you for the input Which better for abdominal angiogaraphy MRA Or Ct angio And if confirmed PAN What is your opinion regarding treatment o...

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RE: Renal Biopsy In PAN 2 days ago

PAN often skips the kidney small vessel parenchyma, glomeruli, vessels are too small. And ANCA is usually negative in PAN This patent has mild ev...

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RE: Renal Biopsy In PAN 2 days ago

I would suspect MPA or GPA as well. Performing ANCA should help as PAN is ANCA negative. If either anti-MPO or Anti-PR3 are positive this would "ru...

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RE: Renal Biopsy In PAN 2 days ago

You might be able to diagnose PAN by MRA. If that wasn't an option or had equivocal result, renal biopsy might help if you were able to capture blo...

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Renal Biopsy In PAN 2 days ago

Hi all can I know your opinion In 61 yr, HTN,CKD base creat 189. (5/23) Analgesic abuse Hist of cholecystectomy histology shown fibroid necrosis PA...

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RE: pregnant 24 yo WF with proteinuria/hematuria 3 days ago

Everything is micromanaged. As I have mentioned previously, I make no secret that I hove has primary aldosteronism for almost 30 years. The late Dr...

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