RE: Proteinuria 23 hours ago

I think it makes very good sense to use the Lymphoma protocol for RTX based treatment of PGMID when the offending (neoplastic) clone is unknown or ...

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RE: Tubule interstitial Nephritis 23 hours ago

I just want to discuss the biopsy report on this particular patient please see my original post regarding her history. Light microscopy reveals 22%...

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RE: Proteinuria 23 hours ago

​I use the 375 mg/m2.  Steroids is given with rituximab as a prophylaxis for infusion reaction but no additional steroid is given. ----------------...

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IS pneumonia 1 day ago

Gentleman age 39 status post kidney transplant cadaveric in November, 2016,with walking pneumonia,on mycophenolate and tacrolimus, any suggestions ...

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RE: tunneled catheter removal 1 day ago

​I remove about 2 permcaths per week for 21 years. I have taken a brand new catheter (outside of the patient) and pulled on both sides as hard as I...

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RE: When is the optimal time for AVF placement? 1 day ago

Remote ischemic conditioning plays little role in prevention of post cardiac surgery Aki based on meta-analysis and a few small RCT. Sent from my i...

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RE: When is the optimal time for AVF placement? 1 day ago

Does remote ischemic remodelling has any role? --------------------------------- Bajinder Reen MD Brampton ON (905) 453-0821 ----------------------...

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RE: When is the optimal time for AVF placement? 1 day ago

Timing of AVF placement is, and will continue to be, a dilemma, especially in elderly population which currently represent the major proportion of ...

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Renal Pathology Video Episodes 1 day ago

I’m Tim Yau, and I’m a clinical nephrologist and medical educator at Washington University in St. Louis.  In 2015, I created the Wash U Nephrology ...

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RE: Lupus membranous GN treatment 1 day ago

Based on a meta-analysis of available publushed trials there is no clear evidence of superior efficacy for induction of remission in Class III +V L...

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RE: Lupus membranous GN treatment 1 day ago

I am not sure that this protocol is applicable to your patient and longer term FU failed to show any superiority to the comparator. See Ayoub and R...

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RE: Rituximab 1 day ago

There is a presumption of equivalence based on verified composition. But to my knowledge, none of the Rituxan biosimilars have undergone rigorous R...

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Rituximab 1 day ago

I have been asked if there is any difference in efficacy among the different rituximab and biosimilars available and whether they can be used inter...

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RE: diuretics and measurement of urinary sodium 1 day ago

This is an important point, often misunderstood, diuretics bring you to a lower total body sodium and try to keep you there. Otherwise you woukd sh...

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RE: IgA Nephropathy with Proteinuria 1 day ago

If steroids are to hVe an effect it may take months to appreciate so I'd complete the course, unless this infection dictates otherwise. -----------...

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RE: Lupus membranous GN treatment 1 day ago

Tac may be faster than cyclophosphamide as it works directly on the podicytes. I'm not sure if this translates into improved long term prognosis. I...

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RE: Lupus membranous GN treatment 2 days ago

Thank you Dr. Glassock. Yes I am going to discuss anticoagulation with him- wanted to do kidney biopsy first. In regards to tacro+mmf I was referen...

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Follow up from Kidney Week 2019 2 days ago

Hi fellow Kidney Educators! I hope you all of have recovered well from Kidney Week! We saw some amazing presentations at Kidney Week from both the ...

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RE: Lupus membranous GN treatment 2 days ago

This patient might need prophylactic anti-coagulation, if no contra-indications exist, as the risk of a VTE is fairly high. Sent from my iPad

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RE: Lupus membranous GN treatment 2 days ago

Creatinine 0.8 alb < 1  upc 6.7 gram ------------------------------ Sumeyye Calp Inal MD Attending Physician (Nephrology) Salem VA Medical Center S...

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RE: Dialysis helping gout ? 2 days ago

I agree, with an eGFR under 30ml/min/1.73m2 Indapamide is not very natriuretic, although this is not well studied, IMO.  More aggressive xanthine o...

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RE: Lupus membranous GN treatment 2 days ago

This lesion might be categorized as Class III + Class V LN. I don’t think that good evidence is available to suggest that any one of the 3 apprsoch...

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Lupus membranous GN treatment 2 days ago

​Dear community members, I would appreciate input from you all in regards to the treatment of Lupus membranous. I have a 40 yo AA male who presente...

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RE: Dialysis helping gout ? 2 days ago

I doubt indapamide would have much diuretic effect at this given eGFR --------------------------------- Amar Mahdi MBChB University Hospital Birmin...

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RE: IgA Nephropathy with Proteinuria 2 days ago

UPDATE: ​Started patient on Prednisone. Repeat labs after 2 1/2 weeks of prednisone therapy. BUN 48 Cr 1.92 K 5.1 Na 136 Bicarb 24 UA Protein 2+, b...

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RE: diuretics and measurement of urinary sodium 2 days ago

Patients receiving diuretics usually eventually come into sodium balance, albeit with a slight- moderately reduced ECFV, depending on the initial r...

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RE: Rituximab Dose In MCD 2 days ago

I am facing the same challenge. Insurance has denied 1st request, going for next step which is appealing then it will be Peer to peer review. Thank...

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diuretics and measurement of urinary sodium 2 days ago

​I have a general question about urinary sodium measurement in someone on chronic diuretics. Specifically, this has come up in patients with calciu...

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RE: Proteinuria 2 days ago

Dr.Leung,  You had mentioned that you have treated patients with PGNMID with no detectable clone and negative bone marrow with 8 weeks of Rituximab...

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RE: Dialysis helping gout ? 2 days ago

Lowering Uric acid could be beneficial.  Rapid lowering with xanthine oxidase inhibitors can ppt gout flare.  If this is "uncontrolled gout" and yo...

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RE: Dialysis helping gout ? 2 days ago

IMO, uric acid > 10 plus active gout means not enough allopurinol. The dose should be titrated against the uric acid level, even in CKD. ----------...

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RE: tunneled catheter removal 2 days ago

I've been asked to weigh in, but have little to add to the discussion above.  If the catheter does not pull out with steady moderate force, I favor...

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RE: Dialysis helping gout ? 2 days ago

Indapamide is a diuretic that is said to produce less hyperuricemia. Sent from my iPad

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RE: When is the optimal time for AVF placement? 2 days ago

When the first article to show this was published, there was a discussion on this. One of the discussants felt that this could be just regression t...

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RE: When is the optimal time for AVF placement? 2 days ago

I agree with Bob. It is quite possible that the slowing of CKD progression after AVF placement was caused by the patients realizing that dialysis w...

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RE: risk of transmission of Thsd7A ab to fetus 2 days ago

thank you, this is encouraging! Will let you know how this goes for this lady. ------------------------------ Mark Nader MD Kidney Care Consultants...

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RE: Rituximab Dose In MCD 2 days ago

We have been able to obtain rituximab for most patients in this circumstance (although sometimes requires appeals, peer to peer review, etc). Ther...

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RE: Dialysis helping gout ? 2 days ago

Orthopedic did not find the painful joint "tap able " and the pain has also improved but uric acid is more than 10 and he is admitted with cardiore...

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RE: tunneled catheter removal 2 days ago

I agree as previously suggested that the main point of adherence is at the cuff , however thick subcutaneous fibrin sheath can wrap tightly against...

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RE: tunneled catheter removal 3 days ago

Although the subcutaneous cuff is the intended site of fibrosis/ anchoring site, in this case, it appears that a catheter fragment fibrosed into in...

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RE: tunneled catheter removal 3 days ago

Chiming in again -  The only point of adherence of the catheter is the cuff. Beyond that to the tip, yes, the sheath encases the catheter but does ...

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RE: tunneled catheter removal 3 days ago

Great discussion everyone, we usually dissect around the cuff if it is close to the exit site, with some traction, it comes out.  If not, we may d...

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RE: renal biopsy in CML patient with acute kidney disease 3 days ago

Yes CML. Already off cefepime completed course and discharged home .  Today his urine analysis found negative blood, 30 protein, 2 white cells, few...

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RE: tunneled catheter removal 3 days ago

Athough I have not personally come across this problem,   there are reports of "Stuck" or difficult to remove HD catheters in the literature. Ebad,...

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RE: risk of transmission of Thsd7A ab to fetus 3 days ago

For your info, we had a case of PLA2R1-associated MN in a French mother and I was just told that she delivered recently, with a healthy baby and mo...

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RE: tunneled catheter removal 3 days ago

As l posted the ref last week Was once in that situation, catheter was removed by endoluminal dilation by IR Bajinder Reen Sent from my iPhone Spel...

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RE: tunneled catheter removal 3 days ago

The method of endoluminal angioplasty works quite well in this situation. There only needs to be minimal expansion of the catheter for it be freed ...

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RE: tunneled catheter removal 3 days ago

To answer the initial three questions:  1) Where is the adherent tissue? - subcutaneous tissue - mostly around the cuff    2) What is it adhering t...

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When is the optimal time for AVF placement? 3 days ago

ASN In The Loop on Nov 26, 2019 reported that "AVF Creation May Slow Kidney Function Decline in Predialysis Patients". It stated "The BMC Nephrolog...

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RE: Rituximab Dose In MCD 3 days ago

The more rapid B cell return with larger patients is an anecdotal observation, but planning to look at this in our cohort and see if there is a sig...

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