RE: 28 year old patient with severe myasthenia/myopathy whose strength significantly improves after dialysis. 14 minutes ago

"Anthony, Roger: Here is the paper that Roger tried to get. Coincidentally, it is from his institution! The authors made some very interesting obse...

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RE: Painless macroscopic hematuria 18 minutes ago

i would not assume he doesnt have sickle cell trait and would rule that out first ------------------------------ Roger Rodby MD, FASN Professo...

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RE: NEPHROCALCINOSIS 22 minutes ago

primary Hyperoxaluria 1-2 are all autosomal recessive so I dont see how this father and 2 uncles with ESRD could fit into this, (besides teh normal...

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Painless macroscopic hematuria 31 minutes ago

I would appreciate the community's advice in this 28 yr old healthy African American male was referred to me for evaluation of painless macroscopic...

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RE: interpretation of renal transplant ultrasound 1 hour ago

DR. Soobadar thanks for the 2 biopsy reports-nothing to suggest TG or acute rejection IMO though the most recent sample is small. if no fever or ot...

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RE: NEPHROCALCINOSIS 3 hours ago

Does ormal urinary oxalate excretion in this case dissuade you from diagnosing Primary Oxalosis? Genetic studies are definitely indicated. -----...

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RE: NEPHROCALCINOSIS 4 hours ago

A bit atypical case. This is primary hyperoxaluria until proven otherwise. This would be THE FIRST entity I would work hard to exclude; there is po...

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RE: 28 year old patient with severe myasthenia/myopathy whose strength significantly improves after dialysis. 4 hours ago

Roger: Here is the paper (coincidentally from your own institution, probably before your time) that you had trouble getting. Very interesting obser...

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RE: vasculitis anca 5 hours ago

Happy belated Independence Day Was she restarted on anticoagulation after first biopsy ? ( my understanding is yes) and would you use different f ...

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RE: vasculitis anca 16 hours ago

Considering the new information, I agree with Rituximab therapy and a steroid minimization protocol. No Avacopan. -----------------------------...

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RE: Resistant hypertension 16 hours ago

This meansxthat a considerable difference between albuminuria and total proteinuria . This is not glomerular proteinuria and could be interstitial ...

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RE: vasculitis anca 16 hours ago

Hi, biopsy; pauci immune crescentri gn, cellular crescent 2/20, fibrocellular in 1/20 35% global glomersulosclerosis 7/20 glomeruli no signi...

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RE: Resistant hypertension 17 hours ago

Thanks Dr George for providing follow up information. It’s a known fact that hypertension and kidney disease are like chicken and egg. That’s why ...

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RE: interpretation of renal transplant ultrasound 19 hours ago

biopsy 2014 Clinical Details: 63 year old male. ESRF secondary to reflux nephropathy. On haemodialysis since July 2014. DCD transplant on 17/11/20...

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RE: interpretation of renal transplant ultrasound 19 hours ago

sorry i am doing night shift now. the junior colleague could not do it so doing both consultant and intern/registrar shift Clinical Details: Dire...

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RE: 28 year old patient with severe myasthenia/myopathy whose strength significantly improves after dialysis. 21 hours ago

Anthony, Roger: Here is the paper that Roger tried to get. Coincidentally, it is from his institution! The authors made some very interesting obser...

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RE: Resistant hypertension 1 day ago

Its gram/gram. However I shall get a 24 hour urine protein estimation. We dont have access to a phase contrast microscopy to look for dysmorphic RB...

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RE: Resistant hypertension 1 day ago

Thanks Dr. Glassock, I added chlorthlidone 12.5 mg to her regimen now and I have hospitalised her. ------------------------------ Jaison George ...

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RE: Resistant hypertension 1 day ago

Thanks a lot Dr. Kesavan. I have hospitalised her today and shall quantify the 24 hour proteinuria. Her echo done in Dec 2025 shows EF 60%,Concentr...

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RE: Resistant hypertension 1 day ago

Please clarify units used for UPCR reports. ------------------------------ Richard Glassock MD, FASN Emeritus Professor Geffen School of Medicin...

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RE: interpretation of renal transplant ultrasound 1 day ago

Regarding UTI were the episodes symptomatic or only asymptomatic bacteriuria. I would not treat ASB and Candida are common colonizers with no signi...

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RE: interpretation of renal transplant ultrasound 1 day ago

Please post de-identified biopsy report ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KPCOP EC [Past Medical Director K...

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RE: Resistant hypertension 1 day ago

There is a chicken-and-egg question in this patient. Is uncontrolled hypertension causing hematuria and proteinuria, or is primary parenchymal kidn...

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RE: Post-surgical renal cortical necrosis in APS - continue PLEX / eculizumab / IVIG, or de-escalate? 1 day ago

I did a quick search, could not find any clinical trials using FcRn antagonists in APLA syndrome. Found two trials, one using anti-CD38 in APLA and...

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RE: interpretation of renal transplant ultrasound 1 day ago

For got to mention the article on Duel Kidney Transplant I referenced excluded oediatric en -bloc kidneys ------------------------------ [Mark] [...

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RE: interpretation of renal transplant ultrasound 1 day ago

current age 74 BK negative as well CMV and EBV not able to trace back operative note on electronic system but i ask transplant coordinator sus...

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RE: C3GN with lambda light chains 1 day ago

I fully understand the dilemma. Just an opinion, but I would be uncomfortable in initiating clone directed therapy is this patient in the absence o...

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RE: Clinical Use of burosumab 1 day ago

I have treated several pts and depending on how much calcitriol she is on, I would either stop it several days before or decrease it by 50 % and co...

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RE: Post-surgical renal cortical necrosis in APS - continue PLEX / eculizumab / IVIG, or de-escalate? 1 day ago

Dr.Achkar - very interesting case report. Thanks. Are you aware of any trials of FcRN antagonism in clinically active APLA syndrome to help validat...

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RE: Resistant hypertension 1 day ago

I highlighted this many RBC’s from day one besides resistant hypertension --------------------------------- Conjeevaram Kesavan MD, MBBS, FASN ...

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RE: Steroid-refractory seronegative demyelinating encephalitis in a kidney transplant recipient 1 day ago

yes, that is correct - initial thought was adem more iikely than glioma. now glioma higher in differential ------------------------------ Vijaya...

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RE: Post-surgical renal cortical necrosis in APS - continue PLEX / eculizumab / IVIG, or de-escalate? 1 day ago

Thank you, IgG anti-cardiolipin and B2GPI antibodies have the highest titers and are considered more relevant than the IgM subtypes. I would sugges...

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RE: Post-surgical renal cortical necrosis in APS - continue PLEX / eculizumab / IVIG, or de-escalate? 1 day ago

we are considering to stop eculizumab as the last plex we were able to show a reduction in apl ab, we are hoping to monitor the levels and repea...

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RE: Post-surgical renal cortical necrosis in APS - continue PLEX / eculizumab / IVIG, or de-escalate? 1 day ago

------------------------------ Vijayakumar Paramasivam MD Nephrologist Renal and Transplant Associates of the North East Springfield MA (484) 362-3...

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RE: 28 year old patient with severe myasthenia/myopathy whose strength significantly improves after dialysis. 1 day ago

Tony: I am curious to know the answer to the question of whether you were cooling the patient while on HD. best regards...Prem Chandran

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RE: interpretation of renal transplant ultrasound 1 day ago

Dr. Venkat, the Wisconsin-Madison group recently published an article on Duel Kidney Transplants- 71% of 100 were placed unilaterally in the iliac ...

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RE: Resistant hypertension 1 day ago

Agree with Dr. Glassock - " Urinalysis shows active urinary sediments (" many RBCs"), trace albumin but UPCR is 1.9." does not suggest GN unless p...

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RE: Clinical Use of burosumab 1 day ago

@Stuart Sprague ------------------------------ Roger Rodby MD, FASN Professor of Medicine Rush University Nephrology Associates Chicago IL (773) ...

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Clinical Use of burosumab 1 day ago

I am treating my first patient with X-linked hypophosphatemia and after some delay have received authorization to give her burosumab. (anti-FGF23 m...

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RE: Dialysis Core Curriculum 2 days ago

Thank you for sharing. Looking forward to reviewing this material. ------------------------------ Gurwant Kaur MD FASN Associate Professor of Me...

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Dialysis Core Curriculum 2 days ago

Dear Nephrology Educators: We wanted to reach out and share a new curricular opportunity that is available in the Dialysis Education space from AS...

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RE: C3GN with lambda light chains 2 days ago

Thanks for this. I will arrange for AP complement testing. im curious though - are there any tests that will change ultimate course of management...

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RE: interpretation of renal transplant ultrasound 2 days ago

"urine acr 3" Units? Is it 3 g/g? If heavy albuminuria, given (de novo?) DQ antibody, need to consider transplant glomerulopathy/chronic AMR. N...

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RE: Post-surgical renal cortical necrosis in APS - continue PLEX / eculizumab / IVIG, or de-escalate? 2 days ago

What are the titers and types of antiphospholipid antibodies ------------------------------ Katafan Achkar MD, FASN Houston Methodist Hospital an...

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RE: Resistant hypertension 2 days ago

I agree with other comments that further investigation of hematuria/proteinuria are warranted to investigate possible intrinsic renal cause of seco...

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RE: C3GN with lambda light chains 2 days ago

Thanks a lot --------------------------------- Shahzad Safdar MD Mt. Auburn Nephrology, Inc. Cincinnati OH (513) 841-0222 --------------------...

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RE: C3GN with lambda light chains 2 days ago

See Jokiranta TS, et al. J Immunol 1999; 163: 4590-4596 for the index case of Lambda monoclonal indirect causation ( via a bifunctional nano body )...

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RE: C3GN with lambda light chains 2 days ago

Reports that are mostly lambda and seldom kappa. ------------------------------ Richard Glassock MD, FASN Emeritus Professor Geffen School of Med...

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RE: C3GN with lambda light chains 2 days ago

Dr Glassock thanks have a question Is it only lambda or can Kappa monoclonal chains also interfere with the action of Factor H on C3 Thanks --...

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RE: Resistant hypertension 2 days ago

Marked hematuria- but no description of erythricyte morphology , Trace albuminuria , but UPCR of 1.9gm/gm or is it mg/micromol? This is not the pat...

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