RE: Acute TMA-Renal limited-Remote GVH 2 hours ago

Many potential causes of endothelial damage and TMA here : GVHD, radiation (if done pre BMT) mtomycin. I have to disagree with your Oncologists, I ...

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RE: Renal Transplant Recipient with Severe Nephrotic Syndrome and AKI in the Setting of CMV Viremia 6 hours ago

I am unclear if APOLLO will asses the impact of birth weights on long term functional outcomes . The use of eGFR as the functional outcome measure ...

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RE: Acute TMA-Renal limited-Remote GVH 8 hours ago

Was immunotherapy used to treat bladder cancer? ------------------------------ Ashraf El-Meanawy , MD, MS, PHD, FASN Professor of Medicine Director...

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RE: Renal Transplant Recipient with Severe Nephrotic Syndrome and AKI in the Setting of CMV Viremia 10 hours ago

I would refuse a 30 year old. But if a 50 yo donor with the same profile dame up, I would consider. The Apollo Trial (ClinicalTrials.gov Identifier...

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RE: Renal Transplant Recipient with Severe Nephrotic Syndrome and AKI in the Setting of CMV Viremia 11 hours ago

Short question - would you allow an A-A with two high risk APOL1 alleles who is age 30 years and had a known birth weight of 2.0 Kg. to serve as l...

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RE: Renal Transplant Recipient with Severe Nephrotic Syndrome and AKI in the Setting of CMV Viremia 13 hours ago

* fraction, not reaction. --------------------------------- Irfan A Agha, MD, MRCP (UK) Dallas Renal Group Dallas, TX 2108375495 ------------------...

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RE: Renal Transplant Recipient with Severe Nephrotic Syndrome and AKI in the Setting of CMV Viremia 13 hours ago

I don’t think we have data to take that step. Just a back of the napkin calculation will place AA donors (living and deceased) at about 3000 a year...

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RE: Renal Transplant Recipient with Severe Nephrotic Syndrome and AKI in the Setting of CMV Viremia 14 hours ago

The question is until more data is available such as ‘APOL1 Long-term Kidney Transplanation Outcomes”  - should transplant physicians not use AA Ki...

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RE: Renal Transplant Recipient with Severe Nephrotic Syndrome and AKI in the Setting of CMV Viremia 17 hours ago

As I posted earlier, in theory ANY viral infection capable of evoking a brisk interferon response is potentially capable of causing Collapsing Glom...

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RE: tunneled catheter removal 17 hours ago

In the situations when I had a tunnneled catheter that was tethered to the SVC, I noted that the SVC was stenosed/sub-totally occluded following r...

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RE: 14 Yr Old Female With Nephrotic Range Proteinuria And Hypertension 18 hours ago

Yes- this is precisely my argument (but admittedly not an iron-clad one). See Awanami et al BMC Nephrol 2017. This case report is suggestive only, ...

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RE: tunneled catheter removal 20 hours ago

In the situations when I had a tunnneled catheter that was tethered to the SVC, I noted that the SVC was stenosed/sub-totally occluded  following r...

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RE: tunneled catheter removal 20 hours ago

This was very helpful information Swapnil!

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RE: Renal Transplant Recipient with Severe Nephrotic Syndrome and AKI in the Setting of CMV Viremia 21 hours ago

Update: The donor in the posted case was a young African American . I am trying to find out what happened to the recipient of the mate kidney from ...

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RE: AMS for how long should you dialyzes? 21 hours ago

I agree. Withdrawing care is often an enormous and angst-filled decision and I have no problem with one or two HD treatments that I am sure will no...

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RE: Renal Transplant Recipient with Severe Nephrotic Syndrome and AKI in the Setting of CMV Viremia 22 hours ago

With reference to viral infection and collapsing glomerulopathy,in addition to  HIV, CMV, Hepatitis C, Parvovirus B19 should also be kept in mind ....

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RE: 14 Yr Old Female With Nephrotic Range Proteinuria And Hypertension 23 hours ago

@K.K. Venkat @Glassock , while the data for the role of intracellular lipid signaling in podocyte disorders is growing  and we will see soon drugs ...

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RE: MPGN in biopsy 23 hours ago

Can you send a cf dna to see if cancer is active ? Sent from my iPhone

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RE: tunneled catheter removal 23 hours ago

Agree with Dr Martin in endoluminal dilatation. Done by the right people, it’s safe and effective See a couple of papers from our centre1. https://...

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RE: AMS for how long should you dialyzes? 23 hours ago

"You need to develop a relationship with your consulting physicians and ask them to trust your judgement" I suppose, but often these are - withdraw...

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RE: MPGN in biopsy 23 hours ago

I missed the part about receiving prednisone. Is that specifically for the GN? I agree to stop the chemo and see and have no problem starting stero...

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RE: 14 Yr Old Female With Nephrotic Range Proteinuria And Hypertension 23 hours ago

Dr. Glassock, Please clarify the following statement: " Your hypothesis is undermined, to some extent, by the observation that treatment with PCSK9...

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RE: IgM Nephropathy 23 hours ago

I agree. From the start I approached this like MCD or an MCD variant which regardless means a trial of steroids. In the end this will be defined by...

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RE: Renal Transplant Recipient with Severe Nephrotic Syndrome and AKI in the Setting of CMV Viremia 1 day ago

This would be an excellent question in many patient populations, but these three to begin with: 1. Transplant recipients from AA donors who develop...

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RE: IgM Nephropathy 1 day ago

I do not understand the discussion. On renal biopsy,  LM shows minimal changes without lesions of FSGS. By IF, there are IgM deposits. In children,...

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RE: Renal Transplant Recipient with Severe Nephrotic Syndrome and AKI in the Setting of CMV Viremia 1 day ago

The corollary question is whether IFN inhibitors (such as Anifrolumab) would benefit IFN associated Collapsing Glomerulopathy? Sent from my iPhone

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RE: 14 Yr Old Female With Nephrotic Range Proteinuria And Hypertension 1 day ago

The plot thickens. My hypothesis is that you need a profound reduction in plasma LDL-C levels (such as achievable with PCSK9 inhibition) to improve...

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RE: 14 Yr Old Female With Nephrotic Range Proteinuria And Hypertension 1 day ago

Your hypothesis is undermined, to some extent, by the observation that treatment with PCSK9 inhibitors can induce a remission in Primary FSGS witho...

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RE: MPGN in biopsy 1 day ago

i spoke with oncologist, her CML is well controlled in remission x 4 years he was planning to stop it after 5 years but now after this biopsy might...

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RE: MPGN in biopsy 1 day ago

The MPGN pattern of injury is usually secondary to infections, autoimmunity, drugs, and cancer (liquid and solid). I would bet on medications here,...

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RE: 14 Yr Old Female With Nephrotic Range Proteinuria And Hypertension 1 day ago

Dr. Peev: I raised the question about the role of lipoprotein lowering in treating FSGS because the Zaritsky paper you had listed includes the foll...

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RE: 14 Yr Old Female With Nephrotic Range Proteinuria And Hypertension 1 day ago

Dr. Venkat, My hope is that the response to the treatment occurred due to concomitant removal of the circulating factor via the apheresis column ra...

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RE: Post renal transplant hematoma 1 day ago

I agree/ good point. Sent from my iPhone

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RE: 14 Yr Old Female With Nephrotic Range Proteinuria And Hypertension 1 day ago

I agree Sent from my iPhone

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RE: MPGN in biopsy 1 day ago

Interesting case Dasatinb usually causes a tma. Here is a cAse series we had published https://journals.sagepub.com/doi/abs/10.1177/239936931988797...

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RE: MPGN in biopsy 1 day ago

dasatinib as a tyrosine kinase inhibitor the typical lesion is a TMA c/w VEGF inhibition. Immune complex gn is not really described but it us hard ...

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RE: 14 Yr Old Female With Nephrotic Range Proteinuria And Hypertension 1 day ago

Since LDL and VLDL removal by apharesis is beneficial in FSGS as mentioned by Dr. Peev, wonder whether therapy with the newer monoclonal antibodies...

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RE: MPGN in biopsy 1 day ago

Found following references regarding proteinuric renal disease in the setting of dasatinib therapy for CML. However, causal relationship is difficu...

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RE: HD for Vanc nephrotoxicity 1 day ago

Good question.  This paper is a pretty good review:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5579760/ It's interesting that the paper doesn't ...

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RE: Post renal transplant hematoma 1 day ago

Agree with Dr. Rodby that Page Kidney is (fortunately) uncommon. Subcapsular (confined space) rather than extracapsular/perinephric location of a l...

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RE: AMS for how long should you dialyzes? 1 day ago

Hospitalist not hospitality. (You can see I am a product of the Chicago public school system). ------------------------------ John Mellas MD Nephro...

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RE: Bicarb on labs 1 day ago

Agree with all.  [HCO3] on the ABG is mathematically estimated and accurate. The BMP measures total dissolved venous CO2 which is "primarily"  HCO3...

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HD for Vanc nephrotoxicity 1 day ago

​Hey folks​, I have a 78yo woman with previously normal renal function (creatinine 0.5 GFR 107 8 days prior to presentation) who was initiated on v...

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RE: 14 Yr Old Female With Nephrotic Range Proteinuria And Hypertension 1 day ago

I will briefly report on a successful treatment of a 21 y/o Hispanic male with bx proven ( steroid resistant) idiopathic FSGS in his native kidneys...

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RE: Post renal transplant hematoma 1 day ago

Considering all the perinephric hematomas we have post biopsy Page kidney is very rare. I believe it is bc you put a hole through the capsule that ...

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RE: AMS for how long should you dialyzes? 1 day ago

You need to develop a relationship with your consulting physicians and ask them to trust your judgement. This is more difficult in the day of the "...

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RE: Post renal transplant hematoma 1 day ago

Agree with Dr. Glassock about "Page Kidney" complicating to peri-transplant hematoma.. If this happens immediately post-transplant, it may be overl...

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RE: 14 Yr Old Female With Nephrotic Range Proteinuria And Hypertension 1 day ago

I have never been very satisfied with the “Nephrosarca” or the ATN hypotheses for AKI developing in the context of severe NS in MCD/FSGS. Total obl...

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RE: 14 Yr Old Female With Nephrotic Range Proteinuria And Hypertension 1 day ago

So I far as I know, except perhaps in Asia, IV Methylprednisolone is not used for the initial therapy of MCD or primary FSGS. I cannot recall seein...

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RE: 14 Yr Old Female With Nephrotic Range Proteinuria And Hypertension 1 day ago

"Nephrosarca" is a hypothesis from several decades ago to explain the mechanism underlying AKI developing in patients with MCD or other glomerulopa...

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