RE: IgAN relapse 3 hours ago

Before Cooperate was rescinded i put a number of igan pts on arb ace combo. Even after the paper’s integrity was questioned, i kept them on it. Coo...

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RE: Covid and kidney transplant 6 hours ago

Certainly I would start to stop MMF --------------------------------- ---------------------------------------------------------------------- Carlo ...

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RE: Dermatomyositis with calcinosis cutis 8 hours ago

Thanks a lot very helpful Really appreciate --------------------------------- Shahzad Safdar MD Mt. Auburn Nephrology, Inc. Cincinnati OH 0222 -...

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RE: IgAN relapse 9 hours ago

Dr. Desai- You are quite correct the the COOPERATE trial report was rescinded due to "data irregularities " and there is no RCT evidence that dual...

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RE: Dermatomyositis with calcinosis cutis 10 hours ago

Here are the promised References- Smith S and Hanson J. J Clin Rheum. 2017; 23:445- Martin D, et al. J Clin Rheum 2019; 25: e35. I hope this helps....

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RE: Unexplained deaths related to dialysis 10 hours ago

The FDA took the~40% Citrate soultion initially developed in Europe off the market in USA. Only 4% NaCitrate allowed. Even if pushed into the patie...

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RE: Kidney biopsy 12 hours ago

Thank you for all the input. I ended up biopsying the kidney. My rationale for going ahead with the biospy: 1) The patient "promised" that he is go...

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RE: IgAN relapse 12 hours ago

This degree of proteinuria with normal Albumin and M0,S1, T1 lesion is very unusual. Was there an EM performed? Foot process effacement? GBM thickn...

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RE: smoldering myeloma in a patient with diabetic nephrolpathy 13 hours ago

Dear Dr. Jhaveri, thanks for the reply. below is the free light chain ratio with cr level.   Ref. Range 11/14/2016 12:18 ...

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RE: IgAN relapse 14 hours ago

I'm not sure she needs dual RAS blockade with both the ACE inhibitor and the ARB.  I wasn't aware of any data that showed that (I believe the COOPE...

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RE: Crescentic GN from MGRS? 14 hours ago

​According to our renal pathologist, strong IgM and crescents are common in Bartonella-glomerulonephritis and doesn't necessarily have to be cryo o...

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RE: Kidney biopsy 14 hours ago

Very interesting discussion which again make this forum so valuable IMO- I think in the end only a careful discussion of benefit and risks between ...

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RE: Kidney biopsy 15 hours ago

One way we could think about this is from the patient's viewpoint. He may be less interested in just having the information than we are. Is he will...

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RE: IgAN relapse 15 hours ago

The “response” to CNI was likely not due to an immunologic remission but rather to a non-specific effect on glomerular proteinuria that was not lon...

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RE: Crescentic GN from MGRS? 15 hours ago

Thank you Dr. Abu-Minshar. Yes, Patient was initially discharged from hospital as preliminary work up performed by ID and cardiology after renal bi...

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RE: Kidney biopsy 15 hours ago

I agree with Drs. Lerman and Mellas that prognostic information and an assessment of risk of recurrent disease in the transplant kidney can be obta...

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RE: Crescentic GN from MGRS? 16 hours ago

Thank you Dr. Leung​ ------------------------------ Chintan V. Shah M.D. Assistant Professor of Medicine University of Florida Gainesville, FL shah...

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RE: smoldering myeloma in a patient with diabetic nephrolpathy 16 hours ago

Some good references here about treatment and renal prognosis: https://datastudio.google.com/s/kTc3TmYjAMg --------------------------------- Tejas ...

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IgAN relapse 16 hours ago

I would appreciate your opinion on my following case. 39y old female. Presenter with urine PCR of ~700 mg/mmol. Normal creatinine, and albumin. Kid...

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RE: smoldering myeloma in a patient with diabetic nephrolpathy 16 hours ago

Dear Dr. Desai, thanks for the reply. do you mean do mass spectrometry in biopsy tissue to find amyloid? Congo red staining in the past were both n...

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RE: smoldering myeloma in a patient with diabetic nephrolpathy 16 hours ago

There is patient-specific info here. Needs to be erased. Update:  thanks for erasing the patient specific info.  Turns out that when you click "EDI...

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RE: Kidney biopsy 16 hours ago

Personal opinion on kidney biopsies: 1 Make diagnosis; especially when uncertain 2 Assist with establishing prognosis depending on histopathology, ...

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RE: smoldering myeloma in a patient with diabetic nephrolpathy 18 hours ago

Thank you very much for the reply, Dr. Rodby. I feel the same, will explain to oncologist. ------------------------------ JingJing Zhang MD, PhD As...

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RE: smoldering myeloma in a patient with diabetic nephrolpathy 19 hours ago

How about mass spectrometry in this case? Heard it may be more accurate that serum FLCs. --------------------------------- Tejas Desai, MD Founder,...

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RE: smoldering myeloma in a patient with diabetic nephrolpathy 21 hours ago

Two biopsies is plenty, if this renal disease were related to the paraproteinemia you should have had no trouble showing that since the plasma Cell...

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RE: Unexplained deaths related to dialysis 22 hours ago

The possibility of accidental IV infusion or  negligence of catheter sealing solution such as trisodium citrate in high concentration or something ...

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RE: Dermatomyositis with calcinosis cutis 1 day ago

Severe and widespread Calcinosis cutis is a recognized but rare complication of Dermatomyositis , particularly the juvenile form or that associated...

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RE: Dermatomyositis with calcinosis cutis 1 day ago

Not on Coumadin Centimeters Ab negative I don’t think it is calciphylaxis Imaging shows soft tissue calcification Thanks --------------------------...

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RE: smoldering myeloma in a patient with diabetic nephrolpathy 1 day ago

Not really. Likely diabetes worsening What is the trend of flc ratio in the serum? And also any other skeletal findings? Sounds like NO renal indic...

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RE: Crescentic GN from MGRS? 1 day ago

based on your corrections it looks like there is a suspicion of an infectious etiology? I would try to rule out infectious endocarditis with barton...

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smoldering myeloma in a patient with diabetic nephrolpathy 1 day ago

Dear colleagues, I have a case here would like to get some suggestions. The patient is 62 yo AAF. She has DM since 2006. She has been strugglin...

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RE: ESA with COVID 1 day ago

This editorial just came out ------------------------------ Michael Rudnick MD University of Pennsylvania Philadelphia PA -------------------------...

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RE: Crescentic GN from MGRS? 1 day ago

I would do a peripheral blood flow.  It is actually quite good for CLL.  You may actually get more clarification.​ ------------------------------ N...

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RE: Unexplained deaths related to dialysis 1 day ago

From what I read, death was post dialysis.  Is there a food place near by that patients usually stop at after dialysis?  Was the death summer or wi...

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RE: Crescentic GN from MGRS? 1 day ago

We do not have peripheral blood flow cytometry unfortunately. However, here is the comment on BM Biopsy flow cytometry: CD38+ plasma cells comprise...

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RE: Unexplained deaths related to dialysis 1 day ago

Yes I tto can remember iusin lodocaine off label for lots of thinfs we believed without RCTs to be effective.  Death is not funny. Neither is fea...

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RE: Crescentic GN from MGRS? 1 day ago

What was the light chain restriction on the CLL flow cytometry? ------------------------------ Nelson Leung MD Mayo Clinic Rochester MN (507) 266-7...

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RE: Unexplained deaths related to dialysis 1 day ago

UNFORTUNATELY, IN A LONG CAREER, ONE CAN LEARN ABOUT ALL THE THINGSD THAT CAN OCCUR. AT ON DIALYSIS FACILITY ACROOS THE RIVER FROM PENNSYLVANIA, TH...

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RE: Unexplained deaths related to dialysis 1 day ago

Another by the grace of God moment. This tragic event occurred in October 1983. The description was published in the famous journal New York Times....

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RE: Crescentic GN from MGRS? 1 day ago

Thank you for your response. I just received info that bartonella IgG titers were high, not sure if that changes the diagnosis? I have updated the ...

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RE: Follow up after AKI 1 day ago

Like it predecessor CKD, the AKI terminology arose because of a perception that varied terminology for the same group of entities was confusing, im...

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RE: Follow up after AKI 1 day ago

Please remind us what lead to decision and justification to begin using AKI as a broad definition for acute kidney failure? -----------------------...

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RE: Kidney biopsy 1 day ago

Just for the debate- all biopsies need not be justified by decision to give immunosuppressive medication as prognosis and possible recurrence post ...

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RE: Kidney biopsy 1 day ago

Large, echogenic kidneys? Would favor HIVAN. This patient illustrates an important rule to follow before performing kidney biopsy: decide before bi...

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RE: Kidney biopsy 1 day ago

The primary question that must be asked and answered before making a decision to perform a kidney biopsy is “in what way, distinct from non-invasiv...

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RE: Kidney biopsy 1 day ago

Rodger for the sake of debate - given his active infection assuming confirmed with CD4 and PCR studies -what would you do with biopsy other than at...

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RE: Unexplained deaths related to dialysis 1 day ago

I am currently working on it prof I was looking forward for some enlightenment ------------------------------ Ahmed Elsayed -----------------------...

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RE: Dermatomyositis with calcinosis cutis 1 day ago

Is she on warfarin? The lesions were biopsied and are ca based? If you believe this could be calciohyleaxis and you are worried about survival, i d...

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RE: Unexplained deaths related to dialysis 1 day ago

I think a table with all the deaths the pt age, date if death time if death related to time if hd ( during , one hour in, four hours after, next da...

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RE: Crescentic GN from MGRS? 1 day ago

I agree, IgM monoclonal is more typically a plasma lymphocytic clone and i think rituxan should be your first choice. I woukd not focus too much on...

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