RE: Ig A Nephropathy In Pregnancy 3 hours ago

This patient 29 w, Proteinuria 24 h 6 gm , Albumine 26 , cr stable predinslone 5 mg Any suggestions?? --------------------------------- Mohamed M...

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RE: EuroLupus Protocol in patient with eGFR 20 15 hours ago

Does anyone still use the older NIH high dose IV CYC regimen for LN anymore.. If so, for what reason?i ------------------------------ Richard Gla...

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RE: Renal Artery stenosis 15 hours ago

Sure; TNF inhibitors were shown to be associated with eGFR decline HR 1.34 in a cohort study of US veterans with incident IBD Sumida et al JAMA ...

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RE: A Philosophical Question 19 hours ago

Perhaps the answer is in improvement in life expectancy and QOL. So turning to AI Based on the available research, there is evidence th...

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RE: Renal Artery stenosis 19 hours ago

Thank you all for Feedback. Dr Sinasis can you explain the rationale of your recommendations re Stop Humira Stop Ozempic Isosorbide and ...

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RE: EuroLupus Protocol in patient with eGFR 20 19 hours ago

I feel this is correct understanding that Cyclophosphamide AUC is generally considered equivalent regardless of the route of administration, whethe...

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RE: A Philosophical Question 19 hours ago

Dr. Slater- if you are correct, the prospect for a lot of empty chairs in dialysis units looms large. While this is a very good development for med...

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Nephrology salary 20 hours ago

Good morning, Why are nephrology salaries significantly lower than our counterparts in medicine? Cities in northeast offer 150k-180k startin...

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RE: A Philosophical Question 21 hours ago

Poweful Topic -despite the advcements mention we have been moving at a snail pace in regards to ESRD treatment which is about to change IMO we a...

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RE: EuroLupus Protocol in patient with eGFR 20 1 day ago

Thank you Dr Nauman and Dr Venkat for your input ------------------------------ Siev Hong Lor PharmD Pharmacist Liverpool Hospital, NSW E: honglo...

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RE: A Philosophical Question 1 day ago

"AI will ruin the soul of Nephrology"!! . Well, if it is any consolation , we won't be alone in purgatory. But, if we are very careful , we can tam...

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RE: A Philosophical Question 1 day ago

Positives & Negatives Genetic testing opened a huge new perspective in diagnostic projections for current and future kidney problems. Better...

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RE: Renal Artery stenosis 1 day ago

Would not waste time STOP Humira STOP Ozempic Call the surgeon > go for as NAUMAN suggested START Isosorbide Dinitrate 10 bid START Fish oil...

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RE: Renal Artery stenosis 1 day ago

I think a severe RAS which is collateralized may be a reflection of a more chronically hypoxic kidney than if not. While collateralization may prot...

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RE: Tough GN case 1 day ago

Noted, agree, we are pursuing the biopsy, and good point about recurrence potential s/p txplt. Thank you! ------------------------------ Jeffrey ...

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RE: Tough GN case 1 day ago

With 9-10 cm kidneys by US I would probably do a kidney biopsy anyway, (if not contraindicated) to put the final nail on the futility issue. And to...

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RE: Renal Artery stenosis 1 day ago

I think I am in the Klein/Campese camp on this case. I would adopt an aggressive conservative , non-surgical management. At least for now. I doubt ...

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RE: Renal Artery stenosis 1 day ago

In this case, the risk benefit ratio for intervention is too high. Given the presence of diabetes and severe and diffuse atherosclerosis, the ris...

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RE: Renal Artery stenosis 1 day ago

Dr. Hirsch: I agree with you that good collaterals supplying the left kidney can explain the maintained renal function despite the 90% RAS, atrophi...

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RE: Renal Artery stenosis 1 day ago

I must respectively disagree . I think stenting is extremely high risk and though I agree with Dr Rodby that dialysis may be inevitable, until the ...

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RE: Renal Artery stenosis 1 day ago

Dr Venkat, The angiogram might also show evidence of good collaterals (or not). That is possibly inferred by the Cr of 1.2 to 1.5 despite severe bi...

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RE: A Philosophical Question 1 day ago

I would add to the many advances cited, progress in preventing progression of CKD to ESRD, which is one of our most important goals, if not the mos...

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RE: Tough GN case 1 day ago

Thank you for the additional thoughts, Dr. Glassock. I agree, endocarditis going on 2 years does seem unlikely, particularly in the absence of F/...

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RE: Tough GN case 1 day ago

Thanks for the thoughts. Her ultrasound findings: RIGHT KIDNEY: 9.4 cm long. Cortex is thin and mildly echogenic. No mass, stone, or obstruction ...

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RE: A Philosophical Question 1 day ago

Yes, science of nephrology and treatment options for kidney diseases have advanced tremendously. If only the socio-economic problems, delayed nephr...

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RE: EuroLupus Protocol in patient with eGFR 20 1 day ago

Agree with Dr. Nauman regarding cyclophosphamide dose in your patient with eGFR of 20 ml/min. Regarding "excluding preexisting chronic renal failur...

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RE: Renal Artery stenosis 1 day ago

Agree with Dr. Rodby that stenting of left renal artery is justified despite the absence of the generally accepted indications (flash pulmonary ede...

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RE: Renal Artery stenosis 2 days ago

24% function in right kidney is about 9 ml/min of GFR. How about stunting in left and auto-transplantation for right kidney. -------------------...

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RE: EuroLupus Protocol in patient with eGFR 20 2 days ago

I have used 500mg every 2 weeks and have not reduced the dose in lower GFR. My understanding is Cyclophosphamide AUC is equivalent for a given dose...

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EuroLupus Protocol in patient with eGFR 20 2 days ago

Hi all, Can I please find out your experience / practice in treating patient with Lupus Nephritis Class III / IV with IV cyclophosphamide? Loo...

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RE: Memb gn with diabetic nephropathy 2 days ago

Absolutely no data on efficacy and safety of RTX for PLA2R+ MN in this situation, but with a falling anti-PLA2R antibody level and the severe super...

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RE: Tough GN case 2 days ago

Rarely Endocarditis causing CKD can evolve over many months. Admittedly two years would be unlikely but I have seen patients with slowly evolving C...

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RE: Tough GN case 2 days ago

Kidney ultrasound findings (size/echogenicity:cortical thickness? Was anti-GBM antibody negative? I expect the biopsy will show advanced glomerulos...

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Memb gn with diabetic nephropathy 2 days ago

69 year old male with history of spinal cord injury, cervical myelopathy with chronic pain, chronic suprapubic catheter, neuropathy, T2DM, HLD, HTN...

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RE: Tough GN case 2 days ago

Thanks for the clarification. Get Outlook for iOS Confidentiality Notice: This electronic message, including any and all attachments hereto, is ...

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RE: starting spironolactone when cystatin C based GFR 21 (cirrhosis) but creatinind based 41 2 days ago

Agree with others' comments, particularly in that Cystatin C may be more accurate than eGFR in setting of cirrhosis which is commonly associated w/...

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RE: Tough GN case 2 days ago

Cardiac echo because of a concern over endocarditis. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ----...

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RE: starting spironolactone when cystatin C based GFR 21 (cirrhosis) but creatinind based 41 2 days ago

Which is the ratio Cys C/ Creat.The dissociation between biomarkers could be related to sarcopenia(multi-comorbilities)?In this case, wouldn't it b...

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RE: Tough GN case 2 days ago

Thank you for the help, Dr. Glassock. Complements (C3 and C4) are entirely normal. Did not do RF, FLC or echo--I take it I should check those? ...

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RE: Tough GN case 2 days ago

What is the C3/C4. rheumatoid factor, FLC, echocardiogram? This could be one of many things, PGNMID , Fibrillary GN,IRGN, etc. you need a good kidn...

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RE: A Philosophical Question 2 days ago

I just celebrated 25 years of practicing nephrology. Nephrology is better and more exciting than ever. Plenty of great science being translated in ...

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RE: Renal Artery stenosis 2 days ago

dm well controlled on Ozempic A1c 6. No protein uria. Only on Lisinopril hctz and amlodipine. systolic 110-130 Thank you -------------...

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RE: Tough GN case 2 days ago

Thank you for the prompt feedback, Dr. Rodby. Yes, apologies for not mentioning it, but urine is consistently positive for hematuria. I don't h...

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RE: Renal Artery stenosis 2 days ago

Creatinine 1.2-1.5 I would not bother with renal vein renins, I would not expect BP to get better, or get her off medication. But the writi...

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RE: Tough GN case 2 days ago

P-ANCA 1:160, do you have Elisa, this 1:160 may ne an atypical ANCA and may not mean anything Any hematuria? PLA2R? immunofixation? Statin doi...

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Tough GN case 2 days ago

I would greatly appreciate feedback on this case. 59 yoF with advancing CKD (developing over [More]

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RE: Renal Artery stenosis 2 days ago

Can we assume no flash pulmonary edema.? The main issue is whether stenting the L kidney will lead to better preservation of overall kidney functio...

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RE: dsDNA + and GBM + 2 days ago

Yes, understood. But false positive results with the commercial ELISA antiGBM tests are very uncommon. Anemia (typically iron deficient and microcy...

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RE: dsDNA + and GBM + 2 days ago

agree, but sometimes we have false positive antibody tests as well. ------------------------------ Teri Jo Mauch, MD, PhD, FASN, FAAP Professor ...

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RE: dsDNA + and GBM + 2 days ago

Positive anti-GBM antibodies would not be expected in aHUS. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-88...

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