RE: Ozempic+statin= rhabdo 1 hour ago

In that case, a long shot but you may want to check for anti-HMGCR autoantibody. --------------------------------- Oded Friedman -----------------...

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RE: Combined ANA, ANCA and PLA2R serology 2 hours ago

that ANCA titer is non specific, need an MPO and PR3 Elisa P/C ratio may not be reliable in the setting of AKI with what sounds like ATN from the ...

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RE: Combined ANA, ANCA and PLA2R serology 4 hours ago

On hydralazine 10 mg per cardiologist and p-ANCA titer was around 1:640 ------------------------------ Laith Al dahabreh MD Leesburg GA (216) 856...

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RE: Alkaline urine in primary hyperaldosteronism 4 hours ago

We will be happy to do that. It is going to be either in July or August. I will forward the zoom link. Warm regards, --------------------------...

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RE: Alkaline urine in primary hyperaldosteronism 4 hours ago

Doctor Bhave is raising a very interesting point in regards to the role of hypokalemia in enhancing NH4+ excretion, and possibly in generating meta...

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RE: Ozempic+statin= rhabdo 5 hours ago

Yes she had diffuse myslgias which are minimally getting bett ------------------------------ Jeffrey Lautman MD Cleveland Kidney & Hypertension C...

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RE: Yellow Fever Vaccine For Lupus Nephritis Patient In Complete Remission 5 hours ago

Yellow fever virus vaccine is a live but attenuated vaccine that is contraindicated in immunosuppressed patients.. I assume that he has been in a C...

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RE: Ozempic+statin= rhabdo 5 hours ago

Did she present with muscle weakness in addition to myalgia and if so, has it persisted despite stopping rosuvastatin? ---------------------------...

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Yellow Fever Vaccine For Lupus Nephritis Patient In Complete Remission 7 hours ago

A 35-year-old man with lupus nephritis, now in complete remission on MMF 1000 mg bid l, HCQ 200 mg bid and prednisolone 5 mg od. He want to travel...

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RE: Alkaline urine in primary hyperaldosteronism 7 hours ago

If possible, your division should make the lecture available to this audience via zoom. Thank you. Mario

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RE: Alkaline urine in primary hyperaldosteronism 8 hours ago

Agree little data on ammonium excretion in primary hyperaldosteronism. The only paper that addresses this clearly is the 1965 Japanese paper with 2...

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RE: ANCA negative pauci immune GN. ANA, anti dsDNA positive. Low complements. 9 hours ago

SCr improved from ~ 5 mg to 1.3 mg/dL. AKI might have spuriously increased the UPr/Cr ratio. What are the current UPr/Cr, complement and anti-DS DN...

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RE: ANCA negative pauci immune GN. ANA, anti dsDNA positive. Low complements. 10 hours ago

Pauci immune pathology is not unusual with SLE, in fact although SLE is often considered the consummate immune complex disease, I think we see the ...

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ANCA negative pauci immune GN. ANA, anti dsDNA positive. Low complements. 11 hours ago

I have a young female who was admitted vomiting, diarrhea, hypotension, with NSAIDs use, had AKI (clinically pre renal/ischemic ATN) with no prior ...

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RE: Ozempic+statin= rhabdo 11 hours ago

I always wonder if these patients need a workup for metabolic diseases. "Drug responses can also be affected by predisposing genetic factors. For ...

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RE: Ozempic+statin= rhabdo 12 hours ago

Dr Glasssock thanks for your reply patient lost approximately 20 lbs on ozempic jeffrey ------------------------------ Jeffrey Lautman MD Cleve...

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RE: Ozempic+statin= rhabdo 12 hours ago

I fully agree. Rosuvastatin is the most likely culprit here, not semaglutide ------------------------------ Richard Glassock MD, FASN Laguna Wood...

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RE: Lupus nephritis with APS and MMF. Relapse during tapering MMF 13 hours ago

I had a similar case where a 35/F was in remission for 3 years and then slow taper was done. Her proteinuria and dsDNA started going up but complem...

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RE: Alkaline urine in primary hyperaldosteronism 13 hours ago

There are no good studies that I know of that indicates enhanced NH4+ excretion in primary hyperaldosteronism independent of hypokalemia. So the po...

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RE: Ozempic+statin= rhabdo 13 hours ago

We have seen many cases of Rhabdomyolysis and AKI with high-dose Rosuvastatin. It is the most likely culprit. Withhold Rosuvastatin and wait. Patie...

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RE: Ozempic+statin= rhabdo 13 hours ago

Even a relatively minor change in body weight might make a difference when one is taking a high dose of a potentially nephrotoxic agent like rosuva...

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RE: Screening for CKD 13 hours ago

Thanks for the excellent discussion. I think we agree on most items; however, I think we should do universal albuminuria screening at least once so...

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RE: Ozempic+statin= rhabdo 13 hours ago

With sitagliptin yes, but not w. semaglutide (Ozempic)...also, it seems it took only 3 wks from the start of Ozempic for the muscle pains to begin....

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RE: Screening for CKD 13 hours ago

Thanks Drs Rodby, Venkat, Hirsch and Weiner for your excellent response to my post. I was chiefly addressing population wide screening of asymptoma...

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RE: Alkaline urine in primary hyperaldosteronism 14 hours ago

The urine anion gap measurement should not be applied to any urine pH above 7, since that implies the presence of excess HCO3-, If that is the ca...

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RE: Alkaline urine in primary hyperaldosteronism 14 hours ago

Dr. MellasI apologize for the typing mistakes . AMD is tough when you become monocular and never learned how to touch type. --------------------...

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RE: Alkaline urine in primary hyperaldosteronism 14 hours ago

The urine anion gap measurement should not be applied to any urine pH above 7, since that implies the presence of excess HCO3-, which will make the...

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RE: Alkaline urine in primary hyperaldosteronism 14 hours ago

Ammonium is the most important component of urinary acid excretion, normally accounting for about two-thirds of net acid excretion. Yet many Hospit...

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RE: combined rejection 14 hours ago

Have you repeated DSA after treatment? ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KPCOP EC [Past Medical Director Kid...

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RE: combined rejection 15 hours ago

UPr/Cr and UAlb/Cr (important prognostic parameters)? Repeat DSA MFI? My impression is that the TCMR component responded partially to bolus steroid...

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RE: Screening for CKD 15 hours ago

IMO, screening for CKD in adults is very important. There was a cost-effectiveness study just published from the Stanford team in Annals (https://...

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combined rejection 17 hours ago

I need ur opinion regarding 15 years female, post LRRTX done 2018, donor was her mother, original kidney disease was FSGS, induction was basilixima...

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RE: Alkaline urine in primary hyperaldosteronism 18 hours ago

Physiology question; If urine oH is elevated due to NH4+ one could measure the urine anion gap or urine NH4+ if alkaline urine pH is due HCO3 one...

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RE: Alkaline urine in primary hyperaldosteronism 22 hours ago

Can someone tell me what the urinary NH4 excretion is in primary hyperaldosteronism with an alkaline urine (in the absence of a UTI)? I can't find ...

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RE: Lupus nephritis with APS and MMF. Relapse during tapering MMF 22 hours ago

In light of normal kidney function, near normal serum albumin and modest proteinuria I might wait a few more months before introducing a new medica...

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RE: Lupus nephritis with APS and MMF. Relapse during tapering MMF 23 hours ago

Dear Dr Glassock, thank you for your immediate response. Tapering was initiated after completing more than 3 years of treatment (slow tapering). St...

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RE: Combined ANA, ANCA and PLA2R serology 1 day ago

What are his current medications?If he is on hydralazine, allopurinol ir anti-thyroid agent the ANCA may be a false positive. Do you have zn anti-M...

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RE: Ozempic+statin= rhabdo 1 day ago

40 mg/ d is a very large daily dose of rosuvastatin . Did she lose weight with Ozempic - if so this sounds like rosuvastatin toxicity aggravated by...

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RE: Lupus nephritis with APS and MMF. Relapse during tapering MMF 1 day ago

I am not exactly clear as to the rationale for tapering MMF. Was a re-biopsy done when he was in clinical remission? What happened to the serologic...

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RE: Alkaline urine in primary hyperaldosteronism 1 day ago

I had not heard of the alkaline urine of primary hyperaldosteronism but it appears it occurs so I thought I might give it a shot. I think as noted ...

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Ozempic+statin= rhabdo 1 day ago

Our practice is taking care of a 65-year-old female who had a creatinine of 0.9 in June of 2022. She has been taking rosuvastatin 40 mg daily for a...

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RE: Alkaline urine in primary hyperaldosteronism 1 day ago

@Satish Balan I agree that urine has very little NH3 but that wasn’t my point. Rather, that increased NH4+ generation & subsequent transport of NH...

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Combined ANA, ANCA and PLA2R serology 1 day ago

71-year-old male patient with past medical history significant for COPD, ex-smoker, history of stage 1 poorly differentiated lung cancer in 2018, s...

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RE: Alkaline urine in primary hyperaldosteronism 1 day ago

Just curious. Is ECF volume expanded with NsHCO3 infusion. Is aldosterone secretion really suppressed by such Cl free infusions? ---------------...

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Lupus nephritis with APS and MMF. Relapse during tapering MMF 1 day ago

Dear Colleagues, Α 23 years old male with history of : APS (thrombosis of ICV , pulmonary embolism and positive in anti-β2GPI IgG 2733 (n.v. 3 ...

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RE: Alkaline urine in primary hyperaldosteronism 1 day ago

Absolutely , I agree Sent from Mail for Windows

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RE: Alkaline urine in primary hyperaldosteronism 1 day ago

Dr Emmett Dr. Emmett hank you so much for your excellent discussion. When I was still active clinically (10 years ago), I had to explain the alka...

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RE: Alkaline urine in primary hyperaldosteronism 1 day ago

I think the big difference is that with exogenous NaBicab loading ECF is expanded and Aldo is suppressed. With primary hyperalo and similar syndrom...

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RE: Alkaline urine in primary hyperaldosteronism 1 day ago

Would you say that primary hyperaldo has features consistent with the exogenous HCO3 paradigm? ------------------------------ John Mellas MD Neph...

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RE: Undetectable FGF23 found when hypophosphatemia normalized 1 day ago

Yes.. in the case of PHPT, the increase in FGF23 seems to be an adaptive mechanism to counteract the PTH-induced increase in activated D3 levels, i...

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