RE: Can recurrent FSGS respond this rapidly and effectively to a short course of plasmapheresis? 45 seconds ago

I do agree that there was no evidence of preformed DSA as the cpra was 0. However, pretransplant evaluation cannot completely rule out preformed DS...

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RE: Can recurrent FSGS respond this rapidly and effectively to a short course of plasmapheresis? 11 minutes ago

The graft dysfunction can not be attributed to FSGS but proteinuria could be- AMR severe enough to cause delayed graft function with heavy proteinu...

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RE: Coffee? 38 minutes ago

Thankyou Tejas! That is very informative. ------------------------------ [Manisha] [Singh] [MD] [FASN] [Assistant Professor] [University of Arkansa...

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RE: Can recurrent FSGS respond this rapidly and effectively to a short course of plasmapheresis? 54 minutes ago

This is a fascinating case. The rapid onset of proteinuria with hematuria and graft dysfunction does not seem typical of a recurrent FSGS. An alter...

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RE: Coffee? 11 hours ago

Ahh yes, coffee and its beneficial effects (or not). Every time I see a reference to coffee I recommend the following video -- it really summarizes...

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RE: Collapsing FSGS 12 hours ago

Since your patient has collapsing FSGS, you may want to try steroids but have some other options in your pocket in case it (likely) doesn't work. R...

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RE: Influenza Vaccine In Dialysis 12 hours ago

high dose trivalent for all dialysis patients, mostly irrespective of age (but my population is veterans who are generally older) https://datastudi...

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RE: Screening for native kidney RCC in renal transplant recipients 12 hours ago

Here are some useful pieces of info regarding RCC screening in patients with acquired cystic kidney disease (from ESRD) https://datastudio.google.c...

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Question On Tacrolomus 15 hours ago

Is there any renal benefit to switch from Prograf BID to Envarsus daily (same target range) in non-kidney, solid organ transplant patients? Theoret...

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Coffee? 15 hours ago

JOURNALS Nutrition Resource Center Coffee may reduce risk for kidney disease Kennedy OJ, et al. Am J Kidney Dis. 2019;doi:10.1053/j.ajkd.2019.08.02...

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Medicinal Director Question 15 hours ago

Medical Director Dialysis Agreements: Question. If any Emergency Agreement is signed for a year, is the Fees reduced to half of FMV? --------------...

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Mergers in Dialysis 17 hours ago

Hi everyone. As we move into the next phases of the Advancing American Kidney Health EO, I thought it might be nice to review some of the historic...

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#NephTwitter Archives 17 hours ago

Hi everyone. As many of you know, a lot of great scientific discussions happen on social media, and in particular Twitter.  One of the challenges o...

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RE: Immunecomplex Glomerulonephritis with Cresecnts and AKI on CKD3 18 hours ago

The clinical features are very suggestive of infection-related IgA dominant GN, but the Pseudomonas Association is unusual.  If evidencevof ongoing...

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RE: Membranous Nephropathy 19 hours ago

Do I rebiopsy him ? No Do I wait for proteinuria resolution as ANTI Pla2 R negative post Ponticelli Yes Role for Rituximab in this setting ? Not at...

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RE: Osteoporosis, Bone Mineral Metabolism And Ckd 20 hours ago

It is important to stress that DEXA scanning and FRAX Scoring will help to predict fracture risk, but the BMD findings with DEXA scanning do not pr...

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RE: Osteoporosis, Bone Mineral Metabolism And Ckd 21 hours ago

This looks like severe osteopenia due to high bone turnover to me, but a bone biopsy would be needed to confirm. PTH suppression my be indicated. ...

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RE: Osteoporosis, Bone Mineral Metabolism And Ckd 21 hours ago

Sorry forget to mention she is 59 year old --------------------------------- Edgard Wehbe MD, FASN Wichita Nephrology Group Wichita KS (316) 993-65...

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Osteoporosis, Bone Mineral Metabolism And Ckd 21 hours ago

I was asked to see a patient with ckd stage 3- creat 1.6 and egfr 35 ml/min with dexa scan showing a lumbar T score -4.1, femur -3.6 and hip -3.1. ...

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RE: Can recurrent FSGS respond this rapidly and effectively to a short course of plasmapheresis? 22 hours ago

Very interesting case-IMO this is a case of DGF with rapid reoccurring FSGS. what make this case very unusual and unique at least in my experience ...

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RE: Hypertensive nephrosclerosis in non hypertensive patient 1 day ago

Hyperfiltration Injury Without glomerulomegaly or proteinuria is highly unlikely. Sent from my iPad

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RE: Hypertensive nephrosclerosis in non hypertensive patient 1 day ago

With this degree of interstitial fibrosis is a prior history of vesicoureteral reflux, with resolution, leaving residual renal scarring possible? A...

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RE: Hypertensive nephrosclerosis in non hypertensive patient 1 day ago

Thank you all for your reply. In fact i was following this lady for the last year, with some hesitation to go for kidney biopsy, because of the abs...

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RE: Membranous Nephropathy 1 day ago

Why would you want re- Biopsy this patient who clearly has anti-PLA2R mediated MN? Please clarify your rationale for considering this step. Sent ...

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RE: Membranous Nephropathy 1 day ago

I’d follow the PLA2R and if it rebounds before or even after proteinuria remission I’d then dose with rituxan --------------------------------- Rog...

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RE: Membranous Nephropathy 1 day ago

Thanks a lot Dr. Glassock for your comments. We have planned for a repeat CT scan and a supraclavicular lymph node biopsy. Unfortunately we wont be...

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RE: Can recurrent FSGS respond this rapidly and effectively to a short course of plasmapheresis? 1 day ago

In my experience, a recurrence of Primary (permeability factor induced) FSGS can Recur very rapidly following transplantation. I have seen it as ea...

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Can recurrent FSGS respond this rapidly and effectively to a short course of plasmapheresis? 1 day ago

A 30-year-old male received a deceased donor transplant. FSGS with nephrotic syndrome was diagnosed by kidney biopsy at age 13 and treated with pre...

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RE: Membranous Nephropathy 1 day ago

This patient most likely has long standing Primary (PLA2R auto-antibody induced ) Membranous Nephropathy with declining (?) proteinuria and PLA2R a...

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Membranous Nephropathy 1 day ago

Hello Everyone,I recently saw a 31y/o patient referred from Outpatient Nephrologist for f/u on Membranous Nephropathy. Patient followed up with by ...

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Membranous Nephropathy 1 day ago

Hello Everyone,I recently saw a 31y/o patient referred from Outpatient Nephrologist for f/u on Membranous Nephropathy. Patient followed up with by ...

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RE: Hypertensive nephrosclerosis in non hypertensive patient 1 day ago

I would agree except these biopsy findings without any proteinuria at all is somewhat puzzling. Was the proteinuria assess via 24 hour urine protei...

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RE: Immunecomplex Glomerulonephritis with Cresecnts and AKI on CKD3 1 day ago

Just to add my pt did not have any underlying infection --------------------------------- Bajinder Reen MD Brampton ON (905) 453-0821 -------------...

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RE: Immunecomplex Glomerulonephritis with Cresecnts and AKI on CKD3 1 day ago

I had similar pt treated him as vasculitis a s partial response --------------------------------- Bajinder Reen MD Brampton ON (905) 453-0821 -----...

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RE: Immunecomplex Glomerulonephritis with Cresecnts and AKI on CKD3 2 days ago

Do you have a urinalysis prior to pseudomonal urosepsis? Hard to say re: IgA-dominant IRGN vs IgAN...hmm, some features go one way & some the other...

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RE: Immunecomplex Glomerulonephritis with Cresecnts and AKI on CKD3 2 days ago

without a staph infection I think you have to call this simply a cescentic IgA. But seems likeI can't put it together with the uti. TDF I would tre...

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Immunecomplex Glomerulonephritis with Cresecnts and AKI on CKD3 2 days ago

Lets Discuss the Clinical case, prognosis and  treatment . 54-year-old male AA descent , with a history of long standing hypertension x 20 yrs , BP...

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RE: BP Goal in Hep C, Cryo GN 2 days ago

Goal is the same as for all other forms of non-Diabetic CKD with proteinuria. This is by extrapolation as this issue has never been studied in a RC...

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RE: Hypomagnesemia and hypercalcemia 2 days ago

24-hour urine magnesium 62 mg suggests renal magnesium loss " > 25 mg /day" that consistent with hypercalcemia induced Bartter  type V.  ----------...

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RE: Hypomagnesemia and hypercalcemia 2 days ago

I am not a Magnesium aficionado.  Although Mg has it own Journal, most of its absorption is in the cTAL and appear to be a passive paracellular pro...

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BP Goal in Hep C, Cryo GN 2 days ago

Is there specific BP goal for Hep C associated Cryo GN? ------------------------------ Christopher H. Girgis M.D. Renal Fellow, PGY-5 OU Nephrology...

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RE: ESA in dialysis patients with Hb above the target. 2 days ago

I second that holding can create a challenge.  Reducing dose is more appropriate.  Darbe is tricky because it can be given weekly or longer interva...

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RE: Hypomagnesemia and hypercalcemia 2 days ago

Does the urinary Mg excretion rate support an absorption issue or a “renal leak” as a cause of hypo-magnesemia? In GI absorption defects or dietary...

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RE: ESA in dialysis patients with Hb above the target. 2 days ago

Darbepoiten alfa ------------------------------ Mustafa Ahmad MD, FASN Consultant Nephrologist King Fahad Medical City Riyadh 966568310309 --------...

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RE: Hypomagnesemia and hypercalcemia 2 days ago

I agree with Drs. Friedman and Glassock.  Just add the I describe this level of 1,25-OH-D3 as " inappropriately normal " and as stated above points...

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RE: ESA in dialysis patients with Hb above the target. 2 days ago

Depends which ESA formulation? ------------------------------ Ashraf El-Meanawy , MD, MS, PHD, FASN Associate Professor of Medicine Director of Dia...

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RE: ESA in dialysis patients with Hb above the target. 3 days ago

See reference below but NB this was for Hb > 13 NOT Hb between 11-11.5 to 13. https://jasn.asnjournals.org/content/jnephrol/18/12/3184.full.pdf ---...

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RE: ESA in dialysis patients with Hb above the target. 3 days ago

Good question, my experience is that if you stop it altogether you end up delaying the response when you restart it and you roller-coaster the hgb ...

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ESA in dialysis patients with Hb above the target. 3 days ago

Will appreciate community's opinion on the strategy when Hb rises above 11 in dialysis patients on ESA. Do we hold for a couple weeks , re-check Hb...

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RE: Hypomagnesemia and hypercalcemia 3 days ago

I think Dr. Friedman’s suggestions are spot on- low PTH, hypercalcemia and a 1,25 Dihydroxy Vitamin D level at upper limit of normal suggests granu...

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