RE: calcium deficit and replacement 1 hour ago

Word of caution. HCO3- deficit calculations in metabolic acidosis are fairly reliable. Ca is far more complex. An accurate equation to calculate a...

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RE: Fibronectin glomerulopath 1 hour ago

Not a current or past smoker. ------------------------------ Sangeeth Kumar Thiruvalla TMM Thiruvalla ------------------------------

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RE: C3 or MGRS 2 hours ago

We don't do formalin fixation, so there would be no need for Pronase digestion. We just do frozen sections , and the IF has already detected kappa ...

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RE: cause of AKI 4 hours ago

Too early to see any response.- were all potentially offending medicatons stoped? Any signs of liver injury? ------------------------------ Richa...

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RE: cause of AKI 7 hours ago

Prof glassock thanks so much Creatinine at presentation 19 5 days of steroids 40 mg and dialysis dependent --------------------------------- M...

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RE: Membranous Nephropathy treatment 10 hours ago

1.Do you have availability of oral cyclophosphamide (if ritux not possible ),will replace both cni and mmf with ponticelli regimen 2. 145 trough c...

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RE: C3 or MGRS 11 hours ago

Looks like having tubular involvement by monoclonal proteins as evident by glucosuria,Hypokalemia . Pronase digestion of the paraffin embedded tiss...

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RE: calcium deficit and replacement 12 hours ago

If the patient is in AKI , probably performing Dialysis , TONIGHT, against a high calcium bath ( 1.5 mmol/l or 3 mg/dl) may be preferable , as it w...

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RE: calcium deficit and replacement 12 hours ago

Your calculation of calcium deficit is incorrect and cannot be used to clinically guide IV calcium therapy. In hypocalcemic states. Is the patient ...

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RE: cause of AKI 12 hours ago

This might be Ashwagandha induced TIN. Serum FLC and IEP must be done, steroid therapy likely indicated. Any liver injury present. ? ------------...

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RE: calcium deficit and replacement 13 hours ago

Why not give oral calcium carbonate. or acetate. I do not see any clear need for IV calcium, What is the cause of AKI.? If rhabdomyolysis extra cal...

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cause of AKI 14 hours ago

47 Female went to GP few weeks with funny taste in mouth making her feel sick. Had been taking PPI for several months - GP advised come off i...

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RE: calcium deficit and replacement 15 hours ago

trying to correct calcium before bicarbonate in case low calcium causes tetany ------------------------------ Muhammad Soobadar MBChB UK --------...

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calcium deficit and replacement 15 hours ago

patient has bad aki needing dialysis and was unable to get dialysis catheter in tonight . clinically well. Adjusted Calcium 2.22 mmol/l (2.2-2.6...

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RE: dealing with CRS in ATG use as induction or treatment of ABMR 15 hours ago

plex for AMR( not biopsy) ------------------------------ Muhammad Soobadar MBChB UK ------------------------------

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RE: Gross hematuria in a patient with failed renal allograft 16 hours ago

We are all humans! This is the beauty of our profession. We keep an eye on each other for the patient's benefit. Let us know the surgical and patho...

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RE: Gross hematuria in a patient with failed renal allograft 16 hours ago

Sorry- i missed that Cystoscopy was done, I assume, it showed gross blood. from the transplant ureter. I agree with Dr. Rubin-a transplant nephre...

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RE: Gross hematuria in a patient with failed renal allograft 16 hours ago

I apologize for not being clear. I meant cystoscopy didn't reveal any bladder lesions. Thanks for your response.. ------------------------------ ...

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RE: Gross hematuria in a patient with failed renal allograft 16 hours ago

@Amit Joshi Based upon your response to Dr. Glassock, your initial post was not correct as you stated: " Cystoscopy, CT angiogram as well as conv...

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RE: Gross hematuria in a patient with failed renal allograft 17 hours ago

Thank you Dr. Rubin, I increased Prednisone dose to 40mg/d, tapering 10mg/week. Currently on 20mg daily with Tacrolimus 2mg q12 hrs. But that has...

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RE: Gross hematuria in a patient with failed renal allograft 17 hours ago

Thank you Dr. Glassock Urine is with blood clots. Cystoscopy showed left ureteral orifice from transplanted kidney effluxing blood consistently....

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RE: Gross hematuria in a patient with failed renal allograft 17 hours ago

Has a Cystoscopy been performed to confirm that the gross hematuria is coming from the allograft? Any clots in urine? What does the urine sediment ...

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RE: Gross hematuria in a patient with failed renal allograft 17 hours ago

It sounds like a significant renal infarct due to severe rejection as the cause of gross hematuria. Might try a brief and low dose course of IV met...

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Gross hematuria in a patient with failed renal allograft 17 hours ago

I would appreciate advise for the following case: 58-year-old man with history of living related kidney transplant in 2020 in Nigeria. Reporte...

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RE: dealing with CRS in ATG use as induction or treatment of ABMR 18 hours ago

Sorry if I caused confusion in this case Patient has mixed rejection based on biopsy and dsa. Will post case over weekend Ward week extremely busy...

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RE: dealing with CRS in ATG use as induction or treatment of ABMR 18 hours ago

Dr. Venturelli: I was only pointing out why some transplant centers include ATG in the treatment of pure AMR. I am not aware of any studies justify...

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RE: Fibronectin glomerulopath 19 hours ago

Is was she a smoker? ------------------------------ Roger Rodby MD, FASN Professor of Medicine Rush University Nephrology Associates Chicago IL (...

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RE: dealing with CRS in ATG use as induction or treatment of ABMR 20 hours ago

Dr. Soobadar- Can you please clarify- Does this patient have ABMR or not? If YES , how was this diagnosis established? ---------------------...

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RE: dealing with CRS in ATG use as induction or treatment of ABMR 22 hours ago

Thanks Dr. Venkat for the clarification. I'm not aware of any published literature on ATG based treatment (not prevention) of pure AMR. Do you kn...

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RE: dealing with CRS in ATG use as induction or treatment of ABMR 22 hours ago

Although ATG is predominantly used for prevention/treatment of T cell-mediated rejection, it is used sometimes in pure antibody-mediated rejection....

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RE: dealing with CRS in ATG use as induction or treatment of ABMR 1 day ago

Good morning dr Soobadar would you mind sharing the biopsy report and DSA MFI There is no standard of care for treatment of ABMR but the majority...

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RE: Fibronectin glomerulopath 1 day ago

No history of diabetes Diabetic retinopathy screening not done ------------------------------ Sangeeth Kumar MBBS,MD, DM , DrNB SCE Neph MNAMS...

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RE: SIADH conundrum 1 day ago

Good question by Dr. Roland .. I guess my interpretation is that Urea is an ineffective osmole across membranes , as it has time to equilibrate . ...

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RE: SIADH conundrum 1 day ago

Thank you for that excellent article by Berl. I guess urea is an ineffective solute in plasma only, but is effective in urine. Thanks so much. --...

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RE: Fibronectin glomerulopath 1 day ago

No double contours were seen by LM so this is nodular GS without MPGN. Do we know the HBA1c and retinal findings? What about smoking history? The E...

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RE: severe hyperparathyroidism (PTH 6745) and hyperphosphatemia 1 day ago

Has AKI or advanced CKD evsrr been seen before consequent to excessive consumption of Dr. Pepper.? I cannot find a single publushed case. But that ...

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RE: Fibronectin glomerulopath 1 day ago

Another cause of an MPGN lesion with negative IF is collagenofibrotic glomerulopathy ( also called type III collagen glomerulopathy)- EM shows the ...

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RE: Intersting case-Need your opinion 1 day ago

Dr Glassock: With respect to nomenclature & avoidance of myth & mystery in an already muddy field, allow me to ask you the following: when you say ...

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RE: severe hyperparathyroidism (PTH 6745) and hyperphosphatemia 1 day ago

I fully agree! A positive Von Kossa stain of the renal tissue will be diagnostic as it used to be when phosphate containing enemas (the fleets and ...

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RE: High output HF from AVF? 1 day ago

I have no personal experience with fludrocortisone in ESKD, but, as you allude to, there are mineralocorticoid receptors in the vasculature, which ...

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RE: severe hyperparathyroidism (PTH 6745) and hyperphosphatemia 1 day ago

that is a lot of Dr Pepper. 150 calories/can? Yikes. But that degree of renal failure and that level of pth, the PO4 doenst have to be from the d...

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RE: SIADH conundrum 2 days ago

This is an example of what I was trying to underscore. Renal physiology cannot and should not be taught using APPs or shortcuts. The fundamentals p...

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RE: Intersting case-Need your opinion 2 days ago

Thank you for sharing this case. I want to know about her chronic viral screening for retroviral infections, chronic hepatitis screening, and Syphi...

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RE: severe hyperparathyroidism (PTH 6745) and hyperphosphatemia 2 days ago

If drinking great quantities of the high fructose corn syrup versions, I wonder what heights the uric acid levels reach? Probably a silly question,...

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RE: High output HF from AVF? 2 days ago

A clinical dilemma for sure. All HOHF in ESKD are not necessarily secondary to HFAVF. As suggested - Access flow measured using brachial art...

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RE: SIADH conundrum 2 days ago

Reimagine V in the electrolyte free water clearance formula as excreted solute divided be Uosm and one quickly sees that increasing excreted solute...

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RE: Renal Biopsy Findings Post Cyclophosphamide In Mpo+ve Patients 2 days ago

Repeat kidney biopsy done today ------------------------------ Muhammad Soobadar MBChB UK ------------------------------

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RE: Renal Biopsy Findings Post Cyclophosphamide In Mpo+ve Patients 2 days ago

Directly entered by electronic request:This lady has AKI with high ANCA titres but no extra renal manifiestation. She also had a period of signific...

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RE: Renal Biopsy Findings Post Cyclophosphamide In Mpo+ve Patients 2 days ago

egfr stable around 18 ml/min ------------------------------ Muhammad Soobadar MBChB UK ------------------------------

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RE: SIADH conundrum 2 days ago

I am well aware of the electrolyte free water clearance. Even though urea is considered an ineffective osmole, it seems to be "effective" enough to...

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