RE: fe urea 58 minutes ago

So the answer to the original question about the diagnostic utility of FE urea in AKI superimposed on CKD is "probably not", but good data are spar...

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RE: fe urea 5 hours ago

Heart failure [ both kinds ] Atrial fibrilation can drop pressure in Carotid baroreceptors - inducing reflex - vasocontriction in arterial tree [ ...

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RE: fe urea 6 hours ago

Is FE-Na just renal perfusion? Is baseball just pitching > hitting? C'mon, you know it's more complicated than that. What's "decreased effective ar...

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RE: MGRS in transplant patient? 6 hours ago

Dr. Linsey: Thanks for the additional information you have provided. CHR causes glomerular capillary wall duplication but well defined electron den...

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RE: MGRS in transplant patient? 8 hours ago

I agree that this discordance between the findings in the serum and the kidney are puzzling and it may not be possible to link them all together. R...

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RE: MGRS in transplant patient? 8 hours ago

If pronase digestion show light chain restriction (likely kappa) then it does not matter what is found in the bone marrow or what heavy chain is de...

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RE: MGRS in transplant patient? 10 hours ago

Thanks all for your interest and help. Dr. Rodby:Thanks for your comments. Will ask pathologist where the biopsy was obtained for Pronase digest...

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RE: Suspect ATN-induced Nephrogenic DI 11 hours ago

Agree that the polyuria is a solute (osmotic ) diuresis, and DDAVP will not help. 24 hour urine urea, glucose , Na and K determinations beedex to d...

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RE: Suspect ATN-induced Nephrogenic DI 11 hours ago

Yes!! Thank you for your valuable input!! ------------------------------ Erin Greer MD MD Avera Nephrology Group Sioux Falls SD (850) 358-9895 ---...

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RE: MGRS in transplant patient? 11 hours ago

I think that Dr. Rodby is spot on. Your could also isolate and analyze the circulating Cryoglobulin and see if it is monoclonal (Type 1) Or Mixed ...

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RE: Suspect ATN-induced Nephrogenic DI 11 hours ago

Uosm 380 to 480, urine output 5-6 liters? That is > 2000 mosm/day of solute (nl 6-800/d). This is a solute diuresis not a water diuresis. It is ur...

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Suspect ATN-induced Nephrogenic DI 13 hours ago

41-year-old male Native American admitted at outside facility following seizure (no previous seizure history). PMH alcoholic cirrhosis and chronic ...

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RE: MGRS in transplant patient? 13 hours ago

Restain the kidney after pronase digestion, I suspect you will then find kappa light chain restriction can you do an immunofixation on the cryocrit...

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RE: fe urea 14 hours ago

David, while your point is appreciated, how does increased "sympathetic nervous system, ANP, RAAS, and intrarenal "hemodynamics" ultimately reflect...

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RE: Atypical P-ANCA Significance 1:40 ? 14 hours ago

"ANCA testing has been abandoned in Europe. America is behind the times." I think this gets the award for the most definitive answer in Communitie...

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RE: Atypical P-ANCA Significance 1:40 ? 16 hours ago

Good morning what if the the atypical P-ANCA was much higher value of 1:640 . ------------------------------ Nasser Shirazi MBBS Renal fellow Wes...

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RE: fe urea 17 hours ago

Thanks Sheldon, this is very important. I will read Molitoris' article. I don't think of low FE-Na as reflecting anything about "perfusion", which ...

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RE: MGRS in transplant patient? 17 hours ago

The biopsy does not support a diagnosis of a MGRSoaternof injury despite the peripheral signs of an IgA MGUS, unless this is this is a complement a...

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RE: MGRS in transplant patient? 18 hours ago

Since there is cryoglobulinemia and IgM-dominant immunofluorescence: 1. Is rheumatoid factor also present? 2. Can IEP be done on cryo-precipitate t...

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MGRS in transplant patient? 1 day ago

52 year old woman with congenital renal disease. She received preemptive live donor allograft 2005 Baseline serum creatinine ~ 1 on MMF/tacro/pre...

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RE: kappa light chain gammopathy with hx of factor V to bx or not? 1 day ago

Yea of course if female! but still other causes of obstruction in such age is mandatory(specially that no active sediment in your patient urinalys...

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RE: kappa light chain gammopathy with hx of factor V to bx or not? 1 day ago

No recent c3. Cbc unremarkable. Pt actually female so obviously prostate / obstruction not applicable. ( 77 yo WF) req Sent from my iPhone

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RE: kappa light chain gammopathy with hx of factor V to bx or not? 1 day ago

What is the Serum C3 level, PLT level, blood film showed any abnormalities? In some cases paraproteins may lead to functional defect in alternativ...

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RE: kappa light chain gammopathy with hx of factor V to bx or not? 1 day ago

10/1/22 follow up for questions asked pt first seen by me 6/22/22 routine urine at that time revealed neg blood and protein ; no glucose in urine,...

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RE: relapse of ANCA vasculitis on Rituximab maintenance regimen with renal cancer 1 day ago

Hello, he was initially pulse with iv soluemdrol 250 mg bid x 3 days in 5/21 at time of Dx then prednisone 80 mg daily slowly tapered to 60 and 40...

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RE: relapse of ANCA vasculitis on Rituximab maintenance regimen with renal cancer 1 day ago

What was the steroid dose and duration? ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ------------------...

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RE: relapse of ANCA vasculitis on Rituximab maintenance regimen with renal cancer 2 days ago

Although increase in SCr/decrease in GFR is reported to be much less after radiofrequency- or cryo-ablation of renal masses compared to partial nep...

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RE: relapse of ANCA vasculitis on Rituximab maintenance regimen with renal cancer 2 days ago

Thanks for reply UA RBC 55-102 at time of Dx and induction only 1 RBC this year in feb and now 40 but UA wbc 182 also ur pr : Cr spot ratio 4.0-5....

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RE: kappa light chain gammopathy with hx of factor V to bx or not? 2 days ago

The spectrum of MGRS is so vast now, Im not sure there is any real clue one way or the other. Some can occur without even finding a circulating pa...

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RE: relapse of ANCA vasculitis on Rituximab maintenance regimen with renal cancer 2 days ago

Do you have serial urine protein and urine hematuria to compare with before? Do you have MPO ELISA not titers to compare over time, titers are not ...

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relapse of ANCA vasculitis on Rituximab maintenance regimen with renal cancer 2 days ago

Hello Everybody, I am following patient 83 year old, last year 5/21 Dx with ANCA Vascultiis MPO Cr 4.6 on admission kidney biopsy showed pauci imm...

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RE: kappa light chain gammopathy with hx of factor V to bx or not? 2 days ago

UPr/Cr was 0.11 g/g. If this was all proteins and not just UAlb/Cr, significant light chain excretion is unlikely. ------------------------------ ...

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RE: kappa light chain gammopathy with hx of factor V to bx or not? 2 days ago

I think I would have suggested a kidney biopsy too, even with the confounding anti-coagulation issues, but the proteinuria was so minimal. Cast Nep...

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RE: c3 GN 2 days ago

Does the patient have full nephrotic syndrome or just nephrotic range proteinuria. The Hematuria glomerular in origin or non specific? C3 depositi...

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RE: kappa light chain gammopathy with hx of factor V to bx or not? 2 days ago

The BM X2 not fulfilling MM criteria does not give me enough comfort to not still want a renal biopsy What is the urine protein level? Any other ob...

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RE: GN with Bartonella endocarditis 2 days ago

Yes, I see, if there is a cat at home who is infected- treatment of the pet may be indicated. ------------------------------ Richard Glassock MD, ...

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RE: GN with Bartonella endocarditis 2 days ago

I think it might. I think they have a few cases now of B. vinsonii subsp. berkhoffii causing some neurological signs as opposed to typical trench f...

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RE: GN with Bartonella endocarditis 3 days ago

Probably B. henselae, statistically. Does it make a clinical difference ? ------------------------------ Richard Glassock MD, FASN Laguna Woods CA...

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RE: kappa light chain gammopathy with hx of factor V to bx or not? 3 days ago

Noted that serum K/L ratio is lower over past several months (22.5 --> 16.2), despite impaired GFR. What are the trends in SCr, hemoglobin/hematocr...

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RE: GN with Bartonella endocarditis 3 days ago

Sorry if I missed it, which Bartonella sp is this? ------------------------------ Katherine James PhD, DVM Dixon CA (530) 574-0730 ---------------...

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RE: kappa light chain gammopathy with hx of factor V to bx or not? 3 days ago

Interesting case- apparently Category G3B/A1 CKD with a Light chain MGUS. You can pretty much disregard the urinary FLC as a sign of a MGRS. any ev...

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kappa light chain gammopathy with hx of factor V to bx or not? 3 days ago

77 yo WF with hx of IgG/k gammopathy , s/p BM bx x2, did not meet "myeloma criteria", and thus per Oncology, just following. sent to me several mon...

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RE: IgA Nephropathy with collapsing FSGS 3 days ago

The following article may be of interest: Kidney Int. 2011 Mar;79(6):643-654. doi: 10.1038/ki.2010.460. ------------------------------ Philippe V...

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RE: GN with Bartonella endocarditis Wednesday, September 28 @ 9:02 PM

At least we now have one RCT as a guide . It says to avoid steroids. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949...

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RE: GN with Bartonella endocarditis Wednesday, September 28 @ 7:41 PM

@David Goldfarb I just read the attached article which may shed some light with your therapeutic dilemma.​ ------------------------------ M...

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RE: fibrillary nephropathy and MDS disease Wednesday, September 28 @ 6:19 PM

MDS is like kidney disease. Some are really bad and some are not so bad. Some can be treated with high dose ESA. Others are pre AML. If it is the l...

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RE: GN with Bartonella endocarditis Wednesday, September 28 @ 6:17 PM

Looks like he is taking really potent drugs but probably not what you prescribed him. That is not predicting a positive outcome. T

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RE: GN with Bartonella endocarditis Wednesday, September 28 @ 5:26 PM

Really appreciated. Dr. Nadasdy, thanks for your thoughts as well. In fact as he returned today after escaping the hospital for a respite, with cre...

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RE: Peripheral B lymphocyte or CD 19 cell count Wednesday, September 28 @ 4:38 PM

There is no reason to check CD19+ cells in PB as he is in a CR with negative ELISA for anti-PLA2R antibody. There is no need to follow ELISA and IF...

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Peripheral B lymphocyte or CD 19 cell count Wednesday, September 28 @ 3:07 PM

Hi All I have a patient with membranous nephropathy which I treated 2 doses of rituximab patient responded very well and his UPC ratio is less than...

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