Necrotising GN without crescents 17 minutes ago

We have a 60 year old man with diabetes and baseline ?ckd with creatinine maintaining around 2.4 mg/dl for 3 months. he developed fever with sudden...

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RE: MCD-TATTO 4 hours ago

Interesting idea, but treatment responsive and relapsing. I do not think do. Sent from my iPad

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RE: MCD-TATTO 5 hours ago

A far-fetched tattoo-NS connection but how about mercury toxicity (although MN reported > MCD)? Apparently higher Hg content in red ink. ----------...

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RE: MCD-TATTO 9 hours ago

The glomerular lesion of syphilis (secondary) is membranous, but it has been reported with syphilis (I know this only bc I just googled it...)  htt...

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RE: Second Transplantation 12 hours ago

Agree-I don’t understand if PRA is negative, why is class II ab mentioned. Also it helps to know which class II abs . If this is to one only and no...

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RE: Second Transplantation 13 hours ago

I am confused by the following statement in your post: " anti HlA class 2 is high MFI leumenx, 2230, PRA negative". What are the HLA class 2 antige...

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RE: MCD-TATTO 13 hours ago

any thought of secondary syphilis in case there has been bodily fluid exchange with the tattoos (assuming that the tattoos were not done in the str...

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RE: MCD-TATTO 13 hours ago

I agree with repeat RTX. A re-biopsy will not add any useful information. Many antigenic stimuli (allergies, immunization, URI, etc) can "trigger...

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MCD-TATTO 14 hours ago

I have a 35-year-old male patient, with no relevant medical or family history with a history of kidney disease, who presented with a complete sudde...

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RE: Peritoneal Dialysis in ESRD with Liver cIrrhosis and ascites 15 hours ago

There is a fair amount of literature on this, most recently was this review from last year by San Khan and Mitch Rosner from last year. I have been...

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RE: Pt with Kidney stones 15 hours ago

Dr. Glassock's question about risk of CaP stones with alkali therapy is important, but unfortunately there is not great data to guide us one way or...

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RE: Amyloidosis and the fibril diameters 16 hours ago

The antibodies used for IgG subtyping are monoclonal. There is a possibility that truncated heavy chain may compromise the recognition by its antib...

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RE: Peritoneal Dialysis in ESRD with Liver cIrrhosis and ascites 16 hours ago

I do not have much personal experience with PD in advanced cirrhosis with ascites, but I do remember the consequences of albumin losses and the nee...

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RE: Peritoneal Dialysis in ESRD with Liver cIrrhosis and ascites 17 hours ago

Try this:  Nader et al PDI 2017. They showed a lower mortality in cirrhotic patients using PD versus HD.  Study is small, however (~ 15 patients). ...

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RE: Peritoneal Dialysis in ESRD with Liver cIrrhosis and ascites 18 hours ago

The main thing of PD in this situation is to prevent hypovolemia, for instance by restricting the duration of the drainage period. Her serum albumi...

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RE: crescentic GN with dbl antibody positivity 18 hours ago

Thank you for the great advice..oral cyc was started with serum cr improving (3.2->2.9->2.5mg/dl). --------------------------------- Ashok Sastry M...

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Peritoneal Dialysis in ESRD with Liver cIrrhosis and ascites 19 hours ago

I have a patient with ESRD, liver cirrhosis and associated ascites who gets weekly ascitic   tap while remains coagulopathic. She has a tunneled Ca...

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RE: Need Opinion 19 hours ago

That’s why I brought it up here...MGMID has been postulated, yes not proven, as such by the group who discovered it & with the most published exper...

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RE: a 8 years boy with MCD(biopsied) and low C3. 22 hours ago

C3 low moderatly ------------------------------ Habeeb Baloch Baluchistan institute of nephrology & urology quetta Quetta 00923330282967 ----------...

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Second Transplantation 22 hours ago

52 years old female patient underwent 1st renal transplant science 2003,she had perfect kidney function till few months ago, biopsy done IFTA 70%,N...

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RE: Need Opinion 1 day ago

I see you point- but as far as the Kidney is concerned I do not know of any exceptions. Can you give me an example? Sent from my iPad

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RE: Need Opinion 1 day ago

Yes, agree except what I’m trying to get across is that not all LC restricted pathologic processes are necessarily due to a clonal neoplasia. -----...

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RE: Need Opinion 1 day ago

Maybe, but as far as I know MRGS is defined by renal biopsy findings not by the presence or absence of a detectable circulating or urinary monoclon...

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RE: Recurrent nephrotic syndrome/MCD? 1 day ago

ok sir thank you.. --------------------------------- Sameh Morgan IBRI 0096896197096 ---------------------------------

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RE: Treating avf stenosis according to Doppler Morphology ?? 1 day ago

Hi Sivaramakrishnan When you say Doppler, are you referring  to flow patterns seen on colour Doppler? or are you referring to spectral Doppler trac...

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RE: Need Opinion 1 day ago

In non-renal literature, are there not other exceptional instances of monotypic (LC restricted) yet polyclonal B-/plasma cell proliferations/popula...

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RE: Recurrent nephrotic syndrome/MCD? 1 day ago

According to RCT evidence CYC is not effective In steroid-resistant Nephrotic syndrome in children (most likely due to Primary FSGS). CYC can be qu...

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RE: Recurrent nephrotic syndrome/MCD? 1 day ago

steroid dependent multirelapsing and incases with steroid resistent cyclophosphamide is also effective if no contraindication or young pt concent t...

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RE: Recurrent nephrotic syndrome/MCD? 1 day ago

Rituximab is generally ineffective in steroid-resultant MCD (usually due to underlying FSGS.). The evidence that combining MMF with a CNI is any mo...

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RE: Need Opinion 1 day ago

If there is clear L chain restriction of the IgG deposits, this disease is categorized as a MGRS, irrespective of presence of monoclonal proteins i...

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RE: Pt with Kidney stones 1 day ago

as I said i messureed all these things last week in the urine but on the way to the lab it got lost. so we are going to restart. my lab is only par...

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RE: Recurrent nephrotic syndrome/MCD? 1 day ago

In Egypt, as ritux is expensive, resistent cases we combine Cni With mmf ans steroid then taper gradually of steroid dose ...it was effective way a...

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RE: Need Opinion 1 day ago

I could not any urine test going back to 2013 His haematologist does not think he has anticardiolipin antibody dyndrome ---------------------------...

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RE: Need Opinion 1 day ago

Dear DrFreidman Thanks for your comments You are correct that at present there is no evidence to categorize this condition considered in the spectr...

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RE: Pt with Kidney stones 1 day ago

It is my impression from reading many posts on use of K Citrate that the risk of aggravating Ca PO4 stone formation by higher urine pH is greatly o...

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RE: Treating avf stenosis according to Doppler Morphology ?? 1 day ago

Yes exactly :). I am very lucky to be part of the team with Dr Steiner.  I am one of the co-investigator of a prospective study where we are trying...

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RE: Pt with Kidney stones 1 day ago

The issue of CaPhos stones and alkali therapy is an important question and why I wanted to know about his urine chems.  But in the absence of an ev...

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RE: Pt with Kidney stones 1 day ago

@John Asplin could empirically giving k Citrate increase risk of calcium Phosphate stones ? Would you not want to measure urine PH as well ? Obviou...

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RE: Treating avf stenosis according to Doppler Morphology ?? 1 day ago

In fact, Dr. Steiner works at your hospital!! ------------------------------ Monnie Wasse MD, MPH, FASN Professor of Medicine Rush University Medic...

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RE: Pt with Kidney stones 1 day ago

For CaOx stones the titration would be by urine citrate excretion, for uric acid stones the titration would be by urine pH. I agree with Dr Lerman ...

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RE: Treating avf stenosis according to Doppler Morphology ?? 1 day ago

The short answer to your question is "yes", we generally treat them the same way, at least initially- with balloon angioplasty-- unless highly recu...

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RE: Pt with Kidney stones 1 day ago

Did you do KUB to see if stones have calcium? --------------------------------- [Mark] [Lerman] [MD,FASN,FACP,FAST] [Past Medical Director Kidney P...

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RE: Pt with Kidney stones 1 day ago

@John Asplin @David Goldfarb ​​ ------------------------------ Roger Rodby MD, FASN Professor of Medicine Rush University Medical Center Chicago IL...

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RE: Need Opinion 1 day ago

Young...recurrent VTE (was he nephrotic then too?)...anemic & thrombocytopenic (see last query below)...lowish C4...anti-dsDNA Ab +ve but ANA -ve (...

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Pt with Kidney stones 1 day ago

Hi I had a patient 28 years from Albania in my office last week who was diagnosed with kindey stones when he went back home. He does not speak germ...

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RE: Recurrent nephrotic syndrome/MCD? 1 day ago

In Pediatrics there is a weak evidence that RTX followed by maintenance MMF can induce long term remission (see attached article). RCT is underway ...

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RE: Treating avf stenosis according to Doppler Morphology ?? 1 day ago

@Monnie Wasse --------------------------------- Roger Rodby MD, FASN Professor of Medicine Rush University Medical Center Chicago IL (312) 850-8434...

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RE: Need Opinion 1 day ago

Remember that lupudms is generally "Full House" IF and this is monoclonal. This would not be typical for SLE. --------------------------------- Rog...

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RE: crescentic GN with dbl antibody positivity 1 day ago

Patients with dual antibody disease will often require some kind of maintenance therapy for the ANCA component of the disease (usually AZA or RTX)...

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RE: crescentic GN with dbl antibody positivity 1 day ago

Try Stephen McAdoo's paper about their experience with dual positive anti-GBM and ANCA over in Europe:  https://www.ncbi.nlm.nih.gov/pubmed/2850676...

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