Indwelling urinary catheter in patients with pyelonephritis 20 minutes ago

Hello, What do you suggest about whether or not to maintain an indwelling urinary catheter in patients with relatively oliguric AKI due to pyelon...

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RE: hyperparathyroidism 31 minutes ago

I already ordered for 24-hour urine test for phosphate, unfortunately it was not requested earlier. Urine Citrate was low at 81 mg/24 hour (norma...

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RE: hyperparathyroidism 46 minutes ago

I confirmed with the patient, last prolia injection was 18 months ago, her first reported renal stone was much earlier than diagnosis of osteoporos...

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RE: hyperparathyroidism 1 hour ago

I agree that an elevated bone alk phos and osteocalcin is very unusual with Denosumab as they are usually suppressed even with an increased PTH. Th...

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RE: TTP 2 hours ago

Thank you again Dr Glassock, Dr Yousef Boobes and Dr Radhakrishnan. ------------------------------ Sai Ravi Machiraju MD Seven Hills Hospital Vis...

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RE: Renal Biopsy In Pulmonary Sarcoidosis 5 hours ago

Does he have bilateral hilar adenopathy? Current SCr 1.2 mg/dL. What was the baseline SCr ("preserved kidney function")? You have several markers t...

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RE: Antibiotic lock for Tenkhoff catheter 6 hours ago

Years ago, when rifampicin was suggested for its intracellular penetrability we tried it. It only preceded in making the patients vomit. In additio...

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RE: Timeline to use a new AV graft 6 hours ago

I am going to hope to conclude this. The promise of access flow surveillance has not worked out for us in the USA. I think the Europeans use it wis...

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RE: Renal Biopsy In Pulmonary Sarcoidosis 7 hours ago

I agree that this is high probability Sarcoidosis. A urine dipstick is not sufficent to evaluated renal sarcoidosis. I would ro a24 hours urine fir...

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RE: Svt Post Hd 7 hours ago

Thanks . Yes svt with rbbb and adenosine restores rythm to sinus tho Short lived. Is increasing k bath and magnesium Dialysate evidence based ? B...

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RE: Svt Post Hd 8 hours ago

A somewhat higher dialysate magnesium or oral magbesium supplementation (cautiously) if pre-dialysis magnesium. Is this arrhythmia clearly not Paro...

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RE: Svt Post Hd 8 hours ago

I would for sure try to avoid low K bath and see if that helps, maybe give him Lokelma or patiromer to help his K and decrease the for HD K remov...

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RE: Renal Biopsy In Pulmonary Sarcoidosis 8 hours ago

Did he have pyuria, or tubular proteinuria? The AKI could be TIN or hypercalcemia, the urine might help I have used renal biopsy many times ...

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RE: Renal Biopsy In Pulmonary Sarcoidosis 8 hours ago

Pth suppressed. Vitamin d was within range ( he was on vitamin d supplements which we asked him To stop. 1,25 Hidroxy not checked If urine dip is...

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RE: Renal Biopsy In Pulmonary Sarcoidosis 8 hours ago

What was the 1,25 dihydroxy Vitamin D and PTH levels during hypercalcemia? With a bland urine and a return of kidney function to normal with fluids...

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RE: hyperparathyroidism 8 hours ago

The increased bone AP and osteocalcin are of concern, since such changes are usually not seen with Denosumab therapy of PM osteoporosis. Perhaps th...

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RE: hyperparathyroidism 9 hours ago

“..not sure a sestamibi will either as it may have some increased uptake depending on when the last dose of Denosumab was..” Not much to be lost b...

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RE: hyperparathyroidism 9 hours ago

"Bone alkaline phosphatase is 33 ug/l (normal less than 22)" Bone -specific alkaline phosphatase was elevated. ------------------------------ K...

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Renal Biopsy In Pulmonary Sarcoidosis 10 hours ago

I have a case of 67 male gentleman who started having aki ( preserved kidney function baseline ) with hypercalcaemia over last 6-7 month ACE level...

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Svt Post Hd 10 hours ago

Hd patient known to have svt on oral verapamil had svt tachycardia with normal bp post hd twice this week . Both times terminated with iv verapamil...

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RE: hyperparathyroidism 11 hours ago

I basically agree with Prof Glassock, I do not believe this is primary HPTH. It may be FHH. I don't think a bone biopsy would be helpful, not sure ...

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RE: Timeline to use a new AV graft 12 hours ago

I would like to provide a reference Nat Rev Nephrol . 2013 Jun;9(6):348-57. doi: 10.1038/nrneph.2013.76. Epub 2013 Apr 16. Vascular access in ...

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RE: hyperparathyroidism 13 hours ago

The history of kidney stones (calcium oxalate) and Denosumab therapy significantly confound the unifying diagnosis in thus case. As far as I know F...

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RE: Antibiotic lock for Tenkhoff catheter 14 hours ago

I typically treat longer the second time, maybe a month, that way if it recurs you are certain that the catheter needs to be changed (and the patie...

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RE: hyperparathyroidism 15 hours ago

To satisfy the desires of the very demanding Rev Occam, we have to explain all of the following Osteoporosis Serum Calcium a little high at 10...

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RE: Renal infarction 15 hours ago

Thank you Dr. Friedman ------------------------------ Mustafa Saidi MD Nephrology Department Albert Einstein Philadelphia PA --------------------...

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RE: Renal infarction 15 hours ago

Thank you Dr. Minshar ------------------------------ Mustafa Saidi MD Nephrology Department Albert Einstein Philadelphia PA ---------------------...

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RE: hyperparathyroidism 18 hours ago

Thank you for your reply's, Her renal function is normal with creatinine of 1 mg/dl, never been reported to have renal issues. She is on regul...

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RE: Antibiotic lock for Tenkhoff catheter 1 day ago

Although catheter replacement seems to be the optimal solution, given the patient's intention and general condition, why not consider rifampicin as...

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RE: Timeline to use a new AV graft 1 day ago

Dr Wynn Good to hear from you I was a fellow at MCG in 1996/7 with Laura Mulloy Agree with you ------------------------------ Muhamm...

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RE: Timeline to use a new AV graft 1 day ago

> An important point, thank you for bringing it up. Yes, I vary the criteria, though not in a fixed manner. Because AVGs clot so much more often, ...

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RE: TTP 1 day ago

For younger patients, (and pregnancy-associated TTP) it is important to consider congenital TTP (inherited mutations of ADAMTS13) This can be wor...

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RE: hyperparathyroidism 1 day ago

This is not primary HPTH. what is her renal function. The PTH and bone chemistries will vary based on when the denosumab is given, though I would e...

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RE: hyperparathyroidism 1 day ago

is her SCr; egfr? -when did she start Prolia; and any real panel report prior to Rx initiation? -when were the renal stones first diagnosed? -di...

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RE: Timeline to use a new AV graft 1 day ago

Are your criteria different for AVF vs AVG?, Am I correct that you measure Access flow monthly, but can measure it at any time if needed to make ...

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RE: Timeline to use a new AV graft 1 day ago

Dr Besarab, again, thank you for your comments (and thanks to Dr Balan as well, for his kind words). A bit more detail in response to: " Do you use...

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RE: TTP 1 day ago

We treated relatively good number of cases of TTP in the last few years, most of them responded well to the standard treatment (PLEX, Steroids, and...

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RE: Living Kidney Donor 1 day ago

Always a delicate issue. I tend to give primacy to primum non nocere in these situations . ------------------------------ Richard Glassock MD, FA...

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RE: hyperparathyroidism 1 day ago

Interesting dilemma. I have seen a few cases like this- i would conclude that the elevated PTH , alkaline phosphTase and the low urine calcium are ...

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hyperparathyroidism 1 day ago

A middle \aged female patient presented with a history of recurrent renal stone formation. She has renal function study. An extensive work up ...

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RE: TTP 2 days ago

For the truly "refractory" cases of TTP (so uncommon to render a RCT highly improbable) several suggestions are made- try twice daily TPE, add capa...

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RE: TTP 2 days ago

Thank you Prof Glassock and Dr Venkat. ------------------------------ Sai Ravi Machiraju MD Seven Hills Hospital Visakhapatnam 9866202945 -------...

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RE: Telenephrology 2 days ago

Rebecca Schmidt is using telenephrology because of the great distance patients have to travel. I understand that the stereoscope works well for tra...

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RE: Telenephrology 2 days ago

If you are looking for rales ,wheezes, frictions rubs, bruits, bowel sounds a remote stethescope might be a good option -------------------------...

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RE: TTP 2 days ago

Truly refractory TTP ( operationally defined as a failure of ADAMTS13 levels to rise above 10-15% of normal levels after 7-10 daily TPE using FFP a...

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RE: TTP 2 days ago

No personal experience. Following reference addresses the problem of refractory TTP: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8185636/ ----...

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RE: Living Kidney Donor 2 days ago

If one looks only at the past medical history, one can easily justify turning down this potential donor. However, I suspect the situation is not th...

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RE: Timeline to use a new AV graft 2 days ago

If I may , I Would like to summarize your response.. In response to your query about my approach: You use three pieces of ...

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Antibiotic lock for Tenkhoff catheter 2 days ago

Dear PD gurus, 63 yo W with HTN, DM, ESKD from DM on PD for 1 year. Had staph epi peritonitis in September which responded to 2 weeks of IP van...

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TTP 2 days ago

Good evening. Over the last few years, I was called to do plasmapheresis in four patients of TTP. The first was in a known patient of SLE. The se...

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