RE: Would SGLT2 be indicated in a 71 F w CDK3b w uACR 39 who is pre-DM (A1c 6.3, 6.4) and HTN 5 hours ago

What is her BMI and urinary sediment exam? Have you done a kidney US examination? Do you know her birthweight? what anti-hypertensive medications a...

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Would SGLT2 be indicated in a 71 F w CDK3b w uACR 39 who is pre-DM (A1c 6.3, 6.4) and HTN 6 hours ago

I am obviously very temped to start this pt on an SLGT2, however If the reading of the most recent KDIGO guidelines is correct, then she strickly s...

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Nephrology Quiz and Questionnaire 10 hours ago

Calling all nephrology fellows and program directors-we need your help with the Nephrology Quiz and Questionnaire. Fellows, try to outsmart the Nep...

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Nephrology Quiz and Questionnaire 10 hours ago

Calling all nephrology fellows and program directors-we need your help with the Nephrology Quiz and Questionnaire. Nephrology Program Directors, ch...

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RE: Kidney Transplantation immunity 10 hours ago

Thank you, Drs, for your esteemed sharing of insights, practice, and valuable participation in discussing and following this patient's care. Your c...

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RE: chronic Hyponatremia, now hypo osmolar , euvolemic , asymptomatic, and undetsctable urine Na 11 hours ago

I agree he needs to have increase in salt intake and this should help increase his Na. But there seems to be a consistent gap between the measured ...

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RE: chronic Hyponatremia, now hypo osmolar , euvolemic , asymptomatic, and undetsctable urine Na 13 hours ago

This patient should show a response to liberalized NaCl intake. ------------------------------ John Mellas MD Nephrology and Hypertension Special...

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RE: Renal thrombotic microangiopathy 15 hours ago

Both NS (Intestinal edema, intuseception) and TAFRO (serositis?) cause abdominal pain. An abdominal CT showing extensive bowel wall thickening due ...

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RE: Renal thrombotic microangiopathy 16 hours ago

As soon as we manage to diurese him, the nausea and bowel pain vanish (which was why I thought it was rather due to edema). Would this be compatibl...

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RE: SIADH in a patient with SAH 20 hours ago

"Can a chronic malnourished state lead to intracellular solute depletion that then drives the hyponatremia " ? The answer is yes for at least one i...

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RE: SIADH in a patient with SAH 21 hours ago

Sent from my iPhone On Sep 20, 2024, at 12:03 AM, Tunde Tijani wrote:  -.. "..Can we prevent ODM by infusing amino acid and potassium phosphate...

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RE: SIADH in a patient with SAH 22 hours ago

-.. "..Can we prevent ODM by infusing amino acid and potassium phosphate simultaneously as we correct the ecf tonicity?.." Possibly; but before ...

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RE: Persistent Hyperkalemia 1 day ago

All very good points Dr. Friedman. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ----------------------...

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RE: SIADH in a patient with SAH 1 day ago

Thanks for the explanation on idiogenic osmoles, Dr. Tijani. It would be interesting to see if they increase with exogenous amino acid infusion. ...

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RE: Persistent Hyperkalemia 1 day ago

Just trying to propose another idea. There is a pediatric entity I have thinked of. Could that be possibly transient PHA (pseudohypoaldosteronism) ...

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RE: Persistent Hyperkalemia 1 day ago

More questions than answers. Even if you had a Ucreat, what would a high UK/Ucreat ratio checked after diuresing with bicarb/lasix mean about hype...

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RE: Apply today!! Travel Support Scholarship for Nephrology Fellows to attend Annual Dialysis Conference, Las Vegas 2025. 1 day ago

Please see details about fellows' application for ADC sponsorship below: Nephrology Fellows (non-pediatric) Nephrology fellows are invited to sub...

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RE: chronic Hyponatremia, now hypo osmolar , euvolemic , asymptomatic, and undetsctable urine Na 1 day ago

Hyponatremia is due in part to hyperglycemia. Probably on a very low Na intake. His poly pharmacy needs to be addressed. There may be component of ...

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RE: Renal thrombotic microangiopathy 1 day ago

Abdominal pain is also a very common presenting feature of TAFRO- i am still inclined to consider this case as "atypical " TAFRO syndrome. Can you ...

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chronic Hyponatremia, now hypo osmolar , euvolemic , asymptomatic, and undetsctable urine Na 1 day ago

White gentleman age 56, with history of schizoaffective disorder and bipolar transferred to our mental health unit with suicidal ideation. Lacks ca...

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RE: Persistent Hyperkalemia 1 day ago

"Usually she comes in with fatigue" Did she have significant muscle weakness and hypoteflexia? If yes, this would argue against pseudo-hyperkalem...

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RE: Renal thrombotic microangiopathy 1 day ago

The initially normal serum albumin with "anasarca" continues to trouble me, in so far as a primary diffuse podocytopathy. LM findings are also at v...

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RE: Persistent Hyperkalemia 1 day ago

Excess oral K intake is a very rare cause of hyprkalemia when GFR is normal except when drugs or other compounds interfere with tubular K secretion...

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RE: Persistent Hyperkalemia 1 day ago

"Isn't it essentially impossible to become significantly hyperkalemic with normal kidney function based on K ingestion alone?" agree with the ...

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RE: Renal thrombotic microangiopathy 1 day ago

Although SAlb remains unchanged, some improvement in SCr and proteinuria has occurred. Current prednisone dose? How long has been on prednisone?Adu...

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RE: Persistent Hyperkalemia 1 day ago

Isn't it essentially impossible to become significantly hyperkalemic with normal kidney function based on K ingestion alone? Various populations ...

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RE: Persistent Hyperkalemia 1 day ago

There have been some anecdotal cases of hyperkalemia induced by Tirzepatide. i would advise exploring this possibility. -----------------------...

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RE: Persistent Hyperkalemia 1 day ago

I agree that is quite unusual to see no EKG changes in somebody with normal renal function with the potassium of we used to be taught of mechanism ...

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RE: Persistent Hyperkalemia 1 day ago

Will check . The time we checked it was the same as serum. And, there was no definite cause for a pseudohyperkalemia - will surely check again. Tha...

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RE: Apply today!! Travel Support Scholarship for Nephrology Fellows to attend Annual Dialysis Conference, Las Vegas 2025. 1 day ago

Hi, How can we apply for travel support to attend ADC, Las Vegas 2025? ------------------------------ Sherzod Abdullaev MD Head of departmen...

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RE: Renal thrombotic microangiopathy 1 day ago

At this point, i would favor a podocytopathy. If already on steroids for >8 weeks without some response, would add plasma exchange and rituximab ...

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RE: Kidney Transplantation immunity 1 day ago

@Riyadh Alsaegh, do you have new information about your patient?. Thank you. ------------------------------ [Benjamin] [Gomez] [] [JProfessor of...

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RE: Persistent Hyperkalemia 1 day ago

24 hour colletions or potassium and creatinine X 3 sets to ind out urine K excretion this should inform about how much postassium she is taking. ...

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RE: Renal thrombotic microangiopathy 1 day ago

He's hospitalized again due to recurrence of edema and abdominal pain (bowel edema?). Bone marrow: small population with monoallelic clonality of...

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RE: Persistent Hyperkalemia 1 day ago

I am struck by the relatively normal ECG with K levels of 9. Would rule of pseudohyperkalemia a little more thoroughly: 1. Either separate the ...

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RE: Apply today!! Travel Support Scholarship for Nephrology Fellows to attend Annual Dialysis Conference, Las Vegas 2025. 1 day ago

Good morning, after some inquiries, I have attached more details about fellows' application for ADC sponsorship for next year's meeting (availab...

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RE: interesting case 1 day ago

Sir we don't have the facility of EM . and his biopsies were run outside so we don't have blocks. But sure I can send you the written report tomorr...

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RE: SIADH in a patient with SAH 1 day ago

To be sure, idiogenic osmoles are defined as organic molecules that are produced by cells to regulate their volume and composition.. -An osmole is...

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RE: interesting case 1 day ago

Do you have EM on the first transplant kidney biopsy? If not, can you have the paraffin block processed for EM? Can you post the LM and IF report f...

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RE: Liver Tx Alone In CKD patients 1 day ago

In CKD, GFR > 30 mL/min/1.73 m2 for deceased donor liver transplant-alone and [More]

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RE: interesting case 1 day ago

Thankyou all for your valuable comments.Can anyone please send me the reference articles/case series/case reports of 1. Missed membranous on LM and...

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RE: Liver Tx Alone In CKD patients 1 day ago

So we can conclude that in living donor programs, decision of combined liver and kidney transplant may be based on GFR measurements of the recipien...

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RE: Persistent Hyperkalemia 2 days ago

here are the articles: Did not include dig or Foxglove... ------------------------------ Roger Rodby MD, FASN Professor of Medic...

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RE: SIADH in a patient with SAH 2 days ago

Appreciate thoughts from Dr. Tijani, Dr. Glassock and Dr. Mario. This patient likely had severe intracellular potassium, Phosphate, Magnesium and...

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RE: Persistent Hyperkalemia 2 days ago

I love it. Sounds like a script from Dr. House. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ---------...

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RE: SIADH in a patient with SAH 2 days ago

The phenomenon of redistribution of water into the ECF and Na into the ICF (causing hyponatremia ) due to severe total body K deficits is well desc...

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RE: SIADH in a patient with SAH 2 days ago

Thanks! Sent from my iPhone

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RE: SIADH in a patient with SAH 2 days ago

As you may recall the idea of "idiogenic osmoles" was generated from experiments in rabbits to account for the intra-cerebral changes which are ass...

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RE: IgA Nephropathy 2 days ago

"My question is: Why did the three studies exclude these patients?" this is the problem with so many past IgAN studies, you can't prove slowing p...

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RE: Persistent Hyperkalemia 2 days ago

Some fun ideas: any possibility of Digoxin ingestion? Foxglove? Chan Su, a traditional Chinese medicine (dig effects) toad venom (di...

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