RE: Immune Complex Mediated MPGN In Addict 17 minutes ago

Short of the TEE that was refused & what's already been reported, how thorough was the search for an occult & chronic infection in this IDU, e.g. S...

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RE: Crescentic GN in a patient with known infective endocarditis 59 minutes ago

Is he oliguric? I have occasionally advocated treating an IRGN once the infection has cleared , but I just dont see doing it here. You can only...

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RE: Hyperphosphatemic, nonazotemic CAT with calcified paw pads 1 hour ago

Question- could this all be due to inadequate therapy of hyperthyroidism -what is the TSH , free T3 and T4 levels. Just speculating. ------------...

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RE: Hyperphosphatemic, nonazotemic CAT with calcified paw pads 1 hour ago

I think this could fit with the equivalent of familial tumoral calcinosis from an inactivating mutation in klotho (or in FGFR or somewhere else fur...

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Hyperphosphatemic, nonazotemic CAT with calcified paw pads 3 hours ago

Hi everyone, I'd love to get your thoughts on this patient we have with very unique skin lesions. It was referred to us by a dermatologist who...

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RE: Immune Complex Mediated MPGN In Addict 4 hours ago

The suggestion of Dr. Fogo needs attention. Also , the results of LC monotypic deposition needs to be addressed. I agree tgat an IRGN is likely, bu...

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RE: Crescentic GN in a patient with known infective endocarditis 4 hours ago

Although the presence of VRE endocarditis provides a good explanation for the Crescentic GN, the advanced COPD at a young age raises the issue of a...

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RE: APKD and ? FMD 5 hours ago

I had a patient with ADPKD and Ehlers Danlos syndrome, vascular type. I regarded this as a coincidental finding following review of the literature,...

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RE: APKD and ? FMD 6 hours ago

Hi, I did attach CTangiogram and Doppler ultrasound reports, please have a look. Also attached MRI brain report. I have not confirmed the diag...

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RE: Immune Complex Mediated MPGN In Addict 6 hours ago

I fully understand your concerns about adding MMF, RTX or other IS agents to the steroid regimen already being used in thus active I'V drug-abuser....

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RE: trial of peritoneal dialysis in presence of diabetic gastroparesis 8 hours ago

Managing gastroparesis while on PD is very frustrating! These patients develop fluid, electrolytes problems, and poor solid intake further deterior...

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RE: Immune Complex Mediated MPGN In Addict 9 hours ago

Did deposits stain for IgM? ------------------------------ Agnes Fogo Professor Vanderbilt University Medical Center Nashville TN (615) 322-3114 ...

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RE: APKD and ? FMD 9 hours ago

Nice case. However is the diagnosis of FMD based on Doppler results alone? Doppler is a good screening test but can by no means confirm renal arter...

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Crescentic GN in a patient with known infective endocarditis 9 hours ago

Good morning: I have an interesting case and a clinical dilemma. The patient is now in house, 46 male, admitted on 9/27/23 for AKI with prese...

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RE: APKD and ? FMD 9 hours ago

Thank you, appreciate the guidance, we are screening. Keeping in mind also if this can just be intimate tear and injury related infarction ? I am a...

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RE: Immune Complex Mediated MPGN In Addict 9 hours ago

Thank you prof. Glassock Thank you Dr mohamed But this first time to meet iv drug abuser who require immunosuppressants Is it safe to give hime im...

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RE: IgA nephropathy 10 hours ago

Dr. Venkat is quite correct- and he raises a very important point-a form of spontaneously reversible AKI has been seen and reported repeatedly in c...

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RE: IgA nephropathy 12 hours ago

Thank you Dr Venkat: no RBC casts reported. ------------------------------ Eithan Orlev-Shitrit MD MONTGOMERY OH (513) 488-6279 ----------------...

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RE: IgA nephropathy 12 hours ago

Thank you Dr Glassock for the detailed answer! It is alcoholic liver cirrhosis, no exposure to silica per his profession ( food engineering). -...

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RE: IgA nephropathy 12 hours ago

Gross hematuria in the setting of IgA nephropathy - any recent COVID infection or vaccination? Given gross hematuria + AKI + possible coagulopafh...

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RE: APKD and ? FMD 13 hours ago

Good case with ADPKD with incidental renal artery stenosis . We think incidental renal artery stenosis need to sure hemodynamic significant by meas...

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RE: Immune Complex Mediated MPGN In Addict 13 hours ago

Good and nice presentation of immune complex mediated MpGN , although the prognosis is poor but in our clinical practice we proceed for active ther...

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RE: Immune Complex Mediated MPGN In Addict 15 hours ago

Also please recheck the kidney biopsy concerning monotypic Light Chain deposition-- this was not reported . If you can, It might help to stain the ...

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RE: Immune Complex Mediated MPGN In Addict 15 hours ago

Tough case. Assuming that all features of infection are absent and ANCA testing is also negative, I Might try MMF and tapering of steroids, or poss...

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RE: Immune Complex Mediated MPGN In Addict 16 hours ago

Hi all Prof. Glassock RF negative Cryo negative Hep Viro negative Patient on high dose steroid has generalized anasarca Albumin 20 , 24 h protei...

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APKD and ? FMD 16 hours ago

I have a 19 year old who presented post MVA with thoracic fractures and lung injury and incidentally we found interesting pathology. She had a fami...

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RE: IgA nephropathy 17 hours ago

A partial answer to your good question can be found in a recently published paper by Li, W et al in Am J Nephrol (2023). In a single center center ...

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IgA nephropathy 19 hours ago

I have a 43 year old male with history of liver cirrhosis who was seen for gross hematuria. At presentation Cr was 1.3 ( 1.0 a year before), UPCR 1...

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RE: trial of peritoneal dialysis in presence of diabetic gastroparesis 1 day ago

Just the gastroparesis problem, thanks, Mark PLEASE NOTE: This message is intended for the use of the person to whom it is addressed. It may cont...

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RE: trial of peritoneal dialysis in presence of diabetic gastroparesis 1 day ago

Mark, You mean in diabetic gastroparesis, or in general? Klemens Klemens B. Meyer, MD Professor of Medicine, Tufts University School of Medicin...

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RE: trial of peritoneal dialysis in presence of diabetic gastroparesis 1 day ago

In my clinical experience, the potential benefit of PD has not panned out, and esophageal reflux can become severe and dominate the upper gastroint...

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RE: Serum Bicarbonate Concentration in Hyponatremic SIADH Patients 1 day ago

Thank you Dr. Soleimani. Much appreciated. ------------------------------ Mario Rubin, M.D. Houston TX (713) 252-5539 ---------------------------...

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RE: Serum Bicarbonate Concentration in Hyponatremic SIADH Patients 1 day ago

Thank you, Dr. Rubin for the interesting question. The AVPR1 (or V1R to the field of nephrology) is an understudied gene in the field of nephrology...

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RE: Treatment of recurrent minimal change disease 1 day ago

Should this lady get a genetic study done? She doesn't satisfy the usual criteria for doing a genetic study but the increasing resistance to treatm...

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Nephrology Teaching in Private Practice 1 day ago

Hi, I am a nephrologist in private practice at a large community hospital (that has evolved into a tertiary care center) with a residency progra...

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RE: Serum Bicarbonate Concentration in Hyponatremic SIADH Patients 1 day ago

Thank you Dr. Solemaini for the added educational pearls. Is there a molecular difference between the V1 receptor in smooth muscle (mainly responsi...

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RE: Treatment of recurrent minimal change disease 1 day ago

She seems rituximab responsive. I do not routinely follow IgG levels on Rituximab, is that something others do? MMF (+/- CNI) may keep her in...

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RE: trial of peritoneal dialysis in presence of diabetic gastroparesis 1 day ago

My experience has been similar to that of others. In general PD instillation worsened "subjectively" to the patient the feeling inadequate gastric ...

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Calciphylaxis vs warfarin skin necrosis 1 day ago

77 WF s/p mechanical AVR/MVR 2010, a-fib/flutter s/p MAZE, HTN, pHTN and CKD stage 4. Two month hx progressive lateral thigh lesions starting as p...

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RE: polycystic kidney disease which is not PKD1/2 related 1 day ago

A additional reason for genetic testing is PGD (preimplantation genetic diagnosis). ------------------------------ Ella Koifman-Zeltzer MD Tel-Av...

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RE: C3 glomerulopathy ? 1 day ago

Thanks for this great insight. In the meantime , while creatinine is still 1.34; microhematuria -5/HPF ACR 848, PCR 1373 HG up to 13.2 fro...

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RE: trial of peritoneal dialysis in presence of diabetic gastroparesis 1 day ago

I don't know why, but I can't remember any PD patient with severe gastroparesis. ------------------------------ Raymond Krediet MD, PhD Academic ...

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RE: Treatment of recurrent minimal change disease 1 day ago

Combination of tacrolimus + mycophenolate may work? May permit lower trough levels of tacrolimus. Also tacrolimus interaction may increase mycophen...

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RE: trial of peritoneal dialysis in presence of diabetic gastroparesis 1 day ago

We use in our case of diabetic kidney disease with gastroparesis , icodextrin based solution at night with 1.36% solution 3 times a day . We follow...

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RE: Treatment of recurrent minimal change disease 1 day ago

It a lot if data bearing in this question but I would try to get her back into a full or partial remission with RTX, and then start MMF for relapse...

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RE: Serum Bicarbonate Concentration in Hyponatremic SIADH Patients 1 day ago

Thank you, Dr. Rubin for your cheerful comment. The nephrology literature has had a dearth of information on V1 receptor in the kidney collecting d...

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Treatment of recurrent minimal change disease 1 day ago

I have a 31 year old female who has had recurrent nephrotic syndrome. Originally seen in 2021 and had kidney biopsy which revealed diffuse podocyto...

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RE: trial of peritoneal dialysis in presence of diabetic gastroparesis 2 days ago

Very interesting anecdote- did you use glucose or icodextrin containing solutions. Most of the literature and Dr. Bargman's experience suggest that...

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RE: C3 glomerulopathy ? 2 days ago

A pattern of injury of MPGN has been associated with Buckley Syndrome, first described by Lagrue 1982 (long before the description of C3GN). These ...

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RE: trial of peritoneal dialysis in presence of diabetic gastroparesis 2 days ago

I have one case referred from GI specialist that 45years old female with diabetic kidney disease and severe gastroparesis . We preceed with CAPD , ...

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