RE: ANCA+ 1 hour ago

I think this is mainly a case of bladder outlet obstruction (? BPH vs Prostatic Cancer). I too would ignore for now) the serologies if renal functi...

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RE: Migraine headaches and hyponatremia 1 hour ago

I missed “over 5 days” part, and was perplexed by Dr Glassock and Dr Friedman calculation. --------------------------------- Awais Nauman HMC Doha ...

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RE: C3 GN case? 1 hour ago

Dr Liang, for us our genetics department does all the liaison with testing centers. Prior to that, for rare diseases, I have contacted prominent au...

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RE: Stone 1 hour ago

Sugarcane aficionado perhaps? Does this patient come from an area that is high for CKDu?  Seems like a lot of silica is found in the water in such ...

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RE: ANCA+ 2 hours ago

Do you have an etiology for the obstruction? Seems like he had a post obstructive diuresis and the creatinine is also coming down from this.  i wou...

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RE: C3 GN case? 2 hours ago

Can you stain the glomerulus for  CFHR5? Would that help confirm the diagnosis? Ref:  https://datastudio.google.com/s/t9c9f4BmmvA -----------------...

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RE: IgA, with CS toxicity, 2.2 gm proteinuria 2 hours ago

well summarized, and as a minor advocate for MMF I would still give this all 6-12 months before even thinking about adding MMF. And during that tim...

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RE: IgA, with CS toxicity, 2.2 gm proteinuria 3 hours ago

I am really thankful to  respected professors in helping out the above scenario. Here is the summary of your valuable suggestions.  1.will taper cs...

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RE: C3 GN case? 6 hours ago

His maternal grandfather had kidney stones and kidney disease (not sure what kind of kidney disease). His father has HTN. Is the CFHR5 mutation e...

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RE: ANCA+ 8 hours ago

Thanks for the replies Cr improved to 2.7 No ureteral obstruction on nephrogram Free K/L ratio is 2.37 Kappa free light chain 119.47 Lambda Free li...

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RE: C3 GN case? 8 hours ago

Any family history of kidney disease? The CFHR5 mutation is apparently inherited as an autosomal dominant disorder. ------------------------------ ...

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RE: C3 GN case? 8 hours ago

I was wondering how the C3GN would tie in with his beta thalassemia intermedia & looking back now, given he was described as a “WM”, that should ha...

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RE: Migraine headaches and hyponatremia 9 hours ago

" Dr Glassock and Dr Friedman in this calculation what did you consider the volume of distribution of Na? Only Extracellular fluid or total body wa...

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RE: AKI with jugular vein thrombosis 9 hours ago

" Now the question is how will likely he is to have thrombosis in renal artery or vein and how aggressive should we be on that treatment. He's alre...

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RE: AKI with jugular vein thrombosis 9 hours ago

I would suspect trauma a the IJV during the ICD placement in June. Can you obtain the operative report? Sent from my iPad

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RE: Stone 9 hours ago

Most silica stones originate from use of antacids containing magnesium silicate. True silica stones are always about excess intake of silica becaus...

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AKI with jugular vein thrombosis 10 hours ago

African-American gentleman about age 50 was having left-sided neck pain for about a week and ultrasound found blood clot in left jugular vein. Also...

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RE: C3 GN case? 10 hours ago

The more one looks into this case, Dr. Nauman is quite correct. One should strongly suspect CFHR-5 mutations and a diagnosis of CFHR-5 Nephropathy....

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Stone 10 hours ago

36 you with HPRT-1 mutation , Kelly seegmiller syndrome , repeated uric acid stones and gouty arthritis. he is on uloric.  recently passed multiple...

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RE: C3 GN case? 10 hours ago

Great catch Dr. Nauman- you may have saved this patients from ineffective therapy.p (MMF and steroids) .What about Eculizumab in CfHR mutations? Se...

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RE: C3 GN case? 11 hours ago

Wow - yes, he does happen to be Cypriot. His father was born in Cyprus and came to the US at the age of 6. Both his paternal grandparents are also ...

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RE: Migraine headaches and hyponatremia 12 hours ago

Total body water- but this is only an approximation. Sent from my iPad

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RE: hypokalemia and eating disorder 13 hours ago

Thank you. Good point. Any laxative use is possible. I do think she has acquired distal RTA. ------------------------------ Deborah Fein MD Nephrol...

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RE: Migraine headaches and hyponatremia 14 hours ago

That (ie oxidative metabolic H2O production) only matches the H2O lost from lungs. --------------------------------- Oded Friedman ----------------...

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RE: Migraine headaches and hyponatremia 14 hours ago

It should need a much larger free water intake to drop Na from 140 to 125, if we consider TBW than 1.72L. Or alternatively if we consider that only...

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RE: Migraine headaches and hyponatremia 14 hours ago

TBW https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/611715 ------------------------------ Joshua Rein DO Instructor Icahn Sc...

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RE: Migraine headaches and hyponatremia 14 hours ago

But you have to add back the water generated by metabolism. Sent from my iPad

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RE: Migraine headaches and hyponatremia 14 hours ago

Dr Glassock and Dr Friedman in this calculation what did you consider the volume of distribution of Na? Only Extracellular fluid or total body wate...

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RE: Migraine headaches and hyponatremia 15 hours ago

And if you add in 0.8 L/d insensible H20 loss (but actually less as only that from upper respiratory tract & skin count), it’d be 2.52 L/d H20 inta...

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RE: Migraine headaches and hyponatremia 15 hours ago

Assuming that insensible water loss equals water generated from metabolism drinking 1.8 L/d of free water (7.5 servings of 8 ounces each) would red...

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RE: Migraine headaches and hyponatremia 15 hours ago

To reduce Na from 140 to 125 over 5 days, he would need to drink more than 1.72L of water per day. ------------------------------ Joshua Rein DO In...

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RE: Acute Peritoneal Dialysis 16 hours ago

Thanks for asking me to comment.  While acute PD has served us in this pandemic when extracorporeal therapies were in short supply, I do not think ...

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RE: C3 GN case? 17 hours ago

Synpharyngitic urinary abnormalities, indolent and prolonged course, without much inflammation make me think of CFHR5 Nephropathy. What is his ance...

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RE: SLE in pregnancy 18 hours ago

Agree with Dr Venkat to check for AntiDNA and Anti-phospholipid and also Anti-Ro & La. I feel she merits a pulse with Methylpred for 3 days and the...

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RE: Fibrous Crescents 18 hours ago

Is MRI measurements of elastin something that is being looked at to quantify fibrosis?  Or non-contrast CMR? Reference:  #NephTwitter Archives:   h...

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RE: Fibrous Crescents 19 hours ago

@John Mellas As far as the pathological assessment of interstitial fibrosis is concerned, it remains an area of great reporting variability​ as it ...

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RE: Acute Peritoneal Dialysis 19 hours ago

Please see the attached multi center international report on the use of PD for AKI. IMO, very helpful. ------------------------------ Mario Rubin, ...

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RE: Acute Peritoneal Dialysis 19 hours ago

I meant to say once the technology of temporary dialysis catheters and hemodialysis improved (e.g. the Teflon Scribner's shunts were abandoned), IP...

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RE: Acute Peritoneal Dialysis 19 hours ago

@David Charytan Acute PD (IPD) was a common practice in the 70's and early 80's. PD catheters were initially places blindly at the bedside and then...

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Acute Peritoneal Dialysis 19 hours ago

​Any North American programs out there that included acute PD as part of their pre-COVID approach to AKI? We used quite a bit of acute PD to manage...

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RE: SLE in pregnancy 21 hours ago

Recommend checking anti-DS DNA antibody and anti-phospholipid antibody screens. Everything you have posted (especially if anti-DS DNA ab is also st...

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RE: Kidneys From cadaveric Donor With nephrogenic Diabetes Insipidus 22 hours ago

------------------------------ [V] [Melnikov] [MD, FASN ] Samaritan Kidney Specialists Corvallis, OR (547) 768-6930 ------------------------------

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RE: C3 GN case? 23 hours ago

Sounds right to me.  I'm glad you mentioned MMF + steroids, because I automatically equate C3GN treatment with eculizumab (and I ignore the cost). ...

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RE: Fibrous Crescents 23 hours ago

As a practitioner not deemed an expert in glomerular disorders I would concur with the real experts' comments. What I do find interesting is that o...

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RE: SLE in pregnancy 1 day ago

Thank you🙏 ------------------------------ Sridhar Ramanaidu MBBS kementerian kesihatan Malaysia Ipoh ------------------------------

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RE: SLE in pregnancy 1 day ago

① Here's a nice list of meds that can and can't be used in pregnancy for lupus nephritis:  https://datastudio.google.com/s/qFcIndXGKgc ② The PROMIS...

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RE: SLE in pregnancy 1 day ago

Thank you very much for all the valuable suggestions. Really appreciate it . Will update the outcome @ ------------------------------ Sridhar Raman...

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RE: SLE in pregnancy 1 day ago

To my knowledge, there have been no direct comparisons of AZA and CsA for therapy of LN in Pregnancy. Trials in non-pregnant patients with LN have ...

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RE: SLE in pregnancy 1 day ago

Clinically seems to be stage 3 or 4 lupus, I would go for biopsy and if disease is aggressive (which it seems to be) I would discuss with family fo...

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RE: SLE in pregnancy 1 day ago

Would you still consider CNI if the creatinine is raised in this patient? Will it make any difference if I dont give IV methlypred but just give IV...

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