RE: Happy July 4th 4 hours ago

I agree that most of the organizations you name are not being forceful enough in their response to the changes occurring within the health care sys...

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RE: Happy July 4th 5 hours ago

Dr Glassock I seemed to have started a new thread. I did not mean to, However, the issues being raised by dr Venkat are important. Over all I ...

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RE: Happy July 4th 6 hours ago

What concerns me most is the complacency of medical organizations such as the American Medical Association (AMA), the American Society of Nephrolog...

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RE: Happy July 4th 6 hours ago

I did not feel very happy this Fourth of July. A major reason for the USA's preeminence in the world is the strong support scientific enquiry has r...

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RE: Happy July 4th 7 hours ago

I may know your wife. I am also from Argentina and left the country in 1976 for the US. The changes of the American society over time have not been...

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RE: Happy July 4th 7 hours ago

Thanks for the compliment. Mt wife is a Pediatric heme -onc physician from Argentina who lived through the horrors of the military takeover in the ...

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RE: Happy July 4th 8 hours ago

Well stated Anatole. Finally a statement in the forum that cannot be challenged, not even by Dr. Glassock. ------------------------------ Mario ...

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RE: Diffuse proliferative GN 9 hours ago

I agree that if the aortic regurgitation is of new onset this fact makes endocarditis a distinct possibility despite negative BC and a negative TTE...

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RE: Diffuse proliferative GN 18 hours ago

Do we know aortic regurgitation is new any previous Echo How high was the rheumatoid factor because Rheumatoid factor can be positive at this age i...

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RE: Diffuse proliferative GN 20 hours ago

I would still hold Endocarditis high in the DD. Other opinions welcome. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA ...

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RE: Diffuse proliferative GN 1 day ago

Update on the patients. Blood cultures, Borrelia, Bartonella and Q fever are all negative. RF is positive. Cryoglobulins are negative. They d...

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RE: Happy July 4th 1 day ago

Happy independence day America --------------------------------- Bajinder Reen MD Etobicoke ON (905) 453-0821 ---------------------------------

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RE: Happy July 4th 1 day ago

I watched the celebrations from Washington on PBS. Brought memories time past. I am an immigrant from the Ukraine. The good old USA was much better...

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RE: Happy July 4th 1 day ago

Yes Dr Glassock, indeed. Happy Independence Day ------------------------------ Prem Chandran MD Adj Clinical Professor, Univ of Iowa Associates ...

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Happy July 4th 2 days ago

Happy Independence Day to all of the ASN Community followers from the good ole USA!!! ------------------------------ Richard Glassock MD, FASN La...

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RE: Hypercalcemia in a patient with SLE/MCTD 2 days ago

Dr. Venkat. Both bisphosphonates and Calcitonin are effective in treating hypercalcemia due to Vitamin D intoxication so the benefits observed in t...

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RE: Hypercalcemia in a patient with SLE/MCTD 2 days ago

Dr Venkat, I agree. I think we will never know the exact mechanism but the case does teach us what e do not know. . ----------------------------...

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RE: Hypercalcemia in a patient with SLE/MCTD 2 days ago

When she was hospitalized with serum calcium of 13.7 mg/dL, treatment with IV calcitonin and zoledronic acid decreased serum calcium to 7.1 mg to 7...

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RE: Hypercalcemia in a patient with SLE/MCTD 2 days ago

I suppose that given the circumstances and the absence of a 25 -OH Vitamin D level at the time of hypercalcemia that we cannot fully exclude the po...

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RE: Hypercalcemia in a patient with SLE/MCTD 2 days ago

Agree, a fascinating chronologic story. "Increased bone resorption due to inflammatory cytokines and/or SLE-associated Increased bone resorption du...

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RE: Hypercalcemia in a patient with SLE/MCTD 2 days ago

Fascinating, very educational experience. That fir posting the follow -up. Agree that exogenous Vitamin D intoxication seems very unlikely -----...

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RE: Hypercalcemia in a patient with SLE/MCTD 3 days ago

Update on this patient To recapitulate, this 40-year-old female with SLE/MCTD had presented with the following features: 1. Severe hypoalbuminemia ...

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RE: Original MCD . Repeat biopsy June 2025 3 days ago

Thank you. I don't really have much of an option. Nothing to lose by doing the genetic studies. I had discussed this with the patient after the pla...

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RE: Original MCD . Repeat biopsy June 2025 3 days ago

Thanks. The initial proteinuria is a bit out of the range typically seen with genetic FSGS and the "partial response" to steroids and CNI is seen i...

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RE: Original MCD . Repeat biopsy June 2025 3 days ago

Thank you That is correct. Patient was clinically very nephrotic with significant edema, low albumin and proteinuria of more than 10g/day at the ...

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RE: Request for Expert Opinion on SLKT in a Case of Primary Hyperoxaluria 3 days ago

Possible that if you post the genotype @John Lieske can tell you based on Mayo Clinic database if it is B6 responsive. Since you won't be able to d...

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RE: Request for Expert Opinion on SLKT in a Case of Primary Hyperoxaluria 3 days ago

Unfortunately, since you're a patient who died six months after simultaneous LK transplant Apparently did not receive intensive perioperative dialy...

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RE: Original MCD . Repeat biopsy June 2025 3 days ago

If my reading of the thread is correct, the patients has demonstrated resistance to therapy with High disease of steroids , CNI and one course of R...

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Original MCD . Repeat biopsy June 2025 3 days ago

Good evening I re biopsied the patient whose case I presented in May. I have attched the original thread below and the biopsy report from the 2n...

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RE: Request for Expert Opinion on SLKT in a Case of Primary Hyperoxaluria 3 days ago

"What treatment for recurrent PH did your patient with SLKT receive who did not survive?" intensified HDF dialysis 10 days before transplant + B6...

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RE: Request for Expert Opinion on SLKT in a Case of Primary Hyperoxaluria 3 days ago

Please let us know the management plan you intend to pursue for this patient. Many thanks. ------------------------------ Richard Glassock MD, F...

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RE: Request for Expert Opinion on SLKT in a Case of Primary Hyperoxaluria Wednesday, July 2 @ 9:09 AM

One should also note that Alnylam has a compassionate use program for lumasiran that you can apply for. We have just received access to lumasiran f...

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RE: Request for Expert Opinion on SLKT in a Case of Primary Hyperoxaluria Tuesday, July 1 @ 8:08 PM

"How will detection of a pyridoxine sensitive mutation alter the planned sequence of LT and KT.?" It would not IMO but in the absence of Lumisari...

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RE: Request for Expert Opinion on SLKT in a Case of Primary Hyperoxaluria Tuesday, July 1 @ 8:02 PM

What treatment for recurrent PH did your patient with SLKT receive who did not survive? ------------------------------ [Mark] [Lerman] [MD,FASN,F...

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RE: ? Cryoglobulinemic GN Tuesday, July 1 @ 4:11 PM

In this setting pronase IF may be helpful in evaluating the hyaline pseudothrombi deposits which were seen by LM but did not appear to be captured ...

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RE: ? Cryoglobulinemic GN Tuesday, July 1 @ 3:18 PM

I resonate with Dr. Venkat's analysis, but organized deposits are not typically seen in Type III cryoimmunoglobulinemia. I still would do Pronase d...

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RE: Request for Expert Opinion on SLKT in a Case of Primary Hyperoxaluria Tuesday, July 1 @ 3:13 PM

What a great discussion of a very formidable and challenging management issue, complicated greatly by the un-Availability of Lumisarin. I sense agr...

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RE: Request for Expert Opinion on SLKT in a Case of Primary Hyperoxaluria Tuesday, July 1 @ 2:16 PM

I am going to be hyperbolic (I dont think that is the right expression but you get the idea) here: Whatever you do do it soon, This is what hap...

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RE: Request for Expert Opinion on SLKT in a Case of Primary Hyperoxaluria Tuesday, July 1 @ 11:19 AM

CLKT vs kidney tx results in better kidney graft survival but similar patient survival in B6 unresponsive PH Was that B6 responsive PH for which...

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RE: Question about HDF convection volume target Tuesday, July 1 @ 11:02 AM

When you ultrafilter 23L /BSA , how accurately can yoy achve the remova;of theinterdialytic fluid accumilated which can cary form 1 to 4?:. This ma...

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RE: Question about HDF convection volume target Tuesday, July 1 @ 10:01 AM

We are implementing a convection volume target of 23 liters per 1.73 BSA in our unit but we are not sure of the best target to monitor. In the best...

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RE: Request for Expert Opinion on SLKT in a Case of Primary Hyperoxaluria Tuesday, July 1 @ 9:32 AM

Is your patients genotype B6 responsive? CLKT vs kidney tx results in better kidney graft survival but similar patient survival in B6 unresponsiv...

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RE: ? Cryoglobulinemic GN Tuesday, July 1 @ 9:30 AM

IgG and IgM3+ with negative IgA on immunofluorescence certainly suggests possibility of cryoglobulinemia , type III (given lack of monoclonality by...

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RE: Request for Expert Opinion on SLKT in a Case of Primary Hyperoxaluria Tuesday, July 1 @ 9:23 AM

I don't have any personal experience in this area. Rapid access to and prompt availability of oxalate blood level results will be critical since ne...

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RE: ? Cryoglobulinemic GN Tuesday, July 1 @ 9:21 AM

Thanks Dr Glassock and Dr Rodby. HCV Ab and syphilis screening was negative. ANA was 0 by CMIA and neg by IFA. Our lab does not run ENA profile i...

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RE: Question about HDF convection volume target Tuesday, July 1 @ 9:01 AM

I believe in individualization, However, calculation of BSA as our normalization factor for persons of different weight and height but same gender ...

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RE: Request for Expert Opinion on SLKT in a Case of Primary Hyperoxaluria Tuesday, July 1 @ 8:40 AM

Sequential liver followed by kidney transplant would be the better option for him at this age. One of the advantages is that the same donor (if wil...

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RE: Microscopic hematuria Tuesday, July 1 @ 8:30 AM

Was the urine microscopic organisms examination done with automated devise or manually as automated devise may miss dysmorphic or lysed RBCs -----...

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RE: Request for Expert Opinion on SLKT in a Case of Primary Hyperoxaluria Tuesday, July 1 @ 8:15 AM

Contrary to DDT, kidney and liver grafts will be obtained from different donors in LDT. So it seems appropriate to do liver transplantation followe...

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Question about HDF convection volume target Tuesday, July 1 @ 6:10 AM

We are implementing a convection volume target of 23 liters per 1.73 BSA in our unit but we are not sure of the best target to monitor. In the best...

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