RE: AKI after living related kidney transplant 10 hours ago

@Gaurav GuptaI am interested in your recommendation for a low salt diet ? Given history of AKI which improved with IV fluids? --------------------...

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RE: Dual ANCA + anti-GBM + 13 hours ago

“Is this ant-GBM antibody Disease with simultaneous ANCA, or ANCA Associated Vasculitis with a positive anti-GBM antibody?” Who knows? — and I do n...

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RE: Dual ANCA + anti-GBM + 19 hours ago

"Up to one third of patients with anti­GBM anti­ bodies also have ANCAs (usually myeloperoxi­ dase ANCA).8,9" (NEJM attached) I...

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RE: Dual ANCA + anti-GBM + 20 hours ago

Dr Glassock. How often do you see ANCA positivity in anti-GBM disease and does it play any role in the renal injury ? Thank you ------------------...

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RE: Dual ANCA + anti-GBM + 21 hours ago

The risk of DAH is greatly decreased in non-smokers but not to zero. If the patient is a non-smoker I think the risk of subsequent development of D...

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RE: Dual ANCA + anti-GBM + 22 hours ago

Is he a cigarette smoker? Dr. Glassock: is it correct to say that pulmonary hemorrhage from anti-GBM antibody is very unlikely in non-smokers? If h...

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RE: Dual ANCA + anti-GBM + 22 hours ago

Great discussion I believe that anti GBM disease with single positivity will relapse less than dual positivity. So on way to conceive management o...

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RE: AKI after living related kidney transplant 23 hours ago

Yes, Foley was placed for 4 days with similar creatinine Get Outlook for iOS

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RE: Dual ANCA + anti-GBM + 1 day ago

Interesting question. The likelihood of a clinically important inmpricemeny in kidney function with maximal therapy Sterouds, CYC, PLEX) is small b...

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RE: Dual ANCA + anti-GBM + 1 day ago

Thank you Dr Glassock If we decide not to treat, is there a risk of lung involvement further down the line? Do you suggest treating MPO positivity ...

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RE: AKI after living related kidney transplant 1 day ago

Excuse if already discussed- given history of self catherization pretransplant- has intermittent lower tract obstruction been excluded by placing f...

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RE: vit d supplement 1 day ago

I totally agree ------------------------------ Stuart Sprague DO, FASN Chief, Division of Nephrology and Hypertension NorthShore University Health...

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RE: Dual ANCA + anti-GBM + 1 day ago

With dialysis- dependency and greatly elevated SCr at start of steroids the expected outcome will likely be poor, irrespective of therapy , but if ...

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RE: Endocarditis GN 1 day ago

I fully agree with Dr. Venkat. Proper therapy of the staph infection must take first priority here, IMO. --------------------------------- Richard...

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RE: Dual ANCA + anti-GBM + 1 day ago

Thank you, Dr Glassock Still passing 1-1.5 liters/day (Pt weight 90kg) pre-dialysis creatinine is around 800 sorry should have said, he was pulsed...

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RE: vit d supplement 1 day ago

Thanks Dr. Sprague- there are many misconceptions about the proper use of DEXA scanning in CKD 3,4 and 5. My general impression is that it is an ov...

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RE: Dual ANCA + anti-GBM + 1 day ago

Is the patient oligo-anuric? If so the Chances of recovery, even with optimal treatment, are very low (because of dialysis dependency and 100% cres...

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RE: vit d supplement 1 day ago

I agree with many of the comments, I would say that in general if the GFR is > 45, there is absolutely no need for activated D and may cause proble...

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RE: AKI after living related kidney transplant 1 day ago

Thank you.

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Dual ANCA + anti-GBM + 1 day ago

60 year caucasian gentleman presented with 2 months of lethargy, fatigue, loss of appetite. Admission Creat 567mmol/l, UO 1litre, progressive incre...

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RE: Endocarditis GN 1 day ago

Regardless of whether this patient has C3-dominant, infection-associated GN (staphylococcal, source-endocarditis) or an unrelated C3 glomerulopathy...

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RE: AKI after living related kidney transplant 1 day ago

In Dent Disease-1, besides the proximal tubule, there are transport abnormalities in the Loop of Henle and collecting ducts also. The following cas...

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RE: Endocarditis GN 1 day ago

It seems likely that both of these cases had post-streptococcal GN- high ASLOT, Low C3 with normal or near normal C4 and a compatible Kidney Biopsy...

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RE: Endocarditis GN 1 day ago

I do agree that there is place here for pronase treated IF. Great case and challenging one .I wouldn't use IS at least for now So motivating that...

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Communities app is working again 1 day ago

Dear All, The Communities app seems to be working properly now. It should now allow you to login and access the discussions. Sorry again for th...

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RE: AKI after living related kidney transplant 1 day ago

Great insights Dr Venkat Many good points but still confused to some extent or i may be missing something: This disease is a proximal disease not...

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RE: AKI after living related kidney transplant 1 day ago

Caveat: With current SCr of 4.9 mg/dL in the recipient, LMW proteinuria may be due to tubular injury from causes other than Dent Disease. Also, the...

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RE: AKI after living related kidney transplant 1 day ago

In a predominantly tubulo-interstitial/hypercalciuric disorder such as Dent Disease, episodes of AKI developing and resolving (at least partially) ...

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RE: AKI after living related kidney transplant 1 day ago

I reproduce my reply from the AST forum here: This is a fascinating case. My summary and thoughts are as follows: Since Dent's disease is an X-lin...

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RE: Endocarditis GN 1 day ago

I realize that the Main reason for performing Paraffin IF is to search for concealed monoclonal Ig deposits, but some cases C3 dominant GN by Froze...

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RE: AKI after living related kidney transplant 1 day ago

Sure i see your point but the symptoms are quite atypical for Dent To follow and hope to have some update ------------------------------ Samir Mal...

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RE: AKI after living related kidney transplant 1 day ago

@Samir Mallat I agree that Dents will not recur in the allograft but it may if the donor kidney is also affected. As I said it is possible that the...

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RE: AKI after living related kidney transplant 1 day ago

tough case.If Slow graft function persists can consider -imaging all vessels (CTA, CTV ) -Persisting ATI with unclear cause can at times be from ab...

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RE: Endocarditis GN 1 day ago

Interesting story, reads like treated endocarditis and then GN delayed after treatment, BUT still bacteremic so not so surprising that the GN is no...

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RE: Communities App failing again 1 day ago

From the "Reply" tab you really have two options. If you just click on truly you are replying to the community and it will show up here as I am doi...

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RE: Endocarditis GN 1 day ago

Tough case. Probably has a smoldering abscess somewhere (myocardial, peri-valvular?). With an active staphylococcal infection, steroids nay be harm...

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Endocarditis GN 1 day ago

Colleagues We have a case here of 43 y/o white male IVDA MRSA IE ( TV and Pulm valve Dx'd 4 wks ago) Tx with vanoc then switched to Dapto ( no...

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RE: Communities App failing again 1 day ago

In addition I have to admit that it is not a very friendly user platform and I need to log in to ASN every time I get a mail …or I may be doing som...

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RE: AKI after living related kidney transplant 2 days ago

Creatinine is 4.9, negative BK PCR, DSA negative. Get Outlook for iOS

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RE: Biopsy In Anti Gbm Disease 2 days ago

Thank you Dr Glassock Sure it helps

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RE: Biopsy In Anti Gbm Disease 2 days ago

The short term renal prognosis is about the same for pure anti-GBM antibody and Combined ANCA and anti-GBM. The combined disease may have a somewha...

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RE: Communities App failing again 2 days ago

The recurring App failures are very frustrating and a source of much embarrassment, as the ASN is believed to be very adept at handling communicati...

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RE: vit d supplement 2 days ago

Value of DEXA scanning in early stage CKD is problematical, but might help to determine need for bisphosphonates (which should be used with great c...

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RE: Refractory anti-GBM disease 2 days ago

Thanks for your reply! I did also question if perhaps we should continue trying to treat given the lack of IF/TA and hope for kidney salvage, but t...

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RE: Refractory anti-GBM disease 2 days ago

Thanks so much for your insights! After lengthy discussion with the patient, that is exactly what we planned to do. Just wanted to make sure it was...

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RE: vit d supplement 2 days ago

If GFR is normal, can't see a rationale for using active vitamin-D analog. In early stages of CKD (1 to 3), most patients will have enough 1-alpha ...

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RE: AKI after living related kidney transplant 2 days ago

What is status of allograft (creat) on belatacept and MMF. have you been following ddcfDNA in this patient. What is BK PCR ? ---------------------...

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TMA and eculizumab 2 days ago

Dear ASN community experts, This is a controversial question that I am going to post. But, would love to have discussion on this : Would you con...

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RE: vit d supplement 2 days ago

No reasons to use activated Vitamin D in early CKD stages 1 or 2 or 3 .May consider them at later stage 4 or 5 specially if severe disease I will ...

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Communities App failing again 2 days ago

Sorry y'all. This recurring problem is at least as frustrating to the ASN as it is to you and Dr Glassock and of course me. What else can I say. T...

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