RE: Erythropoetin and meningioma 1 minutes ago

We find that typically when it comes to ESA use in patients with cancer , our oncology colleagues usually give us the go ahead. A meningioma ...

View Discussion

RE: Gross hematuria in a patient with failed renal allograft 25 minutes ago

@Amit Joshi "Thank you Dr. Rodby, That's concern I had, but came across this article when learning about it. " Thanks for attaching the a...

View Discussion

Erythropoetin and meningioma 25 minutes ago

This one is for all the EPO experts out there; Are you aware of any risk of accelerating meningioma growth in a dialysis patient treated with ery...

View Discussion

RE: Gross hematuria in a patient with failed renal allograft 10 hours ago

For what it is worth (not a great deal) , I agree with Dr. . Lerman. This a failed kidney transplant due to non-compliance. Better to do a transpla...

View Discussion

RE: Gross hematuria in a patient with failed renal allograft 15 hours ago

Thanks Dr. Rubin very interesting and educational to have your vascular radiologist's opinion of the angiogram. my final vote is going to favor n...

View Discussion

RE: Gross hematuria in a patient with failed renal allograft 16 hours ago

The following is what our vascular radiologist thinks: " it's hard for me to tell on 1 image. maybe there js some extrav along the capsule but i ...

View Discussion

RE: Effect Of Plasma Exchange On Complement (c3,c4) 17 hours ago

This a complex question. We usually do not do PLEX in normal subject and some indication will have complement activation and consumption process as...

View Discussion

RE: A 19-Year-Old Male with Frank Hematuria, Proteinuria, and Weak Anti-GBM Positivity 18 hours ago

Wait for the biopsy LM and IF report. Will EM also be available? With NS, I would consider RTX as well , but the splenomegaly still troubles me. An...

View Discussion

RE: Gross hematuria in a patient with failed renal allograft 18 hours ago

I have attached the most often cited paper (NO RCTs are available on this topic) which concluded that there is a lower morbi-mortality with coil em...

View Discussion

RE: Gross hematuria in a patient with failed renal allograft 18 hours ago

Be careful and do not make decisions on the basis of a single center (the surgical and radiological skills are unique to that center), retrospectiv...

View Discussion

RE: Gross hematuria in a patient with failed renal allograft 18 hours ago

@Amit Joshi Slide # 3 appears to show a scarcity of blood vessels in the lower pole with some vascular blushes (see below)? It gives the appearan...

View Discussion

RE: Gross hematuria in a patient with failed renal allograft 19 hours ago

Thank you Dr. Rodby, That's concern I had, but came across this article when learning about it. ------------------------------ Amit Joshi Chica...

View Discussion

RE: Gross hematuria in a patient with failed renal allograft 19 hours ago

Ok, will update once I have more information. Thank you! ------------------------------ Amit Joshi Chicago IL ------------------------------

View Discussion

RE: Gross hematuria in a patient with failed renal allograft 19 hours ago

I have attached select images of allograft angiogram dated 5/27/26. Kidney allograft biopsy was done on 4/7/26. CT-abdomen images that I shared ...

View Discussion

RE: A 19-Year-Old Male with Frank Hematuria, Proteinuria, and Weak Anti-GBM Positivity 19 hours ago

Biopsy came verbally FSGS Waitting for final report Planning for tracrolimus Any suggestion?? --------------------------------- Mohamed Mahmoud ...

View Discussion

RE: Gross hematuria in a patient with failed renal allograft 19 hours ago

Unless you have localized a site of bleeding (post biopsy AVM) I think nephrectomy would be preferred over embolization. Total renal infarction is ...

View Discussion

RE: A 19-Year-Old Male with Frank Hematuria, Proteinuria, and Weak Anti-GBM Positivity 19 hours ago

I see the biopsy was done today.Irrespective of when you may expect realists, would you start steroids empirically? Typically I would but the fev...

View Discussion

RE: A 19-Year-Old Male with Frank Hematuria, Proteinuria, and Weak Anti-GBM Positivity 22 hours ago

What did the kidney biopsy show? other autoimmune workup , C3 level , ASOT titer , chronic viral screen ------------------------------ Saja Moha...

View Discussion

RE: cause of AKI 22 hours ago

Severe acute kidney injury (AKI) and acute interstitial nephritis (AIN) could be related to drug-induced factors, as there are multiple medications...

View Discussion

RE: Gross hematuria in a patient with failed renal allograft 23 hours ago

@John Schwartz Good pick-up but, as Dr. Lerman stated, it will be an unlikely diagnosis in the setting of an asymptomatic patient. As an example,...

View Discussion

RE: Gross hematuria in a patient with failed renal allograft 23 hours ago

@Mark Lerman I think you are making an excellent point. Timing is Key (see below): ------------------------------ Mario Rubin, M.D. Houston ...

View Discussion

RE: Gross hematuria in a patient with failed renal allograft 1 day ago

Thanks John if that is gas or air on the CT within the kidney then it has to be considered but without fever or chills and or pain seems unlikely ...

View Discussion

RE: Gross hematuria in a patient with failed renal allograft 1 day ago

The second image has unequivocal renal parenchymal air (admittedly small). Is beginning transplant emphysematous pyelonephritis a consideration? ...

View Discussion

RE: Gross hematuria in a patient with failed renal allograft 1 day ago

Dr. Joshi was the CT images that you shared taken soon after Gross hematuria began if not how long after. If images are non contrast then acute ble...

View Discussion

RE: technical 1 day ago

thanks Satish ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KPCOP EC [Past Medical Director Kidney Pancreas Transplant M...

View Discussion

RE: complex case of nephrotic syndrome in liver transplant patients 1 day ago

If this is Sirolimus induced diffuse Podocytopathy. Then there is no reason to suspect a high risk for relapse following repeat Liver transplantati...

View Discussion

RE: complex case of nephrotic syndrome in liver transplant patients 1 day ago

Hi update , This patient was discussed at mdt. Campath induction and if relapse of DP for obi ( apparently West London renal unit used Campath indu...

View Discussion

RE: Effect Of Plasma Exchange On Complement (c3,c4) 1 day ago

Dr. Soobadar.. As Dr. Venkat (and his Google AI assistant ) states the levels of C3 and C4 after PLEX (using 5% albumin for replacement fluid ) wil...

View Discussion

RE: Effect Of Plasma Exchange On Complement (c3,c4) 1 day ago

Interesting question. It depends on intensity of PLEX (volume removed per session and number sessions per week) and the type of replacement fluids....

View Discussion

RE: Effect Of Plasma Exchange On Complement (c3,c4) 1 day ago

From Google AI: "Therapeutic plasma exchange (TPE) mechanically removes complement proteins. As a result, C3 and C4 levels acutely decrease by 35...

View Discussion

RE: Gross hematuria in a patient with failed renal allograft 2 days ago

I stated: the renal parenchyma looks quite heterogenous implying an intra-renal process (edema from the rejection process and/or a renal infarct) ...

View Discussion

RE: Gross hematuria in a patient with failed renal allograft 2 days ago

I looked at the CT images again and frankly speaking, without upper cuts, I really cannot tell whether the allograft is in the right or left lower ...

View Discussion

RE: Gross hematuria in a patient with failed renal allograft 2 days ago

@Amit Joshi Thank you. The RLQ allograft (if I have my anatomy correct) is HUGE. In addition, i think that not only there is a medial collection ...

View Discussion

RE: Gross hematuria in a patient with failed renal allograft 2 days ago

Many aspects of this case do not make sense to me, personally. Let's see why: The patient presents with generalized weakness, states that he...

View Discussion

Effect Of Plasma Exchange On Complement (c3,c4) 2 days ago

Dear colleagues Interested to know your thoughts Can plasma exchange reduce c3,c4 level My thought is yes but appreciate your idea / input Bw

View Discussion

RE: Gross hematuria in a patient with failed renal allograft 2 days ago

Thank you Dr. Mohammed, one of the question that came up was to decide between graft nephrectomy vs. embolization is bleeding persists. --------...

View Discussion

RE: Gross hematuria in a patient with failed renal allograft 2 days ago

I have uploaded some of the images. Thank you Dr. Rubin. ------------------------------ Amit Joshi Chicago IL ------------------------------ Fil...

View Discussion

RE: technical 2 days ago

In the browser can go to your photo and click on that. Then click on your name which is the first item in the menu. You will reach your personal ho...

View Discussion

RE: Gross hematuria in a patient with failed renal allograft 2 days ago

So would a repeat ct angiogram or conventional angiogram be more helpful in establishing the cause????? --------------------------------- Syed Moh...

View Discussion

RE: Gross hematuria in a patient with failed renal allograft 2 days ago

How much sensitive the angiogram is to pick a small AVF post biopsy and an aneurysm which periodically and intermittently bleeds and may be missed ...

View Discussion

RE: Gross hematuria in a patient with failed renal allograft 2 days ago

Thank you Dr. Lerman He is hemodynamically stable- required 1 unit PRBC in last week, BP are stable 100-140s systolic. No fever, abdominal pa...

View Discussion

RE: Gross hematuria in a patient with failed renal allograft 2 days ago

key points to be considered Post-graft biopsy gross hematuria , first, we need to rule out biopsy-related vascular complications like AVF, pseu...

View Discussion

RE: cause of AKI 2 days ago

Negative prof glassock --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

View Discussion

RE: cause of AKI 2 days ago

Immunofluorescence microscopy using antibody reagents to kappa and lambda light chains. Were the tubular casts positive for monotypic light chains....

View Discussion

RE: Gross hematuria in a patient with failed renal allograft 2 days ago

@Amit Joshi Would It be possible for you to post the CT images of the renal allograft? Thank you ------------------------------ Mario Rubin, M....

View Discussion

RE: calcium deficit and replacement 2 days ago

Thanks he had line and dialysis today Bad Aki , fluid overload , acidosis , low calcium anuria Can someone help with how to calculate na , k and ...

View Discussion

RE: cause of AKI 2 days ago

What stains you referring to prof glassock ? If ? Congo red negative --------------------------------- Muhammad Soobadar MBChB UK --------------...

View Discussion

RE: Renal Biopsy Findings Post Cyclophosphamide In Mpo+ve Patients 2 days ago

@ prof glassock update -there is a rheumatologist with expertise in CTD / scleroderma reviewed patient There was no clinical evidence of sclerode...

View Discussion

RE: cause of AKI 2 days ago

Were the stains for light chains in casts positive and monotypic? if yes, this might be myeloma cast Nephropathy. , but the exuberant inflammatory ...

View Discussion

RE: cause of AKI 2 days ago

Not back yet Thanks --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

View Discussion