RE: RECURRENT FSGS POST KIDNEY TRANSPLANT 27 minutes ago

Thanks Dr. Glassock. Unfortunately, we don't have EM here in Vietnam, so the diagnosis relies on Light Microscopy and IF. We also can't get Obinutu...

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RE: hypertension and Hypokalemia not responding to eplerenone 6 hours ago

Tomorrow > > > Convince him - he needs indwelling Foley catheter ASAP; keep it until he gets his prostate out. He is going towards nose dive! Would...

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RE: Challenging case of (pseudo?)-hyperkalemia 7 hours ago

No, this hasn't been done yet but would be interesting to try. The patient previously had exome sequencing performed, so we asked genetics to re-an...

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RE: Challenging case of (pseudo?)-hyperkalemia 7 hours ago

Tadalafil and other PDE5 inhibitors are used frequently, in pediatric cardiology at least, for treatment of pulmonary hypertension associated with ...

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RE: Challenging case of (pseudo?)-hyperkalemia 9 hours ago

Why is the patient on Tadalafil 5 mg QD. It us used for erectile dysfunction, in A woman? What symptom or disorder is being treated? Assuming th...

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RE: Challenging case of (pseudo?)-hyperkalemia 9 hours ago

Maybe I missed but can you recheck K in simultaneously drawn paired samples, 1 at body temp & 1 at refrigerator temp/on ice, and report back? ----...

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RE: 24 hr urine creatinine clearance 10 hours ago

This would suggest that of the 1500 mg estimated production, 1200 mg is excreted by filtration and 300 by tubular secretion, which would give an ac...

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RE: 24 hr urine creatinine clearance 10 hours ago

I think in the steady state that about 20% of the creatinine excreted in the urine is derived from proximal tubular secretion in patients with Norm...

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RE: Acute intermittent Porphyria and CKD with proteinuria 10 hours ago

I know nothing about the safety of Givosiran in patients with AIP and established progressive CKD. 50-60% of patients with AIP develop CKD and kidn...

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RE: Acute intermittent Porphyria and CKD with proteinuria 10 hours ago

"MACR was 791 mg/g and a 24 hour protein was 457 mg/day" Is the patient very small? I ask because albumin/ creatinine ratio (expressed /g creatin...

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RE: hypertension and Hypokalemia not responding to eplerenone 10 hours ago

His primary care physician has ordered for him on Nifedipine 30 mg daily on 17th of November but I am yet to find out if he has picked it up or sta...

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RE: Challenging case of (pseudo?)-hyperkalemia 10 hours ago

Interesting, thanks for this comment. Agree that extracellular shift seems to be the only plausible physiologic explanation, but why/how would this...

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RE: hypertension and Hypokalemia not responding to eplerenone 10 hours ago

Thank you. His height is 65 inches and latest weight 79.4 kg making a BMI of 29.2. On 11/3/2025, spot urine potassium was 38 mmol/L and urine ...

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RE: IgA Nephropathy with ?RPGN 11 hours ago

I agree with Dr. Chandra's . I would not give CYC in this case except in reduced dosage for a brief period about 8 weeks. I do not know ( nobody do...

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RE: IgA Nephropathy with ?RPGN 11 hours ago

James: Not disagreeing with the scientific advice of Dr Glassock, allow me to take a slightly different view of emphasizing the hazards of delaying...

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RE: RECURRENT FSGS POST KIDNEY TRANSPLANT 11 hours ago

@ prof venkat your expert thoughts appreciated Kind regards --------------------------------- Muhammad Soobadar MBChB UK ----------------------...

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RE: Challenging case of (pseudo?)-hyperkalemia 11 hours ago

Assume it is not psuedo but real and transient. EKG changes with hyperkalemia are not reliable. Increase in serum K from 5.1 to 7.2 in 8 hours can ...

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RE: RECURRENT FSGS POST KIDNEY TRANSPLANT 11 hours ago

Thanks for case Can you post full report of biopsy ? What was induction agent? You did not give ritux - August ? High dose steroids ? Then rela...

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Acute intermittent Porphyria and CKD with proteinuria 12 hours ago

I have a patient who I am currently seeing in clinic and looking for advice on further management. 35 y.o. south Asian female, with AIP (HMBS IV...

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RE: RECURRENT FSGS POST KIDNEY TRANSPLANT 14 hours ago

I would give RTX or Obinutuzumab now, and continue TPE. What did the EM on the transplant biopsy show.? ------------------------------ Richard G...

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RE: Challenging case of (pseudo?)-hyperkalemia 15 hours ago

Fragile X syndrome is the most common form of inherited intellectual and developmental disability (IDD). It gets its name because when you look at ...

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RE: IgA Nephropathy with ?RPGN 15 hours ago

Thanks so much Dr. Glassock, I really appreciate your thoughts. Unfortunately iptacopan isn't readily available here and seems like it would take s...

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RE: Challenging case of (pseudo?)-hyperkalemia 18 hours ago

Dr. Glassock - Yes, the serum and plasma K levels are usually fairly tightly correlated -- both are checked very frequently actually. Re: exogenous...

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RE: Hyponatremia Dilemma 18 hours ago

This is SIADH and may require tolvaptan based on her urine chemistries and response to therapy. I remain of the belief that cerebral salt wasting...

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RE: Challenging case of (pseudo?)-hyperkalemia 18 hours ago

I think the authors did and found a good correlation at all levels. she may spije urine but how can she spile L to have the K levels go up and do...

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RE: 24 hr urine creatinine clearance 18 hours ago

By the method of Bjornsonn, Cr production in a male, per hour, is as follows: P Cr = [27 - (.173 x age)] x weight / 24. In your patient this eq...

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RE: hypertension and Hypokalemia not responding to eplerenone 18 hours ago

From the information provided he clearly has multiple issues. Coronary artery disease, type 2 diabetes, bilateral moderate ureteral hydronephrosi...

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RECURRENT FSGS POST KIDNEY TRANSPLANT 19 hours ago

I would like to share a challenging case regarding recurrent FSGS post-transplant and seek your expert opinions on the management strategy. A 35-y...

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RE: Challenging case of (pseudo?)-hyperkalemia 20 hours ago

Have you examined a plasma K vs serum K? ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ----------------...

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RE: Challenging case of (pseudo?)-hyperkalemia 20 hours ago

In loght of the very high urine K, Does she somehow have access to high K substances, such as a K containing salt substitute? ----------------...

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RE: hypertension and Hypokalemia not responding to eplerenone 20 hours ago

For example , the brand name for simethicone called "Iberagast" (sold in CVS stores in the US) contains licorice root extract as a sweetening agent...

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RE: hypertension and Hypokalemia not responding to eplerenone 21 hours ago

Please check the contents of the Simethicone las some (non-US) manufacturers add glycyrrhizinate as a sweetener ------------------------------ R...

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RE: hypertension and Hypokalemia not responding to eplerenone 22 hours ago

Thanks- apparent mineralo corticoid excess AME) (an autosomal recessive disorder )is very very rare in the elderly. I would measure the cortisol to...

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RE: hypertension and Hypokalemia not responding to eplerenone 22 hours ago

Yes I mentioned all these possible sources of licorice to the patient not only on the first encounter but also on a subsequent encounter also, afte...

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RE: hypertension and Hypokalemia not responding to eplerenone 1 day ago

Addendum- eplerenone is not effective for displacement if cortisol binging to the MR- it would be predicted to be ineffective in licorice induced h...

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RE: hypertension and Hypokalemia not responding to eplerenone 1 day ago

Dr. Jebur-but the patients age weights against the diagnosis of Liddle Syndome . At this-age licorice induced pseudo hyperaldosteronism would be mo...

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RE: hypertension and Hypokalemia not responding to eplerenone 1 day ago

Is it Liddle's syndrome giving the undetectable level of Renin and Aldosterone?. In Liddle's syndrome Triamterene and Amiloride are the treatment o...

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RE: hypertension and Hypokalemia not responding to eplerenone 1 day ago

"probable moderate to severe aortic insufficiency (in echo done in October, 2025 that was limited window and ejection fraction 50% )and wide pulse ...

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RE: hypertension and Hypokalemia not responding to eplerenone 1 day ago

Partial Nephrogenic Diabetes Insipitus secondary to partial obstructive uropathy from enlarged prostate. Increased volume with both suppressed ...

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RE: hypertension and Hypokalemia not responding to eplerenone 1 day ago

Can Primary aldosteronusm be diagnosed by ARR in patients taking beta blockers for hypertension or CHF.? ------------------------------ Richard G...

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RE: hypertension and Hypokalemia not responding to eplerenone 1 day ago

Aldosterone and renin levels just came back because they have a lot of turnaround time in our Institute ------------------------------ Sadeem Ali...

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hypertension and Hypokalemia not responding to eplerenone 1 day ago

White gentleman age 72, referred to nephrology as outpatient for hypertension difficult to control. Known history of coronary artery disease, type ...

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Challenging case of (pseudo?)-hyperkalemia 1 day ago

Patient is a 20 year old young lady with congenital heart disease (tricuspid atresia) and a Fontan circulation with diastolic heart failure. Over t...

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RE: Anti-GBM antibody positivity without RPGN - approach? 1 day ago

Rare cases of bona fide serology and histologically proven anti-GBM disease with an indolent non RPGN presentation have been reported but they are ...

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RE: 24 hr urine creatinine clearance 1 day ago

The medium level for BMI doe not suggest excessive muscularity, but of course the value dos not include composition, I.e. lean body mass..- which i...

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RE: 24 hr urine creatinine clearance 1 day ago

KI Reports is an open access Journal. You should have no problem obtaining a full PDF on line. ------------------------------ Richard Glassock M...

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RE: How to treat this young patient with IgA nephropathy 1 day ago

Red cells lyse after sitting around at RT, especially n hypotonic urine. This is a "common" reason for a discrepancy between hemoglobinuria and hem...

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RE: How to treat this young patient with IgA nephropathy 1 day ago

@Jay Seltzer Jay. As an expert on urine microscopy, what is your impression of the following statement: "For this reason, hemoglobinuria, more ...

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RE: How to treat this young patient with IgA nephropathy 1 day ago

A false negative urine microscopy would be more common in this case for this reason hemoglobinuria, more than microscopic hematuria correlates wi...

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RE: 24 hr urine creatinine clearance 1 day ago

thanks all/ love your twitter post Prof Rodby he is british indian/pakistani 36 male weight 74 kg height 1.74 m BMI 24.5 @ pr...

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