RE: Metabolic alkalosis, high urine Chloride, new diagnosis of metastatic lung cancer 2 hours ago

Thanks for the FU. What therapy did you choose for presumed ACTH syndrome? ------------------------------ Richard Glassock MD, FASN Emeritus Prof...

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RE: Metabolic alkalosis, high urine Chloride, new diagnosis of metastatic lung cancer 2 hours ago

I wanted to give an update on her 24 hr urine cortisol (this pt with new lung cancer, metabolic alkalosis and hypokalemia) The 24 hr urine cortis...

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RE: Somewhat suppressed aldo, Primary aldosteronism or not? 7 hours ago

I agree with Dr. Rodby's suggestion to "call it a day" and treat this patient medically as a case of "presumed" PHA without any further testing.. ...

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RE: Puzzling Case of Post-Transplant Proteinuria 8 hours ago

"Mild" GBM thickening in the sec of kidney biopsy, can we have some morphometric GBM thickness in the first and seconds transplant. biopsies. Also ...

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RE: Somewhat suppressed aldo, Primary aldosteronism or not? 12 hours ago

This is the problem with diagnosiy PHA, it always seems complicated by meds, overlapping non consistsnt renin Aldo levels. Adrenal vein sampling is...

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RE: Puzzling Case of Post-Transplant Proteinuria 14 hours ago

Dr,. Venkat - Which AI did you use for your search? ------------------------------ Richard Glassock MD, FASN Emeritus Professor Geffen School of ...

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RE: Somewhat suppressed aldo, Primary aldosteronism or not? 14 hours ago

Dr. Anand- thanks for posting the PodCast - I guess I will have to disagree. In my opinion , the Use of RASI , Beta Blocker and MRA can make it ver...

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RE: Somewhat suppressed aldo, Primary aldosteronism or not? 17 hours ago

In patients with suspected primary aldosteronism it is difficult to withhold bp meds esp in cases like mine where the BP was very high. @Richard...

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RE: Puzzling Case of Post-Transplant Proteinuria 18 hours ago

Was transplant RAS ruled out? --------------------------------- Oded Friedman ---------------------------------

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RE: Puzzling Case of Post-Transplant Proteinuria 20 hours ago

Thanks Dr. Glassock Did an AI search: As you had mentioned, it said that heavy glomerular proteinuria without podocyte effacement can occur in the ...

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RE: Somewhat suppressed aldo, Primary aldosteronism or not? 20 hours ago

not an expert on this, not sure, defer to others can say this: agree with Dr Glassock, not sure we can trust the renin and aldo levels here, give...

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RE: Somewhat suppressed aldo, Primary aldosteronism or not? 22 hours ago

wouldn't renin levels be normal or elevated? ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KPCOP EC [Past Medical Direct...

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RE: Timing of blood sampling in twice-weekly hemodialysis regimens 22 hours ago

In my practice I typically measure CrCl in an ICU patient with AKI where the urine output can be reasonably measured. I ask the ICU nurse to accura...

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RE: Timing of blood sampling in twice-weekly hemodialysis regimens 23 hours ago

"With dialysis the SCr falls as does the urine Cr excretion so that the ratio of U x V / S Cr remains rather constant and equal to actual ClCr." ...

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RE: Puzzling Case of Post-Transplant Proteinuria 1 day ago

Dr- Venkat- very unusual case. The lack of a correlation between albuminuria and podocyte FP effacement is well described in the literature. Serum ...

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Puzzling Case of Post-Transplant Proteinuria 1 day ago

I wish to obtain the impressions/recommendations of Forum participants regarding the following patient: Question: How to explain very heavy albumi...

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RE: Timing of blood sampling in twice-weekly hemodialysis regimens 1 day ago

It is fortuitous that ClCr is rather accurate using the standard method of ClCr in AKI or to measure residual kidney function in a patient on dialy...

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RE: Obstructing Urinary Stone 1 day ago

It was a calcium oxalate stone and she has been referred to a urolithiasis expert for a complete evaluation. a repeat US showed that the right side...

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RE: Obstructing Urinary Stone 1 day ago

Dr. Glassock-thanks for follow-up. you may have already addressed but what was stone analysis and workup to avoid additional nephrolithiasis? ---...

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RE: Obstructing Urinary Stone 1 day ago

Dr. Glassock: As I had mentioned previously in this thread, I have consistently noticed an approximate doubling of SCr over the first 24 hrs follow...

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RE: Treatment of membranous nephropathy with microsherular substructure 1 day ago

Thank you very much for taking the time to give me advice Joanne O'Riordan Sent from my iPad

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RE: Severe Hypomagnesemia 1 day ago

Thank you for all the useful comments. Bicarbonate initially was 31 when he also had low K but, with amiloride use both K and Bicarbonate remain no...

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RE: Somewhat suppressed aldo, Primary aldosteronism or not? 1 day ago

@Hormaz Dastoor-thanks for your comments several points spironolactone >100mg/day may not be tolerated in men epleronone is an option if nece...

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RE: Obstructing Urinary Stone 1 day ago

The serum creatinine returned to her usual normal level (0.84mg/dL), approximately one week (or sooner) after laser fragmentation and removal of an...

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RE: Timing of blood sampling in twice-weekly hemodialysis regimens 1 day ago

Luis: I am not sure whether any data exists as to what is a good time to take the blood samples. Proponents of incremental hemodialysis (like Dr Ka...

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RE: Severe Hypomagnesemia 2 days ago

Other ideas or expansions of ones already suggested: (1) Other better tolerated Mg salts [citrate, aspartate, glycinate, gluconate, lactate (see NE...

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RE: recurrent intracerebral hemorrhagic stroke in a young female known case of hypertension VS ANCA associated vasculitis 2 days ago

TThank you, Dr. Mohammed. She has had multiple brain imaging studies, including CT angiography with stroke protocol, MRI, and MR venography. I...

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RE: recurrent intracerebral hemorrhagic stroke in a young female known case of hypertension VS ANCA associated vasculitis 2 days ago

Thanks for case 2023 icb with high bp active urine sediment Was mpo negative then +ve after introduction of hydralazine I am interested to know ...

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RE: another ANCA case 2 days ago

With 500 mg Rituximab , did you check for CD19 depletion. Also did the c- anca ever become negative during therapy or not ?? Guess in refractory ...

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RE: Severe Hypomagnesemia 2 days ago

Magnesium citrate if available has better absorption than the oxide Have u tried sglt2i.. --------------------------------- Dr. Hormaz Dastoor. ...

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RE: another ANCA case 2 days ago

Thank you, Dr. Glassock. ------------------------------ Amit Joshi Chicago IL ------------------------------

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RE: Somewhat suppressed aldo, Primary aldosteronism or not? 2 days ago

(@Mark Lerman) I do not think eprelonone is a strong anti HTN, and I would prefer to use Spironolactone or even Baxdrostat here . Since he has gai...

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RE: Severe Hypomagnesemia 2 days ago

@Bijan Roshan Can try Mag-Tab SR in epic. --------------------------------- Mohammad Atari, M.D. Assistant Professor of Medicine University of Mi...

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RE: Somewhat suppressed aldo, Primary aldosteronism or not? 2 days ago

Could this be secondary hyperaoldosteronism due to obesity? https://pmc.ncbi.nlm.nih.gov/articles/PMC2904339/ https://pmc.ncbi.nlm.nih.gov/arti...

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RE: MPGN with IgM, C1q, kappa and lambda, no Immune Complexes 2 days ago

Thank you Dr.@Lynn Cornell --------------------------------- Mohammad Atari, M.D. Assistant Professor of Medicine University of Mississippi Medica...

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RE: Somewhat suppressed aldo, Primary aldosteronism or not? 2 days ago

I suspect it is primary aldo as well. ------------------------------ John Mellas MD Nephrology and Hypertension Specialists St Louis MO 314537235...

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RE: Biopsy or not to Biopsy 2 days ago

I would not have done too. Not sure I would know what I was looking for 🥺 That’s why we have prof glassock to make us better doctors and thinkers...

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RE: Alveolar haemorrhage in ANCA vasculitis 2 days ago

Thanks prof glassock for help Any comments anti gbm (rpgn) and ph without hypoxemia - would you olex? (I would ) Found an interesting article ht...

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RE: Biopsy or not to Biopsy 2 days ago

None of the above , but will do, was busy clinic ... that's my excuse !! --------------------------------- Dr. Hormaz Dastoor. MD, MSc, FASN Divi...

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Timing of blood sampling in twice-weekly hemodialysis regimens 2 days ago

It is becoming increasingly common to initiate hemodialysis with a twice-weekly schedule as part of an incremental hemodialysis approach. I am wond...

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RE: MPGN with IgM, C1q, kappa and lambda, no Immune Complexes 2 days ago

It's always hard to interpret someone else's immunofluorescence report. If there are no immune type deposits on EM, then I would favour a TMA proce...

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RE: Alveolar haemorrhage in ANCA vasculitis 2 days ago

PLEX has a very limited role in ANCA Vasculitis with pulmonary involvement in absence of anti-GBM disease. I personally do not recommend its use in...

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RE: another ANCA case 2 days ago

Relapsing anti-PR3 ANCA Vasculitis is fairly typical, especially with interruption of regular maintenance dosing of RTX. Avacopan has no real benef...

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another ANCA case 2 days ago

Hello, I came across the following case from friend who reached out to me for a family member. 75 yo F with HTN and osteoporosis 10/2023 Lef...

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RE: Alveolar haemorrhage in ANCA vasculitis 2 days ago

Beat --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Alveolar haemorrhage in ANCA vasculitis 2 days ago

Thanks for update pet scan when steroids at reduced dose Any sensory deficit ? Ncs /emg could be helpful Cardiac mri seems reasonable I would inv...

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RE: recurrent intracerebral hemorrhagic stroke in a young female known case of hypertension VS ANCA associated vasculitis 2 days ago

Thank you, Prof. Lerman. In 2023, at the age of 37, during her first event, her blood pressure was recorded at 200/100-110. However, it was su...

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RE: Severe Hypomagnesemia 2 days ago

Sorry if I missed was serum bicarbonate elevated? ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KPCOP EC [Past Medical D...

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RE: Severe Hypomagnesemia 2 days ago

That's good to know. I just looked and they have many lactate forms, including SR.

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RE: Severe Hypomagnesemia 2 days ago

Magnesium lactate is available on Amazon. ------------------------------ Richard Glassock MD, FASN Emeritus Professor Geffen School of Medicine a...

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