RE: PIGN with only proteinuria? 4 hours ago

To be more complete with the pathology findings, which will aid in the discussion. The pattern is Focal segmental endocapillary proliferative with ...

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RE: 24 hours Urine Collection better or Serum Cystatin C, in a patien with high BUN. 6 hours ago

'He has received total 40.8 g of protein in 24 hours the days of 24 hours urine collection' which is exactly what this gives us when I used 60 KG...

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RE: 24 hours Urine Collection better or Serum Cystatin C, in a patien with high BUN. 6 hours ago

Dr Chander : Very weird results I think he is male ; do not have weight have assumed 110 lb = 50.2 Kg Creatinine excretion 7.8 dl at 365 mg/dl = 28...

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RE: 24 hours Urine Collection better or Serum Cystatin C, in a patien with high BUN. 6 hours ago

Urine creatinine concentration very high and 24 hour excretion rate of creatinine greatly exceeds what would be expected in a malnourished ,sarcope...

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RE: 24 hours Urine Collection better or Serum Cystatin C, in a patien with high BUN. 7 hours ago

Sure. He has received total 40.8 g of protein in 24 hours the days of 24 hours urine collection and 340.8g prior to that. Feed doesn't have crea...

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RE: PLA2R-positive membranous nephropathy, rituximab intolerance 8 hours ago

to piggy back on PLA2r MN, I have a pediatric pt with his condition, received 3 ritux so far ( 6 wk interval roughly), but he is still not negative...

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RE: 24 hours Urine Collection better or Serum Cystatin C, in a patien with high BUN. 9 hours ago

Dr Chander It may be possible instructive to play with numbers Could you upload desidentified data? Patient weight ( ideal Edema free) daily prote...

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RE: Asymptomatic Segmental Arterial Mediolysis Right Renal Artery 10 hours ago

Can you show the angiogram? Why this could not be fibromuscular dysplasia? Was the GI bleeding due to arteriolitis of celiac or gastric artery? SMA...

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RE: 24 hours Urine Collection better or Serum Cystatin C, in a patien with high BUN. 11 hours ago

Thank you, everyone - that was a great discussion. We stopped the tube feeds, and the BUN remained stable; however, it worsened upon resuming feeds...

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RE: recurrent multidrug-resistant Pseudomonas urinary tract infections 13 hours ago

Can you specify what urologic workup was done? In this scenario, I would typically start with a diagnostic cystoscopy, cross-sectional excretory im...

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RE: membranous nephropathy 13 hours ago

I think that is the smart call ------------------------------ Roger Rodby MD, FASN Professor of Medicine Rush University Nephrology Associates...

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RE: membranous nephropathy 14 hours ago

Anti PLA2r titer came back 820. Pt is being treated with oral cytoxan and steroids by the treating physician. Thanks ----------------------------...

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RE: PLA2R-positive membranous nephropathy, rituximab intolerance 15 hours ago

Thank you Dr. Rodby and Dr. Vasquez! ------------------------------ Raman Anam MD Assistant Professor of Medicine LSU Health Shreveport Shrevepor...

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RE: recurrent multidrug-resistant Pseudomonas urinary tract infections 17 hours ago

Correction > > "Wouldn't use Bactrim for your patient due to CKD & not useful for Pseudomonas." ------------------------------ Sinasi Salman MD, ...

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RE: Asymptomatic Segmental Arterial Mediolysis Right Renal Artery 1 day ago

Great question. No good answers. Uncommon condition that remains stable or regresses in 75% and progresses in 25%. Biomarkers predicting progressio...

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RE: 24 hours Urine Collection better or Serum Cystatin C, in a patien with high BUN. 1 day ago

Prof El-Meanawy : Never saw reference but told that early on to prove relative non toxicity of urea, very uremic patients were dialyzed against a b...

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Asymptomatic Segmental Arterial Mediolysis Right Renal Artery 1 day ago

Hi, Seeking any experience with potential Segmental Arterial Mediolysis (SAM) and indication/ need for stenting? 74F presented with recurrent j...

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RE: recurrent multidrug-resistant Pseudomonas urinary tract infections 1 day ago

Ciprofloxacin maybe effective while sensitivity reported as R There are 2 antibiotics that can penetrate into calcifications/stones [harbors f...

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RE: 24 hours Urine Collection better or Serum Cystatin C, in a patien with high BUN. 1 day ago

Cystatin-C is sold as a great alternative and more accurate in elderly, this is not true. Many factors affect Cystatin-C level. 24h urine creatin...

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RE: Lab potassium normal range 1 day ago

In large population based studies the mean plasma K concentration in subjects with an eGFR of 90ml/ min/1.73m2 or more is 3.98mmol /L with a 95% co...

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RE: Lab potassium normal range 1 day ago

Normal serum and plasma potassium levels are not the same. Serum potassium is generally 0.4-0.5mmol/ L higher than Plasma potassium concentration. ...

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recurrent multidrug-resistant Pseudomonas urinary tract infections 1 day ago

A patient with a history of lymphoma and prolonged hospitalization has developed recurrent urinary tract infections (UTIs) caused by multidrug-resi...

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RE: PLA2R-positive membranous nephropathy, rituximab intolerance 1 day ago

Yes Dr. Rodby- that's the Majesty Protocol : https://www.clinicaltrials.gov/study/NCT04629248 ------------------------------ George Vasquez-Rios ...

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Lab potassium normal range 1 day ago

Our hospital chemistry laboratory recently changed the plasma potassium normal range to 3.5-4.5 mmol/L (male) and 3.4-4.4 mmol/L (female). Previous...

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RE: PLA2R-positive membranous nephropathy, rituximab intolerance 1 day ago

what I have seen is similar to Rituximab, 1 gram followed by another 1 gram 2 weeks later ------------------------------ Roger Rodby MD, FA...

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DEADLINE TOMORROW: Case Report Reviewer Volunteer Application Closes May 7! 1 day ago

ASN invites ASN Fellows-in-Training members to serve as reviewers for case reports submitted by trainees for Kidney Week 2025. The reviewing/gradin...

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DEADLINE TOMORROW: Case Report Reviewer Volunteer Application Closes May 7! 1 day ago

If you are interested serving as a reviewer, please complete this form by May 7: https://www.asn-online.org/apply/?ID=21 ASN invites ASN Fellow...

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RE: PLA2R-positive membranous nephropathy, rituximab intolerance 1 day ago

Could you share your standard obinutuzumab induction protocol? Thank you! ------------------------------ Raman Anam MD Assistant Professor of Med...

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RE: PLA2R-positive membranous nephropathy, rituximab intolerance 1 day ago

Thank you Dr Vasquez-Rios! ------------------------------ Raman Anam MD Assistant Professor of Medicine LSU Health Shreveport Shreveport LA (786)...

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RE: PLA2R-positive membranous nephropathy, rituximab intolerance 1 day ago

Thank you Dr. Glassock! ------------------------------ Raman Anam MD Assistant Professor of Medicine LSU Health Shreveport Shreveport LA (786)266...

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RE: 24 hours Urine Collection better or Serum Cystatin C, in a patien with high BUN. 2 days ago

Thanks for the References. The Selistre L et al paper in CKJ in 2023 is the best one, in my opinion, and strongly supports your views. Except for o...

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RE: 24 hours Urine Collection better or Serum Cystatin C, in a patien with high BUN. 2 days ago

Prof. Glassock: Agree that patient may be too ill to benefit from dialysis but sometimes I have been proven wrong, patients that looked that they w...

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RE: PLA2R-positive membranous nephropathy, rituximab intolerance 2 days ago

Agree - obinutuzumab is a great option for PLA2R-MN in patients with intolerance to rituximab or in whom you want to spare from CYC. Obi, it's a fu...

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RE: 24 hours Urine Collection better or Serum Cystatin C, in a patien with high BUN. 2 days ago

I seriously doubt that the average of urea and creatinine clearance woukd be any better than a CCr in estimating true GFR in this case. Having some...

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RE: IgAN therapy in patient desiring future pregnancy and intolerant of steroids 2 days ago

Thanks for the Reference. I can't find a comparison of the ROC of serum creatinine vs US features in predicting IFTA on Kidney Biopsy. Not a very s...

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RE: IgAN therapy in patient desiring future pregnancy and intolerant of steroids 2 days ago

Since the 2017 ultrasound was unremarkable and if imaging now shows smaller kidneys, increased echogenicity and/or cortical thinning, it is very li...

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RE: IgAN therapy in patient desiring future pregnancy and intolerant of steroids 2 days ago

I found this article suggesting that Doppler US can be used to evaluate for tubular atrophy/interstitial fibrosis (TA/IF) in IgAN: Qin X, Zhan...

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RE: Mpo Vasculitis Case 2 days ago

I will get the full report next couple of days and post it Best wishes --------------------------------- Muhammad Soobadar MBChB UK -----------...

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RE: Mpo Vasculitis Case 2 days ago

Thanks prof glassock and sorry late response Meds for bp - furosemide 40 mg od , losartan 75 mg od , Amlodipine 10 mg od Not on hydralazine Bw ...

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RE: 24 hours Urine Collection better or Serum Cystatin C, in a patien with high BUN. 2 days ago

In cases with low GFR what about using average of Urea and Creatinine clearances? One over other under estimates However, if he were my patient wou...

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RE: 24 hours Urine Collection better or Serum Cystatin C, in a patien with high BUN. 2 days ago

"When the BUN rises above 100, is it logical to continue such a high protein diet? It is obvious that most of the protein is being catabolised to n...

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RE: 24 hours Urine Collection better or Serum Cystatin C, in a patien with high BUN. 2 days ago

While I generally agree that a high BUN is a high BUN, the question which I have is whether such a high protein diet can be recommended when the BU...

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RE: 24 hours Urine Collection better or Serum Cystatin C, in a patien with high BUN. 2 days ago

"High BUN in a patient on tube feeding is probably due to high protein diet if considered too high for the rise in creatinine. It may just be a cat...

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RE: 24 hours Urine Collection better or Serum Cystatin C, in a patien with high BUN. 2 days ago

High BUN in a patient on tube feeding is probably due to high protein diet if considered too high for the rise in creatinine. It may just be a cata...

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RE: PLA2R-positive membranous nephropathy, rituximab intolerance 2 days ago

Assuming that these reactions are due to Human anti Chimeric antibodies commonly found with Rituximab therapy, it would seem reasonable to use Obin...

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PLA2R-positive membranous nephropathy, rituximab intolerance 2 days ago

35-year-old Caucasian male truck driver with PLA2R-positive membranous nephropathy (PMN) diagnosed based on antibody titer of 1:160 on 9/10/24. Bas...

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RE: Rituximab for "maintenance " of a CR in PLA2R related MN 2 days ago

All great points Dr. Cerqueira- thanks for your perspectives and key references. We need to distinguish true relapses of full NS after a complete i...

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RE: difficult case ? should we treat as cx negative endocarditis Vs seronegative AAV 2 days ago

Here is a small twist. that needs further discussion. - would the recommendation for no Immunosuppression be the same if this patient had also show...

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RE: Rituximab for "maintenance " of a CR in PLA2R related MN 3 days ago

Selection bias aside! volume 5, pages469–479 (2009) ------------------------------ Tiago Cerqueira, MD, MSc, MBA, FASN Evangelical Hospital ...

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RE: Rituximab for "maintenance " of a CR in PLA2R related MN 3 days ago

Well, I do agree it should be uncommon, but there are some data that draws attention to relapses after CR: Late relapses (in 10 years) occurs in ...

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