Tablo machines 13 minutes ago

We have been having problems with positive water cultures in our tabllo machines that have been used for a good number of years as the main machine...

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Proteinuria in IgA nephropathy- practice patterns 1 hour ago

Error..apologies

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RE: X linked Alport syndrome In Female 3 hours ago

I completely agree with Dr. Glassock that the study by Yamaguchi M, et al. raises a red flag, but because is done in mice, it provides no evidence ...

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Proteinuria of unclear etiology in a pediatric patient. 4 hours ago

Greetings, I have a pediatric nephrology case I would appreciate some adult nephrology perspective on. 3 year old female presented with incid...

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RE: IgAN- ET1a Vs Complement Blockers In High Risk patients 4 hours ago

So how would you make a decision between the 2 drugs , for instance a 40-45 year old who may present with eGFR 40-50 ml/min and uPCR of > 1.5 g/g.....

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RE: IgAN- ET1a Vs Complement Blockers In High Risk patients 5 hours ago

Neither studies of ERA (Atrasentan ) or Complement Factor B inhibitors have reported (published) any results with GFR endpoints in IgAN . See the l...

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RE: C1q Nephropathy - diagnosis? treatment suggestions 5 hours ago

Genetic testing shows G1/G2 haplotype. The APOL1 G1 haplotype is c1024A>G, p.(Ser342Gly) and c.1152T>G, p. (Ile384Met) in cis (rs73885319 and rs609...

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IgAN- ET1a Vs Complement Blockers In High Risk patients 5 hours ago

For patients with High Risk IgAN, we have new FDA approved drugs . The question hence arises , for these high risk group , what should we use 1....

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RE: X linked Alport syndrome In Female 13 hours ago

The results of Yanaguchi et al study (referenced by Dr. Campese ) are very intriguing ( and potentially very worry provoking) but exclusively carri...

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RE: Resistant hypertension 18 hours ago

The search strategyin the ref cited comparing hydralazine to placebo did not yield any randomized controlled trials for inclusion in this review. T...

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RE: X linked Alport syndrome In Female 20 hours ago

The article by Gross et al in KI (thanks to Agnes for pointing this out), included only 20 patients in the randomized arm, and it failed to demonst...

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RE: Resistant hypertension 20 hours ago

My question to the group is what is the evidence that hydralazine is a better BP med than CCB? Has the safety, tolerability, efficacy been studie...

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RE: X linked Alport syndrome In Female 1 day ago

Agree completely with Dr. Glassock's points- hopeful apparent benefit for "progression"- but hit is not based on long-term follow-up ------------...

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RE: X linked Alport syndrome In Female 1 day ago

Many Thanks Dr. Fogo for pointing out this important Phase 3 RCT of Ramipril in Alport's. "Progression" in this study was based on change in albumi...

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RE: X linked Alport syndrome In Female 1 day ago

The phase 3 trial in children with Alport- Early-PROTECT- did give ACEI (ramipril) early- with lesser proteinuria and appeared to decrease progress...

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RE: X linked Alport syndrome In Female 1 day ago

Dr. Campese is absolutely correct that the evidence concerning a long term beneficial effects of RAS inhibition in Alport Syndrome is not based on ...

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RE: MPGN/Lupus/DKD - biopsy. 1 day ago

I would wager a bet that the proteinuria response is probably due to Foundational CKD therapy. Having said that only a repeat biopsy would conclusi...

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RE: MPGN/Lupus/DKD - biopsy. 1 day ago

Apologies for delayed response. In terms of timeline: I first met her in Dec 2023 - already on max Perindopril, Dapa with Cr 111umol/L, Urine...

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RE: Role of Acthar in secondary FSGS 1 day ago

Thank you Dr. Glassock and Dr. Rodby. Appreciate your valuable input. ------------------------------ Zakir Shaik MD MHA FACP Beaumont, TX 409-89...

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RE: Resistant hypertension 1 day ago

Thank you all for suggestion. And healthy discussion. His bp is now maintaining 130 80 reducing oral antihypertensive, iv is off . We don't ha...

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RE: Role of Acthar in secondary FSGS 1 day ago

You probably will have to ask the pathologist who reviewed the biopsy and ask for an evaluation of glomerular size. I know of no study , in humans,...

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RE: Role of Acthar in secondary FSGS 1 day ago

Renal biopsy: RENASIGHT: Negative Referred to bariatric surgeon already. GLP1-A in my understanding very hard to get approved if pt is not a d...

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RE: Resistant hypertension 1 day ago

SO THE RULE OF THIRDS APPLIES. IF EXTRAPOLATED TP DIALYSIS PATIENT, EDW IS WRONG 2/3 OF THE TIME ------------------------------ Anatole Besarab M...

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RE: Role of Acthar in secondary FSGS 1 day ago

I think that is a good point, glomerulomegaiy as the tie breaker. ------------------------------ Roger Rodby MD, FASN Professor of Medicine R...

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RE: Role of Acthar in secondary FSGS 1 day ago

If glomerulomegaly is present in the kidney biopsy and the Family History is negative for kidney disease I probably would not do genetic testing . ...

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RE: Resistant hypertension 1 day ago

We did a study in new transplant patient when they had stable and good creat at 2 weeks we assumed the correct DW was with a good functioning ki...

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RE: X linked Alport syndrome In Female 1 day ago

Thanks Still not clear why like any proteinuric condition ACEI/ ARBS are used to reduce hyperfiltration and proteinuria Why in Alport only ACEI me...

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RE: Resistant hypertension 2 days ago

the statement that the most ardent supporters are " .mainly from those who are eager to sell it in my country" A true statement if ever I heard one...

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RE: Resistant hypertension 2 days ago

What is the gold standard for total body volume Is it Watson volume again?. ------------------------------ Anatole Besarab MD ABesarab Consultin...

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RE: Resistant hypertension 2 days ago

Thanks for the response. I would presume that at low levels or renal disease when there is no Significant accumulation of extracellular Na and W...

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RE: Resistant hypertension 2 days ago

I agree. Thanks

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RE: Resistant hypertension 2 days ago

I have also heard about this coming publication ...mainly from those who are eager to sell it in my country. I am afraid that even the most a...

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RE: The patient who keeps on giving 2 days ago

------------------------------ Dr. Hormaz Dastoor. MD, FASN Nephrology Consultant - Seha Kidney Care. Nephrology Consultant- SSMC,PureHealth LLC. A...

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RE: X linked Alport syndrome In Female 2 days ago

The alleged benefits of ACEi and ARBs in Alport's syndrome are based primarily on animal studies. The evidence in humans is based on retrospective ...

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RE: Resistant hypertension 2 days ago

In terms of the Calf bioimpedance I don't believe they validated their total body water results with other bio Impedance devices There are no d...

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RE: Resistant hypertension 2 days ago

The study was in a primary care setting, so likely a very low incidence of CKD They are in the process of publishing the data and hopefully analyzi...

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RE: Resistant hypertension 2 days ago

Not to keep going on the same subject, but I believe it is an important area of pathophysiology…when I eyeball the abstract you attached I see that...

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RE: Resistant hypertension 2 days ago

Yes I do. Volume is the most important variable and we are terrible at estimating the ideal EDW for our patients. . Mu experience is that blood ...

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RE: Role of Acthar in secondary FSGS 2 days ago

19 seems a bit young for ORG? Maybe get genetic testing looking for podocin mutation? Or is that silly given BMI of 40. UPToDate: Indi...

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RE: Resistant hypertension 2 days ago

Michael, What was the renal function in this cohort of some 21,000 pts. The findings may apply to non CKD. With CKD of various degree or at stag...

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RE: The patient who keeps on giving 2 days ago

Insurance in Abudhabi, is a mix of German and US systems . German in the sense that it is managed by German insurance professionals and the system ...

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RE: Resistant hypertension 2 days ago

Dear Dr. Besarab, Are you saying that you agree with me that genesis of hypertension in advanced CKD is essentially volume retention and that sus...

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RE: Resistant hypertension 2 days ago

NICAS is FDA approved and very well validated you can see the validation information and studies on their website https://www.ni-medical.com/ -...

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RE: Resistant hypertension 2 days ago

In the studies about 1/3 of Patients are hyperdynamic and not just young people like believed by many See figure 1 Once high cardiac power/C...

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RE: Resistant hypertension 2 days ago

The genesis of hypertension in the dialyzed patient is multifactorial and complex, but Scribner long ago emphasized the importance of hypervolemia....

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RE: The patient who keeps on giving 2 days ago

Interesting case. Was pronase IF performed on the FFPE tissue to exclude masked deposits in this case? Should be considered in any case of C3 domin...

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RE: The patient who keeps on giving 2 days ago

I keep seeing this statwment to often. It obviously appears in so many nations. "(fill in your favorite phrase) " Depending on his insurance , it w...

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RE: The patient who keeps on giving 2 days ago

Given rapid response of SCr, proteinuria and C3 hypocomplementemia to steroids, should we consider possibility of an antibody to C3 complement-regu...

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RE: Resistant hypertension 2 days ago

This is an interesting concept raised by Dr. Germain. I thought it was well accepted that chronic hypertension is always the result of sustained in...

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RE: X linked Alport syndrome In Female 2 days ago

Based on weak evidence the general consensus is that ACEi (Ramipril, Enalapril) are preferred for therapy of Alport Syndrome -------------------...

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