Full house with negative serolgy 32 minutes ago

Hi all, I would appreciate your input on this patient. 32M with no past medical history, presented with nephrotic syndrome UPC 4500 mg/g, UACR 3...

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RE: Be aware of the infectious consequences of therapy with complement inhibitors 2 hours ago

Thanks Dr. Rodby! Good to know. ------------------------------ Anuja Java, MD (pronouns: she/her/hers) Associate Professor of Medicine Director,...

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RE: Be aware of the infectious consequences of therapy with complement inhibitors 2 hours ago

You can always go back and edit a post ------------------------------ Roger Rodby MD, FASN Professor of Medicine Rush University Nephrology ...

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RE: Pseudohypertension or true uncontrolled HTN 2 hours ago

"Would you attempt to assess central Aortic mean pressure, by non-invasive means, before beginning antihypertensive therapy in this patient with a ...

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RE: Interesting GN case 2 hours ago

Her seronegative RA could have been MPA all along. 6 gloms is not enough to comfortably rule out a FOCAL, segmental necrotizing lesion, and that ...

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RE: Interesting GN case 2 hours ago

Be sure the patient is not on hydralazine . ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 -------------...

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RE: Interesting GN case 3 hours ago

Based on the information available. I would treat with RTX and steroids, but no PLEX unless anti-GBM positive or linear IgG when IF returns (unlike...

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RE: Interesting GN case 3 hours ago

Unfortunately I couldn't spin her urine. ------------------------------ Daniele Rios Leite MD University of Florida Jacksonville FL (864) 448-478...

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RE: Interesting GN case 3 hours ago

Tough case- 60 year okd with hematuria. Proteinuria without hypoalbuminemua, decline in eGFR, strongly positive anti-MPO , no anti-GBM antibody don...

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RE: Please help with a case of IGA nephropathy 4 hours ago

The presence of an E1 lesion did not predict the response to steroids in the TESTiNG trial so I don't agree with your statement about the E lesion ...

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Interesting GN case 4 hours ago

This is a 60 yo F with PMH of HTN (since around 2024, well controlled), sero-negative RA (previously on MTX, now on HCQ only), pre-DM. Family h/o G...

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RE: Please help with a case of IGA nephropathy 5 hours ago

I am not sure that another round of IS therapy, will induce remission in the patient . The E lesion , as of endothelial proliferation , is the mos...

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RE: Pseudohypertension or true uncontrolled HTN 14 hours ago

Another concern is what happens to DBP when isolated Systolic Hypertension is treated. The critical value of 60-70mmHg for MAP can be breached. (MA...

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RE: Be aware of the infectious consequences of therapy with complement inhibitors 19 hours ago

Thanks Dr. Java for highlighting this very important clinical question. I fully understand the uncertainties that exist today and I am greatly enco...

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RE: Be aware of the infectious consequences of therapy with complement inhibitors 22 hours ago

"Errare humanum est" Thank you for your prompt response Dr. Java. It exemplifies, once again, that we have only uncover the tip of the iceberg an...

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RE: Be aware of the infectious consequences of therapy with complement inhibitors 23 hours ago

Apologies for misspelling Dr. Rubin's name. I find it sloppy when people misspell names. I am so embarrassed I did this. SO SORRY!! -------------...

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RE: Be aware of the infectious consequences of therapy with complement inhibitors 23 hours ago

Dear Dr. Rubin, Thank you so much for highlighting the work! Dr. Glassock brings up an important question that we have attempted to address i...

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RE: Be aware of the infectious consequences of therapy with complement inhibitors 23 hours ago

@Anuja Java @Richard Glassock I am unable to provide an answer to your question, Dr. Glassock. I would like to consult with a colleague (Dr. An...

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RE: Be aware of the infectious consequences of therapy with complement inhibitors 23 hours ago

Dr. Rubin- Many thanks for this very important post and citation. With respect to quantifiable risks of infection (mainly encapsulated bacteria )...

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Be aware of the infectious consequences of therapy with complement inhibitors 1 day ago

I have attached an excellent review (just released online and written by well-known experts) on the infectious consequences of complement inhibitor...

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RE: Pseudohypertension or true uncontrolled HTN 1 day ago

Dr. Rodby- Would you attempt to assess central Aortic mean pressure, by non-invasive means, before beginning antihypertensive therapy in this pat...

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RE: Chronic Active Thrombotic Microangiopathy - kidney biopsy 1 day ago

Dr Bianco: Apart from 'intermittently' low CH50, is there any other evidence that complement is activated? I may have missed something. I would sug...

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RE: Please help with a case of IGA nephropathy 1 day ago

A clinical "remission" of IgAN might be defined as proteinuria < 0.5gm/d, absence of hematuria /hemoglobinuria and a stable , preferably normal . e...

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RE: Pseudohypertension or true uncontrolled HTN 1 day ago

I attached the article that shows what Dr Glassock is referring to. I just worry about the specificity of Osler's sign, psueudo HTN is a...

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RE: Please help with a case of IGA nephropathy 1 day ago

Ideally "remission" - a term we are still defining in IgAN... - would be great pre-pregnancy, but she did respond to tarpeyo and MMF as proteinuria...

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RE: Hemodialysis Associated Headache 1 day ago

The most common cause of headache on HD is vigorous fluid removal & taking post-HD weight below the target wt. I am well-aware there might be other...

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RE: Please help with a case of IGA nephropathy 1 day ago

What us the current level of dipstick hematuria? What is the patients BMI? The desire for pregnancy in the face id active inflammatory (partially t...

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Please help with a case of IGA nephropathy 1 day ago

28‑year‑old female with no significant past medical history presented in April 2024 with intermittent microscopic/gross hematuria for several years...

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RE: Hemodialysis Associated Headache 1 day ago

What is the predialysis and post dialysis Na levels and what Dialysate Na are you using . What happens to the patients Blood pressure , can u ela...

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RE: Hemodialysis Associated Headache 1 day ago

I already tried but no response --------------------------------- Jehad Yousef MD, MBBS Jordan ministry of health ---------------------------------

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RE: Hemodialysis Associated Headache 1 day ago

Could be a " Histamine Release " headache. Have you tried pre-dialysis anti-histamine therapy.? ------------------------------ Richard Glassock M...

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RE: Hemodialysis Associated Headache 1 day ago

Thank you for drawing my attention to this point. --------------------------------- Jehad Yousef MD, MBBS Jordan ministry of health ------------...

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RE: Hemodialysis Associated Headache 1 day ago

Thank you for your response. I will read these articles and try to implement them. --------------------------------- Jehad Yousef MD, MBBS Jordan...

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RE: Hemodialysis Associated Headache 2 days ago

Attached a few article I have on this. ------------------------------ Roger Rodby MD, FASN Professor of Medicine Rush University Nephrolog...

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RE: Chronic Active Thrombotic Microangiopathy - kidney biopsy 2 days ago

Seems that the episode of TMA, suspected to be aHuS although you did not mention what was your work up , has resolved . In the absence of a high ri...

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RE: Hemodialysis Associated Headache 2 days ago

I had few patients like that, some of them had significant improvement in symptoms after switching to different dialyzer membrane Don’t have an art...

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RE: Conventional treatment resistant Anti GBM disease 2 days ago

Dr. Sampathkumar: 1. Was urine available for examination on initial presentation and what did it show, ATN-compatible vs. nephritic? 2. Have you re...

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RE: Chronic Active Thrombotic Microangiopathy - kidney biopsy 3 days ago

I think it depends on the clinical situation. If the creatinine is worsening or proteinuria is worsening, then I agree C5 blockade would be appropr...

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RE: Chronic Active Thrombotic Microangiopathy - kidney biopsy 3 days ago

Dear Dr Leung, At the time of the initial presentation, the patient had laboratory evidence consistent with microangiopathic hemolysis, inclu...

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RE: Chronic Active Thrombotic Microangiopathy - kidney biopsy 3 days ago

Dear Dr Venturelli, Thank you for you suggestion. I will speak with the nephropathologist! Patricia ------------------------------ Patr...

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RE: Chronic Active Thrombotic Microangiopathy - kidney biopsy 3 days ago

Dear Dr Glassock, The patient has even done the genetic panel and it was negative. ADAMTS13 was normal also, it was repeated and normal aga...

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RE: Chronic Active Thrombotic Microangiopathy - kidney biopsy 3 days ago

Hi!! Yes and it was normal. ------------------------------ Patricia D' Almeida Bianco, MD Nephrologist Hospital Santa Casa de Porto Alegre Bra...

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RE: Conventional treatment resistant Anti GBM disease 3 days ago

In anti-GBM disease one cannot define treatment resistance on clinical parameters alone. Despite very responsive immunological disease (rapidly fal...

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RE: Conventional treatment resistant Anti GBM disease 3 days ago

Similar associations of anti-GBM disease with COVID19, HIV and Influenza A exist. As far as I can tell, no TMA was concomitantly present . I know o...

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RE: Pseudohypertension or true uncontrolled HTN 3 days ago

With a positive Osler sign , this is most likely Pseudo -hypertension due to Monkebergs arterial sclerosis. X-rays of the arms will likely reveal a...

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RE: Pseudohypertension or true uncontrolled HTN 3 days ago

Im not sure you will be able to tell without an arterial line? Im also not sure it is worth it Personally I would add 5 amlodipine (5 not 10, ...

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Pseudohypertension or true uncontrolled HTN Tuesday, February 3 @ 2:57 PM

An 88 yr old male with a normal renal fn ( creat 0.96, eGFR 72) was referred to me today for uncontrolled systolic HTN. 4 months ago, his SBPs at h...

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RE: recurrent fainting with peritoneal dialysis start, ? vagal reaction Tuesday, February 3 @ 2:33 PM

Here is the article in question. Files Attached Documentrecurrent fainting with peritoneal dialysis start, ? vagal reaction Attachments

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RE: Conventional treatment resistant Anti GBM disease Tuesday, February 3 @ 1:57 PM

Thanks @prof glassock What about kidney biopsy of patient with dengue ? Any tma? --------------------------------- Muhammad Soobadar MBChB UK ...

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RE: recurrent fainting with peritoneal dialysis start, ? vagal reaction Tuesday, February 3 @ 1:39 PM

baseline BP is good, and yes supine positioned ------------------------------ Radu Raducu MD MD Sanford Hospital BIsmarck ND (203) 606-7322 ----...

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