RE: Pd Question. 5 minutes ago

"I can't really comment about when a mesh is used, but we routinely continue with PD after a hernia repair. We will keep the patient dry for a few ...

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RE: anti gbm serology postive with fever and raised inflammatory markers 1 hour ago

May discuss with Pulom team if can go for bronchoscopy and BAL screen for any co-existing infection ------------------------------ Saja Mohammed...

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RE: Obstructing Urinary Stone 1 hour ago

Reflex vasospssm in the contralateral kidney in acute urinary tract obstruction is stil a hypothesis, in my opinion. The serum creatinine level doe...

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RE: Lupus-associated TMA with no response after four weekly doses of eculizumab: withdraw or continue? 1 hour ago

If the platelet count is now above 100, I suggest repeating the kidney biopsy. Based on the initial presentation and biopsy findings, the patient l...

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RE: Pd Question. 2 hours ago

I would hold PD for at least 24 hours after a pancreatic biopsy, and maybe more if it was a difficult procedure. Roger is right that PD patients ca...

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RE: Lupus-associated TMA with no response after four weekly doses of eculizumab: withdraw or continue? 3 hours ago

Is it correct that this X patient has not received standard "triple therapy " (MMF + Steroids + Obinutuzumab or Voclosporin or Belimumab) ) for sev...

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Lupus-associated TMA with no response after four weekly doses of eculizumab: withdraw or continue? 3 hours ago

Dear colleagues, I'd like to share a diagnostically challenging case from our nephrology unit, on which I would value the community's input. Case p...

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RE: anti gbm serology postive with fever and raised inflammatory markers 4 hours ago

What is your question? Is the serum anti-GbM still positive. How long has the patient been oliguric and on HD. How many PLaeX sessions has he recei...

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RE: anti gbm serology postive with fever and raised inflammatory markers 5 hours ago

@ prof glassock any thoughts on this issue please 🙏🏼 --------------------------------- Muhammad Soobadar MBChB UK -----------------------------...

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RE: Intersting case-Need your opinion 13 hours ago

I totally agree Prof Glassock. This case has taught me a lot ------------------------------ Jagadeesh Kurtkoti MBBS, MD SOUTHPORT ---------------...

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RE: Intersting case-Need your opinion 13 hours ago

Dr. Kurtkoti- remarkable and highly instructive case. Thanks for the FU. It looks like we should retire the use of Eculizumab for C-mediated TMA an...

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RE: Intersting case-Need your opinion 14 hours ago

Dear all, Just an update on this lady. She improved soon after the swithc from Eculizumab to Ravulizumab. She came off dialysis and creatinine is...

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RE: How to interpret VISIONARY Trial data on Sibeprenlimab 14 hours ago

This is the proverbial "64,000 Dollar " question!!a, So far as I know, the final 24 month data from the VISIONARY trial have not yet been published...

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RE: How to interpret VISIONARY Trial data on Sibeprenlimab 16 hours ago

@Roger Rodby@Richard Glassock thanks for your responses. So , this woupd lead to my second question in that would you consider Sibeprelimab as th...

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RE: How to interpret VISIONARY Trial data on Sibeprenlimab 19 hours ago

Without some sort of adjustment for severity of disease at randomization (e.g a prognostic score ) the eGFR slopes (in placebo arm ) between trials...

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RE: PR-3 ANCA with lung involvement 19 hours ago

With a presenting serum creatinine of 1.3mg/dL (maximum) can a multi-drug, PLEX based regimen really be justified? In my opinion, this patient will...

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RE: PR-3 ANCA with lung involvement 19 hours ago

I would consider attached ------------------------------ Roger Rodby MD, FASN Professor of Medicine Rush University Nephrology Associ...

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RE: Obstructing Urinary Stone 19 hours ago

Thanks. No NSAID. Only Opiods- I don't agree that acute total unilateral obstruction will not alter the serum creatinine concentration. The data fr...

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RE: ICI induced IgAV 19 hours ago

I suspect the AKI is as much from the RBC casts and ATN than the 17% crescents, I have no problem with ritux but might wait it out a bit longer -...

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RE: Pd Question. 19 hours ago

Do we need to hold pd for pancreatic biopsy using percutaneous US/CT technique ? I would, PD can be skipped for days typically without a problem ...

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RE: Obstructing Urinary Stone 19 hours ago

"One of the reasons for acute rise in creatinine following unilateral obstruction is reflex vasospasm in the contralateral kidney due to pain or ? ...

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RE: Obstructing Urinary Stone 20 hours ago

what did serum creat do? ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KPCOP EC [Past Medical Director Kidney Pancreas T...

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RE: Obstructing Urinary Stone 21 hours ago

Just an opinion. I would not wait a week. The patient is going to have ureteroscopy and stone removal tomorrow. ------------------------------ Ri...

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Pd Question. 21 hours ago

Dear colleagues , Do we need to hold pd for pancreatic biopsy using percutaneous US/CT technique ? Do we need to hold pd in APKD patient with haem...

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RE: ICI induced IgAV 21 hours ago

I would consider adding RTX at this point. ------------------------------ Richard Glassock MD, FASN Emeritus Professor Geffen School of Medicine...

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RE: Modality Of Imaging For Decline In Kidney Function 22 hours ago

Depends on the purpose of the imaging? ------------------------------ Ashraf El-Meanawy , MD, MS, PHD, FASN Professor of Medicine Director of Dia...

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ICI induced IgAV 22 hours ago

I would kindly appreciate your opinion on this patient 64M with history of NSCLC diagnosed last year s/p left upper lobectomy, has been on durval...

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RE: PR-3 ANCA with lung involvement 23 hours ago

This patient should receive RTX and Steroids according to the PEXIVAS protocol. In my opinion, PLEX is not indicated and the addition of CYC is not...

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RE: How to interpret VISIONARY Trial data on Sibeprenlimab 23 hours ago

Your hypothesis may be incorrect, the placebo rate of eGFR decline will likely vary according to the risk profile of the randomized subjects, which...

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RE: is it lead poisoning? 23 hours ago

What are the units used by your lab? It this level further testing may not be needed. ------------------------------ Richard Glassock MD, FASN Em...

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RE: PR-3 ANCA with lung involvement 23 hours ago

Counsel patient for pregnancy as young and female and use ovarian protective medication --------------------------------- Muhammad Soobadar MBC...

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RE: PR-3 ANCA with lung involvement 23 hours ago

Ask about joint , sensory loss or legs arm and ent symptoms --------------------------------- Muhammad Soobadar MBChB UK -----------------------...

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RE: PR-3 ANCA with lung involvement 23 hours ago

Thanks for case I would use two pulse iv cyclo and rituximab due to pulmonary haemorrhage and crescent and would do plex ( tho this might be deba...

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RE: How to interpret VISIONARY Trial data on Sibeprenlimab 23 hours ago

I guess what I am trying to get at , is the difference between placebo groups in Sibeprelimab and let's say phase 2 Ravulizumab , which could hypot...

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PR-3 ANCA with lung involvement 23 hours ago

I would like to ask for an expert opinion with regards to management of patient currently being seen in the hospital. F/28 years, referred to hos...

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RE: pr3 +ve is it endocarditis ? 23 hours ago

Thanks prof glassock we are following this route of action --------------------------------- Muhammad Soobadar MBChB UK -----------------------...

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RE: is it lead poisoning? 23 hours ago

Thanks prof glassock “plasma lead levels after administration of a chelating agent are much better for diagnosis if chronic lead poisoning.” Do I...

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RE: anti gbm serology postive with fever and raised inflammatory markers 23 hours ago

Question Is this pulmonary haemorrhage? tho pt has no has haemoptysis nor oxygen requirement Is it infection? No fever so i dont think If this...

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RE: anti gbm serology postive with fever and raised inflammatory markers 23 hours ago

@ prof venkat not cigarette smoker or vape user --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: anti gbm serology postive with fever and raised inflammatory markers 23 hours ago

@ prof lerman HRCT done yesterday as hb keeps dropping and pt needing transfusion --------------------------------- Muhammad Soobadar MBChB UK -...

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RE: anti gbm serology postive with fever and raised inflammatory markers 23 hours ago

Anca negative thanks --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Obstructing Urinary Stone 23 hours ago

One of the reasons for acute rise in creatinine following unilateral obstruction is reflex vasospasm in the contralateral kidney due to pain or ? R...

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RE: How to interpret VISIONARY Trial data on Sibeprenlimab 1 day ago

I am not sure what you are asking, are you overthinking it or am I underthinking it? but look at this figure GFR stable on sibeprenlimab , GFR...

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How to interpret VISIONARY Trial data on Sibeprenlimab 1 day ago

Just wanted to get some thoughts on the Sibeprenlimab in the Visonary trial which was relesed at GlomCon Hawaii Looking at it : Placebo gro...

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RE: anti gbm serology postive with fever and raised inflammatory markers 1 day ago

Dr. Muhammad, what about the ANCA serology? He might have an overlap syndrome, which supports the need for plasmapheresis and Cyclophosphamide (CYC...

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RE: anti gbm serology postive with fever and raised inflammatory markers 1 day ago

@Muhammad Soobadar: is the patient a cigarette smoker? If not a smoker, risk pulmonary hemorrhage due to anti-GBM-ab is small. -----------------...

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RE: Obstructing Urinary Stone 1 day ago

As mentioned by Dr. Lerman, SCr trend in the first 24-48 hours following living donor nephrectomy is relevant to this discussion. My experience is ...

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RE: Obstructing Urinary Stone 1 day ago

Thank you, Professor, for sharing this case. I have a similar concern regarding the AKI that the patient experienced due to UUO. I would like to sh...

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RE: Modality Of Imaging For Decline In Kidney Function 1 day ago

I assume that an abdominal CT is being done for reasons other than impaired kidney function. If this is the case, a separate US test is not require...

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RE: Modality Of Imaging For Decline In Kidney Function 1 day ago

Prof. Glassock's case brought back an old teaching, do not know if true or old myth: "Reflex anuria" A long, long time ago heard old Urologists com...

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