RE: Osteoporosis v Renal Osteodystrophy in Renal Transplant Recipient 17 minutes ago

I agree with most of the comments made. A biopsy would give a more definitive diagnosis, though I am not convinced that it is necessary. What is hi...

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RE: A Young Patient with IgA Nephropathy, Portal Hypertension, and Refractory Anemia: One Disease or Many? 1 hour ago

Sorry-i meant hepatic vein , not portal vein, thrombosis. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-888...

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RE: A Young Patient with IgA Nephropathy, Portal Hypertension, and Refractory Anemia: One Disease or Many? 4 hours ago

I also agree with Dr. Venkat that the clinical findings are compatible (including marrow aplasia, reactive arthritis and portal vein thrombosis) wi...

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RE: A Young Patient with IgA Nephropathy, Portal Hypertension, and Refractory Anemia: One Disease or Many? 4 hours ago

What is the patients Mean corpuscular volume and peripheral blood smear, red cell morphology , and Hemoglobin electrophoreses? Could this be IgAN, ...

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RE: A Young Patient with IgA Nephropathy, Portal Hypertension, and Refractory Anemia: One Disease or Many? 5 hours ago

Isolated ineffective erythropoiesis: Have you done blood parvovirus B-19 PCR (IgM and IgG antibodies less reliable)? Parvovirus can cause liver dam...

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A Young Patient with IgA Nephropathy, Portal Hypertension, and Refractory Anemia: One Disease or Many? 6 hours ago

Distinguished colleagues, we seek your insight on a 38-year-old man whose clinical trajectory has recently changed in a way that we are strugglin...

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RE: Anti GBM with Fibrillary GN 14 hours ago

Oral cyclophosphamide (CYC) + RTX combinations have been used to treat FGN. IV CYC is usually not used to treat Anti-GBM disease . What assay was u...

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RE: Osteoporosis v Renal Osteodystrophy in Renal Transplant Recipient 14 hours ago

I agree with Dr. Venkat. Clinically, this is most likely steroid-induced Osteoporosis, post kidney transplant. But a bone biopsy may be the only wa...

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RE: Anti GBM with Fibrillary GN 16 hours ago

Yes. Active UA, since 07/2025. Pt was never referred to a nephrologist before. Walked into ER this past Monday with abnormal eGFR and UA follow...

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RE: Anti GBM with Fibrillary GN 18 hours ago

There are rare reports of anti-GBM-ab RPGN and fibrillary GN occurring together: https://pmc.ncbi.nlm.nih.gov/articles/PMC4720204/ Wonder if anti...

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RE: Osteoporosis v Renal Osteodystrophy in Renal Transplant Recipient 18 hours ago

Pth 30 2020 now 100 --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Osteoporosis v Renal Osteodystrophy in Renal Transplant Recipient 18 hours ago

B alkaline phosphate not done. --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Osteoporosis v Renal Osteodystrophy in Renal Transplant Recipient 18 hours ago

Thanks prof venkat Alp= alkaline phosphate Kind regards --------------------------------- Muhammad Soobadar MBChB UK -------------------------...

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RE: Osteoporosis v Renal Osteodystrophy in Renal Transplant Recipient 18 hours ago

Kidney transplant 31 years ago, on prednisolone and cyclosporine since then. Both these drugs can cause osteoporosis. Intermittently high normal se...

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RE: Follow up 18 hours ago

Dr. Whittier thanks so much -as I stated in my previous post one of my issues when we started letting IR do the biopsies even transplant, kidney bi...

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Anti GBM with Fibrillary GN 19 hours ago

Hello all, Have an interesting case and appreciate your input. 57 year old Caucasian female with hx of rheumatoid arthritis, admitted on 3/16/20...

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RE: Follow up 19 hours ago

yes, when we do the PRB, we typically do the right kidney. our protocol has been nephrology does the majority of the biopsies, but if they need CT ...

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RE: Follow up 20 hours ago

Dr. Whittier- thanks so much for your input- does that mean that when you and your Colleagues, and therefore your fellows under their supervision, ...

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RE: ANCA vasculitis with AIN 20 hours ago

creat gone up ------------------------------ Muhammad Soobadar MBChB UK ------------------------------

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RE: ANCA vasculitis with AIN 20 hours ago

many thanks there is one artery that shows vasculitis . Creatinine has gone down rapidly. RF +ve, normal complement Blood culture negative I ...

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RE: Follow up 22 hours ago

My practice plan is as follows: 1. Refer all outpatient biopsies to the university. High volume center, lower complication rate. 2. Due to the incr...

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RE: Osteoporosis v Renal Osteodystrophy in Renal Transplant Recipient 22 hours ago

adjusted calcium 2.20-2.60 mmol/l phosphate range mmol/l PTH ( 1.5-7.6 ) pmol/l thanks for input ------------------------------ Muhammad...

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RE: Follow up 22 hours ago

Thank you for your valuable input. ------------------------------ Mario Rubin, M.D. Houston TX (713) 252-5539 ------------------------------

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Osteoporosis v Renal Osteodystrophy in Renal Transplant Recipient 22 hours ago

Dear colleagues appreciate input on mx of bone disease and osteoporosis in renal tx recipient Cadaveric Tx Recipient 1995 Maintained on Neoral...

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RE: Follow up 22 hours ago

There are several issues regarding definitions of major complications of percutaneous renal biopsy (PRB). One of them is that they are defined by n...

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RE: Lithium Nephropathy 22 hours ago

I have had a number of cases of Lithium toxicity as well as testified in medical legal caes. The initial problem of toxicity is handled as you all ...

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RE: Follow up 1 day ago

Dr. Grimm thank you so very much for correcting my post on open evidence AI regarding complication rates between native kidneys. I also went back a...

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RE: Follow up 1 day ago

@Paul Grimm There is something strange about some of the findings of the study you referred to: 1.It found a greater risk of major complications ...

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RE: Lithium Nephropathy 1 day ago

The patient has substantial differences in size between the two kidneys. This is unusual in lithium induced nephropathy. think of additional path...

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RE: ANCA vasculitis with AIN 1 day ago

Dr. Glassock: Since SCr has plateaued at 3.7 mg for 3 days and the biopsy does not show any necrosis or crescents in glomeruli, I would follow-up t...

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RE: ANCA vasculitis with AIN 1 day ago

I would start steroids , and wait for the PR3 and MPO before starting Rituximab . --------------------------------- Dr. Hormaz Dastoor. MD, MSc, ...

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RE: ANCA vasculitis with AIN 1 day ago

Dr. Dastoor- would you treat this patient with Steroifs and RTX now based on the information available? ------------------------------ Richard Gl...

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RE: ANCA vasculitis with AIN 1 day ago

Is c- Anca positive with infections , or is it more likely to be a positive p- Anca with infections, drugs etc ?? -------------------------------...

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RE: Lithium Nephropathy 1 day ago

Dr Tirolien: Reviewed your Pt's case history. I have another idea (not disregarding the tole of Ch Lithium nephropathy in the slightest). I realize...

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RE: Follow up 1 day ago

Hi. This underscores why you must check original references when using AI. Dr. Lerman's AI report interpreted the reference exactly wrong. I fo...

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RE: ANCA vasculitis with AIN 1 day ago

Dr. Venkat. Endocapillary hypercellularity and mesangial expansion present . I am not sure the IF can be interpreted and no EM done. If the anti-MP...

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RE: ANCA vasculitis with AIN 2 days ago

Dr. Venkat, there is no EM attempted on paraffin sections . ------------------------------ Pongstorn Pitiranggon MD Pee Dee Nephrology Florence S...

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RE: Follow up 2 days ago

Interesting, I can only report that in my 40 years of clinical nephrology and transplant nephrology I almost never biopsy the left native kidney wh...

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RE: Canine amyloidosis treatment options 2 days ago

Thanks to all for sharing your thoughts. The dog's owner decided to go with chlorambucil since we don't have safety data on tocilizumab. I'll updat...

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RE: Follow up 2 days ago

I am confused because the left kidney is usually chosen for percuutaneous biopsy. Google AI says: "In a percutaneous kidney biopsy, the left kid...

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RE: Follow up 2 days ago

I mistakenly did not state right kidney in my consultation to IR. They had never done a left kidney biopsy unless there was a specific reason to av...

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RE: Follow up 2 days ago

Dr. Rodby can you update us on the training of current nephrology fellows in performing percutaneous renal biopsies on native kidneys and transplan...

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RE: Follow up 2 days ago

I am curious as to why the left kidney was biopsied versus the right kidney. I'm also a little curious as to why shock from a lacerated spleen woul...

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RE: Lithium Nephropathy 2 days ago

I have seen many patients that had early Li nephropathy that were successfully changed to one of the agents Dr Venkat mentioned, especially valproa...

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RE: ANCA vasculitis with AIN 2 days ago

Dr. Glassock: Regarding the possibility of IRGN, I noted that immunofluorescence was negative in glomeruli. However, IMF, however, was performed on...

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RE: Lithium Nephropathy 2 days ago

Alternatives to lithium in treating bipolar disorders include anticonvulsants (valproate, carbamazepine, lamotrigine) and atypical antipsychotics (...

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Lithium Nephropathy 2 days ago

Could you please offer your help and cooperation on this difficult case? Today, during a follow-up consultation, I am seeing a 66-year-old female...

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RE: ANCA vasculitis with AIN 2 days ago

Thank you Drs. Venkat and Glassock. Yes, I am awaiting anti PR3 and MPO. Blood cultures have been negative thus far. Cardiologist and pulmonologist...

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RE: ANCA vasculitis with AIN 2 days ago

The high RF, leucocytosis and low titer ANCA are more suggestive of IRGN than a Vasculitis. I might wait until anti-MPO and anti-PR3 are available ...

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RE: ANCA vasculitis with AIN 2 days ago

" C-ANCA positive 1:40, P-ANCA negative" PR3 and MPO antibody results? BNP results? ------------------------------ K.K. Venkat MD Troy MI (248)...

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