19 Year/Male with Abdominal pain, CT-Diffuse heterogeneous enlarged appearance of the left kidney likely an acute L renal infarct? 2 hours ago

19 yo M with no known prior medical history presented with L sided abdominal pain and found to have Diffuse heterogeneous enlarged appearance of th...

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RE: Acute Renal Infarct 4 hours ago

Thank you for this nice case. We have all seen similar cases over the years. Anticoagulation may be a limited approach and one assumes is to preven...

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RE: Allograft vein thrombosis or hyper acute rejection ? 6 hours ago

​"The HE staining biopsy (Nov 5th) informs an extensive necrotizing endarteritis with secondary thrombosis". Consider repeating Luminex on post-tra...

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RE: Acute Renal Infarct 6 hours ago

Original Message: Sent: 11-29-2020 10:25 From: Richard Glassock Subject: Acute Renal Infarct If this is due to Segmental arterial mediolysis, then ...

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RE: Acute Renal Infarct 10 hours ago

If this is due to Segmental arterial mediolysis, then anticoagulation might be risky, due to rupture and bleeding tendency. Just a thought. Sent fr...

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RE: allograft dysfunction and nephrotic syndrome 11 hours ago

thanks for ur valuable feedback, update of labs result of covid-19 total antibody (IgG & IgM) :- 0.05, Meaning non-reactive. Hep BSAg is negative. ...

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RE: Rituximab/Cytoxan dosing CRRT 12 hours ago

Got it thanks!! ------------------------------ Sandeep Magoon MD Nephrology Associates of Tidewater, LTD and Eastern Virginia Medical School. Virgi...

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RE: Rituximab/Cytoxan dosing CRRT 12 hours ago

Rituxan is a large protein that should not be removed with CRRT. for Cyc we like to wait 12-24 hours before restarting any RRT. https://www.kidney-...

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RE: Acute Renal Infarct 12 hours ago

see this recent similar thread https://community.asn-online.org/communities/community-home/digestviewer/viewthread?GroupId=37&MessageKey=d3d67f97-e...

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Rituximab/Cytoxan dosing CRRT 12 hours ago

Have a patient with PR3 vasculitis on CVVHDF.  Could not find much literature on pharmakokinetics on these 2 meds with CRRT. Any personal experienc...

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RE: Acute Renal Infarct 13 hours ago

Thank you Dr Rodney and Dr Glassock for your input. I did speak to IR and they said nothing could be done with the right kidney segmental artery / ...

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RE: Unexplained Proteinuria 13 hours ago

Wow!! ------------------------------ Lynn Cornell MD Mayo Clinic Rochester MN (507) 538-4356 ------------------------------

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RE: Unexplained Proteinuria 14 hours ago

Chyluria !!! I have been burned once.  Attached is urine from a patient who apparently went into spontaneous remission of "MCD."   --------...

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RE: Post transplant immunosuppressive therapy in covid pt 14 hours ago

Thanks Dr Mark ------------------------------ Sunil Prakash APN BLK Super Speciality New Delhi ------------------------------

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RE: Acute Renal Infarct 17 hours ago

I am curious- how many would screen for Ehlers-Danlos Syndrome, Type 4 (an autosomal dominant condition) with genetic studies for a COL3A1 mutation...

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RE: Acute Renal Infarct 22 hours ago

Fascinating case. Thus might be FNH, Ehlers-Danlos Syndrome or segmental arterial Mediolysis. Males sex makes FMH unlikely and Ehlers-Danlos and Se...

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RE: Acute Renal Infarct 23 hours ago

My guess is he might that kidney no matter what you do, but I would get a vascular surgery and an interventional radiologist opinion on options. I ...

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Acute Renal Infarct 1 day ago

Hi, I would appreciate the communities help in further management of this patient. 24 yr old with no significant PMH presented to ER yesterday wi...

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RE: Unexplained Proteinuria 1 day ago

One thing to think of is chyluria when a patient has proteinuria and a "normal" kidney biopsy that doesn't explain the proteinuria. Chyluria case r...

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RE: High PLA2R and minimal proteinuria 1 day ago

Data exists that in Primary MN the auto-antibody response precedes the development of overt Nephrotic Syndrome by months or even years, but there i...

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RE: High PLA2R and minimal proteinuria 1 day ago

I am not aware of any data about prevalence of anti-PLA2R antibody titer in patients without MN (someone chime in if data exist).  Usually it order...

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RE: Allograft vein thrombosis or hyper acute rejection ? 1 day ago

Suspect this was a vascular catastrophe rather than hyper acute rejection given absence of historical preformed antibodies and surgical finding of ...

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RE: Allograft vein thrombosis or hyper acute rejection ? 1 day ago

Stumbled on this small transcriptomics study of early isolated C4d/DSA/microvascular inflammation-negative intimal arteritis in non-highly sensitiz...

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RE: A case of proteinuria 1 day ago

Good point Dr. Venkat.  I usually do not perform a UACR for evaluation of possible nephrotic syndrome.  A UPCR on an aliquot of intended 24 hour ur...

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RE: A case of proteinuria 1 day ago

"Urine  analysis showed an albumin:creatinine of 1515." Is this UAlb 1515 mg/g creatinine? If yes, makes MCD less likely. Even in severely hypoalbu...

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Allograft vein thrombosis or hyper acute rejection ? 1 day ago

Hello, I would like to share with you a very unfortunate transplant case that occurred in our center.  A 31 yo. male, two years in hemodialysis. ...

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RE: A case of proteinuria 1 day ago

Making a diagnosis of MCD will likely require a kidney biopsy whereas Amyloidosis, MN can be diagnosed without a kidney biopsy. This can be impor...

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RE: A case of proteinuria 1 day ago

Yes, absolutely true..it has to be considered as well ------------------------------ Ahmed Hassan MBBS hospital ------------------------------

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RE: A case of proteinuria 1 day ago

AL Amyloidosis (and MGRS in general ) is always in the differential of proteinuria in the Elderly, but DN, Membranous Nephropathy, MCD and perhaps ...

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RE: A case of proteinuria 1 day ago

I have a differential diagnosis of DM nephropathy, h nephropathy, FSGS based on single kidney and HTN, Membranous as u thought to,specially with ca...

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RE: A case of proteinuria 1 day ago

Can you also obtain a serum anti-PLA2R antibody level (By IFA) fairly quickly ? Sent from my iPad

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RE: A case of proteinuria 1 day ago

Please provide The results of a retinal Exam, serum albumin Level along with a serum free light chain assay And serum Immunofixation. Thanks. Sent ...

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RE: Uremic vs non-uremic preicarditis 1 day ago

Pericardial friction rubs were taught, in years past, to be the sine qua non of uremic pericarditis...usually coupled with an elevated BUN. Back in...

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A case of proteinuria 1 day ago

72 years male patient presented with bilateral lower limbs pitting edema that is noticed over 2 -week period only. Investigations regarding heart a...

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RE: Unexplained Proteinuria 2 days ago

Just for fun, I did my own calculations, in a somewhat different way. 10 ml of normal whole blood contains about 4 ml of packed RBC and 6ml of plas...

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RE: High PLA2R and minimal proteinuria 2 days ago

Appearance of anti-PLA2R antibody in blood can precede clinical MN by a long time. Nephrotic range proteinuria develops gradually in MN. Thus, a va...

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RE: Unexplained Proteinuria 2 days ago

If the initial uPCR was done on the grossly hematuric sample whereas the other tests were run after it had settled, at a Hct of 0.4, 10 mL of blood...

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RE: High PLA2R and minimal proteinuria 2 days ago

Interesting. The anti-PLA2R Test was not indicated in the first place. I would follow proteinuria and eGFR, at 3 month intervals. And do nothing no...

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RE: Unexplained Proteinuria 2 days ago

Not with this degree of proteinuria (albuminuria). Sent from my iPad

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High PLA2R and minimal proteinuria 2 days ago

Hello  Will appreciate help to address management plan for a patient  52 yrs old Gentleman who accidentally found to have protein ++ on dipstick wo...

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RE: Post transplant immunosuppressive therapy in covid pt 2 days ago

Doubt any set guidelines- suspect many programs slowly resume MMF and/or Tac after clinical recovery and conversion to negative RT-PCR ------------...

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RE: Unexplained Proteinuria 2 days ago

Could this be hemorrhagic cystitis such as caused by adenovirus ------------------------------ [Dr Ravindra Attur] [Prabhu] [Professor HoU] [KMC Ma...

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RE: Unexplained Proteinuria 2 days ago

“UPEP Interpretation MILD PROTEINURIA IN SELECTIVE PATTERN.” Mild suggests it was done later in the course of events when proteinuria and hematuria...

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RE: Uremic vs non-uremic preicarditis 2 days ago

Agree . For patients with large effusion or tamponade .drainage is required. In mild to moderate effusion we can sometimes do with aggressive dialy...

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RE: Unexplained Proteinuria 2 days ago

"SPEP/UPEP showing moderate proteinuria in selective pattern with decreased alhpa one, alpha two, beta and gamma globulins, however, serum immunofi...

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RE: Uremic vs non-uremic preicarditis 2 days ago

A very sensible comment of Dr Rudnick,i mmediate drainage rather than a a more conservative approach of aggressive   hemodialysis, is our clinical ...

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RE: Unexplained Proteinuria 2 days ago

UPEP showed:  Albumin  82.5%  Alpha 1 Globulin,  3.1%   Alpha 2 Globulin,  6.9 %   Beta Globulin, 6.4 %   Gamma Globulin, 1.1%  UPEP Interpretation...

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RE: Unexplained Proteinuria 2 days ago

Interesting ------------------------------ Ghansham Das MD Syracuse NY ------------------------------

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RE: Unexplained Proteinuria 2 days ago

Thanks for the clarification. An episode of self-limited infection related GN super-imposed on TBMN ight be the best explanation, but the EM studie...

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RE: Uremic vs non-uremic preicarditis 2 days ago

I believe it's important to distinguish between pericardial effusions  which are a very late manifestation of uremia versus pericardial effusion's ...

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