RE: recurrent AKI on anticoagulated patient 4 hours ago

He's 99KG so will be like 100 mg prednisone daily ------------------------------ Sadeem Ali MD Bridgeport WV (612) 865-9067 -----------------------...

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RE: recurrent AKI on anticoagulated patient 4 hours ago

Urine Analysis today I found for white blood cells and three red blood cells, not Dysmorphic and no cast but this is one reason that we are suspect...

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RE: recurrent AKI on anticoagulated patient 4 hours ago

His height is 74 inches and weighs 99 KG. Acute interstitial nephritis clinically is in Differential. I am Starting him on prednisone hundred milli...

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RE: Non-tunneled CVC Duration 4 hours ago

Tunneled catheters are not really that hard for nephrologists to learn, and achieve good results, just as peritoneal catheters. Even a self-learnin...

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RE: PTLD with electrolyte imbalance 4 hours ago

Could this relate to tubular effects of afinitor (hypoMg/K with secondary hypoK/Ca) after last year’s switch from cellcept on top of ongoing progra...

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RE: PTLD with electrolyte imbalance 5 hours ago

The only data I can find is on patients treated for testicular cancers with VDB. Hypomagnesemia can persist for at least a year, maybe longer. I ca...

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RE: recurrent AKI on anticoagulated patient 5 hours ago

With relatively unremarkable urine - most likely Nonoliguric ATN vs less likely AIN - if latter doubt steroids without stopping offending drug is g...

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RE: ? Membranous GN 5 hours ago

May have been hypertensive 6 months ago. However, normal BP now despite advanced renal dysfunction suggests that elevated BP in the ED 6 months ear...

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RE: recurrent AKI on anticoagulated patient 5 hours ago

He was never oliguric. Rate of rise of Creatinine has recently increased ------------------------------ Sadeem Ali MD Bridgeport WV (612) 865-9067 ...

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RE: PTLD with electrolyte imbalance 5 hours ago

As far as I know, the toxic effects of vinblastine on renal Mg handling can last for a long time. I will check to see how long. Sent from my iPad

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RE: PTLD with electrolyte imbalance 6 hours ago

Dear Dr Glassock, is that possible after more than one year? ABVD was in late 2018! ------------------------------ Mohamed Elrggal, MD Alexandria E...

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RE: Addtion of MRA to ACE/ARB in combination with K lowering agents for worsening proteinuria in diabetic CKD 7 hours ago

Thanks- sounds like a good plan. Tough case-bad prognosis. Sent from my iPad

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RE: PTLD with electrolyte imbalance 7 hours ago

Phosphorus was normal, sorry not to mention it --------------------------------- Mohamed Elrggal, MD Alexandria Egypt +20 1270004590 --------------...

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RE: PTLD with electrolyte imbalance 7 hours ago

@Mohamed Elrggal , on presentation, was he hypoP too (or normoP which is why you didn't provide his serum P)? ​​ ------------------------------ Ode...

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RE: Kidneys From cadaveric Donor With nephrogenic Diabetes Insipidus 7 hours ago

Roger, I agree. Was it Homer Smith who described the development of the tubular system as a great under-recognized "achievement" as we went from sa...

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RE: Kidneys From cadaveric Donor With nephrogenic Diabetes Insipidus 8 hours ago

" the now deceased potential donor is from a family with a known mutation and with urine osmolality less than 50 even under severe hyperosmolar hyp...

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RE: PTLD with electrolyte imbalance 8 hours ago

My guess is that this is a late complication of VDBD therapy, with persistent renal magnesium wasting (mainly vinblastine related) and severe resis...

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RE: Addtion of MRA to ACE/ARB in combination with K lowering agents for worsening proteinuria in diabetic CKD 8 hours ago

Sorry for the confusion, I used IDDM as short hand for insulin dependent diabetes mellitus - He has DM2 with severe proliferative diabetic retinopa...

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RE: PTLD with electrolyte imbalance 9 hours ago

we are waiting for the biopsy to know whether this is a recurrence of a new PTLD! ------------------------------ Mohamed Elrggal, MD Alexandria E...

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RE: PTLD with electrolyte imbalance 9 hours ago

Before admission, he didn't receive any chemo, antibiotics or PPi He has been tumor free since nearly one and half year.  Yes, i was mainly askin...

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RE: PTLD with electrolyte imbalance 9 hours ago

hypoMg can explain the hypoK and hypoCa Is he taking a PPI?  you need to do urine electrolyte studies when these levels are low for starters and se...

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RE: recurrent AKI on anticoagulated patient 9 hours ago

I do not have a problem with a week or two of empiric higher dose steroids.  I see he is non oliguric, was he ever oliguric? Is the "delta" creatin...

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RE: Addtion of MRA to ACE/ARB in combination with K lowering agents for worsening proteinuria in diabetic CKD 9 hours ago

I am going to assume that "IDDM" doesn't mean Type 1 DM but is Type 2 DM on insulin.  Double RAASi in diabetes? Seems logical for your situation bu...

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RE: recurrent AKI on anticoagulated patient 9 hours ago

There was no apparent insult on 15th of June. Patient refuses biopsy although cardiologist OKed holding apixaban for five days because there is no ...

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PTLD with electrolyte imbalance 9 hours ago

Dear Colleagues,  I want to share with you this case A 33-year-old kidney transplant recipient man presents with severe lower extremity muscle we...

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RE: recurrent AKI on anticoagulated patient 10 hours ago

It would appear the differential diagnosis is recurrent AKI due to; Pre renal causes, volume or pressure. Non oliguric ATN, Was there an  insult on...

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RE: Addtion of MRA to ACE/ARB in combination with K lowering agents for worsening proteinuria in diabetic CKD 10 hours ago

I have a very large personal experience of doing exactly that, for patients who remain hypertensive and proteinuric on a single RASI. The rationale...

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RE: Urine pH and Urine Protein 10 hours ago

I would concur with Dr Rodby's analysis. pH > = 9, not possible with urine HCO3 as the base. ------------------------------ John Mellas MD Nephrolo...

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RE: Addtion of MRA to ACE/ARB in combination with K lowering agents for worsening proteinuria in diabetic CKD 10 hours ago

I add spironolactone to help control the blood pressure based on PATHWAY-2 and ReHOT data. I target a systolic BP of 120 because of the presence of...

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RE: Addtion of MRA to ACE/ARB in combination with K lowering agents for worsening proteinuria in diabetic CKD 10 hours ago

Does he really have Type I DM?. This would be quite unusual in a 70 year old. How much retinopathy does he have? If he really has T1DM and no re...

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RE: recurrent AKI on anticoagulated patient 12 hours ago

Urine Analysis today again found no casts and no Dysmorphic red cells but three monomorphic red blood cells were found per high power field while t...

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Addtion of MRA to ACE/ARB in combination with K lowering agents for worsening proteinuria in diabetic CKD 12 hours ago

I have a 70 year old WM with PMHx of IDDM with florid microvascular complications, HTN,  obesity, CAD, whom we see for CKD 4 due to diabetic nephro...

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RE: Kidneys From cadaveric Donor With nephrogenic Diabetes Insipidus 12 hours ago

Thank you all - indeed, any potential recipient would need to obtain full explanation, as would be the case for marginal donors  - but in this case...

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RE: Kidneys From cadaveric Donor With nephrogenic Diabetes Insipidus 12 hours ago

Absolutely no experience with accepting such a donor but Rodger’s suggestion for determining donor’s maximum urine osmolality makes good sense prio...

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RE: recurrent AKI on anticoagulated patient 12 hours ago

Is urinalysis still unremarkable except few RBC’s? --------------------------------- [Mark] [Lerman] [MD,FASN,FACP,FAST] [Past Medical Director Kid...

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RE: recurrent AKI on anticoagulated patient 13 hours ago

13 cm kidneys are large if the patient is of average height. Do you have any explanations for such Kidney enlargement?. Common causes are Diabetes,...

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RE: recurrent AKI on anticoagulated patient 13 hours ago

Creatinine 3.2 on 26th of June compared to 2.85 on 25th of June compared to 2.76 on 24 of June compared to 2.58 on 23rd of June compared to 2.3 on ...

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RE: recurrent AKI on anticoagulated patient 14 hours ago

What is the predicted creatinine based on the kinetic eGFR formula? Seems like the rate of rise is decreasing, but I haven’t plotted your values on...

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RE: Urine pH and Urine Protein 14 hours ago

" The renal tubule cannot generate a urine pH above about 7.5-8.0, as far as I know." Interesting wording. the kidney does not alkalinize the urine...

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RE: recurrent AKI on anticoagulated patient 14 hours ago

Creatinine continues to rise to 3.2 today compared to 2.85 yesterday. Non oliguric with total urine output about 2 L in last 24 hours. Net 985 mL p...

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RE: Hypercalcemia And Hyperphosphatemia 14 hours ago

There could also be an element of hypercalcemia from immobilization if the GB is bad. ------------------------------ Roger Rodby MD, FASN Professor...

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RE: Kidneys From cadaveric Donor With nephrogenic Diabetes Insipidus 14 hours ago

Wouldnt the recipient need to consent, and the problem is i can only imagine how badly a potential recipient would want a kidney , but is making 4 ...

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RE: Kidneys From cadaveric Donor With nephrogenic Diabetes Insipidus 15 hours ago

Thank you Dr. Friedman. Will try to track down the publications, keeping in mind the expected differences in scope of urine output and implications...

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RE: Hypercalcemia And Hyperphosphatemia 17 hours ago

I would be somewhat skeptical of the eGFR value because concomitant thyrotoxic myopathy and GB Syndrome could have significantly decreased creatini...

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RE: Hypercalcemia And Hyperphosphatemia 20 hours ago

Thanks for your insights Dr. Venkat Failed to mention a few pertinent things as you pointed out. Cr 0.7, eGFR 162, CK 143. 1,25 vitamin D pending, ...

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RE: Kidneys From cadaveric Donor With nephrogenic Diabetes Insipidus 1 day ago

The closest published experience I could find addressing your query were 3 reports describing successful use of donor kidneys with 2 other heredita...

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RE: Urine pH and Urine Protein 1 day ago

In the cited study (White SL, et al, 2011) Urinary pH was not measured so the effect of urine pH on diagnostic accuracy of Urinary dipsticks for de...

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RE: Urine pH and Urine Protein 1 day ago

The citation in this slide from the 2019 ISN meeting might be of help.  Slide from  https://datastudio.google.com/s/sFKuZa8BPYM -------------------...

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RE: Urine pH and Urine Protein 1 day ago

Highly buffered very alkaline urine can give a “false positive “ for albumin by dipstick but this will have no discernible effect on the immunoturb...

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Urine pH and Urine Protein 1 day ago

Can the pH of urine of (>/=9.0 or <5) affect the protein measurement for albumin on a standard urinalysis or the urine albumin Cr ratio? ----------...

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