RE: Anticoagulation On Dialysis 3 hours ago

I think low single dose Enoxaparin is fine for anti-Coagulation of the dialysis circuit in hemodialysis , but I tend to avoid it for systemic antic...

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RE: GN in post transplant 3 hours ago

"Given his 3rd kidney wanted to try to keep this kidney as long as possible for him" agree suspect cPRA is very high limiting chances for 4th cro...

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RE: Transplantation case 3 hours ago

awaiting biopsy results ? ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KPCOP EC [Past Medical Director Kidney Pancreas ...

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RE: Type 1 Cryo proliferative GN without identifiable clone on treatment without improvement in proteinuria 5 hours ago

If I may ask a follow up question to the group weighing in on this case, how do we actually monitor disease progression? Renal function is stable a...

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RE: Rapidly progressive glomerulonephritis 6 hours ago

Thank you everyone Clinically, I'm leaning more toward IgA dominant IRGN because of the age, the presentation with AKI in the absence of crescent...

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RE: Anticoagulation On Dialysis 6 hours ago

No cause found prof glassock after work up --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Anticoagulation On Dialysis 6 hours ago

Did this patient have a cardio embolic source of the CRAO (e.g. patent foramen ovale, aortic arch atheromatous placques? Just curious?) --...

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RE: Anticoagulation On Dialysis 7 hours ago

Thanks prof glassock In the dialysis units I worked /work enoxparin 20-40 mg is used on machine and we don’t monitor xa. We use heparin less and ot...

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RE: Anticoagulation On Dialysis 7 hours ago

I try to avoid Enoxaparin in patients with ESKD on dialysis due to poorly predictable pharmacokinetics. I prefer unfractionated heparin for such pa...

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RE: Effect Of Plasma Exchange On Complement (c3,c4) 7 hours ago

Thanks prof glassock --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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Anticoagulation On Dialysis 7 hours ago

45 male on hd via permcath Bg type 1 diabetes On clopidogrel and aspirin for central retinal artery occlusion in July 2024 ( from Different hospi...

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RE: Effect Of Plasma Exchange On Complement (c3,c4) 7 hours ago

I think it is reasonable to postulate that reduced levels of C3;and C4 post PLEX contribute to the well described increase in the incidence of bact...

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RE: GN in post transplant 7 hours ago

Yes those are random and agree not very accurate. His hematuria is definitely better. I believe most of his proteinuria is driven by global glomeru...

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RE: Effect Of Plasma Exchange On Complement (c3,c4) 8 hours ago

It is from real case that I posted Complement normal prior to plex and post plex abnormal Do you think low complements can be a cause of infecti...

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RE: Rapidly progressive glomerulonephritis 9 hours ago

https://pmc.ncbi.nlm.nih.gov/articles/PMC10372422/ Hi prof glassock just a thought this article describes my thought process ( tho related to obesi...

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RE: Rapidly progressive glomerulonephritis 9 hours ago

Interesting concept - how do you explain your posited linkage of glomerular hyperfiltration and infection in determining a fall in eGFR. Just curio...

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RE: Rapidly progressive glomerulonephritis 9 hours ago

Thanks for Case Biopsy endocapillary and mesangial proliferative glomerulonephritis, 6/17 glomeruli globally sclerotic, no definitive crescents ar...

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RE: Rapidly progressive glomerulonephritis 9 hours ago

I fully agree with the value of EM-I am less confident of the value of KN55 staining for gdIgA deposition. An opinions on these points? ---------...

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RE: Transplantation case 10 hours ago

Body weight trends, pre-AKI, at AKI and post-AKI? You mention preserved urine Na/K+ ratio. Do you have 24hr UNa? May have urinary salt-wasting for ...

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RE: Post-Preeclampsia TMA Pattern vs. INF2 Podocytopathy: A Diagnostic Dilemma 10 hours ago

Many thanks Simone for the very informative response, I learned a lot! ------------------------------ Emilio Venturelli MD Scuola di specializza...

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RE: Post-Preeclampsia TMA Pattern vs. INF2 Podocytopathy: A Diagnostic Dilemma 10 hours ago

Thanks Dr. Guevara - Pineda for the clarifications ------------------------------ Emilio Venturelli MD Scuola di specializzazione in Nefrologia, ...

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RE: Rapidly progressive glomerulonephritis 10 hours ago

EM (pending) results will be informative. Numerous subepithelial humps will make IgA-dominant IRGN more likely. ------------------------------ ...

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RE: GN in post transplant 11 hours ago

Agree with Dr. Venkat as clinically meaningful improvement in proteinuria. more likely reflects the increased urinary creatinine excretion accompan...

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RE: Post-Preeclampsia TMA Pattern vs. INF2 Podocytopathy: A Diagnostic Dilemma 11 hours ago

Thank you, Dr. Sanna. Unfortunately, the patient's extended family resides in Argentina while she is currently living here in Bogotá, which will...

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RE: Post-Preeclampsia TMA Pattern vs. INF2 Podocytopathy: A Diagnostic Dilemma 11 hours ago

I think cascade testing in the family would still be informative, especially to identify carriers in pre-symtpomatic phase for surveillance, early ...

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RE: GN in post transplant 12 hours ago

Dr. Pujari: Are the proteinuria results you report based on timed collections or random UPr/Cr ratios? If the latter, since SCr is lower UCr should...

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RE: GN in post transplant 12 hours ago

None of the reported patients exhibited nephrotic range proteinuria. Therefore, as mentioned the nephrotic quantity in this case represents the exp...

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RE: GN in post transplant 12 hours ago

I would not consider a crescent to be a manifestation rejection. There is a small case series reported to my knowledge on de novo pauci-immune GN i...

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RE: Post-Preeclampsia TMA Pattern vs. INF2 Podocytopathy: A Diagnostic Dilemma 12 hours ago

Thank you, Dr. Sanna it is highly plausible that the uncle's mild renal impairment at age 75 represents an unrelated, multifactorial kidney disea...

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RE: Post-Preeclampsia TMA Pattern vs. INF2 Podocytopathy: A Diagnostic Dilemma 13 hours ago

Thanks! Family history is a bit odd since I would have expected progressive disease by that age. It is also possible that kidney disease in paterna...

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RE: Post-Preeclampsia TMA Pattern vs. INF2 Podocytopathy: A Diagnostic Dilemma 13 hours ago

Thank you both for these brilliant and highly enlightening insights. Dr Balan, the link you highlighted between INF2 mutations, complement cell-s...

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RE: Transplantation case 14 hours ago

As I previously stated, even if there are no other evidence of volume depletion and dehydration, the fact that the acute kidney injury responds and...

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RE: Post-Preeclampsia TMA Pattern vs. INF2 Podocytopathy: A Diagnostic Dilemma 14 hours ago

Thank you Emilio for calling me into this :) Interesting case. I can say a few things, mostly from the INF2 genetics: The R218W variant is a ...

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RE: Post-Preeclampsia TMA Pattern vs. INF2 Podocytopathy: A Diagnostic Dilemma 14 hours ago

It is also interesting to note that variants in inverted formin 2 gene have recently been associated with TMA. Usually the mutational hotspots are ...

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RE: Transplantation case 15 hours ago

To add to my previous question, what was the highest and lowest creatinine in the last year? That would help us better -------------------------...

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RE: GN in post transplant 16 hours ago

Would get UAC and UPC ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KPCOP EC [Past Medical Director Kidney Pancreas Tra...

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RE: Transplantation case 16 hours ago

The patient reports adequate oral fluid intake on a daily basis, and there was no clinical evidence suggesting insufficient hydration. Furthermore,...

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RE: GN in post transplant 17 hours ago

Proteinuria has decreased slightly frok 14.8g to 13.3g but no hematuria anymore. I don't expect his Proteinuria would improve to great extent given...

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RE: Rapidly progressive glomerulonephritis 18 hours ago

Non-crescentic RPGN with IgA and C 3 deposition and a skin rash indicates either IgA Vasculitis or IgA dominant, infection related GN. In thusc cas...

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RE: Non-necrotizing granulomatous interstitial nephritis 20 hours ago

Dear Professors! This patient received pulse intravenous methylprednisolon (500 mg/day for 3 days) and was subsequently transitioned to an oral ma...

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Rapidly progressive glomerulonephritis 22 hours ago

Hi everybody, I'm looking forward for your opinion about a case and thank you in advance for the time you'll be able to dedicate to this discussion...

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RE: Type 1 Cryo proliferative GN without identifiable clone on treatment without improvement in proteinuria 1 day ago

Thank you, Dr. Leung, for your valuable input on this. Cryoglobulins have been negative x 2. Complements were well within normal range. Flow ...

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RE: GN in post transplant 1 day ago

Agree. Incidentally, the article that Dr. Lerman mentioned regarding the magnitude of the proteinuria in pauci-immune GN quotes a range of 0.1 to 1...

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RE: GN in post transplant 1 day ago

Re biopsy would probably might help get more information? His Cr continues to improve to 5.2 from 5.6 this AM..which is very good

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RE: GN in post transplant 1 day ago

I agree with you on that. His MPO and PR3 is negative as well

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RE: Post-Preeclampsia TMA Pattern vs. INF2 Podocytopathy: A Diagnostic Dilemma 1 day ago

Sorry- i mistranslated the biopsy report. ------------------------------ Richard Glassock MD, FASN Emeritus Professor Geffen School of Medicine...

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RE: GN in post transplant 1 day ago

Lots of exceptions to the rules in this complex patient. Trying to find a single cause (Reverend Ockham's rule ) is likely impossible in this insta...

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RE: GN in post transplant 1 day ago

No ATN was described on the biopsy. The diarrhea could be the consequence of CMV enteritis. It deserves a full evaluation including colonoscopy wit...

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RE: GN in post transplant 1 day ago

I agree with Dr. Lerman's statement regarding the magnitude of proteinuria in renal vasculitis. On the other hand, most likely the nephrotic range ...

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RE: GN in post transplant 1 day ago

Repeat urine studies are pending. Also, he did have some diarrhea. So I wonder he has some ATN component which could be getting better as well. It'...

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