RE: Hypokalaemia 8 hours ago

Excellent - thanks all. ------------------------------ Dr Adam Rumjon MBBS MRCP London ------------------------------

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RE: Hypokalaemia 9 hours ago

Urinary K wasting and glycosuria with a nl serum glucose, proximal tubular disease (partial fanconi) I have seen this with HIV drugs , specifi...

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RE: Hyponatremia 9 hours ago

" The U Na of 120 (120 x 2 = 240) does not allow for U K or other U osmoles suggesting the actual U osm should be much higher than 240." Good po...

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RE: Hyponatremia 9 hours ago

serum osmolality 265 urine osmolality 240 urine Na 120 Is suspicious for a chronic SIADH with the concentrated urine. The U Na of 120 (120 x ...

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RE: Hypokalaemia 10 hours ago

…the units of the UACR are mg/mmoL. --------------------------------- Dr Adam Rumjon MBBS MRCP London ---------------------------------

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RE: Hypokalaemia 10 hours ago

Thank you very much. The phosphate level was within the normal range, 1 mmol/L. Thank you - yes I should send a urinary RBP and B2M. -----------...

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RE: Hypokalaemia 12 hours ago

Looks like possible proximal tubule dysfunction (? Lamuvidine). Can you obtain a urinary Beta2 microglobulin or retinol binding globulin in the uri...

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Hypokalaemia 12 hours ago

I was wondering whether I might be able to pick your collective brains. I can't quite work out why this woman has a low potassium... She was refe...

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RE: Hyponatremia 14 hours ago

What is the serum urea. . The urine findings suggest low urea excretion, maybe Hyponatremia is due to low solute (urea) excretion. , but tge excess...

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RE: Hyponatremia 15 hours ago

Case studies have been reported showing association between NSAIDS and hyponatremia. -According to UpToDate: Hyponatremia — NSAIDs diminish the ...

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RE: Hyponatremia 15 hours ago

NSAIDs and hyponatremia ( euvolemic hyponatremia ) has rarely been reported. Usually Ibuprofen. what was uric acid? What was NsAID ? https://d...

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Hyponatremia 18 hours ago

55 year old lady with background of hypertension on Coveram and metoprolol, had recent total knee replacement surgery and maintained on NSAIDs, pre...

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RE: Gross hematuria in a pregnant patient 18 hours ago

Thanks, Dr. Alhosaini. ------------------------------ K.K. Venkat MD Troy MI (248) 420 7798 ------------------------------

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RE: Hypokalemia and hyperparathyroidism 20 hours ago

Thank you all for your thoughts. I will do genetic study for Bartters and Gitelmans syndrome ------------------------------ Wael Jebur MD, FA...

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RE: Gross hematuria in a pregnant patient 21 hours ago

My understanding from article 2 is that electrophoresis showed high beta globulin in all samples with different degrees of urine osmolality, this i...

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RE: Nephrotic range proteinuria associated with cGVHD 1 day ago

As Dr. Rodby stated, FSGS is not common in SCT patients. This seems to me like a secondary FSGS with the normal Salb and glomerulomegaly. Is he obe...

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RE: IF negative anti-GBM 1 day ago

Thanks Dr. Fogo. I agree that PLA2R + MN with superimposed crescentic GN due to aGBM and ANCA is a consideration. The totally negative IgG and the ...

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RE: Gross hematuria in a pregnant patient 1 day ago

@Mohamad Alhosaini: Regarding the use of UAlb/Cr, UPr/Cr and urine protein electrophoresis to differentiate non-glomerular from glomerular bleeding...

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RE: IF negative anti-GBM 1 day ago

Anti-GBM antibody disease and membranous nephropathy can coexist -it is thought that one injury can unmasked cryptic epitopes and play a part in tr...

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RE: IF negative anti-GBM 1 day ago

"She was started on haemodialysis due to oligoanuria within days of presentation and remains dialysis dependent although improving urine output." ...

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RE: IF negative anti-GBM 1 day ago

Thank you. The antiGBM has been repeated multiple times and after PLEX - the lowest has been 500 (there are two tests pending). They are runnin...

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RE: Nephrotic range proteinuria associated with cGVHD 1 day ago

Dr.Venkat's suggestion is a very good one. If the patient has been on a CNI for a long time to suppress GVHD, then a secondary form of FSGS due to ...

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RE: Gross hematuria in a pregnant patient 1 day ago

Thank you Dr. Venkat, very nice articles, of note the urine electrophoresis showed spike in beta globulin fraction and the albumin seemed to be oka...

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RE: IF negative anti-GBM 2 days ago

Too bad no EM. False negative IF for IgG very uncommon in anti-GBM disease. . Something is very fishy about this case. What assay was used for anti...

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RE: Nephrotic range proteinuria associated with cGVHD 2 days ago

Was cyclosporine or tacrolimus used post-stem cell transplant/GVHD? If yes, for how long? Besides GVHD itself, chronic CNI-related afferent arterio...

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RE: IF negative anti-GBM 2 days ago

. ------------------------------ Victoria Sasongko MBBS FRACP Nephrologist Lismore Base Hospital Lismore, NSW Australia -------------------------...

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RE: IF negative anti-GBM 2 days ago

What does 2+ 'membranous granular " mean? Can you post the de-identified pathology report.? ------------------------------ Richard Glassock MD, F...

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RE: Nephrotic range proteinuria associated with cGVHD 2 days ago

Any Family History of kidney disease. I think I might do genetic testing. Any features by IF that suggest anti-nephrin auto-antibody. If so, I migh...

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RE: Nephrotic range proteinuria associated with cGVHD 2 days ago

Thank you for your answer. This is not TMA or MGN. I believe it is FSGS. eGFR by Cistatin C is 40 mL/min. uProt. is in the 3 g/day range. pro...

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RE: Gross hematuria in a pregnant patient 2 days ago

@K.K. Venkat Thank you ------------------------------ Mario Rubin, M.D. Houston TX (713) 252-5539 ------------------------------

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IF negative anti-GBM 2 days ago

Hi everyone, Presenting a case of a 65yo F, background AF, diabetes, bronchiectasis and hypothyroidism presented with RPGN (Cr normal > 500umol/L...

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RE: Nephrotic range proteinuria associated with cGVHD 2 days ago

Forgot to attach ------------------------------ Roger Rodby MD, FASN Professor of Medicine Rush University Nephrology Associate...

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RE: Nephrotic range proteinuria associated with cGVHD 2 days ago

What is NOW Creatinine, proteinuria, serum albumin what was the % foot process effacement? GVHD has been associated with a number of glomerul...

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Nephrotic range proteinuria associated with cGVHD 2 days ago

60 year-old white male, diagnosed with AML 10 years ago, treated with chemotherapy and allergenic HCT. He developed.cGVHD AND WAS TREATED AT THE TI...

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RE: Gross hematuria in a pregnant patient 2 days ago

@Mario Rubin: Regarding effect of non-glomerular bleeding on urine protein quantitation, the following references are helpful: 1. https://avmajo...

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RE: Gross hematuria in a pregnant patient 2 days ago

Macroscopic hematurua can be produced by addition of as little as 5ml of whole blood to the usual 1000-1500ml of daily urine excretion. This would ...

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RE: Gross hematuria in a pregnant patient 2 days ago

@K.K. Venkat I was aware of the finding of proteinuria in cases associated with gross hematuria (independently of other sources of bleeding in th...

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RE: Gross hematuria in a pregnant patient 2 days ago

@Mohamad Alhosaini: "do you see protein/cr of 1.5 g/g from non-glomerular bleeding?" One hundred mL of normal blood contains several grams of alb...

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RE: Maintenance Therapy For IgA Nephropathy Presented With RPGN 3 days ago

Your very welcome. I hope that your patient continues to do well. Your prompt and aggressive approach has a lot to do with the good outcome (short ...

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RE: Maintenance Therapy For IgA Nephropathy Presented With RPGN 3 days ago

Thank you all for your valuable input on this case. I truly appreciate your assistance. Best, Iyad --------------------------------- Iyad Manso...

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RE: Maintenance Therapy For IgA Nephropathy Presented With RPGN 3 days ago

I had written a response to this yesterday but somehow never got posted. At this point my opinions may be redundant or irrelevant. Regardless, this...

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RE: Maintenance Therapy For IgA Nephropathy Presented With RPGN 3 days ago

@Richard Glassock I feel retinitis pigmentosa is not associated with Vogt Koyanagi Harada syndrome. Probably this patient may have a mutation in ...

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RE: 52 yo Male with predominant Class V LN. 3 days ago

Dear Professor Robdy Thank you. Much appreciated. ------------------------------ M Kaisar Nephrologist Brisbane ------------------------------

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RE: 52 yo Male with predominant Class V LN. 3 days ago

He did have a dose of Obinutizumab with no improvement in proteinuria. I think the proteinuria is driven by scarring and secondary 'FSGS' pathology...

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RE: 52 yo Male with predominant Class V LN. 3 days ago

Dear Professor Fogo, I agree. I was unable to find any evidence for proliferative disease. The biopsy report was also somewhat unusual IMO. Clini...

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RE: 52 yo Male with predominant Class V LN. 3 days ago

Thank you Professor Glassock. From what I could find - the ANA was 1:640 but has been as high as 1:2560, Anti-DNA (FEIA) 65 ([More]

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RE: 52 yo Male with predominant Class V LN. 3 days ago

Thank you Dr Venkat. That is my feeling ie inactive disease. ? Role of reducing the dose of MMF by 1/3? ------------------------------ M Kaisar N...

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RE: Gross hematuria in a pregnant patient 3 days ago

@Roger Rodby Dr. Rodby, do you see protein/cr of 1.5 g/g from non-glomerular bleeding? ------------------------------ M.N. Alhosaini -----------...

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RE: low serum albumin ? etiology Monday, March 10 @ 1:21 AM

Thank you Dr.Friedman and Dr.Rodby for all your advice. Sorry I need to add some information . Endoscopy findings: The gastric body mucosa sh...

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RE: Maintenance Therapy For IgA Nephropathy Presented With RPGN Monday, March 10 @ 12:56 AM

Thanks. For reasons that are poorly understood, MMF or MPA , not AZA , is the IS agent of choice in IgAN with continued evidence of activity (such ...

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