American Society of Nephrology

RE: TMA with Covid-19 11 hours ago

Altogether, the data provided in the Keith et al (2020) retrospective analysis of PLEX in ARDS (propensity matched) is mainly hypothesis generating…

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RE: TMA with Covid-19 13 hours ago

Interesting thanks for the reference —————————— Aqeel Siddiqui MD Nephrology Associates Wynnewood PA ————————–…

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RE: Hydroxychloroquine and clearance 14 hours ago

Thank you for your expedite answer.  I was thinking more on the efficacy of HD to treat a potentially lethal acute hydroxyxhloroquine toxicity not …

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RE: CRRT – Citrate anticoagulation with Ca-containing solutions 14 hours ago

No personal experience but there is a body of literature on use of Ca-containing dialysate/replacement with RCA removing/reducing Ca infusion requi…

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RE: Hydroxychloroquine and clearance 14 hours ago

A trial of Chloroquine in ESRD patients with COVID19 in Sweden was just abruptly stopped for safety reasons. Extreme caution should be observed in …

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Hydroxychloroquine and clearance 15 hours ago

I am reading an old comprehensive review from 06/1979 about the side effects and toxicities (acute and chronic, voluntary and involuntary)  of chlo…

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RE: TMA with Covid-19 15 hours ago

Interesting case. i think the question you are really asking is whether there is any role for plasma exchange to treat TMA that is probably seconda…

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RE: CRRT – Citrate anticoagulation with Ca-containing solutions 15 hours ago

We have always used calcium containing solutions for CVVHD, Metabolic alkalosis is expected with ACD and you can prevent or treat it by adding norm…

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RE: Protective factors for COVID19 pneumonia in CKD – registret data 16 hours ago

Thanks- interesting data. Hypothesis generating – not proof of principle. But encouraging for HCQ, nonetheless. ? Adjustments for confounders. Sent…

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Protective factors for COVID19 pneumonia in CKD – registret data 18 hours ago

This is very interesting registry data from Spain, collected during the last few weeks March 18 – April 4. The link is in Spanish and from twitter …

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RE: Transplant Medications And COVID-19 20 hours ago

@Mark Lerman Dr Lerman, Covid positive without or with pneumonia? I guess we are going to see many asymptomatic or minimally symptomatic KTRs with…

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RE: Transplant Medications And COVID-19 21 hours ago

Agree with aggressive work up including bronchoscopy to confirm COVID19 and exclude bacterial and or fungal infection. What is CRP,ferritin, IL6 le…

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Vascular Access procedures in an Era of Covid 22 hours ago

I wonder what other’s experiences are with regard to obtaining vascular access procedures (both surgical and Interventional) in an era of covid. Cu…

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RE: Lupus Nephritis 22 hours ago

Good point! I see her today in “video” clinic and will assess. —————————— Brian Thornton MD Summit Nephrology Medical Group, In…

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RE: Lupus Nephritis 22 hours ago

Thank you for the input. Although she was worsening on MMF, she has had no response to the cytoxan and perhaps it is time to consider RTX and MMF. …

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RE: Lupus Nephritis 22 hours ago

No current evidence of MAHA. No TMA noted on biopsy. Unfortunately the lab did not provide MPV. —————————— Brian Thornton MD Su…

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RE: Lupus Nephritis 22 hours ago

​Brian Is she taking her prednisone? (And ” She says she is ” is not the right answer.) Joanne Bargman —————————— Joanne Bargma…

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RE: Limiting staff exposure with CRRT/IHD in COVID 22 hours ago

I have heard suggestions of decreasing treatment times in hospitalized patients. My first concern would be that patients with respiratory compromis…

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RE: Transplant Medications And COVID-19 22 hours ago

Since superinfections are common in immunosuppressed transplant recipients (CMV predisposing to infections by other microbes is a good example) and…

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RE: Histiocytic Nephropathy 23 hours ago

Are there any therapies available directed specifically against CD-68 +ve cells? A hematologist/oncologist may be able to help. ——————-…

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RE: TMA with Covid-19 23 hours ago

Picture was not Consistent with DIC. Tocilizumab is a good option as we do have a available in the hospital for COVID-19 in severe cases. cr did co…

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RE: Transplant Medications And COVID-19 23 hours ago

Done with contrast to rule out PE. Showed diffuse ground glass opacities and no PE. ——————————— Mohammad Alsawah MD Detroit …

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RE: Lupus Nephritis 1 day ago

Sounds like she couldn’t tolerate MMF due to GI issues and can’t tolerate CYC because of cytopenias.  I was also wondering if you could convert you…

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RE: Transplant Medications And COVID-19 1 day ago

False negative COVID19 tests are fairly common, depending on sampling method. False positive COVID tests are quite uncommon. Because this patients …

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RE: Histiocytic Nephropathy 1 day ago

Are the EM results available yet. Was a liver biopsy done? Sent from my iPad

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RE: Transplant Medications And COVID-19 1 day ago

What would you do if they have bilateral lung infiltrate and fever and require high level of oxygen. It’s getting pretty common to see KTR in the i…

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RE: Histiocytic Nephropathy 1 day ago

Now Day 9 of admission, patient continues to be anuric while on steroids( solumedrol pulse followed by Oral 1 mg per kg Prednisolone) As the patien…

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RE: Histiocytic Nephropathy 1 day ago

Sorry for my previous misinformation.  I just Discussed with Dr.Swarnalatha our Renal Pathologist, she confirmed that the Oil red O stain was done …

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RE: Histiocytic Nephropathy 1 day ago

Lipid stain was not on frozen section. And the CD68 extensive positivity puts to rest the doubts about LCAT, it is histiocytic glomerular and inter…

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RE: LDL apheresis in recurrent FSGS 1 day ago

Yes, when he was on intensive TPE schedule of three times a week early post transplant, proteinuria was down to subnephrotic range of 2-3 grams. –…

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RE: TMA with Covid-19 1 day ago

I’d suspect Covid-19-assoc DIC on top of her established metastatic breast CA/chemotherapy-related TMA. Are labs c/w DIC? Did MAHA resolve post-dox…

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RE: LDL apheresis in recurrent FSGS 1 day ago

Does proteinuria resolve with more frequent PLEX? —————————— [Mark] [Lerman] [MD,FASN,FACP,FAST] [Past Medical Director Kidney …

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RE: TMA with Covid-19 1 day ago

Consider tocilizumab if D-DIMER,FERRITIN,CRP,,IL6 IS ELEVATED The content in this comment/discussion is not intended to be medical advice for a par…

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RE: Transplant Medications And COVID-19 1 day ago

From AST – Immunosuppres s ion in COVID-19 positive patients There is absence of consensus at this point: In patients with COVID-19 without pneum…

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RE: covid 19, cytokines and crrt 1 day ago

In addition to counterarguments already noted, another taken from toxicokinetics has to do with endogenous pro-inflammatory cytokine clearance in t…

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RE: Lupus Nephritis 1 day ago

Is there any evidence of MAHA or TMA?With refractory LN and 65 % Crescents Class IVQ LN needs to be considered (Pauci immune MPA superimposed on Cl…

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RE: covid 19, cytokines and crrt 1 day ago

Thank you Dr. Rodby. I read your editorial and appreciate you sending it. I agree that NxStage can achieve higher uf rates, I was just trying to po…

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Lupus Nephritis 1 day ago

23 yo woman with probable two year history of lupus symptoms formally diagnosed after skin biopsy for cutaneous manifestation subsequently found to…

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RE: TMA with Covid-19 1 day ago

I think to think of Ahus is. Good though In ards compliment activation plays role But before that you should also consider viral related macrophge …

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RE: Unexplained AIN 1 day ago

Hi everyone, So I have some updates, the latest Cr is down to 2.79 (the trend has been 4–>3.3–>2.79) on prednisone taper (decreasing by 10mg q 2 …

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RE: Covid 19 Without Crrt Available 1 day ago

Thank you ! Anyone using Cytosorb? —————————— Paul El Azoury MD, FASN University of Vermont Champlain Valley Physician Hospital…

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RE: TMA with Covid-19 1 day ago

Please check and see if the patient has hematophagocytic lymphohistiocytosis (HLH)- the plasma ferritin levees should be greatly elevated. If so, a…

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RE: Covid 19 Without Crrt Available 1 day ago

I agree that “removing the cytokines” is not a scientifically based rationale for CRRT in a patient with severe COVID19, unless it is combined with…

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RE: covid 19, cytokines and crrt 1 day ago

Attached is an editorial I wrote on this many years ago but principal still applies.  Studies using convection for sepsis have not shown it to be h…

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RE: covid 19, cytokines and crrt 1 day ago

Thank you Dr. Desai. Very helpful. —————————— Brian Michel MD Haddon Renal Medical Specialists Cherry Hill NJ 856 428 8992 —-…

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RE: Covid 19 Without Crrt Available 1 day ago

“We are seeing a lot of AKI with COVID-19in the ICU , what will be the best timing for initiating CRRT ? Do you think it will make any difference i…

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RE: LDL apheresis in recurrent FSGS 1 day ago

GFR has been around 65 with serum creatinine 1.2 to 1.4 range and serum albumin around 3.6-3.9. His replacement solutions with weekly TPE is 5% alb…

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RE: TMA with Covid-19 1 day ago

Very sick patient. With COVID I doubt I would plex patient. I wonder if this is underlying aHUS and the second hit is this infection. ————-…

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RE: LDL apheresis in recurrent FSGS 1 day ago

I had a patient many years ago who had a history of FSGS.  She had one transplant that was failing and required a second transplant.  She had a sis…

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CRRT – Citrate anticoagulation with Ca-containing solutions 1 day ago

Hi, Do you have any experience using citrate anticoagulation for CVVH/CVVHD when the replacement fluid (or dialysate) has Ca++ content? We have a p…

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