RE: Follow up on patient with lupus nephritis 5 hours ago

Thanks so much for your kind words. I was very surprised too. ------------------------------ Deborah Fein MD Nephrologist Pattner and Grodstein ...

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RE: Follow up on patient with lupus nephritis 11 hours ago

This anecdote represent support for the use of Benlysta to control both renal and extra-renal Lupus,especially to allow for steroid-free management...

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RE: Follow up on patient with lupus nephritis 13 hours ago

Since she had many others lupus related symptoms (alopecia, discoid skin changes, fatigue and arthralgias) it seemed that Benlysta would be a benig...

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RE: Follow up on patient with lupus nephritis 14 hours ago

Dr. Fein- It is interesting that you chose to add Benlysta, as the RCT involving thus drug did not show any benefits in use of Benlysta Class ...

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RE: High dose Rosuvastatin and non glomerular proteinuria 14 hours ago

20 years ago I participated in preparation of a publication on statins and adverse kidney events, using FDA voluntary reporting data. We found that...

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RE: whether to Biopsy this Kidney of myeloma patient and whether to treat asymptomatic Uti before Biopsy? 17 hours ago

According to the values listed the UACR is 452mg/gm creatinine and theUPCR is 1464mg/ gm creatinine.(conventional units. ). The UACR/UPCR ratio is ...

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RE: High dose Rosuvastatin and non glomerular proteinuria 18 hours ago

Rosuvastatin on the other hand less toxic to muscles and less drug interaction Recently saw an AA 40 years of age with Rhabdo due to his normal ...

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RE: Follow up on patient with lupus nephritis 18 hours ago

I couldn't agree more with you Dr Fein. Insistent pharmacologic approach at any cost in lupus nephritis is reminiscent of the days before the arriv...

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RE: High dose Rosuvastatin and non glomerular proteinuria 19 hours ago

I agree with the epidemic. Have seen multiple cases and reported several to the FDA. Have been educating my local cardiologists about the package i...

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RE: High dose Rosuvastatin and non glomerular proteinuria 19 hours ago

I agree with your concerns. My experience is of more worrying nature. In the last three years , I have encountered 5 instances of Rhabdomyolysis wi...

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RE: High dose Rosuvastatin and non glomerular proteinuria 1 day ago

I agree- ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ------------------------------

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RE: Diffuse Scleroderma And Thrombotic Microangiopathy 1 day ago

I agree. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ------------------------------

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RE: Diffuse Scleroderma And Thrombotic Microangiopathy 1 day ago

Dr Glassock my interpretation was pts with scleroderma associated TMA 10-15% had underlying complement abnormalities -----------------------------...

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RE: High dose Rosuvastatin and non glomerular proteinuria 1 day ago

Rosuvastatin Pandemic initiated by Cardiologists last year Unfortunately MAX dose of 40 mg Rosuvastatin has become a "routine Rx" by most cardiol...

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RE: Diffuse Scleroderma And Thrombotic Microangiopathy 1 day ago

So 50% or more of patients Scleroderma who do not have SRC but are hypertensive can have non-C associated TMA lesions in the kidney, is this a corr...

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RE: Diffuse Scleroderma And Thrombotic Microangiopathy 1 day ago

This is from one article Thrombotic microangiopathy can occur in up to 50% of patients with hypertensive emergency and 10-15% with scleroderma Gene...

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RE: Diffuse Scleroderma And Thrombotic Microangiopathy 1 day ago

There seems to be a growing movement that all TMA is causally related somehow to C activation (usually alternate pathway). Is this true? I do not k...

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RE: whether to Biopsy this Kidney of myeloma patient and whether to treat asymptomatic Uti before Biopsy? 1 day ago

The majority of this thread is focused on whether or not there's any role of renal biopsy. But this was based on the assumption that was clear that...

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RE: whether to Biopsy this Kidney of myeloma patient and whether to treat asymptomatic Uti before Biopsy? 1 day ago

someone else checked in April, 2015, Keppra was 1060 and lambda 27.42 and GFR 112. After that, Kappa to lambda ratio in June, 2024 was 33.67 when E...

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RE: whether to Biopsy this Kidney of myeloma patient and whether to treat asymptomatic Uti before Biopsy? 1 day ago

I am pasting the note of haematologist oncologist below. "Advised nephrologist to get 24 urine protein and IFE. At this time, per criteria he doe...

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RE: whether to Biopsy this Kidney of myeloma patient and whether to treat asymptomatic Uti before Biopsy? 1 day ago

On January 27, 2025 when last tested urine for albumin and protein, urine spot creatinine was 47.9 mg/dL, urine microalbumin was 216.9 ug/mL and ac...

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RE: Diffuse Scleroderma And Thrombotic Microangiopathy 1 day ago

It would be exceptional for CM-TMA. But I could envision RL-TMA in a pt with earlier PET + SSc-myositis overlap syndrome presenting with isolated p...

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RE: Would you give empiric rituxan for pulmonary renal syndrome? PLEX not available 1 day ago

we gave it. Her Anti GBM came back negative. No cocaine use as far as I know ------------------------------ Nimra Sarfaraz (516) 637-3820 ------...

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RE: High dose Rosuvastatin and non glomerular proteinuria 1 day ago

By any chance Not started on Fenofibrate --------------------------------- Shahzad Safdar MD Mt. Auburn Nephrology, Inc. Cincinnati OH (513) 8...

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RE: High dose Rosuvastatin and non glomerular proteinuria 1 day ago

Would love to hear everyone's answers. Just yesterday did a new consult on a t2 diabetic 5 yrs duration, well controlled HPT on carvedillol and ram...

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Follow up on patient with lupus nephritis 1 day ago

Last year I posted a case of a 25 yo female with class V lupus nephritis since age 12. She had particularly severe NS with persistent serum albumin...

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RE: Diffuse Scleroderma And Thrombotic Microangiopathy 1 day ago

Interesting idea - but the patient does not have "malignant " hypertension, no systemic MAHA and normal GFR- it seems unlikely that this is C media...

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RE: Diffuse Scleroderma And Thrombotic Microangiopathy 1 day ago

While you await complement testing, might reexamining kidney tissue for C5b-9 staining (the ex vivo C5b-9 deposition test on endothelial cells if a...

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RE: Diffuse Scleroderma And Thrombotic Microangiopathy 1 day ago

Since this is not SRC I think that it will make no difference if you use ACEi or ARB for BP control. I agree with stopping MMF. I would avoid stero...

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RE: Diffuse Scleroderma And Thrombotic Microangiopathy 1 day ago

Thanks Dr Glasock Will discuss with Rheumatology and will proceed with Rituximab especially also symptomatic Myositis So will stop Cellcept Any r...

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RE: Rituximab for "maintenance " of a CR in PLA2R related MN 1 day ago

Below is a small study that showed value of repeat biopsy relapsing MN and that in absence of fresh deposits can be treated with conservative thera...

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RE: MMF/Myfortic/cyclosprin/proton Pump Inhibitor 2 days ago

PPI interfere with GI absorption of Mycophenolic acid (MMF and MPA. They have no effects on Mycophinale metabolism. PPI Lower the acheuvement of th...

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RE: High dose Rosuvastatin and non glomerular proteinuria 2 days ago

Tubular damage is increased in patients receding high -dose Rosuvastatin. ------------------------------ Richard Glassock MD, FASN Laguna Woods ...

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RE: Diffuse Scleroderma And Thrombotic Microangiopathy 2 days ago

With a normal serum creatinine this is not SRC, but rather renal limited TMA in the presence of Scleroderma-overlap syndrome Type. Treatment is not...

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RE: Would you give empiric rituxan for pulmonary renal syndrome? PLEX not available 2 days ago

Yes- this is highly likely to be RPGN and DAH due to anti-TNF biologics (Golimumab). High dose IV and oral steroids and RTX are empirically justifi...

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Would you give empiric rituxan for pulmonary renal syndrome? PLEX not available 2 days ago

Hi all, looking for insight on my very sick patient. In short I suspect pulmonary renal syndrome. Earliest a kidney biopsy would be able to be done...

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RE: follow up case 2 days ago

Maybe try OBI then. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ------------------------------

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RE: follow up case 2 days ago

Thank you. He had Rituximab in late January. ------------------------------ M Kaisar Nephrologist Brisbane ------------------------------

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RE: Light chain deposition disease in transplant kidney allograft 2 days ago

She has been referred to hematology/oncology and further investigations are pending. ------------------------------ Pongstorn Pitiranggon MD Pee ...

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Diffuse Scleroderma And Thrombotic Microangiopathy 2 days ago

Thanks and would appreciate help from the expert on this 31-year-old married Caucasian female with no smoking alcohol or drug abuse. history of R...

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RE: follow up case 2 days ago

The course is most consistent with Primary diffuse Podocytopathy (MCD/ FSGS) resistant to steroids and CNI. I suppose you could try RTX or Obinutuz...

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follow up case 2 days ago

Good morning, Apologies for all the detail. I would be grateful for feedback regarding this case. The original posting is as below from June l...

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RE: Mpo Vasculitis Case 2 days ago

What medications are being used for treatment of hypertension. This might be a hydralazine induced positive MPO. What does the IF and EM show? -...

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Mpo Vasculitis Case 2 days ago

Dear all, Would like an opinion on this case 80 male bg HTN Presented with lethargy and tiredness Crp raised mpo 70(0-20) creatinine 0.84 urine ...

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RE: Light chain deposition disease in transplant kidney allograft 2 days ago

Are you asking what to do regarding the LCDD or C4d? The good news is that dara VD should take care of both assuming that this is a plasma cell clo...

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RE: High dose Rosuvastatin and non glomerular proteinuria 2 days ago

Thanks Dr Rodby very helpful If no tubular damage then why increasing incidence of microhematuria and renal failure Thanks ---------------------...

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RE: Light chain deposition disease in transplant kidney allograft 2 days ago

Transplanted kidneys are still kidneys and such a case is a great reminder of that. I would follow the same workup we do for a patient without tr...

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RE: Rituximab for "maintenance " of a CR in PLA2R related MN 2 days ago

I truly believe we are treating the PLA2R antibody, and that everything else will follow. One approach is to not even treat that, but to give An...

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RE: High dose Rosuvastatin and non glomerular proteinuria 2 days ago

Rosuvastin increases tubular proteinuria , this is well established, but this is not tubular damage per se, it is blocking normally filtered normal...

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Using telenephrology and initiating new dialysis for urgent indication or otherwise 2 days ago

I am assuming many of us do TeleNephrology for consultations in the hospitals especially in regional sites where we do not have in-person Nephrolog...

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