RE: Kidney Biopsy in AL Amyloidisis 2 minutes ago

AL amyloidosis is diagnosed via two distinct non-renal sites (fat pad pad biopsy + bone marrow . ​renal biopsy is unnecessary and carries high blee...

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RE: IgA-Nephropathy: to complement or not to complement? 7 minutes ago

"His current creatinine-based eGFR is 68, cystatin C-based eGFR is 35." Tough question, Dr. Glassock! Requires evaluation of patient for muscle m...

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Kidney Biopsy in AL Amyloidisis 51 minutes ago

Here is a question for the Open Forum participants, stimulated by an actual case (discussed recently on the Rush University Kidney Biopsy Conferenc...

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RE: IgA-Nephropathy: to complement or not to complement? 2 hours ago

Dr. Venkat- which eGFR (Creatinine or Cystatin C) most likely represents mGFR in this patient? ------------------------------ Richard Glassock MD...

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RE: de-novo MGRS with LCDD 5 hours ago

After more digging I still am still unable to find any prior SIEP or free light chains pre-dating her Xpant but as noted by others it seems suspici...

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RE: IgA-Nephropathy: to complement or not to complement? 6 hours ago

Dr. Kuhn, do you have serial kidney ultrasound results on this patient? Progressive decrease in the size of the kidneys, increasing echogenicity, a...

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RE: de-novo MGRS with LCDD 6 hours ago

n our program, all patients undergoing renal transplant evaluation have serum protein electrophoresis, immunoelectrophoresis, and kappa:lambda ligh...

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RE: de-novo MGRS with LCDD 6 hours ago

The average time for LCDD to recur is approx 2 years after kidney transplant so It would be consistent with recurrence. It would also be usual for ...

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RE: de-novo MGRS with LCDD 7 hours ago

thanks Jonathan, please know I am not being critical of your management, it always easier in retrospect ! You followed the advice of your hematolog...

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RE: de-novo MGRS with LCDD 8 hours ago

As I did deeper into this topic I was surprised to find wuite a body of literature about the pros and cons of pursuing possible MGRS in thos cases ...

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RE: de-novo MGRS with LCDD 9 hours ago

Below is the Kidney Bx report ------------------------------ Jonathan Slater MD Renal & Transplant Associates of New England Longmeadow ...

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RE: IgA-Nephropathy: to complement or not to complement? 14 hours ago

@Hormaz Dastoor: He is of Caucasian ancestry I initially applied for reimbursement for iptacopan because of his young age, impaired kidney functio...

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RE: Intersting case-Need your opinion 15 hours ago

Indeed, they give the 900mg dose up to twice weekly. ------------------------------ Paul Grimm MD [Pediatric Nephrology/Transplant] Stanford Univ...

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RE: IgA-Nephropathy: to complement or not to complement? 15 hours ago

Thanks you Dr. Glassock for the intellectual exchanges ... I love picking your mind and extracting your thoughts on such topics . Thanks Dr. Kuhn f...

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RE: de-novo MGRS with LCDD 16 hours ago

Macro* is a typo she has been on dual IS of Taco/MMF As mentioined she never had native kidney Bx and I can not find a serum immunofixation or fr...

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RE: de-novo MGRS with LCDD 17 hours ago

I think it is reasonable to assume if LCDD were diagnosed 11/24 when renal function was baseline, and appropriate treatment begun -graft outcome wo...

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RE: CAKUT, pediatric neph input 18 hours ago

" Genetic testing would become more persuasive only if studies identify additional syndromic clues ". Can I conclude from this statement that genet...

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RE: CAKUT, pediatric neph input 20 hours ago

Dear Mark, You raise a fair question. The reported hepatomegaly should certainly be evaluated, although it may be entirely unrelated to the renal ...

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RE: de-novo MGRS with LCDD 1 day ago

I'm a bit lost in all of these abbreviations but I dont see how this is not recurrent disease. Isnt this the classic presentation? This is th...

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RE: Dapagliflozin In Hd Patient With Diastolic Dysfunction 1 day ago

Dr. Soobadar. What did you do with the SGLT2i suggestion for therapy of HFpEF in your oliguric patient with ESKD treated by HD ? Just curious. ...

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RE: secondary IgA Nephropathy 1 day ago

But the issue here is the unexplained disparity between Scr and the very benign kidney biopsy findings , the latter perfectly compatible with very ...

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RE: de-novo MGRS with LCDD 1 day ago

In this case it is difficult to determine whether this is de novo or recurrent LCDD - an underlying low grade lymphoma prior to transplant cannot b...

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RE: Colleague Managing Home Hd Cohort 1 day ago

Jorge: I recognize & value you decade's of experience with home HD & agree with almost everything you stated. Except with regard to button-hole tec...

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RE: IgA-Nephropathy: to complement or not to complement? 1 day ago

Dr. Dastoor- thank you very much for your comments and opinions. I tend to agree with you that a re-biopsy in this patient might be useful, but I w...

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RE: IgA-Nephropathy: to complement or not to complement? 1 day ago

Thanks Dr. Kuhn- both my good, now departed, friend Barry Benner and I appreciate these comments . ------------------------------ Richard Glassoc...

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RE: de-novo MGRS with LCDD 1 day ago

@Richard Glassock, @Nelson Leung @RogerRodby @KKVenkat @MarioRubin ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] ...

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de-novo MGRS with LCDD 1 day ago

eetings colleagues I would like to share the following interesting patient 59 y/o ESRD presumed DN s/p DDTx 9/2024 cb DGF and Bx r/o reject...

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RE: Colleague Managing Home Hd Cohort 1 day ago

Dr Chadran and group : My experience in Home hemo is very old , over 35 years ago! We preferentaly trained Patient to do self sticks, seldom had pa...

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RE: de-novo MGRS with LCDD 1 day ago

i would have loved to see BMBX when IGK spike and hypercalcemia. would get BMbx now . what is SLC ,SPEP now ? sorry what is current IS? what does m...

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RE: secondary IgA Nephropathy 1 day ago

Immune complex GN can recover spontaneously after the offending antibody is stopped, not sure if all affected gloms will recover, some will be fibr...

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RE: IgA-Nephropathy: to complement or not to complement? 1 day ago

Thank you all for sharing your expertise. I will therefore refrain from starting iptacopan and instead apply for reimbursement for sparsentan (I am...

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RE: IgA-Nephropathy: to complement or not to complement? 1 day ago

True , but the uPCR and eGFR data did show benefit for patients with S1 and T1 lesions . Though this patientbhaf an inadequate biopsy, I think if w...

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RE: IgA-Nephropathy: to complement or not to complement? 1 day ago

Is it easier to obatin approval for Iptacopan than for Tirzepatide? ------------------------------ Awais Nauman HMC Doha ------------------------...

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RE: de-novo MGRS with LCDD 1 day ago

Correction UPCR has been low grade 150 to 250 mg/ gm ------------------------------ Jonathan Slater MD Renal & Transplant Associates of New...

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de-novo MGRS with LCDD 1 day ago

Greetings colleagues I would like to share the following interesting patient 59 y/o ESRD presumed DN s/p DDTx 9/2024 cb DGF and Bx r/o reje...

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RE: IgA-Nephropathy: to complement or not to complement? 1 day ago

Here is my specific question- in the published 24 month eGFR slope data from the NEJM APPLAUSE report can you infer a benefit (attenuation of the s...

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RE: IgA-Nephropathy: to complement or not to complement? 1 day ago

Show me some data that Iptacopan has benefits in patients without inflammation and low grade but fluctuating proteinuria with stable eGFR and I wou...

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RE: IgA-Nephropathy: to complement or not to complement? 1 day ago

@Richard Glassock I agree with you in that the patient will benefit from addition of ET1 - either Sparsentan or Atrasentan and perhaps a ns- MRA as...

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RE: IgA-Nephropathy: to complement or not to complement? 1 day ago

I would not use Iptacopan in this case, because of the absence of inflammatory signs ( no hematuria , no crescents, ) , the predominance of glomeru...

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IgA-Nephropathy: to complement or not to complement? 1 day ago

I would appreciate your input regarding a 33-year-old patient with biopsy-proven IgA nephropathy. His first symptoms occurred in 2014, at the age ...

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RE: secondary IgA Nephropathy 1 day ago

Thanks. Eagerly awaiting results. ------------------------------ Richard Glassock MD, FASN Emeritus Professor Geffen School of Medicine at UCLA L...

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RE: Intersting case-Need your opinion 1 day ago

Thank you for everyones opinion. I agree Eculizumab dose may be inadequate based on the blood test results. CH50 level was done as per instruct...

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RE: secondary IgA Nephropathy 1 day ago

Dr Glossock, I called and asked him to do labs which he agreed to do on Friday. Thank you ------------------------------ Radhika Thalla MD Phy...

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RE: Steroid-refractory seronegative demyelinating encephalitis in a kidney transplant recipient 1 day ago

Yes, she's on MMF, prednisone 5 mg,, her last dose of Belatacept was June 20 ------------------------------ Vijayakumar Paramasivam MD Nephrologi...

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RE: secondary IgA Nephropathy 1 day ago

Dr. Thalla- Do you have any additional follow up information to post- like serum Cystatin C, fasting serum creatinine, or 24 hour endogenous crea...

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RE: Steroid-refractory seronegative demyelinating encephalitis in a kidney transplant recipient 1 day ago

Thanks-does she remain on MMF and low dose steroids ? is eGFR stable? is neurologic condition still improving? ------------------------------ ...

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RE: Intersting case-Need your opinion 1 day ago

thanks Dr. Grimm, the exact concern in my post above "The high C5b-9 levels suggest the Eculizumab is not very effective which could be due to prot...

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RE: Intersting case-Need your opinion 1 day ago

In addition to the CH 50 level, which should be low, you can actually send Eculizumab trough levels to Cincinnati Children's Hospital. 99 µg/...

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RE: Intersting case-Need your opinion 2 days ago

Thank you Dr Glassock. Your clarification much appreciated in this area of secondary aHUS as you precisely stated... ----------------------------...

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RE: IgAN case 2 days ago

In small short term studies from China HCQ lowers proteinuria but its long term effects on GFR are unknown. Combination therapy with modern approve...

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