RE: Iron replacement strategy in dialysis 2 hours ago

Ferritin >500 μg/L is a red flag, especially if it's rising without clear inflammation. But the real signal is transferrin saturation (TSAT): once ...

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RE: Iron replacement strategy in dialysis 5 hours ago

You're right, that's probably an unrealistic target goal. But I wonder if our ferritin protocols are too generous and I also wonder if some of the ...

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RE: Iron replacement strategy in dialysis 6 hours ago

Not meaning to sound flippant but good luck keeping the ferritin 1-300. May I ask where this data comes from? Is it observational ? My guess is i...

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RE: Resistant Rejection 7 hours ago

Dr Pineda is spot on about further tissue staining for markers of PTLD. Dr Aleydan I want to clarify what does "Late Active" signify in histopatho...

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RE: Iron replacement strategy in dialysis 8 hours ago

Based on my personal experience a slightly higher ferritin target may be necessary and acceptable. Then the question becomes one of overruling th...

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RE: PLEX in Crescentic IgA Nephropathy 11 hours ago

I do not think that this patient would qualify for the suggestion made by KDIGO CPG to treat with a combination of CYC + Steroids. I agree that the...

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RE: PLEX in Crescentic IgA Nephropathy 13 hours ago

In this patient with crescentic IgA nephropathy/IgA vasculitis nephritis, routine PLEX is not recommended, as evidence for benefit in IgAV-associat...

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RE: PLEX in Crescentic IgA Nephropathy 16 hours ago

Dr. Gharib- you raise some important issues. We do need to know the results of C3/C4 serum levels, Rheumatoud Factir levels, Cryoglobulin Aasays an...

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RE: PLEX in Crescentic IgA Nephropathy 22 hours ago

It seems that the major contribution of very low GFR (serum creatinine 4 mg/dl) comes from ATI from RBC casts as suggested by Dr. Rodby especially ...

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RE: PLEX in Crescentic IgA Nephropathy 22 hours ago

------------------------------ Mohamed Gharib MBBS Ain shams university Cairo 01000322177 ------------------------------

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RE: PLEX in Crescentic IgA Nephropathy 22 hours ago

------------------------------ Mohamed Gharib MBBS Ain shams university Cairo 01000322177 ------------------------------

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RE: unexplained rhabdomyolysis 23 hours ago

Yes multiple times --------------------------------- Dr. Hormaz Dastoor. MD, MSc, FASN Divisional Head of Nephrology Sheikh Shakhbout Medical Cit...

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Iron replacement strategy in dialysis 1 day ago

Based on the most recent evidence of iron overload contributing to liver cirrhosis, I am revising my own personal goals for iron replacement in dia...

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RE: IgA Nephropathy case 1 day ago

The notion that hematuria is an independent predictor of outcome is "all the rage" and could be targeted (as what prompted your post) I think yo...

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RE: CMNephritis 1 day ago

Long term CNI may have been doing well enough but it can lead to CKD, and you have an opportunity for remission with an anti-CD 20 drug. If you ...

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RE: CMNephritis 1 day ago

Thank you for responding: Patient 1 Patient 2 S. Albumin 3.7 4.0 Creatinine 3.7 2.76 (up from 1.86) U. protein 1.44 gmn 460 mg Tacrolimu...

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RE: unexplained rhabdomyolysis 1 day ago

I'm sure someone measured his thyroid function tests as hypothyroidism does cause mild non-traumatic rhabdo. ------------------------------ Da...

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RE: IgA Nephropathy case 1 day ago

Consistently in the 70s, no change over the 6 months since I have been seeing her. ------------------------------ Ritu Vyas MD Catonsville MD (4...

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RE: CMNephritis 1 day ago

I would taper (and stop) the CNI and treat both patients with RTX or Obinutuzumab . What is the current level of proteinuria, serum albumin snd eGF...

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RE: IgA Nephropathy case 1 day ago

What is her current eGFR- she might beca candidate fir moderate dose steroids + MMF or one of the anti- April-/ April/BAFF agents. --------------...

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IgA Nephropathy case 1 day ago

Hello, I have a 48 year female who I have been following for biopsy proven IgA. She is on Lisinopril 2.5 (unable to tolerate any higher due to lo...

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CMNephritis 1 day ago

I have two patients in their 60's with biopsy proved membranous nephritis. One has elevated Eliza PLA2R and the other does not. They have been doin...

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RE: PLEX in Crescentic IgA Nephropathy 1 day ago

Dr. Charytan- No direct comparator RCT of CYC vs RTX in IgA Vasculitus have been published- but three independent observational trials (one oroen...

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RE: PLEX in Crescentic IgA Nephropathy 1 day ago

For me, it is more about this degree of crescentic IgAN not warranting CYC. This is based on the assumption that CYC is a superior drug for bad vas...

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RE: PLEX in Crescentic IgA Nephropathy 1 day ago

There is no evidence-based indication for PLEX in IgA vasculitis or infection-related IgA-dominant vasculitis." ------------------------------ Sa...

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RE: PLEX in Crescentic IgA Nephropathy 1 day ago

Im curios about the evidence behind your recommendation that ritux is likely better than cytoxan here- can you summarize evidence --------------...

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RE: Somewhat suppressed aldo, Primary aldosteronism or not? 1 day ago

Thanks for your extensive research - tell Claude I would like to meet him😂😂 ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] ...

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RE: unexplained rhabdomyolysis 1 day ago

I’m sure you can come up with other unifying narratives but here’s one, (sero-ve) SjD: - chronic lymphocyte-predom TIN - distal tubulopathy (with ...

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RE: Somewhat suppressed aldo, Primary aldosteronism or not? 1 day ago

@Mark Lerman sorry I am on a plane , but was able to get Claude to research and answer ...and I think he/she has summarized it pretty well. The mai...

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RE: Somewhat suppressed aldo, Primary aldosteronism or not? 1 day ago

if Renin is low - is it suppressed is the question-some articles suggest it is normal or high. if it is suppressed then how would you distinguish t...

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RE: Somewhat suppressed aldo, Primary aldosteronism or not? 1 day ago

@Hormaz Dastoor-please see below regarding Obesity related Hypertension Clin Kidney J . 2025 Jul 9;18(8):sfaf218. doi: 10.1093/ckj/sfaf218 ...

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RE: Nephrotic Range Proteinuria And Unremarkable Renal Biopsy 2 days ago

Thanks Dr. Dastoor for tgis clarification. I agree. Of late, I use less steroids and more Anti-CD20 MoAB for therapy of presumed MCD/FSGS . -----...

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RE: Nephrotic Range Proteinuria And Unremarkable Renal Biopsy 2 days ago

The biopsy report suggested possible MCD of FSGS or perhaps just an podocytopathy. I don't think we are sure of the best treatment , but if the pa...

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RE: unexplained rhabdomyolysis 2 days ago

Yes ordered a whole panel beyond complement --------------------------------- Dr. Hormaz Dastoor. MD, MSc, FASN Divisional Head of Nephrology Sh...

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RE: unexplained rhabdomyolysis 2 days ago

Have you done genetic testing for conditions beyond complement disorders? ------------------------------ Roger Rodby MD, FASN Professor of ...

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RE: Nephrotic Range Proteinuria And Unremarkable Renal Biopsy 2 days ago

I am really moving toward rituximab alone as a primary therapy for a podocytopathy. The only issue is it may take some time to get approval. In tha...

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RE: Nephrotic Range Proteinuria And Unremarkable Renal Biopsy 2 days ago

Dr.Dastoor- add or switch to RTX? What is the evidence that RTX + steroids is any better than RTX alone in Primary MCD ? I prefer monotherapy with ...

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RE: Somewhat suppressed aldo, Primary aldosteronism or not? 2 days ago

@Mark Lerman I think obesity in relation to hypertension is defined as a hyperaldo state characterized high sodium retention , volume expansion, LO...

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RE: PLEX in Crescentic IgA Nephropathy 2 days ago

The bottom line is that this is not IgA Nephropathy and guidelines from IgA Nephropathy literature does not apply to this patient. This is either a...

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RE: PLEX in Crescentic IgA Nephropathy 2 days ago

While reading the case my mind veered towards IgA Dominant infection related GN , but a lot of the features were absent 1. Often diabetic - No 2. ...

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RE: Nephrotic Range Proteinuria And Unremarkable Renal Biopsy 2 days ago

Start steroids , if MCD lesion should respond quickly with steroids . If no response would add Rituximab . A couple of similar cases we had respon...

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RE: PLEX in Crescentic IgA Nephropathy 2 days ago

Since IgA-dominant infection-related GN is in the differential diagnosis, what were C3 and C4 complement levels? ------------------------------...

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RE: unexplained rhabdomyolysis 2 days ago

He has both muscles and tubular affection ..what causes this are ..1.toxic like lead or cadmium and needs work up 24 urine ,,and uric acid level .....

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RE: Nephrotic Range Proteinuria And Unremarkable Renal Biopsy 2 days ago

Got it, Thankyou for your kind response Dr Rodby --------------------------------- Umer Hassan Resident Shaikh Zayed Hospital Lahore Labore 0336...

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RE: Nephrotic Range Proteinuria And Unremarkable Renal Biopsy 2 days ago

I think I would give oral steroids now, there is no guarantee that reevaluation of the biopsy will get you any closer to a diagnosis. I would ant...

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RE: PLEX in Crescentic IgA Nephropathy 2 days ago

you have given evidence for Crescentic GN but not RPGN which depends on AKI and we have no creatinine data. 3/15 gloms with crescents is not that b...

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RE: PLEX in Crescentic IgA Nephropathy 2 days ago

This is an extremely difficult and challenging case. Is this infection related IgA dominant Glomerulonephritis or IgA Vasculitis (formerly Henoch S...

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PLEX in Crescentic IgA Nephropathy 2 days ago

Greetings! I hope this message finds you well. I am taking care of a 55 year old female with RPGN due to crescentic IgAN with IgA vasculitis and ...

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RE: Puzzling Case of Post-Transplant Proteinuria 2 days ago

Dr. Venkat, with such high uncertainty concerning the cause of proteinuria in this case, what is your plan of management.? ----------------------...

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RE: Nephrotic Range Proteinuria And Unremarkable Renal Biopsy 2 days ago

Thanks for your response, Worthy Colleagues Currently, follow up after 1 week with 24 hours urinary proteins and re reporting of biopsy is planned...

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