RE: IgAN - Management Question 1 hour ago

With the marked signs of inflammation , and progressive loss of nephrons , I would start with a very short course of pulse IV MP. Just an opinion. ...

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RE: Please help with renal biopsy results - vascular insult - etiology unclear 2 hours ago

Richard, You may want to add here the editorial on goal BP I emailed to you a few months ago. If you don’t have it any longer, I could send you a c...

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RE: Please help with renal biopsy results - vascular insult - etiology unclear 2 hours ago

First, I would determine if this patient has hypertension and/or orthostatic hypotension. Often, in these patients orthostatic hypotension is asymp...

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RE: IgAN - Management Question 2 hours ago

EM is currently not available , but i assume she has podocytopahty with low serum albumin. She is on ARB, SGLT2 and ns-MRA , not on ET1a , as she...

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Iptacopan --- Does it work ????????? 3 hours ago

So , we have been using Iptacopan for nearly a year . In IC- MPGN - No response , perhaps it works great in C3G - but we prefer to use C3 Blocker...

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RE: Please help with renal biopsy results - vascular insult - etiology unclear 3 hours ago

Dr. Campese, Given the severe non-glomerular vascular disease on kidney biopsy, the absence of proteinuria or CHF and an undescribed "neuropathy" w...

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RE: IgAN - Management Question 3 hours ago

Great questions? no good evidence to select the "best choice" . In my opinion , I would use oral steroids and MMF , with an initial IV pulse of IVM...

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IgAN - Management Question 3 hours ago

Have a 35 year old SE Asian Female eGFR is 49 ml/min Urinalysis : Hematuria uPCR : 7.2 g/g Biopsy : M1 E1 S1 T1 C1 Question : St...

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RE: Please help with renal biopsy results - vascular insult - etiology unclear 4 hours ago

""Why do I hate eGFR values so much and just prefer a serum creatinine? That is rhetorical but also editorial. " @Roger Rodby -and the answer is?" ...

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RE: Please help with renal biopsy results - vascular insult - etiology unclear 4 hours ago

"Why do I hate eGFR values so much and just prefer a serum creatinine? That is rhetorical but also editorial. " @Roger Rodby -and the answer is? ...

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RE: Please help with renal biopsy results - vascular insult - etiology unclear 4 hours ago

Can you provide the levels of BP and HR standing and sitting? does she have any clinical features of autonomic dysfunction? The biopsy is su...

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RE: Please help with renal biopsy results - vascular insult - etiology unclear 5 hours ago

Dr. Rodby. I agree. Even if the APOL1 high risk alleles are found, it would not bring us any closer to an effective treatment regimen for this pati...

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RE: PLA2R negative Membranous Nephropathy- Management Q 5 hours ago

In PLA2R MGN we have an antibody to treat and an early marker and we can "head it off at the pass" In PLA2R negative MGN it is not so easy and w...

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RE: Please help with renal biopsy results - vascular insult - etiology unclear 5 hours ago

Why do I hate eGFR values so much and just prefer a serum creatinine? That is rhetorical but also editorial. I think APLO1 would explain this, b...

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RE: Please help with renal biopsy results - vascular insult - etiology unclear 9 hours ago

"Renal US : Right 9.2 cm, Left 10 cm" The left kidney is generally longer than the right. This discrepancy of ~ 0.8 cm may not be significant by ...

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RE: Please help with renal biopsy results - vascular insult - etiology unclear 16 hours ago

I also agree with Dr. Lerman's concerns over the use of high dose Ketamine in this case. Ketamine abuse can cause sterile pyuria, ulcerative cystit...

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RE: Please help with renal biopsy results - vascular insult - etiology unclear 19 hours ago

Dr. Lerman - you raise a very important point. APOL1 risk allekes are commonly linked to a Podocytopathy and proteinuric CKD. A lesser known and ap...

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RE: Please help with renal biopsy results - vascular insult - etiology unclear 22 hours ago

Agree with high risk APOL1 testing as high risk testing has even without proteinuria APLOL 1 high risk variants in African-Americans can cause acce...

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RE: Please help with renal biopsy results - vascular insult - etiology unclear 22 hours ago

The degree of global glomeruloscleroisis and IFTA is quite compatible with the patients chronological age. The Absence of abnormal. Proteinuria mak...

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RE: PLA2R negative Membranous Nephropathy- Management Q 1 day ago

Hi Dr. Soobadar, Thank you, No discrepancy in urine protein/cr and albumin/cr. From Jan 2026 attached (faint spike, BM was done before - negative)....

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RE: Treatment /Management of MN 1 day ago

Thanks for discussion appreciate it --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: to do kidney biopsy or not 1 day ago

Thanks everyone for help --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: PLA2R negative Membranous Nephropathy- Management Q 1 day ago

Thanks for case I would wait couple of weeks and review with blood and urine acr . What about mgus? Any change in serum free light chain ratio or...

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Please help with renal biopsy results - vascular insult - etiology unclear 1 day ago

67 year old african american female with PMH of Hypertension, Fibromyalgia, Hypothyroidism, Vitamin D Def, Neuropathy, Sjogren disease, Depression,...

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RE: Seeking Input for an NSF I-Corps Dialysis Initiative 1 day ago

Hi all, in effort to make sure we're exhausting the opportunity to connect within this network I wanted to follow-up on this thread. If you don't ...

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RE: Bile Cast Nephropathy causing Unresolved ATI 1 day ago

Thanks for your input. Usually, the reported bilirubin in bile cast nephropathy is 25, with it never being reported below 15. The peak bilirubin ...

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RE: Bile Cast Nephropathy causing Unresolved ATI 1 day ago

According to AI: "Plasmapheresis is rarely effective if started 4 weeks after established acute kidney injury (AKI) from bile cast nephropathy. The...

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Bile Cast Nephropathy causing Unresolved ATI 1 day ago

Would like the community's input regarding a difficult case. 38 year old male history of homeopathic medication intake for three years for body...

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RE: PLA2R negative Membranous Nephropathy- Management Q 1 day ago

Dr. Kaur -thanks for the very helpful additional information. Yes, you patient might be on the cusp of a major relapse. I woukd be inclined to trea...

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RE: PLA2R negative Membranous Nephropathy- Management Q 1 day ago

Thank you Dr. Glassock. April 2023 renal biopsy. Proteinuria upto 11 gms. July 2023: Rituximab x 2 doses = resolution of nephrotic syndrome,...

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RE: Painless macroscopic hematuria 1 day ago

This patient most likely has an AVM till proven otherwise. A selective renal angiogram will be my next step (already mentioned by Dr. Glassock). ...

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RE: Painless macroscopic hematuria 1 day ago

A clot in the R renal pelvis and unilateral gross hematuria (same side as the clot) makes Glomerular Disease, acquired or hereditary , very unlikel...

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RE: Painless macroscopic hematuria 1 day ago

forgive me Dr. Glassock (for being stubborn) but @Edwin Anand did your urologist check blood from urine from contralateral ureter for microhematuri...

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RE: Painless macroscopic hematuria 2 days ago

This important finding rules out Nutcracker syndrome , IgA Nephropathy, Alport Syndrome or other glomerular diseases but not SSTrait, a small renal...

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RE: CD19, ritux, and membranous 2 days ago

Thanks Dr. Hirsch for initiating this very informative and in depth discussion of a contemporary topic of the ever- changing management of MN. We n...

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RE: CD19, ritux, and membranous 2 days ago

In the not too distant future, I strongly suspect that OBI will replace RTX as the preferred initial approach to treatment of MN , and that assessm...

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RE: Painless macroscopic hematuria 2 days ago

A follow up- I reviewed his cystoscopy. It showed blood emanating from the right ureteric orifice alone. Hence they did a ureteroscopic exam. It ...

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RE: CD19, ritux, and membranous 2 days ago

@Sheldon Hirsch "Roger, with that sort of thinking in mind...I have a patient who is now four months p the initial ritux rx, with an unchanged PL...

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RE: CD19, ritux, and membranous 2 days ago

If your patient without any change in anti-PLA2R antibody 4 months after an initial dose of RTX was found not to be peripherally depleted in CD19 B...

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RE: CD19, ritux, and membranous 2 days ago

Roger, with that sort of thinking in mind...I have a patient who is now four months p the initial ritux rx, with an unchanged PLA2r. I sent a CD19,...

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RE: PLA2R negative Membranous Nephropathy- Management Q 2 days ago

Dr. Kaur - thanks for the follow up. The fact that this patient enters into a CR with RTX therapy places herin a favorable prognostic category - ab...

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RE: Resistant hypertension 2 days ago

Thank you so much Dr. Rodby, Dr. Glassock, Dr. Dastoor for the opinion. ------------------------------ Jaison George MD, MBBS Kollam, India ----...

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RE: PLA2R negative Membranous Nephropathy- Management Q 2 days ago

Hello All, This patient from a few years ago responds to rituximab that I am not giving on a consistent maintenance basis, since her proteinuria...

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RE: CD19, ritux, and membranous 2 days ago

@Christian Kuhn writes "CD19 is usually monitored after rituximab because the drug (ritux/obi) occupies the CD20 epitope and can also induce CD20...

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RE: Persistant metabolic acidosis after cystectomy 2 days ago

Recent information --------------------------------- Conjeevaram Kesavan MD, MBBS, FASN Duluth GA (678) 699-8521 ------------------------------...

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RE: CD19, ritux, and membranous 2 days ago

As far as I am able to determine, no information exists concerning a possible interactions between Rituximab and Eculizumab, Ravulizumab , Iptacopa...

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RE: Dog with hematuria and highly unusual renal ultrasonographic findings 2 days ago

Please let us know what the final diagnosis is in fascinating canine case of the mysterious kidney ultrasound -nematodes, cancer , infection , calc...

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RE: CD19, ritux, and membranous 3 days ago

Thank you. As the immune response is quite specific, I wonder if the internalization of the FcR which follows Ritux therapy is unique to CLL cells ...

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RE: CD19, ritux, and membranous 3 days ago

There you go ------------------------------ Christian Kuhn MD Kantonsspital St. Gallen St. Gallen ------------------------------ Files At...

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RE: Dog with hematuria and highly unusual renal ultrasonographic findings Sunday, July 12 @ 1:53 PM

Great plan, Eva! I have seen a few cases where the bladder urine is sterile, but the urine in the obstructed kidney shows bacteria. It's one of the...

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