RE: Nephrotic Range Proteinuria And Unremarkable Renal Biopsy 2 hours 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 3 hours 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 3 hours 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 3 hours 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 4 hours 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 4 hours 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? 4 hours 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 4 hours 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 5 hours 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 5 hours 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 5 hours 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 6 hours 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 6 hours 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 7 hours 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 7 hours 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 8 hours 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 8 hours 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 10 hours 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 17 hours 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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RE: another ANCA case 20 hours ago

Dr. Soobadar - What evidence can you cite to support your suggestions of IV CYC + RTX + PLEX in this patient? -------------------------...

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RE: Nephrotic Range Proteinuria And Unremarkable Renal Biopsy 21 hours ago

given age would be sure routine cancer surveillance is uptodate ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KPCOP EC [...

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RE: Puzzling Case of Post-Transplant Proteinuria 22 hours ago

why not try , see no reason for additional IS given stable creatinine and normal serum albumin and unremarkable histopathology. my curiosity begs f...

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RE: another ANCA case 22 hours ago

Thank you, Dr. Soobadar for your valuable suggestions. ------------------------------ Amit Joshi Chicago IL ------------------------------

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RE: another ANCA case 1 day ago

If b cell deplete then either 2 cyclo with obi or just obi --------------------------------- Muhammad Soobadar MBChB UK -----------------------...

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RE: another ANCA case 1 day ago

I would combine 2 pulses in cyclo with ritux with weaning ateroids Check cd19 counts Ensure crp coming down with steroids ( if not concurrent se...

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RE: Nephrotic Range Proteinuria And Unremarkable Renal Biopsy 1 day ago

The absence of EM is unfortunate. But unless you feel very strongly about having EM confirmation of a diffuse Podocytopathy, I would treate empiric...

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RE: Puzzling Case of Post-Transplant Proteinuria 1 day ago

No, she is not on ARB, ACE-I, SGLT2-I or other anti-proteinuric measures. ------------------------------ K.K. Venkat MD Troy MI (248) 420 7798 --...

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unexplained rhabdomyolysis 1 day ago

I saw a 42 year old gentleman , who is an ex- army vet . He had been on several rotations in Yemen in 2014/2015 ( exposure to metals/ chemicals /...

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RE: Nephrotic Range Proteinuria And Unremarkable Renal Biopsy 1 day ago

How sudden/abrupt/explosive was the onset of nephrotic edema? How much weight gain over what period of time? The more abrupt the onset, a podocytop...

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RE: Puzzling Case of Post-Transplant Proteinuria 1 day ago

given stable serum creatinine and normal albumin- forgive me if I missed this but is treatment with ARB,SGLT2 being used and if so any decrease in ...

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CLOSING TODAY! - Nephrology Quiz and Questionnaire 1 day ago

Calling all nephrology fellows and program directors-we need your help with the Nephrology Quiz and Questionnaire. Take the quiz today! Each year...

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CLOSING TODAY! - Nephrology Quiz and Questionnaire 1 day ago

Reminder: The Nephrology Quiz and Questionnaire closes TODAY! Calling all nephrology fellows and program directors-we need your help with the Neph...

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RE: Early post-transplant thrombocytopenia with schistocytes: ATG:CNI-associated TMA or multifactorial? 1 day ago

As per prior post CNI dose not related to post- Tx TMA - can increase TAC to appropriate trough levels IMO ------------------------------ [Mark...

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Nephrotic Range Proteinuria And Unremarkable Renal Biopsy 1 day ago

Dear seniors, I want to discuss a case of 64 years old male, treated case of HCV(SVR achieved, currently PCR negative), no other known co-morbs pr...

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RE: Early post-transplant thrombocytopenia with schistocytes: ATG:CNI-associated TMA or multifactorial? 1 day ago

Happy to note your patient's recovery. We have had experience restarting CNI after recovery from post-transplant TMA. without problem. Admittedly, ...

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RE: Early post-transplant thrombocytopenia with schistocytes: ATG:CNI-associated TMA or multifactorial? 1 day ago

Dear Colleagues, A brief two-week update, with latest results from September 17: creatinine improved to 0.58 mg/dL, platelets recovered to 300,00...

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RE: Early post-transplant thrombocytopenia with schistocytes: ATG:CNI-associated TMA or multifactorial? 1 day ago

Dear Colleagues, A brief two-week update, with latest results from September 17: creatinine improved to 0.58 mg/dL, platelets recovered to 300,00...

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RE: proteinuria ? cause 2 days ago

Thanks for the prompt replyFirst kidney biopsy from right was inadequate sampleSecond biopsy from left and is hydronephrotic .stent was removed few...

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

There are multiple urine tests over the past several months consistently showing very high UAlb/Cr and UPr/Cr ratios. Urine protein electrophoresis...

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RE: proteinuria ? cause 2 days ago

Was the biopsy of the left or right kidney.? Any hematuria or acanthocyturia by urinalysis (red cell casts in tubules) ? Any family history of kidn...

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proteinuria ? cause 2 days ago

77 years old female with history of chronic hydronephrosis on the left. Cystoscopy and stents ×3. Noted to have scarring of the ureter in May 2025....

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

Renin is not suppressed in Obesity related hyperaldosteronism 10.1093/ckj/sfaf218 Regardless treatment is medical IMO -----------------------...

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RE: Resistant Rejection 2 days ago

Good morning Interesting case. Given the lack of response to steroids and thymoglobulin, I would question whether the persistent inflammation re...

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

if urine is non-milky and confident patient provided urine with normal TG level then Chyluria very unlikely. would get urine electrophoresis again ...

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RE: Resistant Rejection 2 days ago

DSA?- positive or negative is necessary to classify this mixed rejection t-cell + ABMR -which has important implications for prognosis and addition...

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Resistant Rejection 2 days ago

Clinical History A 37-year-old woman with a history of systemic lupus erythematosus (SLE), diagnosed in 2009, has a significant obstetric history ...

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

According to Claude, a normal TG level in a single urine specimen does not rule out Chyluria. He recommends an oral fat challenge test, similar to ...

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

Could this be a lab error? Unlikely, I admit. ------------------------------ Richard Glassock MD, FASN Emeritus Professor Geffen School of Medic...

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

What is serum creatinine? were 24 hr urine albumin and protein and creatinine done? ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,...

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

My AI search was from Claude and it gave different results than yours, this ocurrs fairly commonly, in my experience. It matters how you ask the qu...

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