RE: cause of AKI 4 hours ago

Personally, I would avoid Infliximab in this case due its propensity to induce vasculitis. ------------------------------ Richard Glassock MD, ...

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RE: Sarcoidosis? 4 hours ago

Thanks prof rodby Sorry pred 60mg first and wean and then add mmf and continue for 12 month with low dose steroid and mmf rheumatologist prefer met...

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RE: cause of AKI 4 hours ago

Thanks prof rodby worth exploring Bw --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Sarcoidosis? 5 hours ago

I would use moderate dose prednisone starting 60 and taper as response, I think that will give you the fastest response. then for maintenance I ...

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RE: cause of AKI 5 hours ago

steroids didn't work and yet the kidney is not "dead" as i wold have predicted if on hd this long nd no recovery. Im not excited about MMF what...

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RE: cause of AKI 5 hours ago

I have no opinions on this very difficult questions, Simply no data upon which to base an opinion. ------------------------------ Richard Glassoc...

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RE: Sarcoidosis? 6 hours ago

Thanks prof glassock . I would do mmf and small dose pred Mmf 500 mg bd and pred 5 mg od for 12 month and review (opinion not ebm) Repeat biopsy ...

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RE: cause of AKI 6 hours ago

@ prof glassock would you consider mmf as second line and if so at what dose and at what point ( how long would you call futility? --------------...

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RE: cause of AKI 6 hours ago

I do not know of any comparative data concerning the risk of severe TIN is Ashgawanda vs PPI.this risk of developing AIN with PPI is estimated to b...

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RE: Sarcoidosis? 6 hours ago

No evidenced based answer to your very good question. I do not know. It is so uncommon, nor real data. This spreads to be an ANCA negative Pauci- i...

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RE: Sarcoidosis? 8 hours ago

IF neg except fibringen in the crescent. No deposits or foot process effacement findings on the EM. PLAR2 neg. didn't do the anti-GBM with the cre...

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RE: cause of AKI 9 hours ago

Dr.Glassock- assuming myeloma excluded- wouldn’t PPI induced AIN/AKI be more likely vs ashwagandha ? How often does latter cause severe Tubuliinter...

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FeNa 12 hours ago

Hi all, does anybody still teach FeNa at M2 level? Do we know if step 1 and step 2 still test it? ------------------------------ Anna Vinnikova,...

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RE: is it SIADH 13 hours ago

How sad.Thanks for the follow-up. Pretty classical case.of SIADH and a lung malignancy. ------------------------------ Richard Glassock MD, FAS...

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RE: Sarcoidosis? 13 hours ago

Crescentic glomerular lesions are an uncommon , but well recognized , finding in Sarcoidoisis. No reason to question the diagnosis in this case. Wh...

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Sarcoidosis? 15 hours ago

The patient is clinically suspected to have sarcoidosis, but some atypical findings. He is a 77yo who began feeling unwell 2 mo prior and found to...

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RE: is it SIADH 15 hours ago

unfortunately pt was found to have lung cancer for best supportive treatment ------------------------------ Muhammad Soobadar MBChB UK ----------...

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RE: SGLT2 inhibitors in MCD 16 hours ago

The beneficial role for RASi and /or SGLT2i in classical MCD with nephrotic syndrome I has never been established. ------------------------------...

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RE: ICI induced IgAV 16 hours ago

Overall GFR decline in crescentic GN, depends not only on the extent of crescentic involvement bit also on the extent of tubulo-interstitial injury...

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RE: cause of AKI 20 hours ago

Thanks Would you consider mmf or any other agents prof glassock ? --------------------------------- Muhammad Soobadar MBChB UK ----------------...

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RE: ICI induced IgAV 20 hours ago

Thanks prof glassock Hypothetical scenario If patient was also having macroscopic haematuria and was on anticoagulant too in above scenario I t...

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RE: SGLT2 inhibitors in MCD 20 hours ago

Sorry just to clarify , the author states he uses Steroids and RASi, and asked about the use of Sglt2i. The answers recommend not to use Sglt2i. D...

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RE: ICI induced IgAV 1 day ago

The evidence that CYC is effective in IgAV is weak and no data on use in ICI induced IgAV. I would avoid. ------------------------------ Richard ...

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RE: ICI induced IgAV 1 day ago

Thanks prof glassock Would cancer history also make you stay away from cyclo ? --------------------------------- Muhammad Soobadar MBChB UK --...

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RE: resistant c3gn 1 day ago

Remember, Pegcetacoplan only treats the C activation, not the underlying cause-in this case possibly a monoclonal disorder. ---------------------...

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RE: cause of AKI 1 day ago

This seems most likely due to ashgawandha induced TIN. Prognosis rather poor. ------------------------------ Richard Glassock MD, FASN Emeritu...

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RE: ICI induced IgAV 1 day ago

No gross ( macroscopic ) hematuria so a anti-coagulant induced nephropathy is quite unlikely. Crescentic IgAV is very likely the cause of AKI in th...

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RE: ICI induced IgAV 1 day ago

This is not IgAN, it is IgAV and RTX works very well in IgAV. ------------------------------ Richard Glassock MD, FASN Emeritus Professor Geffen ...

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RE: SGLT2 inhibitors in MCD 1 day ago

Short and sweet- like Dr. Rodby - NO! ------------------------------ Richard Glassock MD, FASN Emeritus Professor Geffen School of Medicine at UC...

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RE: cause of AKI 1 day ago

this patient is still dialysis dependent and the treating physician felt to do repeat kidney biopsy to see if patient would benefit from MMF as on ...

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RE: SGLT2 inhibitors in MCD 1 day ago

I would like to paraphrase Dr Hirsch's above. as: no ------------------------------ Roger Rodby MD, FASN Professor of Medicine Rush Unive...

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RE: ICI induced IgAV 1 day ago

"I am hesitant on giving rituximab as I'm a bit worried if he develops a reaction he has limited lung reserve (post partial lobectomy) and that thi...

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RE: ICI induced IgAV 1 day ago

Dr. Ssa -does oncology believe durvalumab can be permanently discontinued? ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST...

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RE: ICI induced IgAV 1 day ago

Is the patient on blood thinner ? --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: ICI induced IgAV 1 day ago

Does ritux work in ig a n? I thought it did not ( La Fayette et al) Not sure about ritux in crescentic ig a What about mmf and steroid ? ----...

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RE: SGLT2 inhibitors in MCD 1 day ago

As far as I understand this, RAASI and SGLT2Is generally have no significant role at presentation/early in the course of diseases where immunologic...

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RE: resistant c3gn 1 day ago

some updates repeat complement testing shows some interesting additional findings. + C3 nef (1+) +C5 nef (2+), + C4 nef (1+) . c3 and c4 low, c5 ...

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RE: Alport -FSGS 1 day ago

Interesting concept - no data. ------------------------------ Richard Glassock MD, FASN Emeritus Professor Geffen School of Medicine at UCLA Lagu...

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RE: resistant c3gn 1 day ago

@Richard Glassock i fully understand your reservations , given the lack or organized deposits on the EM . The 15 nm sized deposits suggest fibrils ...

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RE: SGLT2 inhibitors in MCD 1 day ago

I am not sure if i understood the jist of the question . Is the author suggesting if there is benefit of SGLT2i in patients with complete remissi...

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RE: Alport -FSGS 1 day ago

If the asymptomatic ( absence of protienuria / hematuria ) - were to test positive for the mutation - would you still treat with with RASi and SGLT...

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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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Nephrology Quiz and Questionnaire 1 day ago

Calling all nephrology fellows and program directors-we need your help with the Nephrology Quiz and Questionnaire. Fellows, try to outsmart the Nep...

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RE: Alport -FSGS 1 day ago

Let me say that while a biopsy is NOT needed, if you get positive genetic testing first, these patients usually come to us for proteinuria and get ...

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RE: Alport -FSGS 1 day ago

Completely agree. Per Kashtan et al. 2018 Kidney International (doi 10.1016/j.kint.2017.12.018) consensus classification Alport syndrome is defin...

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RE: A Young Patient with IgA Nephropathy, Portal Hypertension, and Refractory Anemia: One Disease or Many? 1 day ago

Distinguished Colleagues, Update on the pending questions. - Alpha globin genotyping (Dr. Glassock): heterozygous −α3.7 deletion, α+ thalassemi...

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RE: Alport -FSGS 1 day ago

Treatment of FSGS due to X-linked Alport's in a female with RAS-inhibition and SGLT2i inhibitor seems very reasonable especially to reduce proteinu...

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RE: SGLT2 inhibitors in MCD 1 day ago

I suppose an exception might be made for an ann obese patient with T2DM and MCD, but this is not evidence based. ------------------------------ ...

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RE: SGLT2 inhibitors in MCD 2 days ago

I doubt it . - and the severe proteinuria that exists in MCD would have made patients ineligible for inclusion in the Dapagliflozin and Empaglifloz...

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RE: resistant c3gn 2 days ago

Great discussion of a very complex and nuanced case. C3GN is an enigma inside of a riddle. It seems to be more of a "pattern of injury" rather than...

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