RE: Refractory membranous Nephropathy 6 hours ago

See Giri, Glassock and Fervenza. KI Reports 2026; 11: 106416 for a discussion of defining refractory (resistant) MN. ----------------------------...

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RE: AKI & Immune complex GN 6 hours ago

"UACR dropped 1,100--->60mg/d" Was this after starting prednisone + mycophenolate? Has SCr improved from peak of 2.4 mg over the last 10 days sin...

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RE: Refractory membranous Nephropathy 6 hours ago

Great question. I wish I had a good answer. Electron lucent deposits are presumed to be a sign of inactive disease . Whether electron dense fresh d...

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RE: Refractory membranous Nephropathy 6 hours ago

Dr Glassock , Does presence of deposits on EM indicate active disease ? Are there any Electron microscopy features which suggest active disease ...

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RE: C3G Or FSGS 8 hours ago

Since genetic testing is not indicated in steroid-sensitive MCD, I would (probably) ignore these findings, unless there is a family history of CKD....

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RE: AKI & Immune complex GN 8 hours ago

Yes Doc. RF was negative. C3, and IgG equal IgG (3+) C1q (3+) C3 (3+) Kappa (3+) Lambda (3+). No significant staining for IgA, IgM and fibri...

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RE: AKI & Immune complex GN 8 hours ago

If a Rheumatoid Factor is normal I think you can stop the evaluation for Endocarditis. I might look for a viral lobby- Parvovirus or EBV.. how inte...

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RE: SGLT2 inhibitors in MCD 8 hours ago

Probably yes, but long term FU data are largely lacking. ------------------------------ Richard Glassock MD, FASN Emeritus Professor Geffen Schoo...

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AKI & Immune complex GN 8 hours ago

Hi all, sorry for the long post. Need your help --------------------------------------------- 38 YO WF Presentation: Gross hematuria (later Mi...

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RE: C3G Or FSGS 9 hours ago

Just wanted to give an update and get some thoughts on the genetic profile of this patient . He responded well to steroids with complete resoluti...

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RE: SGLT2 inhibitors in MCD 11 hours ago

can we say the same about statins, as some of this patients severe dyslipidemia is reversible once the immunologic process is reverse ----------...

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RE: Sarcoidosis? 13 hours ago

Finding papers on GN in sarcoid was not hard. Finding papers on crescentic GN in sarcoid was harder. Finding papers on ANCA GN in sarcoid was much ...

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RE: Nephrotic range proteinuria with IC-mediated glomerulopathy 13 hours ago

Since "interferon storm" has been implicated in causing podocyte injury in the setting of viral infections, use of interferon in this patient might...

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RE: Nephrotic range proteinuria with IC-mediated glomerulopathy 15 hours ago

Hi everyone, It has been a while since I posted this thread. It turns out that she has chronic parvovirus viremia with a relatively low titer (14...

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RE: FeNa 15 hours ago

Hi Anna, yes, we are still teaching FENa to pre-clerkship students. Although FENa is flawed, it is helpful conceptually to teach about how fantasti...

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RE: cause of AKI 1 day ago

Did you stop the Ashgawanda as well? ------------------------------ Richard Glassock MD, FASN Emeritus Professor Geffen School of Medicine at UCL...

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RE: cause of AKI 1 day ago

agree with avoiding infliximab but given persistent intense TIN with lymphocytes and apparent lack of IFTA-MMF seems worth a try unless leukopenia ...

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RE: cause of AKI 1 day ago

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

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RE: Sarcoidosis? 1 day 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 1 day ago

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

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RE: Sarcoidosis? 1 day 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 1 day 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 1 day 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? 1 day 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 1 day 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 1 day 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? 1 day 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? 1 day 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 1 day 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 1 day 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 1 day 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? 1 day 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? 1 day 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 1 day 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 1 day 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 1 day 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 1 day ago

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

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RE: ICI induced IgAV 1 day 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 1 day 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days ago

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

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