RE: Dapagliflozin In Hd Patient With Diastolic Dysfunction 12 minutes ago

I fully agree with Dr. Campese that clinical trials need to be under ptaken to further evaluate the rather impressive potential benefits of SGLT2i ...

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RE: Dapagliflozin In Hd Patient With Diastolic Dysfunction 54 minutes ago

I would tend to concur with Dr Campese. By what mechanism would a SGLT2-I work in an essentially anephric patient? Just wondering. --------------...

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RE: Dapagliflozin In Hd Patient With Diastolic Dysfunction 1 hour ago

The study by Wu JY et al is a retrospective uncontrolled analysis of approximately 5,000 patients taking SGLUT 2 inhibitors and 183,000 not taking ...

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RE: secondary IgA Nephropathy 1 hour ago

I will add my skepticism to all above. His renal function does not match the biopsy. Creatinine level is dependent on production and clearance, whi...

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Mayo Clinic GN Symposium Learning Opportunity for Nephrology Fellows 2 hours ago

Dear Nephrology Fellow Community, Please take a look at this unique opportunity to delve into glomerular disease management in light of emerging ...

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RE: Dapagliflozin In Hd Patient With Diastolic Dysfunction 2 hours ago

Thanks prof glassock @ dr dastoor I use dapa ( just practice based what i use ) What do you use ? --------------------------------- Muhammad So...

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Mayo Clinic GN Symposium Learning Opportunity for Clinicians at all Levels of Training 2 hours ago

Dear Kidney Educator Community, Please take a look at this unique opportunity to delve into glomerular disease management in light of emerging di...

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RE: Painless macroscopic hematuria 3 hours ago

Thank you. Will review it. ------------------------------ Mario Rubin, M.D. Houston TX (713) 252-5539 ------------------------------

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RE: CAKUT, pediatric neph input 4 hours ago

"The patients main concern is the abdominal pain, and I did not have an answer for him. Could this congenital variant be related to his pain someho...

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RE: secondary IgA Nephropathy 5 hours ago

His creatinine on March 26th was 2.45, June 2nd 2.22 and July 7th is 2.34. Feb 2026 Creatinine was 1.4. Feb 2025 creatinine was 1.2. --------...

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CAKUT, pediatric neph input 6 hours ago

Hello everyone, I was asked to see a 30 yr old m who had some trouble with urinary stream, and abdominal pain on either side of his umbilicus. No...

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RE: secondary IgA Nephropathy 6 hours ago

Thanks for this report. Very helpful. Remarkably " benign" !! What was the serum creatinine level when this kidney biopsy was performed.? . ----...

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RE: secondary IgA Nephropathy 10 hours ago

Final Diagnosis Kidney biopsy: IgA nephropathy. Oxford IgA nephropathy classification ( M0, S0, E0, T0, C0). Light microscopy: The renal biopsy ...

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RE: secondary IgA Nephropathy 13 hours ago

Dr. Thalla- can you post the de-deidentified kidney biopsy pathology report for this patient ?. . I think it might help to focus the discussion. ...

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RE: Dapagliflozin In Hd Patient With Diastolic Dysfunction 16 hours ago

It is interesting that u specifically mentioned dapagliflozin in ESRD patients . Is that a personal preference or is there some evidence favoring ...

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RE: Painless macroscopic hematuria 20 hours ago

I believe this the reference https://doi.org/10.1002/pbc.25592 "is important to note that this claim traces back to older case series and textb...

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RE: Painless macroscopic hematuria 21 hours ago

@K.K. Venkat I was not aware of that anatomic left renal vein predilection. Do you have the reference(s) of that report? Thank you ------------...

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RE: Painless macroscopic hematuria 21 hours ago

It has been reported that sickle cell trait is more likely to cause unilateral hematuria from the left kidney. This was attributed to the longer le...

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RE: Painless macroscopic hematuria 22 hours ago

Dr. Anand-thanks so much for follow-up on this interesting case confirming SCT which is most likely cause given the extensive workup you have share...

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RE: Painless macroscopic hematuria 22 hours ago

Dr. Anand. Thanks. We all learned from this case. urgent Cystoscopy is key and SS trait must be considered in all Black subjects with gross hematur...

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RE: Dapagliflozin In Hd Patient With Diastolic Dysfunction 23 hours ago

In large scale Observational studies SGLT2i have benefits in ESKD patients with HFrEF and HFpEF.( See Wu J-Y. et al Front Cardiovascular Med 2026; ...

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RE: secondary IgA Nephropathy 1 day ago

A serum creatinine of 2.2mg/dL in completely unexpected in a patient with IgAN and a MEST-C score of M0, E0, S0, T0, C0 and minimal proteinuria des...

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Dapagliflozin In Hd Patient With Diastolic Dysfunction 1 day ago

Patient is home hd Not much urine but not measured Learning disability fragile X syndrome Echo - normal lv and lv function Impaired diastolic d...

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RE: Painless macroscopic hematuria 1 day ago

The Hb electrophoresis confirmed that he has sickle cell trait!! Thanks to all in the group for your responses. I learnt something new --------...

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RE: AL amyloidosis 1 day ago

@Richard Glassock, no, the current ISA criteria does not require a bone marrow for a complete response assessment. However, we are borrowing from m...

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RE: secondary IgA Nephropathy 1 day ago

I agree with @Mark Lerman "Biopsy does not explain AKI, when did creatinine rise from baseline ? if creatinine does not improve may need to consi...

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RE: secondary IgA Nephropathy 1 day ago

for those who are skeptical regarding this patient's creatinine level-I would attempt to measure GFR directly. We in Dallas rely on Glofil-125 (...

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RE: secondary IgA Nephropathy 1 day ago

SGLTi I started just 10 days ago. Ozempic , he started in 2024 and had lost 60 lbs. his creatinine after weight loss was 1.2-1.3 in May 2025. He ...

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RE: secondary IgA Nephropathy 1 day ago

Thank you for Reply. That was my first thought before biopsy. Humira last dose was in November. Unfortunately no creatinine checked from May 2025 t...

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RE: Please help with renal biopsy results - vascular insult - etiology unclear 1 day 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: secondary IgA Nephropathy 1 day ago

There are reports of Humira-associated AKI due to acute interstitial nephritis, secondary IGA nephropathy, etc. Noted that Humira was stopped in Ja...

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RE: secondary IgA Nephropathy 1 day ago

Thanks -thus is very helpful. Can you also clarify the timing of the prescription of SGLT2i and GLP1RA and the observed ruse in serum creatinine. W...

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RE: secondary IgA Nephropathy 1 day ago

His BMI is 31-32. No RBC casts in tubules. No evidence of AIN or ATN in biopsy. ------------------------------ Radhika Thalla MD Physician...

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RE: secondary IgA Nephropathy 1 day ago

The very sparse clinical literature suggests (but does not prove) that patients with IBD can "hyperabsorb" creatinine, from such sources as dietary...

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RE: secondary IgA Nephropathy 1 day ago

With active Crohn's disease , I would expect this patient to be malnourished, hence a creatinine of 2.2 mg/dl , may potentially suggest a more seve...

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RE: secondary IgA Nephropathy 1 day ago

One additional measure that might be appropriate is to measure Serum creatinine after fasting. ------------------------------ Richard Glassock M...

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RE: secondary IgA Nephropathy 1 day ago

This is certainly very mild IgAN. With such minimal proteinuria there is no clear indication for SGLT2i or RASi. How obese is the patient?. Any RBC...

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RE: secondary IgA Nephropathy 1 day ago

Thank you for reply. Creatinine is increased in February. Previous creatinine was 1.2 ( in May 2025 with his physical)s. Biopsy is done in June. ...

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RE: secondary IgA Nephropathy 1 day ago

Thank you for the reply. Kidney biopsy showed LM : a total of 15 glomeruli, of which is 1 is globally sclerosed. Mild mesangial cell proliferatio...

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RE: secondary IgA Nephropathy 1 day ago

agree no indication for Budesonide, but cautious use of ARB, and SGLT2 might be considered. Biopsy does not explain AKI, when did creatinine rise f...

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RE: secondary IgA Nephropathy 1 day ago

With such minimal proteinuria and the lack of any inflammation or crescents in a kidney biopsy I would suspect a spurious elevation of serum creati...

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secondary IgA Nephropathy 1 day ago

43 yr old with PMH of Ulcerative colitis with AKI creatinine increased to 2.4 ( baseline 1.2) and hematuria. Proteinuria of 0.2 gms. BP is usally i...

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RE: AL amyloidosis 1 day ago

Is a repeat bone marrow biopsy with cytogenetic analysis required for determination of a complete response in AL Amyloid treated with autologous SC...

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RE: AL amyloidosis 2 days ago

Not detected on SPEP, SIFE, and UPEP --------------------------------- [Sheng] [Kuo] MD, FASN ---------------------------------

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RE: AL amyloidosis 2 days ago

what about her monoclonal IgM lambda. is that still positive? ------------------------------ Nelson Leung MD Mayo Clinic Rochester MN (507) 208-1...

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

Agree with Prof Rodby. Too much reliance on serum creatinine and eGFR. Definitely pt has chronic renal ischemic damage and considering his age pro...

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RE: AL amyloidosis 2 days ago

I have been holding off on this re-biopsy, as I didn’t believe it will yield another diagnosis. However, it’s been 3 years and hematology was so co...

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RE: AL amyloidosis 2 days ago

Her initial bone marrow biopsy showed 10-15% plasma cell myeloma, lambda monotypic without amyloid (Congo Red negative). Most recent lambda free L...

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RE: AL amyloidosis 3 days ago

what is The lambda free light chain and kappa lambda ratio? IgM AL amyloidosis cases are harder to treat then non IgM cases. what did the original ...

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RE: AL amyloidosis 3 days ago

An update since last post in 2023 and hoping for additional guidance. Chinese female with history of HBV and hyperlipidemia initially presented w...

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