RE: Potential donor with mutation in NR3C2 Gene 1 minutes ago

Dr. Achkar- I fully agree with your compassionate use of APOL1 genotyping of all donors of African ancestry. The issue relates to when non-APOL1 ge...

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RE: Potential donor with mutation in NR3C2 Gene 35 minutes ago

We don't do routine genetic tests on all our donors. However, we have very active paired exchange program and one of our recipients developed Nephr...

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RE: Immunosuppression in Lupus/APLA 55 minutes ago

This patient is losing nephrons at an abnormal pace (about 50ml/min/1.73 m2 over 7 years) despite low level active inflammatory disease.the MPGN fe...

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Immunosuppression in Lupus/APLA 4 hours ago

I would appreciate community input in this puzzling case of SLE/APLA: 67-year-old woman with progressive renal impairment on a background of previ...

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RE: Parvovirus B19 associated FSGS 4 hours ago

You're correct that the biopsies didn't show collapsing features, although I feel it's behaving like that clinically. The pathologist called it FSG...

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RE: Potential donor with mutation in NR3C2 Gene 6 hours ago

I agree with Dr. Rubin. Can we really justify routine,universal genetic testing for all potential living donors, especuslly apparently healthy altr...

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RE: Potential donor with mutation in NR3C2 Gene 7 hours ago

Maybe I am missing something but, why were genetic studies done in this potential donor? Personally, I have had no experience with patients with th...

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RE: AKI/ANCA Vasculitis 7 hours ago

I would not be too worried about Avacopan- The FDAz has announced an intent to withdraw the drug from approval , for lack of proven efficacy.. This...

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RE: IgA Nephropathy 8 hours ago

Based on information provided It is entirely possible that this patient has IgA Vasculitis (IgAV )and not IgAN. Using this supposition, largeltb ba...

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Potential donor with mutation in NR3C2 Gene 8 hours ago

I would appreciate the community input on the following case: 59-year-old African American female with no significant past medical history who pr...

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IgA Nephropathy 8 hours ago

Dear Colleagues, I'd like to seek your professional opinion about the management of a patient i follow in the office. 40 y/o lady, came with elev...

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AKI/ANCA Vasculitis 9 hours ago

I have a very pleasant 57y.o. male with a hx of pulmonary interstitial fibrosis, renal cell carcinoma s/p partial nephrectomy in 2020, DMII, HLD wh...

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RE: PD question - Peritoneal dialysis in bile peritonitis with an indwelling PTGBD and exhausted hemodialysis vascular access 12 hours ago

Roger: there may be triple negatives in how I said it !. I do advocate cessation of PD in some someone with ongoing biliary leak. There was a tim...

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RE: Bivalirudin for CRRT 13 hours ago

More attached bivalrudin is an accepted systemic anticoagulant and I see no reason why it could not be used in CRRT --------------------...

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RE: PD question - Peritoneal dialysis in bile peritonitis with an indwelling PTGBD and exhausted hemodialysis vascular access 13 hours ago

Dr Chandran, "I have little (if any) hesitation on advocating cessation of PD in a Pt w. a biliary leak as you described. I have seen a few patie...

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RE: PD question - Peritoneal dialysis in bile peritonitis with an indwelling PTGBD and exhausted hemodialysis vascular access 15 hours ago

Dr Duong: I have little (if any) hesitation on advocating cessation of PD in a Pt w. a biliary leak as you described. I have seen a few patients wi...

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RE: Bivalirudin for CRRT 16 hours ago

Thanks! Jeff Berns

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RE: Bivalirudin for CRRT 16 hours ago

Very small study ( 5 patients in each group)- needs confirmation in a larger study. No such study done (?) in the succeeding 15 years -why? -----...

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RE: Bivalirudin for CRRT 17 hours ago

refernce attached ------------------------------ Roger Rodby MD, FASN Professor of Medicine Rush University Nephrology Associates Chicago I...

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RE: Parvovirus B19 associated FSGS 19 hours ago

I would ask my ID colleagues what this faint parvo pcr means, and if they think that IVIg has any role for chronic disease especially in the settin...

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APPLICATION CLOSING SOON: Volunteer to serve as a case report reviewer for Kidney Week 2026! 19 hours ago

ASN invites ASN Fellows-in-Training members to serve as reviewers for case reports submitted by trainees for Kidney Week 2026. The reviewing/gradin...

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APPLICATION CLOSING SOON: Encourage fellows to volunteer as case report reviewers for Kidney Week 2026! 19 hours ago

ASN invites ASN Fellows-in-Training members to serve as reviewers for case reports submitted by trainees for Kidney Week 2026. The reviewing/gradin...

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RE: Parvovirus B19 associated FSGS 1 day ago

I must admit tgat I have no personal experience with treating Parvovirus induced FSGS. And the literature consists mainly of case reports And limit...

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Parvovirus B19 associated FSGS 1 day ago

Hello all, I'm looking for advice on a case of parvovirus B19 associated FSGS. A 43-year-old Filipino gentleman presented last year with overt ...

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RE: FSGS vs C3G and Canavan Disease 1 day ago

Returning to this case , with a cresenteric and necrotizing GN , strong C3/IgM condominamce , weak IgA and IgG , should we be considering Bartonell...

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RE: Bivalirudin for CRRT 1 day ago

We considered it during COVID bc of so much filter clotting and was in a treatment algorithm, but I'm not sure we ever used it but I looked at th...

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RE: PD question - Peritoneal dialysis in bile peritonitis with an indwelling PTGBD and exhausted hemodialysis vascular access 1 day ago

Seems like you are between "A rock and a hard place" I suppose you could do PD with smaller more frequent exchanges you may get some leakage f...

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PD question - Peritoneal dialysis in bile peritonitis with an indwelling PTGBD and exhausted hemodialysis vascular access 1 day ago

Dear colleagues, I would like to share and seek your expert advice on a highly challenging clinical case below. Case summary A 57-year-old wo...

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Bivalirudin for CRRT 1 day ago

We are exploring use of bivalirudin for CRRT circuits (prefilter) that clot early or repeatedly. We do not currently use citrate and are reluctant ...

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RE: Renal-restricted antiGBM 1 day ago

Thanks for posting thus interesting case. Q1- i would stop PLEX and monitor anti-GBM leveks periodically Q2 I would taper and stop CYC Q3. I ...

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RE: Persistent Paraneoplastic Membranous Nephropathy After Curative Nephrectomy: Where Should We Go Next? 2 days ago

This case is certainly one that brings to mind Hickams Dictum- "the patient can have as many diseases as they damn well please " ----------------...

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RE: Persistent Paraneoplastic Membranous Nephropathy After Curative Nephrectomy: Where Should We Go Next? 2 days ago

The EM findings do not fit with MN and look more like MPGN. Can we have another opinion on the renal pathology in this . case. Dr. Brodsky, Dr. Fog...

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RE: Persistent Paraneoplastic Membranous Nephropathy After Curative Nephrectomy: Where Should We Go Next? 2 days ago

Yes, we tested for cryoglobulinemia more than once, with proper collection and processing. Unfortunately, although it was also our main suspicion, ...

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RE: Persistent Paraneoplastic Membranous Nephropathy After Curative Nephrectomy: Where Should We Go Next? 2 days ago

It may be a long shot but I would still test for VEGF ( and my Ai consultant agrees).. the renal cell carcinoma just does not fit into this picture...

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RE: Persistent Paraneoplastic Membranous Nephropathy After Curative Nephrectomy: Where Should We Go Next? 2 days ago

We have all serologies negative, including viral loads and HCV DNA. Flow cytometry did not identify any abnormalities. ANA is also negative. We con...

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RE: Persistent Paraneoplastic Membranous Nephropathy After Curative Nephrectomy: Where Should We Go Next? 2 days ago

The overall picture is more compatible with Type II (mixed ) cryoglobulinemia with neuropathic Vasculitis than POEMs Syndrome, but I would do a ser...

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RE: Persistent Paraneoplastic Membranous Nephropathy After Curative Nephrectomy: Where Should We Go Next? 2 days ago

Before excluding POEMS Syndrone in this case you should do special flow cytometry for monoclonal cell and do serum VEGF.levels . Up to 20% of POEMS...

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Renal-restricted antiGBM 2 days ago

Dear doctors, I would like to share a patient who, per renal pathology, luckily, has the "mildest form of antiGBM dz" they have seen. 53 y/o la...

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RE: Persistent Paraneoplastic Membranous Nephropathy After Curative Nephrectomy: Where Should We Go Next? 2 days ago

Please find the attached files. ------------------------------ Joao E Lima Souza MS UNIVERSIDADE FEDERAL DE PERNAMBUCO Universidade federal de pe...

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Persistent Paraneoplastic Membranous Nephropathy After Curative Nephrectomy: Where Should We Go Next? 2 days ago

Requesting guidance regarding a case of a 51-year-old male with a two-year history of recurrent edematous syndrome and hypertensive emergencies, wi...

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RE: Hd Patient Running Out Of Access 2 days ago

It is worth a try. The rectum, sigmoid colon ascending and descending colon are retroperitoneal structures. I suspect the risk of perforation is mo...

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RE: Hd Patient Running Out Of Access 2 days ago

I agree with Dr . Rodby. The peritoneal membrane in pretty resistant to radiation injury . I have never seen any significant peritoneal membrane ir...

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RE: Hd Patient Running Out Of Access 2 days ago

"I was thinking along radiation to peritoneum and damage and therefore high risk of pd not working" Good thought , but radiation is very targeted...

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RE: Osteoporosis In Stage 5 Ckd 2 days ago

Again I agree and it is similar to the article I mentioned earlier J Clin Pharmacol 2022 Apr 2;62(9):1132–1141. doi: 10.1002/jcph.2050 --------...

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RE: Membranous nephropathy 2 days ago

Hi. Thanks very much! Very Interesting case. If you have a chance please let us know how your pt is doing with treatment Thanks for sharing this ...

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RE: Osteoporosis In Stage 5 Ckd 3 days ago

The rationale , efficacy and safety issues concerning the use of Rososuzunab or Teriparatide in Adynamic Bone Disease in CJD is very well summarize...

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RE: Osteoporosis In Stage 5 Ckd 3 days ago

May I ask you what is Rational of using Romosozumib in this patient? How teriparatide modefied dose may help? --------------------------------- Wa...

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RE: Membranous nephropathy 3 days ago

Hi Dr. Garrick. The duodenal biopsy report came two days ago and it's benign and no dysplastic features. So I hope I can take this as a PLA2R negat...

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RE: Canine amyloidosis treatment options 3 days ago

Yes! These are my colleagues at the International Veterinary Renal (and Urinary) Pathology Service. It is physically within Texas A&M. Those are th...

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RE: Canine amyloidosis treatment options 3 days ago

A friend of mine just sent me this poster. It looks like mass spectrometry proteomics is being explored in veterinary medicine. The technique here ...

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