RE: Management Challenges in a Patient with C3 Glomerulonephritis 4 hours ago

Dr. Schwartz- thanks for the PDF's of the citations,. ------------------------------ Richard Glassock MD, FASN Emeritus Professor Geffen School o...

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RE: Management Challenges in a Patient with C3 Glomerulonephritis 8 hours ago

Here are the 2024 ASN Presentation and the 2025 NEJM Publication of Valiant trial. ------------------------------ John Schwartz MD Dallas Ne...

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RE: Management Challenges in a Patient with C3 Glomerulonephritis 12 hours ago

Dr. El-Meanawy raises an interesting point that requires additional consideration, I think. Although tge clinical and pathological features of tgis...

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RE: Management Challenges in a Patient with C3 Glomerulonephritis 15 hours ago

The stability of creatinine through the years is interesting. I have seen IgG related GN / MN with hidden epitopes mascaraed as C3. The problem...

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RE: Management Challenges in a Patient with C3 Glomerulonephritis 18 hours ago

The Sobi ERA 2026 release looks like the right lead — let me pull the full poster list. I think the poster you mean is first-authored by **Dean Wa...

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RE: Management Challenges in a Patient with C3 Glomerulonephritis 18 hours ago

In terms of infections , I have used Pegcetacoplan in around 10 cases with C3G and Iptacopan for 8 patients with IgA Nephroapthy. All patients wer...

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RE: Management Challenges in a Patient with C3 Glomerulonephritis 19 hours ago

Hi, Dr. Dastoor, thanks for your suggestions and reference. I am wondering if the increase of proteinuria is due to worsening kidney function s...

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RE: Management Challenges in a Patient with C3 Glomerulonephritis 19 hours ago

Hi, Dr. Lerman, thank you so much for your suggestions. I will relay your opinion to our transplant team. Jingjing ------------------...

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RE: Management Challenges in a Patient with C3 Glomerulonephritis 19 hours ago

Hi, Dr. Glassock, thank you so much for the reply. I am actually not sure between these two. Our pathologist reported C3GN. I did not see lipod...

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RE: Denovo Idiopathic MPGN of Renal Allograft 21 hours ago

What type of donor LKD vs DD ? Tac monotherapy is unusual unless HLA identical LKD which is still uncommon not to use antimetabolites +/- low dose ...

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RE: Denovo Idiopathic MPGN of Renal Allograft 1 day ago

It depends on whether the C3 IF was interpreted from an advanced sclerotic glomeruli or not. We need to see the full (deidentified ) full biopsy re...

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RE: Denovo Idiopathic MPGN of Renal Allograft 1 day ago

Wouldn’t ‘trace’ C3, despite low serum C3, weigh heavily against both (masked) PGNMID & IRGN? C3 staining is nearly universal in PGNMID & C3 domina...

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RE: A case of a young man with a biopsy showing full house pattern on IF, with negative Lupus serology and positive MPO Antibody 1 day ago

He has not taken Hydralazine ------------------------------ Katafan Achkar MD, FASN Houston Methodist Hospital and CLS Health Webster TX (832) 46...

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RE: Denovo Idiopathic MPGN of Renal Allograft 1 day ago

What was the evidence that the disease of the native kidney was IgAN? I agree with Dr. Rodby that excluding an infection or PGNMID is very importan...

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RE: Management Challenges in a Patient with C3 Glomerulonephritis 1 day ago

Thanks Dr. Lerman Very helpful advice. I also agree with the suggestions of Dr. Dastoor, but I am not optimistic about favorable response to Pegcet...

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RE: Management Challenges in a Patient with C3 Glomerulonephritis 1 day ago

Can you please post the reference for this figure? Thank you. ------------------------------ Mario Rubin, M.D. Houston TX (713) 252-5539 --------...

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RE: Denovo Idiopathic MPGN of Renal Allograft 1 day ago

I always go back to this for MPGN and with the Igs on biopsy, you are on the left side have infections been completely ruled out? I would get...

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RE: Management Challenges in a Patient with C3 Glomerulonephritis 1 day ago

The attached image kind of summarizes what you should expect in terms of uPCR and eGFR response to therapy with a Complement blocker. Having used...

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Denovo Idiopathic MPGN of Renal Allograft 1 day ago

57-year-old woman with ESKD secondary to IgA nephropathy s/p kidney transplant in 2016, maintained on tacrolimus monotherapy, with baseline creatin...

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RE: Management Challenges in a Patient with C3 Glomerulonephritis 1 day ago

Agree no absolute contraindication to trying Iptacopan or Pegcetacoplan in this patient but patients profile suggests unlikely to prevent ESRD give...

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Applications Due 10/31: NephSIM Nephrons 1 day ago

Dear all, Applications are now open for the 2027 NephSIM Nephrons Program, a 6-month virtual mentoring and education program for medical student...

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RE: Management Challenges in a Patient with C3 Glomerulonephritis 1 day ago

Very challenging case. The posted single EM image seems to have features of DDD- how did you conclude that this was C3GN . The patients has a very ...

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Management Challenges in a Patient with C3 Glomerulonephritis 1 day ago

Dear colleagues, I would like to get some suggestions from you. Patient is a 31-year-old male. In 11/2017(age 22), he was found to have cr 2.3 a...

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RE: A case of a young man with a biopsy showing full house pattern on IF, with negative Lupus serology and positive MPO Antibody 3 days ago

Was he taking hydralazine? ------------------------------ Levi Short MD, FASN Wichita Nephrology Group PA Wichita KS ---------------------------...

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RE: NUP133 Mutation 3 days ago

Yes, it makes a lot of sense Dr Rodby. Nevertheless, this is recommended by standard practice in medical genetics. Indeed we do recommend it in our...

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RE: NUP133 Mutation 3 days ago

"Tough post-conception discussion if the stars do not align.". Powerful statement.. a life altering decision. Why take any chance. I am convinced. ...

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RE: NUP133 Mutation 3 days ago

This gets to the root of so many daily decisions we make as doctors, We dont look for everything in everybody regardless of risk, we draw the line ...

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RE: NUP133 Mutation 3 days ago

Yes, and these are wild estimates completely agnostic of population structure and cultural habits of the actual patient. Plus this is a truncating ...

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RE: A case of a young man with a biopsy showing full house pattern on IF, with negative Lupus serology and positive MPO Antibody 3 days ago

Another puzzling case of unexplained IC-GN, I would screen for infections in particular SBE. Any extraglomerular staining (TBM, vessels) that may ...

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RE: NUP133 Mutation 3 days ago

Maybe I’m looking at this wrong, but if the highest population-specific allele F for this variant is 0.2372%, the estimated carrier F is 0.4733%, g...

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RE: NUP133 Mutation 3 days ago

Agree is a rare form of NS/FSGS, but unfortunately this is how recessive diseases occur. This is a single variant cascade testing so it's usually i...

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RE: NUP133 Mutation 3 days ago

With a gene frequency for this mutation of 1 in 16000 individuals in the general population, screening of non-non-relatives will not likely detect ...

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RE: Hypokalemia in Pregnancy Friday, October 9 @ 2:58 PM

Dear ALL Thank you very much for your valuable comments and suggestions. I want to send you an updating about the blood and urine tests result...

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RE: NUP133 Mutation Friday, October 9 @ 2:45 PM

unless she plans on marrying a relative, is screening potential spouse really necessary for this rare gene? ------------------------------ Roger...

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RE: NUP133 Mutation Thursday, October 8 @ 11:58 PM

@Edgard Wehbethanks , we have a few nutcracker girls, but almost all have either painless or painful hematuria...they have mild proteinuria but thi...

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RE: NUP133 Mutation Thursday, October 8 @ 8:59 PM

When you mentioned that the patient was skinny, it reminded me of a young patient we saw a few weeks ago for proteinuria. The workup revealed ortho...

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RE: NUP133 Mutation Thursday, October 8 @ 6:56 PM

Thanks! Agree, current data do not support an effect of single heterozygous variants in recessive genes to contribute to nephrotic syndrome/FSGS. S...

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RE: NUP133 Mutation Thursday, October 8 @ 6:03 PM

As an asymptomatic unaffected carrier of an autosomal recessive gene, she may want to have potential mates tested, but for now simple reassurance s...

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RE: Hypokalemia in Pregnancy Thursday, October 8 @ 4:31 PM

The ABG on the evening of October 1 are consistent with a normal term pregnancy. (Chronic respiratory alkalosis ). The serum creatinine and serum K...

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RE: NUP133 Mutation Thursday, October 8 @ 3:33 PM

Given the autosomal recessive inheritance the etherozygous pathogenic or likely pathogenic variant should make her a carrier and she should not dev...

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NUP133 Mutation Thursday, October 8 @ 1:43 PM

Am following a 19 year old college girl who came to me for review of her proteinuria She has been complaining of occasional bubble in the urine ...

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A Special ASN Kidney Week 2026 Event for Fellows: Immigration Journeys, Career Success Stories, and Networking Thursday, October 8 @ 1:27 PM

Hi all, Do you have questions about navigating the US immigration system while building a career in nephrology? There is an amazing opportunity a...

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RE: Hypokalemia in Pregnancy Thursday, October 8 @ 1:04 PM

Was there a history of diarrhea? A metabolic acidosis makes it more like a distal RTA and unlikely to be Gitelman or Gellery syndrome. I think a GI...

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RE: Hypokalemia in Pregnancy Thursday, October 8 @ 12:42 PM

I am gravitating to a mitochondriopathy precipitated by the metabolic stress of her pregnancy & febrile illness (all would also contribute to her e...

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RE: Hypokalemia in Pregnancy Thursday, October 8 @ 12:41 PM

The RTA and AKI would seem to make a Gitelman or Geller syndrome unlikely. I do not disagree with genetic testing (I seldom am) but this clinical e...

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RE: Hypokalemia in Pregnancy Thursday, October 8 @ 11:36 AM

I doubt a singe dose of gent did anything but she may have Gitelman, often symptomatic until pregnancy. is Genetic testing available? Is her BP o...

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Hypokalemia in Pregnancy Thursday, October 8 @ 7:00 AM

Dear All Good day hoping you are doing well, I'm seeking your input in this case, please A 33-year-old woman, gravida 1 para 0, at 39+4 weeks...

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RE: Would you Re biopsy this IgA? Thursday, October 8 @ 2:59 AM

Unfortunately, at present there are no non-invasive tests that will confidently exclude or include IgAN in the diagnose. . . --------------------...

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RE: Would you Re biopsy this IgA? Wednesday, October 7 @ 8:21 PM

Dr. Venkat, I think you are right, for completeness sake serology is easy to get, if all negative even more reason not to biopsy. I'll add. Thank y...

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RE: Would you Re biopsy this IgA? Wednesday, October 7 @ 8:15 PM

Dr. Kaur: My suggestion to obtain serological tests was based on non-availability of the kidney biopsy report from the past. While it may not be ab...

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