RE: Lupus planning pregnancy, now with low C3/C4. 28 minutes ago

would think of patient as whole . If kidney biopsy is negative for LN but complement have gone done ds dna up and extra renal manifestation of lupu...

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RE: Lupus planning pregnancy, now with low C3/C4. 50 minutes ago

I would be interested to know your thoughts on advising her if she undergo a kidney biopsy and that was negative for LN? Would you recommend that s...

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3rd Generation Gadolinium Use In Pt With CKD IV/V 51 minutes ago

Dear colleagues I have a pt with progressive diabetic CKD IV/V, baseline cr 3.2-3.5, gfr 14-16, proteinuric Head ct scan showed left parietal lobe...

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RE: Lupus planning pregnancy, now with low C3/C4. 3 hours ago

i think if she proceeds with pregnancy-you must monitor UPC, SEDIMENT, RENAL FUNCTION(CREATININE) OFTEN AT LEAST EVERY 2 WEEKS. could add CNI ,cont...

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Apply to Participate in the ASN FIT Bowl at Kidney Week 2026 7 hours ago

Hi All, Test your knowledge against your peers! Win ultimate bragging rights at Kidney Week! Join the American Society of Nephrology (ASN) F...

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Encourage Your Fellows to Participate in the FIT Bowl at Kidney Week 2026 7 hours ago

Encourage your fellows to join the American Society of Nephrology (ASN) Fellows-in-Training (FIT) Bowl at Kidney Week 2026 in Denver, CO. This year...

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RE: Colleague Managing Home Hd Cohort 20 hours ago

Thanks a lot --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: anti gbm serology postive with fever and raised inflammatory markers 21 hours ago

Thanks prof lerman will definitely post as soon as available Best wishes --------------------------------- Muhammad Soobadar MBChB UK ---------...

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RE: Lupus planning pregnancy, now with low C3/C4. 21 hours ago

7( continue to try pregnancy ) --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Lupus planning pregnancy, now with low C3/C4. 21 hours ago

Interested with what you would do 1You would go back to mmf and steroids ? 2 mmf and steroids / do a biopsy and if class IV add obi 3 mmf and ster...

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RE: pr3 +ve is it endocarditis ? 21 hours ago

Creatinine roughly 1.10 in your neighbourhood 👍🏼 --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------...

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RE: anti gbm serology postive with fever and raised inflammatory markers 21 hours ago

Dr. Soobadar-thanks-renal biopsy hopefully will clarify if ARF is reversible - please share results ------------------------------ [Mark] [Lerman...

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RE: pr3 +ve is it endocarditis ? 22 hours ago

-TOE Result today . Challenging case for T-TEER. Although the TR originates from a favourable location, the imaging windows are compromised due to ...

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RE: anti gbm serology postive with fever and raised inflammatory markers 22 hours ago

@ Prof lermann thank really helpful . patient had methy pred , biopsy pm and dialysis and tomorrrow plex anuric since coming to renal ward. ...

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RE: Lupus planning pregnancy, now with low C3/C4. 23 hours ago

Agree you are playing with fire, The bigger issue is how DO you get her into remission tat will last longer that she can get through pregnancy. ...

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RE: anti gbm serology postive with fever and raised inflammatory markers 1 day ago

Initially oliguric, now anuric. Any urinalyses available from either the peripheral hospital or your institution? Blood culture positive for coag...

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RE: Lupus planning pregnancy, now with low C3/C4. 1 day ago

I too strongly feel this lady is likely to have adverse pregnancy outcomes due to worsening immunological activity which may predate a clinical rel...

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RE: anti gbm serology postive with fever and raised inflammatory markers 1 day ago

Looking at this from the other side, how confident are you in the diagnosis of urinary tract infection? Your positive culture was for CONS which is...

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Applications for ASN ITE Committee Now Open 1 day ago

Dear Kidney Educators, Thank you for your continued commitment to training in nephrology. The American Society of Nephrology (ASN) In-Training Ex...

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RE: Lupus planning pregnancy, now with low C3/C4. 1 day ago

I asked my AI colleague (Claude) to opine on this case. He agreed that with the history of ClassIV LN and the the recent changes in serology implyi...

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RE: Lupus planning pregnancy, now with low C3/C4. 1 day ago

YES, uncommon but anyone who sees cases of LN frequently can remember a case or two. If she becomes pregnant it will be difficult but a successful ...

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RE: anti gbm serology postive with fever and raised inflammatory markers 1 day ago

probably not as its immunosuppression which increases risk with serious infection. Plex is not indicated in simultaneously dialysis-dependent at pr...

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RE: anti gbm serology postive with fever and raised inflammatory markers 1 day ago

Thanks both Guess kidney biopsy will help us here . Is there harm to plasma exchange if this turned out to be infection related ? And if harm in ...

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RE: anti gbm serology postive with fever and raised inflammatory markers 1 day ago

All renal screen negative . Cryoglobulin not sent ( complement normal ) Virology negative Methyl pred - biopsy and if delay for results start ple...

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RE: anti gbm serology postive with fever and raised inflammatory markers 1 day ago

Dr. Lerman is correct bacterial sepsis, including urosepsis, can cause anti-GBM formation and possibly to glomerular disease. Rare, but I have seen...

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RE: anti gbm serology postive with fever and raised inflammatory markers 1 day ago

AGREE WITH PLAN- but would repeat and confirm the anti-GBM titre on a fresh sample in a reference lab, and send MPO/PR3-ANCA, ANA, complements C3/C...

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RE: Lupus planning pregnancy, now with low C3/C4. 1 day ago

This patient needs triple therapy for active LN and should avoid pregnancy. Contraceptives are indicated. ------------------------------ Richard ...

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RE: Latent TB and Membranous Nephropathy 1 day ago

thanks prog glassock will bring it as paper in journal club for discussion hopefully can change practice. ------------------------------ Muham...

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RE: anti gbm serology postive with fever and raised inflammatory markers 1 day ago

and if biopsy result delayed will start plex and wait for biopsy result to come back . does that sound ok? @prof glassock your input valued ---...

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anti gbm serology postive with fever and raised inflammatory markers 1 day ago

74 m bg HTN and usually fit and well baseline egfr 56 m/min Admitted inextremis with aki 3, oliguria , hyperkalaemia ,acidosis and raised inflamm...

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ASN FIT Bowl 1 day ago

We have 3/4 fellows from Harbor-UCLA hoping to participate in the FIT Bowl at ASN this year, we are looking for one more fellow to join so we can f...

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Lupus planning pregnancy, now with low C3/C4. 2 days ago

30 year old significant for Hypothyroidism, SLE with history dating back to 2015 ,Renal Biopsy done with results of lupus nephritis classs III and ...

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RE: PLA2R negative Membranous Nephropathy- Management Q 2 days ago

Thanks. Good discussion. The current FDA endorsed pivotal Phase 3 Trial of Felzartamab in MN uses CNI as a comparative arm , not OBI so it will not...

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RE: PLA2R negative Membranous Nephropathy- Management Q 2 days ago

@Richard Glassock: Is there more information that you are aware off about the Trillini cohort. Few things are missing for me to make heads or tails...

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RE: PLA2R negative Membranous Nephropathy- Management Q 2 days ago

Trial of Felzartamab against Obinutuzumab has to be designed with non-inferiority endpoint. Companied do not like to conduct such trials. A double ...

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RE: Anti-PLA2R antibody +ve MN on a background of malignancy 3 days ago

Thanks Dr. Lambeau for these fresh and important insight into the connection between PLA2R and Cancer!! ------------------------------ Richard Gl...

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RE: Latent TB and Membranous Nephropathy 3 days ago

In the MENTOR trial of RTX vs CsA NEJM) infectious complications were twice as frequent with CsA. My AI consultant (Claude) stTes very clearly that...

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RE: Latent TB and Membranous Nephropathy 3 days ago

Thanks dr dastoor for learning experience and sharing your experience @ prof glassock thanks for learning experience Can I ask if there is paper...

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RE: Anti-PLA2R antibody +ve MN on a background of malignancy 3 days ago

I would suspect a link between MPN and PLA2R1-MN. PLA2R1 has been proposed as a tumor suppressor gene, and is involved in various types of cancer, ...

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RE: PLA2R negative Membranous Nephropathy- Management Q Saturday, August 1 @ 1:32 PM

This discussion may be moot- as Felzartamab has no benefits in RTX resistant MN- see Trillini et al KI Reports, 2026 ---------------------------...

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RE: Anti-PLA2R antibody +ve MN on a background of malignancy Saturday, August 1 @ 10:54 AM

I think this is a very reasonable approach, considering the clinical circumstances. Good luck. ------------------------------ Richard Glassock ...

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RE: PLA2R negative Membranous Nephropathy- Management Q Saturday, August 1 @ 7:28 AM

We do not use CNI for membranous, at least I don't . However at the ERA 2026 , when the Obi trial was presented , the first and main question that ...

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RE: PLA2R negative Membranous Nephropathy- Management Q Saturday, August 1 @ 6:01 AM

I see-it is all about access, not comparative efficacy and safety.. Do you really think that CNI are safe and effective for MN in an era of biologi...

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RE: Anti-PLA2R antibody +ve MN on a background of malignancy Saturday, August 1 @ 5:27 AM

Dear colleagues, As per the previous discussion, and after reading the article Dr.Rodby suggested, I repeated his anti-PLA2-R level, and decided...

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RE: PLA2R negative Membranous Nephropathy- Management Q Saturday, August 1 @ 2:23 AM

I agree but the Obi trial should have also been compared to Rituximab. I think it was compared to CNI for 2 reasons 1. Rituximab is not FDA appro...

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RE: PLA2R negative Membranous Nephropathy- Management Q Saturday, August 1 @ 12:07 AM

How can such a trial of Felzartamab show superiority to OBI-assuming that OBI is approved by the FDA for therapy of MN as a consequence of the MAJE...

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RE: PLA2R negative Membranous Nephropathy- Management Q Friday, July 31 @ 11:28 PM

@Richard Glassock could you elaborate why Felzartamab would be a meaningless approval , if OBI was also compared to a CNI. ----------------------...

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RE: PLA2R negative Membranous Nephropathy- Management Q Friday, July 31 @ 6:55 PM

In my opinion, CNIs (Tacrolimus or Cyclosporin + or - low dose steroids ) are no longer considered a standard of care for treatment of MN. If one a...

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RE: PLA2R negative Membranous Nephropathy- Management Q Friday, July 31 @ 5:37 PM

Thank you, have put in for Obi prior Auth. Have a great weekend. ------------------------------ T. Kaur, MD FACP Nephrologist/HTN/Kidney Stones ...

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RE: PLA2R negative Membranous Nephropathy- Management Q Friday, July 31 @ 4:57 PM

Will Felzartamab gain approval for MN from FDA by comparison to a CNI ?. If so . the approval will be meaningless. The comparator will have to be O...

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