RE: Management of persistent amyloidosis and nephrotic range proteinuria despite Very good partial response to BMT and prior chemo 27 minutes ago

Renal function has been maintained. Normal creatinine at 0.6-0.8 mg/dl Sent from my iPhone

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RE: Pauci-Immune GN, Chronic, Minimally Active 58 minutes ago

With hematuria (any acanthocytes or red cell casts) , proteinuria, declining kidney function, positive Anti-MPO ANCA and a barely adequate kidney b...

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RE: Management of persistent amyloidosis and nephrotic range proteinuria despite Very good partial response to BMT and prior chemo 1 hour ago

Dr. Leung - no meaningful response of proteinuria after a good but incomplete hematological remission. Does this mean that that the chronic damage ...

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Pauci-Immune GN, Chronic, Minimally Active 2 hours ago

53 yr lady, Multiple Sclerosis not on any active therapy, Ca Breast diagnosed in 2012, had lumpectomy had chemotherapy with Adriamycin/Cyclophospha...

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RE: Management of persistent amyloidosis and nephrotic range proteinuria despite Very good partial response to BMT and prior chemo 2 hours ago

I don't see any meaningful response. What is the creatinine doing? ------------------------------ Nelson Leung MD Mayo Clinic Rochester MN (507) ...

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intra-operative CRRT 4 hours ago

wondering if colleagues who practice in liver transplant centers can comment on use of intraop CRRT during liver transplant -are you doing that r...

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RE: Membranous nephropathy 6 hours ago

Very good point Dr. Venkat , unless the Anti-PLA2R antibody by ELISA is a false positive, which can occur uncommonly in patients with T2DM. Doing a...

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RE: Pseudohypertension or true uncontrolled HTN 7 hours ago

Very interesting and astute observation Dr. Aledan. Many thanks. But if I understand the phenomenon correctly, an "auscultatory gap" if present wou...

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RE: Pseudohypertension or true uncontrolled HTN 8 hours ago

@Hayder Aledan I did not look for an auscultatory gap in this patient (was not even thinking about it till I read more on arterial stiffness) To ...

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RE: Membranous nephropathy 8 hours ago

I get the impression that Drs. Glassock and Rodby will treat with rituximab/obintuzumab regardless of degree of chronicity on biopsy because PLA2R-...

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RE: Managing severe hypertension in outpatient settings 12 hours ago

I would not send to the ER and try to confirm HTN with HBPM or ABPM. Review mediations such as NSAIDs, stimulants, alcohol and asking for any pain...

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RE: Pseudohypertension or true uncontrolled HTN 12 hours ago

Any big auscultatory gap is present? --------------------------------- Hayder Aledan MD, FASN Professor Basra Nephrology and Transplantation Cente...

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RE: Membranous nephropathy 12 hours ago

I agree with Dr. Rodby, except that I would prefer to do a kidney biopsy. This is a matter of clinical judgement and expert opinions can differ. No...

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RE: ANA-Negative Lupus Nephritis with ANCA Positivity 12 hours ago

Very nice response, Dr. Aledan. Many thanks, for sharing your clinical reasoning.. There are 5 histological criteria for diagnosing LN on a kidney ...

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RE: Membranous nephropathy 13 hours ago

In adults with nephrotic syndrome, positive PLA2R antibodies, preserved eGFR (≥60 ml/min/1.73 m²) and no secondary cause, several cohorts show that...

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RE: ANA-Negative Lupus Nephritis with ANCA Positivity 14 hours ago

1. Can this be lupus nephritis with negative ANA/anti‑dsDNA? Yes, we see cases of seronegative PN especially class V and full house IF has high spe...

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RE: AAV ? 20 hours ago

Thank you for your questions. Unfortunately, we do not have access to electron microscopy in our center and DNAJB9 staining was not performed. The ...

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RE: AAV ? 23 hours ago

What does the EM show? Have you done a DNAJB9 stain? What is tihe serum Rheumatoid Factir level.? Any clinical features of scdroderms. ;( peri-ungu...

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RE: Membranous nephropathy 23 hours ago

Where is the evidence of "single nephron " hyperfiltration in this case? where are the RCT shoeing benefit of SGLT2i and NS-MRA on progressive loss...

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AAV ? 23 hours ago

Dear Colleagues, I would like to seek your expert opinion regarding the case of a 66-year-old female patient currently under our care. She was admi...

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RE: Membranous nephropathy 23 hours ago

Thanks to all of your advice. I am planning to treat him with obi if we can get if for him. It will be the first time I have used it. My experience...

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RE: Membranous nephropathy 23 hours ago

I suppose he may not have sub epithelial deposits but I doubt it, and he may have diabetic changes as well, but with that PLA2R I would feel comfor...

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RE: Management of persistent amyloidosis and nephrotic range proteinuria despite Very good partial response to BMT and prior chemo 23 hours ago

Thank you Dr.Leung and all ASN team Following was her proteinuria/Albuminuria trend Date of BMT was 3/2023 24-hour urine protein in reverse ...

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RE: Membranous nephropathy 1 day ago

Dr Glassock, if obesity and associated hyperfiltration caused by it are contributive to proteinuria in this case, wouldn't SGLT2i and NSMRA be help...

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RE: Membranous nephropathy 1 day ago

Thanks for case his proteinuria is < 3 g Ns normal albumin Thanks prof glassock Can we rule out malignancy/ renal vein thrombus and virology ( l...

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ANA-Negative Lupus Nephritis with ANCA Positivity 1 day ago

Dear Colleagues, I would like to seek your expert opinion regarding the case of a 66-year-old female patient currently under our care. She was admi...

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RE: Membranous nephropathy 1 day ago

Based on the recommendations of Dr. Fervenza and colleagues a repeat kidney biopsy would be reasonable in this case with an eGFR of [More]

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RE: Management of persistent amyloidosis and nephrotic range proteinuria despite Very good partial response to BMT and prior chemo 1 day ago

To interpret the response, we will need the proteinuria and creatinine at baseline and the proteinuria and creatinine now. After a deep hematologic...

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RE: Pseudohypertension or true uncontrolled HTN 1 day ago

No COI. But I recommend an evaluation using the CONNEQT device for this patient and any other patient with isolated Systolic Hypertension and a pos...

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RE: Should I continue treatment 1 day ago

Based on the slight increase in anti-GBM antibody I might continue PLEX q. o.d for a while longer. ------------------------------ Richard Glassoc...

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RE: Pseudohypertension or true uncontrolled HTN 1 day ago

I looked up the CONNEQT device; it has a blood pressure cuff. My personal research experience with these systems that non-invasively derive central...

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RE: Should I continue treatment 1 day ago

anti GBM antibody levels 2/17 5.9 AI 2/20 1.7 2/21 2.6 2/22 2.2 2/23 3.9 remarkably stable so far. ID following splenectomy vaccination...

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RE: IgAN With Crescents 2 days ago

MRI /genetic panel pending insurance authorization Dr.Glassock --------------------------------- Pooja Tanjavour MD Rch Cucamonga CA (909) 631-...

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Membranous nephropathy 2 days ago

I recently saw a 56-year-old African-American patient in my clinic in consultation. He has a 20-year history of membranous nephropathy having been ...

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RE: Diagnostic dilemma/ LCAT??? 2 days ago

Many thanks Dr. Schwartz. Rare disease with not much available for therapy. Prognosis very poor. ------------------------------ Richard Glassock...

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RE: IgAN With Crescents 2 days ago

I still do not understand the complicating liver disease- is it Hemachromatosis or not. ? I think you have to treat the presemed crescentic IgAN wi...

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RE: IgAN With Crescents 2 days ago

Hello all This patient complained of blurry vision after taking 1 week of cellcept . Cellcept discontinued. Steroids dose reduced . Ophthalmology...

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RE: Should I continue treatment 2 days ago

remains positive after several treatments. ------------------------------ Robert Hillyer MD Metropolitan Nephrologists Grosse Pointe Park MI (58...

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RE: Should I continue treatment 2 days ago

I was informed by Nephropath that digestion of paraffin block often obliterates the antiGBM antibodies on the specimens. Serum was positive for ant...

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RE: Should I continue treatment 2 days ago

I agree with Dr. Rodby. I do not know what to make of the lack of linear IgG on Pronase digested IHC of paraffin embedded specimens, if indeed Pron...

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RE: Should I continue treatment 2 days ago

I will assume double positive ANCA antiGBM related crescentic GN. But from paraffin block there was no linear IgG associated with the crescents? ...

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Should I continue treatment 2 days ago

Patient is an 79 year old female with history of moderate obesity, DM type II, and hypertension. No previous renal disease. creatinine 1.1 June 202...

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RE: thrombocytopenia 2 days ago

PD may be a good alternative --------------------------------- Dr. Hormaz Dastoor. MD, MSc, FASN Divisional Head of Nephrology Sheikh Shakhbout ...

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RE: thrombocytopenia 2 days ago

Any unusual clotting observed, such as in dialyzer?Thus might be HIT..Can your measure anti%-PF 4 antibodies?. Azswithch to a nin-heparin anticoagu...

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RE: Managing severe hypertension in outpatient settings 2 days ago

Thank you so much Dr. Rodby and Dr. Glassock for your feedback. Appreciate it. I agree, it's a dilemma to decide whether an asymptomatic patient wi...

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RE: Newly Diagnosed Anca Vascultis 2 days ago

Classical APSGN does not require continued infection for development of disease. Treatment of the infection has a minimal effect on severity of dis...

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RE: thrombocytopenia 2 days ago

Any procedures or formal clotting time measurements that can give you some idea about how well he clots? ------------------------------ K.K. Venk...

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RE: Diagnostic dilemma/ LCAT??? 2 days ago

Here are four papers (original - old - new - newest) on LCAT deficiency and the kidney. ------------------------------ John Schwartz MD Dall...

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RE: thrombocytopenia 2 days ago

Thrombocytopenia can be an immune side effect of polysulfone membranes. If you haven't done so, maybe change to a cellulose triacetate dialyzer and...

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RE: Refractory membranous Nephropathy 2 days ago

Thanks dr dastoor . Keep us updated It’s great opportunity for me to learn with you in this complex case with expert guidance of prof glassock and...

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