RE: Renal thrombotic microangiopathy 15 minutes ago

May be consider situximab if not tried --------------------------------- Bajinder Reen MD Etobicoke ON (905) 453-0821 --------------------------...

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RE: Renal thrombotic microangiopathy 17 minutes ago

If it was atypical Tafro May be you are removing VEGF which may be elevated in Tafro @Bill Whittier had one patient with VEGf (if man get pregnant....

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RE: Renal thrombotic microangiopathy 1 hour ago

Dear community, I would like to provide a follow-up on this patient. With ongoing plasmapheresis, the patient maintains normal kidney function, w...

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RE: Hyponatremia 3 hours ago

One of the possibilities could be the piperacillin tazobactam. Preparation in 10 ml dilution will give you an osmolality of 1278 most/kg and, if gi...

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RE: C3G- pre and post Pegcetacoplan 4 hours ago

Can you post the genetic report of this patient? Out of curiosity, not that this is going to change the management but would like to see what copy ...

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RE: Hyponatremia 9 hours ago

Although it cannot explain the isotonic hyponatremia in this patient, since she is on IV furosemide + PO metolazone, need to know if she has become...

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RE: Hyponatremia 12 hours ago

I must assume that an AGMA was excluded in thus case but this should be documented by laboratory results. ------------------------------ Richard...

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RE: Hyponatremia 12 hours ago

is there any high anion gap acidosis? any reason to think of ketoacidosis or d-lactic acidosis? this can increase the unmeasured osmoles. ------...

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RE: C3G- pre and post Pegcetacoplan 13 hours ago

Thinking generically (and very simplistically), with progressively decreasing GFR in chronic GN, the balance between the following factors may affe...

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RE: renal limited microangiopathy 16 hours ago

No they did not report factor H antibody. they just reported antigen ------------------------------ Swathi Pullela DO KDMS Nephrology & Hypertens...

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RE: case of IG A Nephropathy 17 hours ago

Thank you Dr Glassock and Dr venkat for your input/ advice Immunoflirocence was negative for IG G and complement ! Her BMI has been 31-32 BP was...

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RE: Hyponatremia 17 hours ago

But where is the hypotonicity . That is the issue here. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 -...

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RE: Hyponatremia 18 hours ago

Diuretic-induced hypotonic hyponatremia --------------------------------- Abed Elhakam El-Lababneh MD Undergraduate student Al-Yarmouk Universit...

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RE: Hyponatremia 19 hours ago

Is it possible that the increased Osmolal Gap is the consequence of unmeasured osmoles accumulating in CKD? Just curious, as tge Osmolal Gap tends ...

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RE: Hyponatremia 22 hours ago

I think the VBG rules out pseudohypoNatremia this is not Hyperosmolar hyponatremia (glucose and mannitol) i doubt this is possible but dod you ...

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RE: C3G- pre and post Pegcetacoplan 23 hours ago

Dr. Dastoor- thanks for this post. A careful reading of the NEJM paper of Pegcetacoplan in C3GN (Fakhouri F, et al 2025) discloses that this kind o...

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C3G- pre and post Pegcetacoplan 1 day ago

This is a case of a 19 year old boy from India . He was found to have sudden onset of proteinuria around 18 months ago His serologocal workup , i...

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Hyponatremia 1 day ago

57 year old lady admitted with Right sided heart failure , Pul Htn, hx of CAD , ascites and CKD with baseline creatinine of around 2 mg /dl She w...

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RE: case of IG A Nephropathy 1 day ago

In my opinion , the IgA deposits seen in many healthy living donors (typically without IgG or C3 deposits) should not be regarded as "igANephropath...

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RE: case of IG A Nephropathy 1 day ago

Maybe- but if IgG and C3 are absent it looks more like the pattern seen in healthy living transplant donors . Could be just aggregated gdIgA withou...

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RE: NBLU 2026 1 day ago

Thanks Dr. Aliano. The ASN is supporting NBLU again this year with travel support for attendees. Fellows receive $350 in travel support, though ...

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RE: case of IG A Nephropathy 1 day ago

Immunofluorescence: kappa 1+. lamdba 2+; EM: sparse mesangial electron dense deposit Dr. Glassock: I realize that the lambda > kappa IgA and mesa...

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RE: case of IG A Nephropathy 1 day ago

Addendum- as Dr. Venkat suggests it would be very important to know the biopsy findings of the earlier episode of Vasculitis- did it show an IgA va...

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RE: Collapsing Glomerulopathy in a Kidney Transplant Recipient 1 day ago

dr. Venkat. Thanks for the follow up on your very informative case of Collapsing Nephropathy in a kidney transplant., --------------------------...

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RE: case of IG A Nephropathy 1 day ago

I fundamentally agree with Dr.Venkat that this patient is manifesting the adverse effects of maladaptive glomerular capillary hypertension stemming...

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RE: case of IG A Nephropathy 1 day ago

Glomeruomegaly, normal SAlb level and mild podocyte effacement: suggest secondary FSGS caused by scarring/nephron loss/hyperfiltration from healing...

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NBLU 2026 1 day ago

Hi everyone, Wanted to share an informational flyer about the NBLU (Nephrology Business Leadership University) conference which is happening late...

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RE: case of IG A Nephropathy 1 day ago

Was C3 and IgG negative on IF. If so this might be incidental lanthanic IgA deposition and the proteinuria is the resukt of maladaption from the pr...

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RE: case of IG A Nephropathy 1 day ago

additional record hx of depression hx of goitre meds lisinopril 40 mg daily spironolactone 25 mg bid amlodipine 10 mg daily for htn most tecen...

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case of IG A Nephropathy 1 day ago

Dear faculty I would appreciate your input regarding my patient with iG a nephropathy 29 year old white woman had ANCA GN , GPA diagnosed at age...

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RE: FSGS conundrum 1 day ago

Good Points Dr Raducu.- Pateints as you describe are exceptional but they exist and are not detected by therapeutic trials of potentially effecti...

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RE: Collapsing Glomerulopathy in a Kidney Transplant Recipient 1 day ago

Further update on this patient: In my last update (posted 1.10.26), I had reported that this patient (recipient of a DCD deceased donor kidney tran...

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RE: FSGS conundrum 1 day ago

how long to wait until we can call that Rituximab does not work and we need to try something different ? I personally had 2 cases with primary FS...

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RE: Cystatin eGFR/Cr. eGFR =0.39 1 day ago

As a biomarker of risk for CVD and other adverse events "eGFR -Cystatin C " may be superior to "eGFR-creatinine" but this advantage more likely tha...

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RE: Cystatin eGFR/Cr. eGFR =0.39 2 days ago

Thank you, got it ------------------------------ Prem Chandran MD Adj Clinical Professor, Univ of Iowa Associates In Kidney Care, PLC Des Moines ...

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RE: Cystatin eGFR/Cr. eGFR =0.39 2 days ago

Let me try again.. ------------------------------ Bhupinder Singh MD, FASN Chief Medical Officer Paradise Valley AZ -----------------------------...

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RE: Cystatin eGFR/Cr. eGFR =0.39 2 days ago

Dr Singh: I am missing the attached reference you alluded to from Leslie Inker. Thanks.... ------------------------------ Prem Chandran MD Adj Cl...

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RE: Membranous Nephropathy with Rapid Progression 2 days ago

How long has he been dialysis-dependent with stable urine output of ~ 1.0 L/day and pre-dialysis SCr levels now? Obviously, longer this period: ...

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RE: Membranous Nephropathy with Rapid Progression 2 days ago

Not much clinical suggestion of that. Patient has improved with anti biotics and diuresis. Albeit renal recovery has not yet occurred, and remains ...

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RE: renal limited microangiopathy 2 days ago

The normal serum C3 levels make anti-Factor H antibody Disease less likely but does not rule out this diagnosis, but the normal serum AP activity m...

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RE: renal limited microangiopathy 2 days ago

Did they report factor H antibody --------------------------------- Shahzad Safdar MD Mt. Auburn Nephrology, Inc. Cincinnati OH (513) 841-0222...

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RE: Cystatin eGFR/Cr. eGFR =0.39 2 days ago

Interesting novel data. This kind of eGFR approach may eventually find a niche in clinical trials or practice. For the time being , I prefer a meas...

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RE: Cystatin eGFR/Cr. eGFR =0.39 2 days ago

Thank you all for an interesting discussion and I hope that the referenced patient is doing well. We recently initiated a clinical trial in CKD/met...

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RE: renal limited microangiopathy 3 days ago

No they do not-in my opinion. The C-activation may be occurring only at tissue sites or only intermittently The laboratory features asses C activat...

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RE: Cystatin eGFR/Cr. eGFR =0.39 3 days ago

Just curious, from what is known about this patient , other than weight loss, would anyone start RASi , with or without SGLT2i, a MRA, hypouricemic...

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RE: Cystatin eGFR/Cr. eGFR =0.39 3 days ago

Cystatin-C has more problems than creatinine. It is inducible gene and the bulk of the tissue producing it vary. Drugs and disease process can affe...

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RE: renal limited microangiopathy 3 days ago

yes, I have ordered the genetic panel but does the complement panel rule out complement mediated aHUS ------------------------------ Swathi Pulle...

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RE: Membranous Nephropathy with Rapid Progression 3 days ago

Is there alveolar hemorrhage? ------------------------------ Ashraf El-Meanawy , MD, MS, PHD, FASN Professor of Medicine Director of Dialysis Med...

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RE: Membranous Nephropathy with Rapid Progression Friday, March 6 @ 12:19 PM

More than half of the patients with ANCA negative crescentic GN superimposed on MN (PLA2R positive or negative ) fail to respond to immunosuppressi...

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RE: Membranous Nephropathy with Rapid Progression Friday, March 6 @ 10:07 AM

Creatinine seems to be between 7 and 8 and he continues to have UOP Of around 1L still. Renal Doppler is normal and PLA2R is awaited. -----------...

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