RE: Intersting case-Need your opinion 13 minutes ago

In addition to the CH 50 level, which should be low, you can actually send Eculizumab trough levels to Cincinnati Children's Hospital. 99 µg/...

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RE: Intersting case-Need your opinion 2 hours ago

Thank you Dr Glassock. Your clarification much appreciated in this area of secondary aHUS as you precisely stated... ----------------------------...

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RE: IgAN case 3 hours ago

In small short term studies from China HCQ lowers proteinuria but its long term effects on GFR are unknown. Combination therapy with modern approve...

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RE: Intersting case-Need your opinion 3 hours ago

Dr. Chandran- my apologies for not having responded to your excellent question in May, within this thread . I must have mussed it. My comment was m...

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RE: IgAN case 3 hours ago

Would you please share with us more details about the repeat biopsy results, persistent or worsening heavy proteinuria in the nephrotic range, whic...

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RE: IgAN case 3 hours ago

I don't believe she is in the resolving phase, especially considering she had nephrotic-range proteinuria. Persistent hematuria, along with stable ...

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RE: IgAN case 3 hours ago

would use low dose steroids and MMF 1.5 gms daily. Dr. Glassock what do you think about adding HCQ ? doi: 10.3389/fimmu.2026.1783946 ------...

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RE: IgAN case 3 hours ago

I would start MMF right now. Just an opinion. ------------------------------ Richard Glassock MD, FASN Emeritus Professor Geffen School of Medici...

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RE: IgAN case 3 hours ago

If the patient is not obese, then SGLT2i therapy may not needed. ------------------------------ Richard Glassock MD, FASN Emeritus Professor Geff...

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RE: IgAN case 4 hours ago

Yes, I'm very concerned of her current condition. My goal is to subside this acute flare (seems to be in the resolving phase) and eventually preser...

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RE: IgAN case 4 hours ago

Thank you professor Glassock. You prefer a moderate dose of steroid. When would you start MMF? ------------------------------ Tuan Nguyen DO AN M...

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RE: Steroid-refractory seronegative demyelinating encephalitis in a kidney transplant recipient 4 hours ago

Avoiding an mTOR inhibitor as first choice given her nephrotic-range proteinuria and advanced IFTA, where it is likely to worsen proteinuria and be...

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RE: Steroid-refractory seronegative demyelinating encephalitis in a kidney transplant recipient 4 hours ago

2019 txp biopsy showed - cni toxicity Renal Allograft, core biopsy (diagnosis based on light microscopy only): - Negative for acute rejection. -...

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RE: Colleague Managing Home Hd Cohort 5 hours ago

"Is there a preferred needling technique" : depends on your nursing personnel who trained the patient. There are several differences between center...

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RE: Intersting case-Need your opinion 6 hours ago

Jagdeesh: The reason I asked about which lab did the assay is that C5b-9 is notoriously difficult an assay to do & standardize. The serum collectio...

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RE: Dapagliflozin In Hd Patient With Diastolic Dysfunction 6 hours ago

@ dr Dastoor Thanks I used dapa in kidney clinic ( practice of unit ) Cardiology also mentioned dapa and finenorone but not great evidence based ...

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RE: Intersting case-Need your opinion 6 hours ago

Has the genetic study reported any C5 variants that cause unresponsiveness to eculizumab? That could be a factor here too. There is persistent hemo...

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RE: CAKUT, pediatric neph input 7 hours ago

@Guido Filler - what about hepatomegaly ? ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KPCOP EC [Past Medical Director ...

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RE: CAKUT, pediatric neph input 7 hours ago

Dear Varsha, This is an interesting presentation. I suspect that the small right kidney explains his reduced GFR and perhaps some of the proteinuri...

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RE: IgAN case 13 hours ago

Seems to be a very high risk patient . I would seriously consider pulse steroids , followed by Testing dose dose steroids and MMF. If no response...

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RE: Dapagliflozin In Hd Patient With Diastolic Dysfunction 13 hours ago

@Muhammad SoobadarI mentioned dapa , as there is some data on its safety in ESRD patients . In the case of Empa such data seems to be lacking . Hen...

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RE: Intersting case-Need your opinion 15 hours ago

Seems like the alternate pathway is still very active . You could consider Pegcetacoplan or Iptacopan. My personal choice is a C3 blocker , as it ...

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RE: Intersting case-Need your opinion 18 hours ago

Dear Prem, not sure what assay was used but the level reported was 264 ( 0-219 ng/ml) ------------------------------ Jagadeesh Kurtkoti MD, MBBS...

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RE: Intersting case-Need your opinion 18 hours ago

Dear Mark, LDH is a little high around 350 ( Normal 120-250), few fragments still seen on smear, very minimal Urine output and she is on dialysis...

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RE: Intersting case-Need your opinion 18 hours ago

Dear Dr Soobadar, we used standard dosing 900 weekly for 4 weeks and then 1200 fn. She is vaccinated ------------------------------ Jagadeesh Kur...

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RE: Intersting case-Need your opinion 18 hours ago

Dear Saja, all of that is negative. Thank you ------------------------------ Jagadeesh Kurtkoti MD, MBBS SOUTHPORT ------------------------------

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RE: Intersting case-Need your opinion 18 hours ago

Jagdeesh: Qstn: which lab did the C5B-9 assay? ------------------------------ Prem Chandran MD Adj Clinical Professor, Univ of Iowa Associates I...

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RE: secondary IgA Nephropathy 19 hours ago

How woukd Adulimumab antibodies explain the elevated Serum creatinine? ------------------------------ Richard Glassock MD, FASN Emeritus Professo...

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RE: Intersting case-Need your opinion 19 hours ago

The high C5b-9 levels suggest the Eculizumab is not very effective which could be due to protein loss - can you get drug levels ? Measure CH50 whic...

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RE: IgAN case 20 hours ago

Yes, and non-Chinese as well. ------------------------------ Richard Glassock MD, FASN Emeritus Professor Geffen School of Medicine at UCLA Lagu...

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RE: Dapagliflozin In Hd Patient With Diastolic Dysfunction 20 hours ago

The "beneficial" effects of SGLT2i are myocardial function not mediated by an interaction with SGLT2 receptors, as such receptors are not present i...

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RE: Dapagliflozin In Hd Patient With Diastolic Dysfunction 20 hours ago

First- do as much as you can to control volume excess with salt restriction and slow gradual ultrafiltration. if Symptomatic HFpEF , interfering wi...

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RE: Intersting case-Need your opinion 20 hours ago

I have further update on this case. She remains , unfortunately, dialysis dependant despite being on Eculizumab since mid May when she first presen...

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RE: IgAN case 20 hours ago

@ prof glassock is is true that mmf and steroids tend to work well for Chinese patients --------------------------------- Muhammad Soobadar MBCh...

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Colleague Managing Home Hd Cohort 21 hours ago

Did colleagues running home haemodialysis cohort ? Is there a preferred needling technique for the said cohort ? And what is personal experience o...

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RE: IgAN case 21 hours ago

VCyclophosphamide is not indicated in this patient. I would use oral systemic steroids in moderate doses (TESTING reduced dose protocol) , stop NEF...

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IgAN case 21 hours ago

Hello colleagues and experts, Please advise on this case: An early 20 y/o Chinese origin with no other medical history, diagnosed with IgAN Ox...

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RE: Dapagliflozin In Hd Patient With Diastolic Dysfunction 21 hours ago

Thanks prof Campese Bw --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Dapagliflozin In Hd Patient With Diastolic Dysfunction 21 hours ago

Several clinical trials have proven that SGLT2 ihibitors are beneficial in patients with HF. The benefit is attributed largely to indirect effects:...

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RE: Dapagliflozin In Hd Patient With Diastolic Dysfunction 23 hours ago

@ prof glassock what would you ? Should I discuss it with patient and If he want drug and I am using it off label what are the consequences of thi...

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RE: Dapagliflozin In Hd Patient With Diastolic Dysfunction 23 hours ago

I fully agree with Dr. Campese that clinical trials need to be under ptaken to further evaluate the rather impressive potential benefits of SGLT2i ...

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RE: Dapagliflozin In Hd Patient With Diastolic Dysfunction 1 day ago

I would tend to concur with Dr Campese. By what mechanism would a SGLT2-I work in an essentially anephric patient? Just wondering. --------------...

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RE: Dapagliflozin In Hd Patient With Diastolic Dysfunction 1 day ago

The study by Wu JY et al is a retrospective uncontrolled analysis of approximately 5,000 patients taking SGLUT 2 inhibitors and 183,000 not taking ...

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RE: secondary IgA Nephropathy 1 day ago

I will add my skepticism to all above. His renal function does not match the biopsy. Creatinine level is dependent on production and clearance, whi...

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Mayo Clinic GN Symposium Learning Opportunity for Nephrology Fellows 1 day ago

Dear Nephrology Fellow Community, Please take a look at this unique opportunity to delve into glomerular disease management in light of emerging ...

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RE: Dapagliflozin In Hd Patient With Diastolic Dysfunction 1 day ago

Thanks prof glassock @ dr dastoor I use dapa ( just practice based what i use ) What do you use ? --------------------------------- Muhammad So...

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Mayo Clinic GN Symposium Learning Opportunity for Clinicians at all Levels of Training 1 day ago

Dear Kidney Educator Community, Please take a look at this unique opportunity to delve into glomerular disease management in light of emerging di...

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RE: Painless macroscopic hematuria 1 day ago

Thank you. Will review it. ------------------------------ Mario Rubin, M.D. Houston TX (713) 252-5539 ------------------------------

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RE: CAKUT, pediatric neph input 1 day ago

"The patients main concern is the abdominal pain, and I did not have an answer for him. Could this congenital variant be related to his pain someho...

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RE: secondary IgA Nephropathy 1 day ago

His creatinine on March 26th was 2.45, June 2nd 2.22 and July 7th is 2.34. Feb 2026 Creatinine was 1.4. Feb 2025 creatinine was 1.2. --------...

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