RE: Elevated of B2-microglobulin in dialysis patients 1 hour ago

Dr. Rosales. Thanks for the additional information. As noted in comments in thus thread, on-line HDF is not widely available (yet) in the USA and i...

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RE: Hypomagnesemia 2 hours ago

Thanks Dr. Rodby. I’ll see if I can convince him on sglt2i I remember Josh Waitzman say in the “Channel your enthusiasm” podcast that he uses high...

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RE: Elevated of B2-microglobulin in dialysis patients 3 hours ago

Greetings to everyone. In response to Dr. Glassock and Dr. Rodby's comments about HDF... I think our clinical practice is not necessarily an ex...

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RE: Hypomagnesemia 4 hours ago

I assume he never received venetoclax (lymphoma) or cetuximab (head and neck, prostate, and bowel cancer) PPIS do it but they are off and that w...

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RE: Elevated of B2-microglobulin in dialysis patients 4 hours ago

This middle molecules are important v middle molecules (MM) are not important, HDF v HD argument has been going on for years. Franky I find it tire...

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Hypomagnesemia 5 hours ago

A 67 yr old male with type 2 diabetes developed cramping of his muscles and was found to have a low serum Magnesium of 1.0. He has had several low ...

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RE: Re: kidney biopsy findings in a young lady 7 hours ago

Proteinase K works as well as pronase. In the article on MPGN with masked monoclonal depositis. Mayo used pronase and Arkana (Nephropath at the tim...

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RE: Elevated of B2-microglobulin in dialysis patients 14 hours ago

Thanks. I agree. The Rosales experience in Chile seems to be an outlier, at least in respect to conventional HD, but maybe it needs more validation...

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RE: primary Membranous nephropathy and HBV infection 14 hours ago

In the absence of HBV infection I would treat such a patient without delay,, if Nephrotic Syndrome (NS) was present. With concomitant HBV, I do not...

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RE: Elevated of B2-microglobulin in dialysis patients 15 hours ago

B2M level is rarely measured in our practice. Kidney is not the only organ that clears B2M. I think we will be chasing our tail if it is used in al...

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RE: primary Membranous nephropathy and HBV infection 16 hours ago

Do you have any threshold of the PLA2R levels by ELISA above which you would recommend immunosuppressive therapy regardless of any other factor? fo...

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RE: Aspergillosis in resistant ANCA associated GN 18 hours ago

I think the initial treatment was effective, perhaps a bit too aggressive if anything, which leads me to suspect that this entire 'relapse' could b...

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RE: Steroid dependent FSGS with "tip lesion" 19 hours ago

Sparsentan has never been tested for this approach and is not approved by the FDA for this indication. The drug failed to meet its primary end poin...

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RE: Steroid dependent FSGS with "tip lesion" 20 hours ago

Is it worth trying Sparsentan to maintain remission after giving Rituximab and tapering Prednisone ? --------------------------------- Rochak Var...

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RE: PIGN with Nephrotic Syndrome case 22 hours ago

Prior serologies not available. But i did all of them recently and C3 and C4 not low anymore; SIFE with Faint free lambda light chain noted with no...

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RE: Elevated of B2-microglobulin in dialysis patients 23 hours ago

Dr. Rodby-are you aware of any dialysis center in the USA (of course primarily using conventional HD) that monitors Serum B2 microglobulin levels o...

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RE: Re: kidney biopsy findings in a young lady 23 hours ago

Thank you. I may elect to repeat the biopsy in that case considering her age and prospects of transplantation ------------------------------ [Sri...

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RE: Re: kidney biopsy findings in a young lady 23 hours ago

Thank you Dr Rodby ------------------------------ [Sriram] [Sriperumbuduri] [MBBS FASN] [Assistant Professor in Nephrology] [Virginia Commonwealt...

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RE: Re: kidney biopsy findings in a young lady 23 hours ago

Thank you Dr Fogo ------------------------------ [Sriram] [Sriperumbuduri] [MBBS FASN] [Assistant Professor in Nephrology] [Virginia Commonwealth...

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RE: PIGN with Nephrotic Syndrome case 23 hours ago

Low C3 and C4 makes this unlikely to be post-streptococcal GN. The therapy of infection-related GN is not steroids and RTX. What is his current C3 ...

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RE: Elevated of B2-microglobulin in dialysis patients 23 hours ago

Before the availability of high flux hemofilters we saw a sizable number of dialysis patients affected with carpal tunnel syndrome and sometimes bo...

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PIGN with Nephrotic Syndrome case 23 hours ago

I have a 70-year-old male with past medical history of HTN, DM 2, TIA, current smoker started to have LE swelling December 2023. Found to have AKI ...

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RE: Aspergillosis in resistant ANCA associated GN 1 day ago

90 and CYC, prednisolone, avacopan, and rituximab. There is no excuse for the ID lack of help, you really need some really good ID and pulmonary...

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RE: Elevated of B2-microglobulin in dialysis patients 1 day ago

I have no doubt middle molecules are important and the reason HDF is showing less mortality than HD, in more and more reports. However I wonder h...

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RE: Re: kidney biopsy findings in a young lady 1 day ago

nice article explaining the role of Pronase digestion IF, attached 1) regular IF sample not adequate 2) there may be masked monoclonality --...

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RE: Re: kidney biopsy findings in a young lady 1 day ago

As pointed out by Dr. Fogo the sampling for frozen IF is not really adequate for any interpretation. This might be a concealed monoclonal gammopath...

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RE: Elevated of B2-microglobulin in dialysis patients 1 day ago

I cannot imagine a situation where monitoring serum Beta2microglobulin levels in patients on PD for therapy of ESKD as a guide to management decisi...

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RE: Elevated of B2-microglobulin in dialysis patients 1 day ago

Additionally, you can check these articles: Impact change in serum beta microglobulin by combination therapy of peritoneal dialysis and hemodialy...

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RE: Elevated of B2-microglobulin in dialysis patients 1 day ago

Regarding PD Maruyama etal,in a large scale registery,found that serum B2M contributes tenuous but significantly to worse outcome and residual ki...

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RE: Elevated of B2-microglobulin in dialysis patients 1 day ago

Greetings Dr Rosales Thank you very much for your reply, Regards, ------------------------------ Ahmed Yassin MD, FASN Saudi German Hospit...

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RE: Elevated of B2-microglobulin in dialysis patients 1 day ago

I think B2-microglobulin could be considered in PD where middle molecules are dealt with, Regards, ------------------------------ Ahmed Yassin ...

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RE: Re: kidney biopsy findings in a young lady 1 day ago

Paraffin IF can be useful when the specimen for usual frozen IF is unsatisfactory. ------------------------------ Agnes Fogo Professor Vanderbilt...

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RE: Elevated of B2-microglobulin in dialysis patients 1 day ago

Thanks. Very interesting .The Chilean experience is vastly different from the USA where hemofiltration is seldom used and routine serum B2 microglo...

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RE: Elevated of B2-microglobulin in dialysis patients 1 day ago

Greetings Dr. Yassin, I can comment on aspects of our clinical practice. In our center, we used B2M regularly (every 3 months) to monitor efficien...

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RE: Case of SLN normal dsDNA high SSA/SSB 1 day ago

Dr. Vishnepolsky: Thanks for the additional information.Can you please post serial C3/C4 values going as far back as possible (at least since the b...

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RE: Re: kidney biopsy findings in a young lady 1 day ago

Thank you Dr Fogo. What's the role of paraffin IF in the setting of possible LN ? ------------------------------ [Sriram] [Sriperumbuduri] [MBBS...

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RE: Re: kidney biopsy findings in a young lady 1 day ago

Thank you Dr Glassock ------------------------------ [Sriram] [Sriperumbuduri] [MBBS FASN] [Assistant Professor in Nephrology] [Virginia Commonwe...

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RE: Re: kidney biopsy findings in a young lady 1 day ago

Thank you Dr Nauman Any thoughts on the pathologist impression ? ------------------------------ [Sriram] [Sriperumbuduri] [MBBS FASN] [Assista...

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RE: Aspergillosis in resistant ANCA associated GN 1 day ago

Very complicated case and a situation where advice on Communities site may not be applicable, since decision making requires consideration of so ma...

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Elevated of B2-microglobulin in dialysis patients 1 day ago

Dear respected Kindly,what is your experience regarding elevated serum B2-microglobulin in dialysis patients? ------------------------------ A...

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Aspergillosis in resistant ANCA associated GN 1 day ago

A very active (skiing and racing exotic cars) 90 Y.O M presented for re-evaluation of aortic valve after TAVR and had AKI when we were consulted. H...

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Elevated of B2-microglobulin in dialysis patients 1 day ago

Dear respected Kindly ,what is your experience with dialysis patients with high B2-microglobulin? Regards, ------------------------------ Ahm...

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RE: Case of SLN normal dsDNA high SSA/SSB 1 day ago

@K.K. Venkat she had controlled disease for 15 years until IS has been progressively decreased due to pts symptoms and kind of blossomed into curre...

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RE: Steroid dependent FSGS with "tip lesion" 1 day ago

I don't think the 'tip lesion" characterization means a great deal in terms of therapy or prognosis . This course can often be seen with the NOS va...

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Steroid dependent FSGS with "tip lesion" 1 day ago

Dear ASN members I would like to discuss an interesting case with you and request your valuable input. I have a 57 years old male with PMH of w...

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RE: Case of SLN normal dsDNA high SSA/SSB 1 day ago

The dialogue in this thread has been very fruitful as it has exposed an area of deep controversy in management of LN- how to use serological "indic...

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RE: Case of SLN normal dsDNA high SSA/SSB 2 days ago

We have a difference of opinion on this issue. Not easily resolved, but the recent paper from Italy tends to support my argument even if low serum ...

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RE: Case of SLN normal dsDNA high SSA/SSB 2 days ago

The key question in this patient is whether hypocomplementemia is worsening progressively, or llow but stable. If over her long-term follow-up, hyp...

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RE: primary Membranous nephropathy and HBV infection 2 days ago

All good points. HBV infection might be acting as an "adjuvant" like COVID. I am still concerned about giving RTX to a patient kniwn to be infected...

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RE: Case of SLN normal dsDNA high SSA/SSB 2 days ago

All good points- I am putting emphasis on the low complement and the likely inadequate intensity of therapy with MMF. If blood MPA levels are below...

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