Possible Pd Case 1 hour ago

1/ Would we refer for pd tube for patient with bmi 65? No hernia or previous abdominal surgery 2/ would we refer someone with lymphoma and retrop...

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RE: Collapsing Fsgs 3 hours ago

Thanks a lot Yes CMV and parvo were negative --------------------------------- Shahzad Safdar MD MD Mt. Auburn Nephrology, Inc. Cincinnati OH...

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RE: Would you rebiopsy? Is this C3GN? 14 hours ago

Thanks for the update. How is the patient being treated now - another course of prednisone? Please post information on response to treatment. ---...

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RE: Would you rebiopsy? Is this C3GN? 16 hours ago

I wanted to post an update as this was a good learning case for me. Dr. Nester was kind to review the path and these were her thoughts: Not a C3GN,...

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RE: Renal thrombotic microangiopathy 18 hours ago

No paraprotein was detected in serum immunofixation and the kappa/lambda ratio was normal. Complement tests were unremarkable apart from a slight...

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RE: (another) Refractory Minimal Change Disease (Dialysis dependent and I promised patient I would submit) 19 hours ago

I have sent slides to Dr. D'Agati at Columbia for second opinion regarding clues to Ab-mediated podocytopathy and am working on Obintuzumab therapy...

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RE: Peritoneal Dialysis PET test: Need for baseline? 19 hours ago

I do a PET once in a while in a patient who is willing to work with the same. The reason is to show my residents how it is done and chart the D/P v...

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RE: Peritoneal Dialysis PET test: Need for baseline? 20 hours ago

Dr. Rodby , Can you please give an example of one your patients that you started incremental PD and tweaked the prescription clinically , that pr...

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RE: Peritoneal Dialysis PET test: Need for baseline? 21 hours ago

I agree Roger and do not think that a baseline PET or regular follow-up PET is necessary in the absence of particular problems such as trying to un...

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RE: tip variant fsgs relapse in pregnancy 1 day ago

Her initial presentation had 13 G of proteinuria, post pulse by a week or 2 she had dropped to 9 G and 2 months later 120 mg so very responsive. ...

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RE: Recurrent FSGS in Transplant 1 day ago

"Thanks Dr. Rubin for your well considered remarks. My "dissent" is largely based on the weaknesses of the TANGO collaboration study design. It is ...

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RE: tip variant fsgs relapse in pregnancy 1 day ago

We usually do NOT recommend a re-biopsy in steroid responsive NS, pregnant or not. If in full relapse she should be treated with Steroid or CsA mon...

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RE: Pla2r positive MN 1 day ago

Understood- but the relapse rate is under 10% for spontaneous and > 25% for treatmdnt relatrd remussikns. This advantage of spontaneous remission a...

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RE: tip variant fsgs relapse in pregnancy 1 day ago

How quickly did her prior episode of proteinuria remit on steroids? Need for repeat biopsy and choice of a short course of steroids vs prolonged CN...

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RE: Pla2r positive MN 1 day ago

The spontaneous remission does occur. At 25% rate means that 3 out of 4 patients will not remit. To make decision about wait or not hinges on the r...

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RE: Peritoneal Dialysis PET test: Need for baseline? 1 day ago

Thanks Swap, The overnight drain volume with the standard 2L 2.5% dianeal fill gives you a good idea whether you can use a 2.5% for the lo...

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tip variant fsgs relapse in pregnancy 1 day ago

I am due to see my patient who had a tip variant fsgs and had went into complete remission on steroids in 2017/18. She emailed me from her holiday ...

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RE: Peritoneal Dialysis PET test: Need for baseline? 1 day ago

I asked my PD expert colleague ( @Brendan Mccormick) and this is his input: "We still do baseline PETs (4.25%) and I find them useful for the foll...

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RE: Recurrent FSGS in Transplant 1 day ago

I would strongly consider 2nd transplant ( DD if possible ) given young age of patient despite high risk of recurrence with prophylactic measures a...

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Peritoneal Dialysis PET test: Need for baseline? 1 day ago

The ISPD recommends a PET in the first 6-12 weeks of starting PD. https://pubmed.ncbi.nlm.nih.gov/33563110/ "Guideline 2a: Identification of fa...

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RE: Recurrent FSGS in Transplant 1 day ago

@Richard Glassock I am perplexed by your personal reluctance to accept the proven concept of the failure of transplant nephrectomy to diminished th...

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Applications Now Open for Kidney TREKS – A Week-Long Research Course and Longitudinal Mentorship Program 1 day ago

Dear all, Applications are now open for the 2025 ASN Kidney TREKS (Tutored Research and Education for Kidney Scholars) Program. Kidney TREKS fost...

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Applications Now Open for the 2025 Kidney TREKS Program! 1 day ago

Dear Kidney Educators, Please share the opportunity to apply to the ASN Kidney TREKS (Tutored Research and Education for Kidney Scholars) Program...

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RE: Appreciate Input in this case ESP 1 day ago

Since the gut is still working, tamoxifen and prednisone trial. Thanks for the community support. ------------------------------ Sachin ---------...

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RE: Recurrent FSGS in Transplant 1 day ago

Dr. Imane Beggah: It has been suggested (but not everyone agrees) that FSGS is more likely to recur if recipient and donor are highly HLA-matched, ...

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RE: Recurrent FSGS in Transplant 2 days ago

However, retransplantation (using a deceased donor and avoiding a good HLA match which may decrease chance of recurrent FSGS) DR Venkat Can you el...

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RE: Collapsing Fsgs 2 days ago

I assume you rule out Parvovirus B19 and CMV infections. Agree for genetic test to rule out APOL1 and other FSGS implicated genes giving his young...

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RE: (another) Refractory Minimal Change Disease (Dialysis dependent and I promised patient I would submit) 2 days ago

This is odd for MCD to have this fulminant course or dialysis-dependence AKI and even this elderly man may have severe arterionephrosclerosis, but ...

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RE: (another) Refractory Minimal Change Disease (Dialysis dependent and I promised patient I would submit) 2 days ago

No commercial test, but you could try the nephrology department of the University Hamburg. They have a test and are interested im samples. Autoan...

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RE: Recurrent FSGS in Transplant 2 days ago

Daratumumab has success in case reports for treatment of rFSGS by possible targeting anti-Nephrin Abs (attached from last ASN). May be used prophy...

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RE: Fibronectin Glomerulopathy 2 days ago

Three choices- 1) Conservative with RASi - I do not think that SGLT2i will be of much help. If the proteinuria falls by > 40% keep using RASi ind...

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RE: Fibronectin Glomerulopathy 2 days ago

Many thanks Dr. Glassock for your help in solving the dilemma in this case. DNAJB9 tissue staining was positive. So what are your thoughts on treat...

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RE: Patient 2 days ago

I appreciate your input Dr. Glassock. They were collected and the results are still pending. I will keep you posted. ---------------------------...

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RE: Recurrent FSGS in Transplant 2 days ago

Thanks - very important consensus driven paper. Figure 1 on the incidence of " recurrent " FSGS is meaningless as it conflates all categories of FS...

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RE: Recurrent FSGS in Transplant 2 days ago

I hope that the recently attached publication sheds some additional light in this case. ------------------------------ Mario Rubin, M.D. Hou...

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RE: Patient 2 days ago

What is the Plasma and Urinary Osmolality? Do you have values for 24 hour Sodium, Potassium and Urea excretion? .The polyuria could be a combinatio...

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RE: (another) Refractory Minimal Change Disease (Dialysis dependent and I promised patient I would submit) 2 days ago

There is no commercially available assay for anti-Nephrin antibody. I understand the issue of "no transplant" but I have been involved in kidney tr...

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RE: (another) Refractory Minimal Change Disease (Dialysis dependent and I promised patient I would submit) 2 days ago

I'm going to see about sending his biopsy to Columbia (from upstate NY) for any clues to antibody mediated podocytopathy. This would help in decidi...

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Patient 2 days ago

Post obstructive diuresis: I have a 64 yr old male with obstructive uropathy who had a foley placed and is doing very well but his post obstru...

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RE: Recurrent FSGS in Transplant 2 days ago

Agree with the already made management suggestions and the pessimistic prediction regarding outcome of a second transplant in this patient. However...

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RE: Collapsing Fsgs 2 days ago

The clinical story is most compatible with Primary (permeability factor related ) FSGS, with feature of Collatsing Nephripoapy, I would probably do...

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RE: Recurrent FSGS in Transplant 2 days ago

Dr. Rubin's and Dr. Rodby's management strategies are both quite reasonable, although in diametrically opposite pathways. A genetic form of FSGS wo...

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Collapsing Fsgs 2 days ago

26 year-old a single male does not speak any English, truck driver by profession, with no history of alcohol drug abuse moved from Uzbekistan one y...

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RE: Recurrent FSGS in Transplant 2 days ago

Thank you Dr. Rodby for requesting my opinion about this difficult case. I fully agree with the assertions that this is most likely a case of FSGS ...

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RE: Re: autonomic dysreflexia 2 days ago

Thank you Dr Glassock It was thrombotic- If I remember correctly, I think it`s protein C deficiency- he is on anticoagulation I am planning to ...

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RE: Recurrent FSGS in Transplant 2 days ago

As nephrotic as he was this sure seems like permeability factor podocytopathy FSGS, unfortunately he was steroid unresponsive which does not bode w...

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RE: (another) Refractory Minimal Change Disease (Dialysis dependent and I promised patient I would submit) 2 days ago

Addendum- this patients has a very high risk of recurrent disease (FSGS) in a kidney allograft. Perhaps as high as 70%, especially if this is due t...

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RE: Recurrent FSGS in Transplant 2 days ago

Highly unlikely that this is Genetic FSGS. A second kidney transplant has a 90%+ likelihood of another recurrence with loss of graft- especially if...

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RE: (another) Refractory Minimal Change Disease (Dialysis dependent and I promised patient I would submit) 2 days ago

Thanks Dr. Glassock. This "community" perspective and input is INVALUABLE! Thank you all ------------------------------ Craig Hurwitz MD North...

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RE: Re: autonomic dysreflexia 2 days ago

Good morning and Happy New Year. I don't have much experience with vasodilators for AD other than topical nitroglycerine for acute presentations,...

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