RE: Recurrent FSGS in Transplant 17 minutes ago

Dear all, Thank you for taking the time out to write your opinions and sharing your expertise. This has been truly educational. Our unit h...

View Discussion

RE: Peritoneal Dialysis PET test: Need for baseline? 4 hours ago

The timing of this debate in Kidney-360, and me just now asking that exact question, is uncanny. I am months behind in my journals, catching up is ...

View Discussion

RE: Standard of care for nephrology consultation prior to acute hemodialysis 7 hours ago

Treatment of hyperkalemia and delaying dialysis has become easier with the availability of better alternatives to Kayexalate. Pulmonary edema in an...

View Discussion

RE: Recurrent FSGS in Transplant 7 hours ago

Nice summary- I agree! ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ------------------------------

View Discussion

RE: Standard of care for nephrology consultation prior to acute hemodialysis 10 hours ago

All opinion: This scenario is not uncommon. The odd thing I find here is that "the ER and ICU teams were beside themselves". If medical treatment...

View Discussion

RE: Peritoneal Dialysis PET test: Need for baseline? 10 hours ago

Thie is the debate on PET that was recently published in Kidney-360 Ramesh Saxena MD, PhD, FASN Professor, Division of Nephrology, D...

View Discussion

RE: Recurrent FSGS in Transplant 11 hours ago

Dr Glassock Generally recurrence is obvious based on dropping serum albumin alone (and in anuric pts the appearance of proteinuria), so a protoco...

View Discussion

RE: Recurrent FSGS in Transplant 11 hours ago

Thanks Dr. Radhakrishnan for for excellent advice. I think that broad agreement exists that this patient should be considered a candidate for a sec...

View Discussion

Standard of care for nephrology consultation prior to acute hemodialysis 11 hours ago

Last night on-call I was consulted at midnight by the ER doc for a chronic HD patient with hyperkalemia (7.8 mEq/L) and junctional bradycardia (30/...

View Discussion

RE: Recurrent FSGS in Transplant 12 hours ago

@Selva Saravanan Saminathan Have you all decided what to do. I think the overall consensus on this side of the atlantic is as follows: Opt for...

View Discussion

RE: Recurrent FSGS in Transplant 13 hours ago

@Jai Radhakrishnan Thank you for your expert opinion. ------------------------------ Mario Rubin, M.D. Houston TX (713) 252-5539 --------------...

View Discussion

RE: Recurrent FSGS in Transplant 13 hours ago

I note the discussion points with respect to this case. This is undoubtedly a complicated situation, but emerging data as highlighted in the discus...

View Discussion

RE: Potassium Threshold For Op Management 14 hours ago

This is also a pet peeve of mine Dr Rodby. I trained in the era where a potassium in renal clinics of 5.5-6.5mmol/L with no change in renal func...

View Discussion

RE: Fibronectin Glomerulopathy 16 hours ago

I don't understand how the diagnosis of fibronectin GN was made in the setting of positive DNAJB9 and no electron microscopy. I think fibrillary is...

View Discussion

RE: Possible Pd Case 18 hours ago

Dr. Soobadar: Rather than determining eligibility for PD by BMI, I find it more informative to look at "the lay of the land". In other words, what ...

View Discussion

RE: (another) Refractory Minimal Change Disease (Dialysis dependent and I promised patient I would submit) 18 hours ago

Please update us of the progress good luck ------------------------------ Arvind Madan MBBS, MD Partner Central Florida Kidney Specialists Or...

View Discussion

RE: Possible Pd Case 19 hours ago

Eligibility for PD as therapy for ESKD is mostly determined on a case by case basis. Extreme (morbid) obesity is regarded by many as a relative, bu...

View Discussion

Possible Pd Case 21 hours 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...

View Discussion

RE: Collapsing Fsgs 23 hours ago

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

View Discussion

RE: Would you rebiopsy? Is this C3GN? 1 day ago

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

View Discussion

RE: Would you rebiopsy? Is this C3GN? 1 day 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,...

View Discussion

RE: Renal thrombotic microangiopathy 1 day ago

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

View Discussion

RE: (another) Refractory Minimal Change Disease (Dialysis dependent and I promised patient I would submit) 1 day 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...

View Discussion

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

View Discussion

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

View Discussion

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

View Discussion

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. ...

View Discussion

RE: Recurrent FSGS in Transplant 2 days 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 ...

View Discussion

RE: tip variant fsgs relapse in pregnancy 2 days 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...

View Discussion

RE: Pla2r positive MN 2 days ago

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

View Discussion

RE: tip variant fsgs relapse in pregnancy 2 days 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...

View Discussion

RE: Pla2r positive MN 2 days 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...

View Discussion

RE: Peritoneal Dialysis PET test: Need for baseline? 2 days 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...

View Discussion

tip variant fsgs relapse in pregnancy 2 days 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 ...

View Discussion

RE: Peritoneal Dialysis PET test: Need for baseline? 2 days 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...

View Discussion

RE: Recurrent FSGS in Transplant 2 days ago

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

View Discussion

Peritoneal Dialysis PET test: Need for baseline? 2 days 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...

View Discussion

RE: Recurrent FSGS in Transplant 2 days ago

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

View Discussion

Applications Now Open for Kidney TREKS – A Week-Long Research Course and Longitudinal Mentorship Program 2 days ago

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

View Discussion

Applications Now Open for the 2025 Kidney TREKS Program! 2 days ago

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

View Discussion

RE: Appreciate Input in this case ESP 2 days ago

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

View Discussion

RE: Recurrent FSGS in Transplant 2 days 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, ...

View Discussion

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...

View Discussion

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...

View Discussion

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 ...

View Discussion

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...

View Discussion

RE: Recurrent FSGS in Transplant 3 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...

View Discussion

RE: Fibronectin Glomerulopathy 3 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...

View Discussion

RE: Fibronectin Glomerulopathy 3 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...

View Discussion

RE: Patient 3 days ago

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

View Discussion