Very High risk membranous 4 hours ago

Dear Colleagues I need your expert opinion on this case: 40 y old, male, Known Membranous nephropathy. treated with RTX and he was on cyclos...

View Discussion

RE: Terlipressin 10 hours ago

Thanks. Understood. The reason I asked is that some believe that Terlipressin can also be used in septic shock, resistant to nor-epinephrine. --...

View Discussion

RE: Terlipressin 11 hours ago

ADH = Vasopressin We have experience with Vasopressin use in CCU: usually not the first choice in shock states. Vasopressin use is very tricky; y...

View Discussion

RE: Requesting advice on IgA nephropathy patient 14 hours ago

I am not aware of registry of steroid induced avascular necrosis of Hip or major joint. Of severe side effects. Does anyone know that such registry...

View Discussion

RE: Renal Biopsy Post Plex 14 hours ago

Dialysis has no effect on anti-GBM antibody levels. The best time to measure anti-GBM antibody levels is immediately before starting a session of P...

View Discussion

RE: Terlipressin 14 hours ago

In what Disease states do you plan to use Terlipressin? ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ...

View Discussion

RE: Requesting advice on IgA nephropathy patient 14 hours ago

What is the basis of the claim that the "side effects " of TRF-Budesonide are much less than those seen with moderate doses of oral methylprednisol...

View Discussion

Terlipressin 14 hours ago

Dear Colleagues- We are trying to add Terlipressin to our formulary drug list. Would like to know from the group about their experience with Terlip...

View Discussion

RE: Case 14 hours ago

What is the microscopic appearance of the RBC in urine. If dysmorphic, I would do a kidney biopsy, if the patient consents, --------------------...

View Discussion

RE: Requesting advice on IgA nephropathy patient 14 hours ago

True that Peyer's are not necessarily the site of IgA1 production in all patients not these lymphocytes will be sensitive to budesonide. However, t...

View Discussion

RE: KFRE 14 hours ago

I woukd say that his risk of developing ESKD at some point in his expected lifetime is likely higher than a healthy individual with two kidneys, bu...

View Discussion

TERLIPRESSIN IN HRS 14 hours ago

Hello We are trying to add Terlipressin to our formulary drug list. Would like to know from the group about their experience with Terlipressin an...

View Discussion

RE: cystatin C gfr 14 hours ago

Cystatin-C is being wrongfully touted as accurate, this is not true. In addition to pore size, cystatin-c production is controlled by large number ...

View Discussion

RE: KFRE 15 hours ago

Thanks prof . How you explain risk to patient is. More than 5 out of 100 is increased risk ? --------------------------------- Muhammad Soobada...

View Discussion

RE: Case 15 hours ago

Creatine 0.8 eGFR 90 --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

View Discussion

RE: Renal Biopsy Post Plex 15 hours ago

After plex how long need to wait before taking bloods for anti-gbm titre? And after dialysis? --------------------------------- Muhammad Soobad...

View Discussion

RE: Renal Biopsy Post Plex 15 hours ago

Wcc was 8 before cyclo is now 5 --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

View Discussion

RE: a Puzzling case 15 hours ago

This patient needs a measured GFR . He may have a " 'shrunken pore syndrome ". ------------------------------ Richard Glassock MD, FASN Laguna Wo...

View Discussion

RE: cystatin C gfr 19 hours ago

The Shrunken Pore Syndrome (SPS) is a hypothesis originally developed by Grubb and Colleagues (see GrubbA. Clinical Biochemustry , 2020 ; 83 :12-20...

View Discussion

RE: Dialysis Consent 21 hours ago

1) We do require consent but it lasts for a year, that was a compromise the last time we went to our hospital's Risk Management 2) separate g...

View Discussion

RE: cystatin C gfr 22 hours ago

I am also not a Cystatin C enthusiast. There are a couple of situations where it might be helpful, but not routinely. The eGFR (and the cystatin C)...

View Discussion

Dialysis Consent 1 day ago

Hi all, I am curious about need for consents for dialysis in the hospital for patients on dialysis. 1) Do you require consents for continuing di...

View Discussion

RE: cystatin C gfr 1 day ago

Thank you very much sir for your response can you elaborate a bit more on the SPS - its patho genesis perhpas and its relevance for us in clin...

View Discussion

KDIGO-2025 guidelines for renal anemia, now available as draft 1 day ago

Dear colleagues, a draft of the 2025 KDIGO guidelines on renal anemia is available (see attached with some comments of mine) and open for comments...

View Discussion

RE: cystatin C gfr 1 day ago

When eGFR -creatinine is "stable " and eGFR-Cystatin C is "declining" how do you know which one of the two estimates is giving the "correct" pictur...

View Discussion

RE: cystatin C gfr 1 day ago

I am not a Cystatin C enthusiast. It has limited value and should be used when indicated, not as a routine. The biggest drawback is that there is n...

View Discussion

RE: a Puzzling case 1 day ago

I would do a 24 hour urine for creatinine clearance and a cystatin -creatinine eGFR. There are several issues with cystatin C measured GFR which wi...

View Discussion

RE: Ac proliferative GN w IC deposits 1 day ago

I agree fully with Dr. Rodby. Not really full-house Nephropathy. Needs more serology, including Rheumatoid Factor, HCV, HBV. If she proves to have ...

View Discussion

RE: Ac proliferative GN w IC deposits 1 day ago

the post above you looks almost identical! https://community.asn-online.org/discussion/non-lupus-full-house-crescenteric-gn-managment-question...

View Discussion

RE: Non-Lupus Full house Crescenteric GN managment question 1 day ago

can you post a deintintified biopsy reading? non-lupus full house GN may have a worse prognosis than lupus full house GN See attached) Woul...

View Discussion

Non-Lupus Full house Crescenteric GN managment question 1 day ago

Dear All. I need group help to manage this interesting but confusing case. 26 years old lady with BMI 39 and history of migraine and normal k...

View Discussion

Ac proliferative GN w IC deposits 1 day ago

Hello everyone, I have a 49 year young caucasian woman, nurse by profession, who was ref to me for proteinuria. PCP noticed it 6m ago and I was ...

View Discussion

RE: Management In ADTKD 1 day ago

Since new nephrons cannot be generated by this approach, any increase in GFR would likely be due to worsening single nephron hyperfiltration . This...

View Discussion

RE: Management In ADTKD 1 day ago

You are welcome. Due to the novelty and potential for the approach, we might be able to lobby the company to provide the 3 month therapy for free. ...

View Discussion

RE: Requesting advice on IgA nephropathy patient 1 day ago

Thanks so much for all the ideas, I have a much better plan of how to present this to him. ------------------------------ Jayson L. Yap, MD Renal...

View Discussion

RE: Collapsing FSGS 1 day ago

Was she tested for COViD during either episode of AKI/NS? Do you have EM results on kidney biopsy, any tubulo-reticular inclusions (TRI)? Was she t...

View Discussion

RE: A case of C3GN 1 day ago

" The deposits are variable in Lshape and position, including mesangial deposits, paramesangial, intramembranous, and subepithelial deposits resemb...

View Discussion

RE: Requesting advice on IgA nephropathy patient 1 day ago

Dear dr Glassock , Would you start MMF after 2 months of steroids ? And for how long will keep on MMF ? thanks ----------------------------...

View Discussion

RE: Requesting advice on IgA nephropathy patient 1 day ago

Interesting idea but no studies have ever been performed to study the question. I would be concerned that the two drugs taken together (or sequenti...

View Discussion

RE: A case of C3GN 1 day ago

Interesting case for which I have no insightful answers but rather additional ques have u sent gentic testing for compl disorders assoc with C3...

View Discussion

RE: A case of C3GN 2 days ago

Dr Venkat - Thanks for pointing out the typo regarding the proteinuria- I have corrected it. The EM findings consistent with c3 gn per report- I...

View Discussion

Collapsing FSGS 2 days ago

Dear Colleagues, I'd be grateful for your opinions Patient is a 30 year old lady of West African origin with tablet controlled type 2 Diabetes....

View Discussion

RE: hereditary nephropathy? 2 days ago

With family history of renal failure, predominantly mesangial lesion, no immune deposits on IF. This could be Type III Collagen Glomerulopathy or F...

View Discussion

RE: Requesting advice on IgA nephropathy patient 2 days ago

I think that oral methylprednisolone and oral controlled released budesonide have different site of action and it is like combing diltiazem with am...

View Discussion

RE: Requesting advice on IgA nephropathy patient 2 days ago

In the presence of hematuria and glomerular inflammation I think that Oral prednisone followed by MMF maintenance therapy are good choices. No comp...

View Discussion

RE: hereditary nephropathy? 2 days ago

Unfortunately, without EM or genetic studies it will be very difficult, if not impossible., to determine a diagnosis. in this patient, The IF seems...

View Discussion

RE: Requesting advice on IgA nephropathy patient 2 days ago

I have similar patient few months age with similar MESTC score. Baseline Cr was 2 and UPCR 1 g/g My plan was: Methylprednisolone 32 mg for 2 months...

View Discussion

RE: Requesting advice on IgA nephropathy patient 2 days ago

Totally agree with Dr. Rodby and I would start now with low dose methylprednisolone plus budesonide. Switch to sparsentan and also add finerenone. ...

View Discussion

RE: Requesting advice on IgA nephropathy patient 2 days ago

My choice for this patient is moderate dose oral steroids for 2 months (TESTING II protocol) followed by MMF for Maintenance, ifca responses in hem...

View Discussion

RE: Requesting advice on IgA nephropathy patient 2 days ago

I do agree with Dr Roddy about anti April or anti April plus anti baff class of drugs My issue is how do u convince a pt to choose placebo contro...

View Discussion