RE: Very High risk membranous 5 hours ago

An important point is that a serum creatinine of this magnitude does not imply irreversibility in MN or other diffuse podocytopathies. ---------...

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RE: Ac proliferative GN w IC deposits 5 hours ago

See Meuleman M-S , et al Nephrol Dialysis Transplant, November, 2024 for an excellent recent publication on this topic and how to use analysis of c...

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RE: Very High risk membranous 6 hours ago

AKI (due to ATN, "nephrosarca", podocyte effacement interfering with glomerular filtration and/or tubular damage from heavy proteinuria) is most co...

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RE: candiduria after starting cephalexin while already on empagliflozin 25 mg qd for months 6 hours ago

Tough question. No good evidence to guide decisions making. She likely has underling progressive Diabetic Nephropathy secondary to poorly controlle...

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RE: Ac proliferative GN w IC deposits 9 hours ago

If 3+ is maximum, it could be a 4+ or 5+ C3. Separating ICGN from C3GN can be very tricky. Just a suggestion, additional serology might be helpful,...

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candiduria after starting cephalexin while already on empagliflozin 25 mg qd for months 9 hours ago

White lady age 65 has BMI 38.5, hypertension, major depressive disorder, coronary artery disease, sleep apnea, type 2 diabetes at least since 2006...

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RE: Ac proliferative GN w IC deposits 10 hours ago

Can it be C3GN with igG +2 and C3 +3 only 1 order difference and also kappa and lambda are +3 and +2? --------------------------------- Alaa Nabih...

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RE: Very High risk membranous 10 hours ago

Wat is the explanation 🤔 of rising creatinin till dialysis dependent with only 25% ifta and no renal vein thrombosis ---------------------------...

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RE: Terlipressin 11 hours ago

We too use it in patients with advanced chronic liver disease, ascites, and AKI when there is hypotension. Along with iv albumin if albumin levels ...

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RE: Eosinophilic infiltrates in a transplant recipient 13 hours ago

Revisited this discussion after 7 years. The patient continues to have a creatinine of around 1.8 to 2 and apart from obesity and hypertension, is ...

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RE: Case 21 hours ago

Dr. Rodby- I see your point. Is her life expectancy too short to give any opportunity for benefits from treatment of a kidney biopsy defined dise...

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RE: Very High risk membranous 22 hours ago

With a serum creatinine of 10mg/dL I would be concerned about side effects from the use of a full dose cyclical CYC regimen, in this case. ------...

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RE: Very High risk membranous 1 day ago

PLA2R is 170, high but not astronomical. I look at the PLA2R more than the proteinuria I think rituxan (assuming it worked before) I prefer, ...

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RE: Case 1 day ago

at 74 with albuminuria about 500 mg/g the is total proteinuria about 900 mg/g Cr 0.8 she has "severe COPD, mild -moderate Tricuspid Regurgitati...

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RE: Case 1 day ago

You are missing out on a useful diagnostic test. Too bad. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-88...

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RE: Very High risk membranous 1 day ago

What was his response to RTX previously? The relapse of severe Nephrotic Syndrime after cessation of CNI is not surprising. Cyclical CYC, in usual ...

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RE: Terlipressin 1 day ago

Its a good tool to have at your disposal. Reliably increases MAP without need for ICU and inotropes, which is great in busy hospitals. Reverses HRS...

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RE: cystatin C gfr 1 day ago

amazing discussion and good reminders of the actual factors that need to be focused on ty all for enriching the discussion -------------------...

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RE: Ac proliferative GN w IC deposits 1 day ago

This is an ICGN, probably auto-immune (she has Hashimoto's disease and auto-immune diseases itend to occur together), possibly C3GN. Please add C3 ...

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RE: Ac proliferative GN w IC deposits 1 day ago

Dr Rodby. Please see the LM below Dr Glassock - She DOES have breast cancer but its localized enough to warrant ONLY lumpectomy - no chemo, no...

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RE: Case 1 day ago

Thanks prof. We don’t spin urine in England UK unfortunately . So I would not know Bw --------------------------------- Muhammad Soobadar MBChB...

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Very High risk membranous 1 day 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...

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RE: Terlipressin 1 day ago

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

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RE: Terlipressin 2 days 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...

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RE: Requesting advice on IgA nephropathy patient 2 days 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...

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RE: Renal Biopsy Post Plex 2 days 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...

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RE: Terlipressin 2 days ago

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

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RE: Requesting advice on IgA nephropathy patient 2 days 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...

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Terlipressin 2 days 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...

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RE: Case 2 days ago

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

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RE: Requesting advice on IgA nephropathy patient 2 days 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...

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RE: KFRE 2 days 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...

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TERLIPRESSIN IN HRS 2 days 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...

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RE: cystatin C gfr 2 days 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 ...

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RE: KFRE 2 days ago

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

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RE: Case 2 days ago

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

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RE: Renal Biopsy Post Plex 2 days ago

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

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RE: Renal Biopsy Post Plex 2 days ago

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

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RE: a Puzzling case 2 days ago

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

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RE: cystatin C gfr 2 days ago

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

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RE: Dialysis Consent 2 days 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...

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RE: cystatin C gfr 2 days 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)...

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Dialysis Consent 2 days 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...

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RE: cystatin C gfr 2 days 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...

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KDIGO-2025 guidelines for renal anemia, now available as draft 2 days 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...

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RE: cystatin C gfr 2 days 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...

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RE: cystatin C gfr 3 days 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...

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RE: a Puzzling case 3 days 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...

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RE: Ac proliferative GN w IC deposits 3 days 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 ...

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RE: Ac proliferative GN w IC deposits 3 days ago

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

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