RE: C3G case 1 hour ago

Based on the IF and EM findings I would recommend that the kidney biopsy be reprocessed for Paraffin IF, after Pronase digestion, the disparity bet...

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RE: Drug induced ANCA disease or IgA with crescents? 3 hours ago

Another guess; this time from a foot soldier of nephrology I feel like IgA started the war first and very damaging, progressive. MPO ANCA and A...

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RE: Drug induced ANCA disease or IgA with crescents? 4 hours ago

Thanks. ------------------------------ Viswanathan Iyer MD,FACP,FASN Harrisburg PA 717342 4705 ------------------------------

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C3G case 4 hours ago

Dear Community members, I have a 37 year F, who is HBV positive, was not on treatment, No Hx of DM or HTN, presenting with on/off lower extremit...

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RE: Drug induced ANCA disease or IgA with crescents? 4 hours ago

Just a guess- but I think the most likely explanation is drug- induced (Hydralazine) ANCA induced crescentic GN superimpised upon Quiescent Celiac ...

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Drug induced ANCA disease or IgA with crescents? 5 hours ago

82-year-old woman with htn, djd, hypothyroidism, celiac disease, and exocrine pancreatic insufficiency. -h/o htn many years - maintained on amlodip...

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RE: Very High risk membranous 8 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 8 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 9 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 9 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 12 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 12 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 13 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 13 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 14 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 16 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 1 day 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 1 day 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 2 days 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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