RE: Aspergillosis in resistant ANCA associated GN 11 minutes ago

90 and CYC, prednisolone, avacopan, and rituximab. There is no excuse for the ID lack of help, you really need some really good ID and pulmonary...

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RE: Elevated of B2-microglobulin in dialysis patients 33 minutes ago

I have no doubt middle molecules are important and the reason HDF is showing less mortality than HD, in more and more reports. However I wonder h...

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RE: Re: kidney biopsy findings in a young lady 37 minutes ago

nice article explaining the role of Pronase digestion IF, attached 1) regular IF sample not adequate 2) there may be masked monoclonality --...

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RE: Re: kidney biopsy findings in a young lady 2 hours ago

As pointed out by Dr. Fogo the sampling for frozen IF is not really adequate for any interpretation. This might be a concealed monoclonal gammopath...

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RE: Elevated of B2-microglobulin in dialysis patients 2 hours ago

I cannot imagine a situation where monitoring serum Beta2microglobulin levels in patients on PD for therapy of ESKD as a guide to management decisi...

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RE: Elevated of B2-microglobulin in dialysis patients 2 hours ago

Additionally, you can check these articles: Impact change in serum beta microglobulin by combination therapy of peritoneal dialysis and hemodialy...

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RE: Elevated of B2-microglobulin in dialysis patients 2 hours ago

Regarding PD Maruyama etal,in a large scale registery,found that serum B2M contributes tenuous but significantly to worse outcome and residual ki...

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RE: Elevated of B2-microglobulin in dialysis patients 3 hours ago

Greetings Dr Rosales Thank you very much for your reply, Regards, ------------------------------ Ahmed Yassin MD, FASN Saudi German Hospit...

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RE: Elevated of B2-microglobulin in dialysis patients 3 hours ago

I think B2-microglobulin could be considered in PD where middle molecules are dealt with, Regards, ------------------------------ Ahmed Yassin ...

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RE: Re: kidney biopsy findings in a young lady 5 hours ago

Paraffin IF can be useful when the specimen for usual frozen IF is unsatisfactory. ------------------------------ Agnes Fogo Professor Vanderbilt...

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RE: Elevated of B2-microglobulin in dialysis patients 6 hours ago

Thanks. Very interesting .The Chilean experience is vastly different from the USA where hemofiltration is seldom used and routine serum B2 microglo...

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RE: Elevated of B2-microglobulin in dialysis patients 7 hours ago

Greetings Dr. Yassin, I can comment on aspects of our clinical practice. In our center, we used B2M regularly (every 3 months) to monitor efficien...

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RE: Case of SLN normal dsDNA high SSA/SSB 8 hours ago

Dr. Vishnepolsky: Thanks for the additional information.Can you please post serial C3/C4 values going as far back as possible (at least since the b...

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RE: Re: kidney biopsy findings in a young lady 9 hours ago

Thank you Dr Fogo. What's the role of paraffin IF in the setting of possible LN ? ------------------------------ [Sriram] [Sriperumbuduri] [MBBS...

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RE: Re: kidney biopsy findings in a young lady 9 hours ago

Thank you Dr Glassock ------------------------------ [Sriram] [Sriperumbuduri] [MBBS FASN] [Assistant Professor in Nephrology] [Virginia Commonwe...

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RE: Re: kidney biopsy findings in a young lady 9 hours ago

Thank you Dr Nauman Any thoughts on the pathologist impression ? ------------------------------ [Sriram] [Sriperumbuduri] [MBBS FASN] [Assista...

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RE: Aspergillosis in resistant ANCA associated GN 10 hours ago

Very complicated case and a situation where advice on Communities site may not be applicable, since decision making requires consideration of so ma...

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Elevated of B2-microglobulin in dialysis patients 12 hours ago

Dear respected Kindly,what is your experience regarding elevated serum B2-microglobulin in dialysis patients? ------------------------------ A...

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Aspergillosis in resistant ANCA associated GN 13 hours ago

A very active (skiing and racing exotic cars) 90 Y.O M presented for re-evaluation of aortic valve after TAVR and had AKI when we were consulted. H...

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Elevated of B2-microglobulin in dialysis patients 13 hours ago

Dear respected Kindly ,what is your experience with dialysis patients with high B2-microglobulin? Regards, ------------------------------ Ahm...

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RE: Case of SLN normal dsDNA high SSA/SSB 19 hours ago

@K.K. Venkat she had controlled disease for 15 years until IS has been progressively decreased due to pts symptoms and kind of blossomed into curre...

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RE: Steroid dependent FSGS with "tip lesion" 20 hours ago

I don't think the 'tip lesion" characterization means a great deal in terms of therapy or prognosis . This course can often be seen with the NOS va...

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Steroid dependent FSGS with "tip lesion" 21 hours ago

Dear ASN members I would like to discuss an interesting case with you and request your valuable input. I have a 57 years old male with PMH of w...

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RE: Case of SLN normal dsDNA high SSA/SSB 23 hours ago

The dialogue in this thread has been very fruitful as it has exposed an area of deep controversy in management of LN- how to use serological "indic...

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RE: Case of SLN normal dsDNA high SSA/SSB 1 day ago

We have a difference of opinion on this issue. Not easily resolved, but the recent paper from Italy tends to support my argument even if low serum ...

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RE: Case of SLN normal dsDNA high SSA/SSB 1 day ago

The key question in this patient is whether hypocomplementemia is worsening progressively, or llow but stable. If over her long-term follow-up, hyp...

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RE: primary Membranous nephropathy and HBV infection 1 day ago

All good points. HBV infection might be acting as an "adjuvant" like COVID. I am still concerned about giving RTX to a patient kniwn to be infected...

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RE: Case of SLN normal dsDNA high SSA/SSB 1 day ago

All good points- I am putting emphasis on the low complement and the likely inadequate intensity of therapy with MMF. If blood MPA levels are below...

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RE: Renal thrombotic microangiopathy 1 day ago

Dr. Christian Kuhn: Can you please post an update on this patient --------------------------------- Alaa Nabih Abdalla nephrology fellow Egypt --...

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RE: Case of SLN normal dsDNA high SSA/SSB 1 day ago

This case is complicated but IMO Dr Venkat makes a very important broad point: anytime renal disease--esp proteinuria-- worsens five, ten, fifteen ...

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RE: Case of SLN normal dsDNA high SSA/SSB 1 day ago

Such cases of low serum C3/C4 in LN with no histological activity on KB must be uncommon. Do you have any literature citations that show how common...

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RE: Case of SLN normal dsDNA high SSA/SSB 1 day ago

There are cases of LN which are serologically persistently active without active inflammation. Increasing SCr and proteinuria can be the result of ...

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RE: Case of SLN normal dsDNA high SSA/SSB 1 day ago

Isn't a low C3/C4, rising proteinuria and declining eGFR sufficient evidence of disease "activity" but a urine sediment exam is certainly appropria...

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RE: Case of SLN normal dsDNA high SSA/SSB 1 day ago

Is the urine sediment active? Are C3 and C4 on a downward trend? Before subjecting this 74-year-old patient who has already had one opportunistic i...

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RE: Case of SLN normal dsDNA high SSA/SSB 1 day ago

Dr. Abdalla. Your concerns about worsening proteinuria and declining kidney function are quite appropriate. The threshold for rebiopsy of patients ...

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RE: Case of SLN normal dsDNA high SSA/SSB 1 day ago

pt does not have APS, platelets normal It seems like all roads lead to Vitamin R and her insurance seems to work only on Thursdays will need to s...

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RE: primary Membranous nephropathy and HBV infection 1 day ago

Dear Pr. Glassock, the model system according to which HBV therapy (without the use of immunosuppressive drugs) induces PLA2R1-MN remission, would ...

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RE: Re: kidney biopsy findings in a young lady 1 day ago

Its very odd, but they haven't described the intensity of staining in their report. ------------------------------ [Sriram] [Sriperumbuduri...

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RE: Case of SLN normal dsDNA high SSA/SSB 2 days ago

Im not convinced a repeat biopsy would help but she seems to be getting worse despite MMF albeit at low dose I would like to escalate therapy ...

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RE: Re: kidney biopsy findings in a young lady 2 days ago

The IF was done on glomeruli with extensive or global sclerosis so negative result does not help. The deposits by EM in multiple locations suggests...

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RE: Case of SLN normal dsDNA high SSA/SSB 2 days ago

Worsening renal function and worsening proteinuria may indicate endothelial injury ..she has anemia and we don't know platlet count ..may be thromb...

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RE: Case of SLN normal dsDNA high SSA/SSB 2 days ago

What features in her clinical and laboratory tests makes you think of a superimposed TMA? Renal limited TMA (wotput peripheral manifestations) is f...

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RE: Case of SLN normal dsDNA high SSA/SSB 2 days ago

Renal biopsy was 1 year back --------------------------------- Alaa Nabih Abdalla nephrology fellow Egypt ---------------------------------

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RE: Case of SLN normal dsDNA high SSA/SSB 2 days ago

The pathology does not suggest a TMA, but an evaluation for anti phospholipid antibody is reasonable . Just an opinion, -------------------------...

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RE: Re: kidney biopsy findings in a young lady 2 days ago

What is the staining intensity of C3 and IgG. Any Paraffin IF done after Pronase digestion. ? ------------------------------ Richard Glassock MD,...

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RE: Re: kidney biopsy findings in a young lady 2 days ago

What was impression of Histopathologist. There is not much proliferation in intact gloms but to me it seems it is Primary/Idiopathic Immune Complex...

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RE: Case of SLN normal dsDNA high SSA/SSB 2 days ago

Any thrombocytopenia ?? TMA ..APS should be excluded --------------------------------- Alaa Nabih Abdalla nephrology fellow Egypt ---------------...

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Re: kidney biopsy findings in a young lady 2 days ago

Hi everyone, I wanted to discuss this patient who was referred for advanced CKD 4 Young lady in her 20s with HTN since the beginning of this y...

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RE: Case of SLN normal dsDNA high SSA/SSB 2 days ago

My impression of this case is that it is one dominated by SS manifestations, not SLE, and the dose of MMF tolerated is inadequate to prevent furthe...

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RE: primary Membranous nephropathy and HBV infection 2 days ago

Thanks Dr Awais for the article, couldn't get access to full manuscript but found another publication from Chinese group supporting the idea that a...

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