RE: PIGN with Nephrotic Syndrome case 1 hour ago

Prior serologies not available. But i did all of them recently and C3 and C4 not low anymore; SIFE with Faint free lambda light chain noted with no...

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

Dr. Rodby-are you aware of any dialysis center in the USA (of course primarily using conventional HD) monitors Serum B2 microglobulin levels on a r...

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

Thank you. I may elect to repeat the biopsy in that case considering her age and prospects of transplantation ------------------------------ [Sri...

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

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

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

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

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RE: PIGN with Nephrotic Syndrome case 2 hours ago

Low C3 and C4 makes this unlikely to be post-streptococcal GN. The therapy of infection-related GN is not steroids and RTX. What is his current C3 ...

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

Before the availability of high flux hemofilters we saw a sizable number of dialysis patients affected with carpal tunnel syndrome and sometimes bo...

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PIGN with Nephrotic Syndrome case 2 hours ago

I have a 70-year-old male with past medical history of HTN, DM 2, TIA, current smoker started to have LE swelling December 2023. Found to have AKI ...

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RE: Aspergillosis in resistant ANCA associated GN 3 hours 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 3 hours 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 3 hours 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 4 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 5 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 5 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 5 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 6 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 6 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 8 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 9 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 10 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 11 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 12 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 12 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 12 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 13 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 15 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 16 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 16 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 21 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" 23 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" 1 day 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 1 day 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 2 days 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 2 days 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 2 days 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 2 days 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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