RE: MPO-ANCA Vasculitis in the Setting of Infective Endocarditis - Infection triggered mimic? 8 minutes ago

Thank you for the follow -up. How long are you planning to treat him for MPO-Vasculitis and what is the natural Hx after treatment? ----------...

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$6million for Bridge funding over 3 years 42 minutes ago

HI All, In this time of uncertainty regarding federal funding and reduced paylines at NIH due to changes in Institute funding strategies, KidneyC...

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Distal RTA type 1 3 hours ago

Seeking an advice about new onset type 1 RTA: 69 yo male presented with Acute Kidney Injury on CKD G3a:A2 (from DKD+HTN+smoking) due to rhabdomyoly...

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RE: IgA Nephropathy with worsening proteinuria 3 hours ago

I think , if the patients eGFR is stable or stabilizing and the primary concern is proteinuria (less than 3 grams) then Sparsentan or Atrasentan , ...

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RE: MPO-ANCA Vasculitis in the Setting of Infective Endocarditis - Infection triggered mimic? 4 hours ago

Rare, but could be two independent conditions. My anecdotal experience that we followed a patient referred for worsening of Renal function. We did ...

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RE: IgA Nephropathy with worsening proteinuria 4 hours ago

Just an Opinion but think a course of oral systemic steroids (TESTING trial protocol) would be my preference. No real RCT evidence concerning optim...

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RE: unilateral renal cysts 4 hours ago

Dr. Chebib- Thank you for your detailed differential diagnosis of unilateral cystic kidney disease. very helpful. Can you briefly explain why a som...

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RE: IgA Nephropathy with worsening proteinuria 4 hours ago

Acutely worsening proteinuria , hypoalbuminemia points towards more acute process. Should this be treated as aprimary podocytopathy ? Is Tarpeyo a ...

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RE: IgA Nephropathy In A Transplant Recipient 5 hours ago

Donor-recipient relationship and degree of HLA-matching? Recipient's current age? Recipient race/ethnicity? Twenty-six-years transplant vintage w...

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RE: unilateral renal cysts 6 hours ago

Thank you , I will have my colleague do the workup and share findings with you. That was a quick and excellent differential diagnosis and workup ...

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RE: unilateral renal cysts 6 hours ago

Thank you for sharing this case. Here is the differential: atypical ADPKD, Mayo class 2A, mosaiscim; but less likely to see this much proteinu...

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RE: IgA Nephropathy In A Transplant Recipient 7 hours ago

The native kidneys of the recipient were not examined by IF. A zero time biopsy of the graft was not performed. Transplant was in 1999. The donor...

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RE: IgA Nephropathy In A Transplant Recipient 8 hours ago

"Longstanding LRD kidney transplant recipient" How long ago was kidney transplant done? Donor-recipient relationship and degree of HLA-matching? ...

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RE: unilateral renal cysts 8 hours ago

UAlb/Cr vs UPr/Cr suggests glomerular proteinuria. This will be unusual in ADPKD. ------------------------------ K.K. Venkat MD Troy MI (248) 420...

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RE: unilateral renal cysts 9 hours ago

Unilateral cystic kidney disease is a real phenomenon(although rare) that may be due to somatic (non-germ cell) mutations. It seems to have a very ...

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RE: IgA Nephropathy with worsening proteinuria 9 hours ago

Great questions I do not think that staining for C4D or MBL will lead anywhere, as the MASP inhibitor (Narsoplimab)) completely failed to modify th...

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RE: IgA Nephropathy with worsening proteinuria 9 hours ago

Dr. Glassock , do you suggest , that in the era of Complement based therapies , in addition to C3 staining , we should consider staining for Factor...

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unilateral renal cysts 11 hours ago

39 year old male , had some flank pain and underwent CT without contrast : Showed normal sized kidneys bilaterally and presence of multiple smal...

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RE: IgA Nephropathy with worsening proteinuria 11 hours ago

It might be worth pointing out that this patient would meet the criteria for use of steroids (+ or - MMF) ot Iptacopan according to the UpToDate ms...

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RE: Crescentic GN with atypical ANCA 13 hours ago

The biopsy mentioned mesangial hypercellularity, is that something common with mesangial expansion from diabetes or idiopathic nodular sclerosis? o...

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RE: IgA Nephropathy with worsening proteinuria 14 hours ago

Also the S1 lesions while considered to be more indicative of chronicity , in your patient are of the podocytopathic variant . This variant is cons...

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RE: IgA Nephropathy In A Transplant Recipient 14 hours ago

I would't do that Why is he/she off antimetabolite agent? any signs of activity (M, E or C) on biopsy? ------------------------------ Emilio...

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RE: IgA Nephropathy In A Transplant Recipient 15 hours ago

Tarpeyo is supposed to work locally, specifically in the distal ileum, aiming to reduce the production of abnormal IgA from the gut-associated immu...

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RE: IgA Nephropathy with worsening proteinuria 15 hours ago

I have no issues with using atrasentan or sparsentan . Unfortunately our health system will not approve either , without a trial of steroids as pe...

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RE: Atrasentan experience and first thoughts 16 hours ago

Just as a follow up after 7 weeks His eGFR from a nadir of 31 ml/min is now 37 ml/ min His uPCR which was 0.8 grams per day , , unfortunately ha...

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RE: IgA Nephropathy In A Transplant Recipient 16 hours ago

So this is de novo IgAN. Was the native kidneys of the recipient ever examined by IF. Was a zero time biopsy of the graft performed. . How can you ...

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RE: IgA Nephropathy with worsening proteinuria 16 hours ago

I think I might try add on Atrasentan or stop RASi and Start Sparsentan. Alternatively, a 6 month course of moderate dose steroids in tapering dosa...

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RE: IgA Nephropathy with worsening proteinuria 17 hours ago

You have already optimized foundational treatment with ARB and Sglt2i. Despite that, the patient seems to have 1. Worsening renal function, decli...

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RE: IgA Nephropathy In A Transplant Recipient 17 hours ago

Biopsy proven IgAN. Original disease is reflux nephropathy. No vasculitis. --------------------------------- Gary Singer MD, FASN Partner Midwest...

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RE: IgA Nephropathy with worsening proteinuria 17 hours ago

M0E0S1T0 - C0 UA - 2 + blood, 3+ protein, 20-40 RBC/HPF BMI 28 BP 132/75 ------------------------------ ChiragVaidya -------------------...

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RE: IgA Nephropathy In A Transplant Recipient 22 hours ago

Not a good idea , in my opinion. Maybe try anti-April or April -BAFF when they become available. Are you sure this is recurrent IgAN not IgAV ? ...

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IgA Nephropathy In A Transplant Recipient 23 hours ago

Longstanding LRD kidney transplant recipient with biopsy proven IgA nephropathy. Current medications include prednisone, tacrolimus, sparsentan an...

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RE: treatment desision of igA vasculitis 1 day ago

------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ------------------------------

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RE: treatment desision of igA vasculitis 1 day ago

Please see UpToDate for practice suggestions . The existing "guidance" is under revision, so new ones will be available soon. -----------------...

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RE: treatment desision of igA vasculitis 1 day ago

M 0 e 0 s 0 t 0 c 1 1 mg/kg he was already taking at the time of biopsy for last 4 weeks Any guidelines in adults of treating igaV I searched kdigo...

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RE: treatment desision of igA vasculitis 1 day ago

Adiagnosis of IgA V seems reasonably certain. With normal kidney function, stable low level of proteinuria, no nephrotic syndrome I think it might ...

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RE: IgA Nephropathy with worsening proteinuria 1 day ago

What is the urine sediment exam or degree of hematuria by dipstick? What is the MEST-C score of the recent biopsy? What is the patients BMI and ave...

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IgA Nephropathy with worsening proteinuria 1 day ago

I have a 51-year-old gentleman whom I started seeing in April 2024 after one of my senior partners retired. Patient has known history of biopsy-pro...

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treatment desision of igA vasculitis 1 day ago

34 years old male with no prior co morbids presented with 10 days hx of abd pain arhtralgia and paedal swelling. before coming to us his work up sh...

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RE: Crescentic GN with atypical ANCA 1 day ago

How recent was his COVID-19 infection? Was it severe? Was he treated? ------------------------------ Omar Maarouf MD Thomas Jefferson University ...

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RE: Crescentic GN with atypical ANCA 1 day ago

Does 1 small cellular creascent (among 8 non-sclerotic glomeruli) , Mesangial C3 deposition , no IgG or monotypic dePosits, miderste exudation, sev...

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RE: Crescentic GN with atypical ANCA 1 day ago

20 Pack years, quit 35 yrs ago. I am wondering if the acute nephritis is the reason for the recent decline in renal function and its worth treat...

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RE: HIGH FERRIN IN HEMODIALYSIS PATINTS 2 days ago

Wow. George's paper is over 20 years old and still relevant. Yes, I have done my share of Indium scans.. Following excised of these old grafts in "...

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RE: HIGH FERRIN IN HEMODIALYSIS PATINTS 2 days ago

Correct. The same applies to a retained non-functional renal allograft. I have attached an oldie regarding infected vascular accesses written by my...

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RE: HIGH FERRIN IN HEMODIALYSIS PATINTS 2 days ago

Yes both have been described. A low grade smoldering failed AVG can be difficult to detect on physical exam alone. In practice, if the ESA dose is ...

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RE: HIGH FERRIN IN HEMODIALYSIS PATINTS 2 days ago

Absolutely Documented in PD best but also my experience in NDD-CKD and even those on HD, If CRP > 5 but [More] Files Attached DocumentRE: HIGH...

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RE: HIGH FERRIN IN HEMODIALYSIS PATINTS 2 days ago

After peridontal disease would also consider retained old vascular access grafts and transplant kidneys as another source of inflammation. ------...

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RE: Crescentic GN with atypical ANCA 2 days ago

Thanks- the nodular glomerulosclerosis is very impressive while crescentic disease is not. Pronase digestion is negative- no clear evidence for a d...

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RE: Crescentic GN with atypical ANCA 2 days ago

Thank you, Dr. Glassock and Dr. Rodby, for your valuable inputs Yes, he does not have DM Yes, the Congo red staining and DNAJB9 sta...

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RE: Crescentic GN with atypical ANCA 2 days ago

Could you post the entire biopsy report (deidentified)? ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 -...

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