RE: IgA Nephropathy In A Transplant Recipient 22 minutes 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 31 minutes 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 35 minutes 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 40 minutes 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 44 minutes 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 1 hour 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 2 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 2 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 6 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 7 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 12 hours ago

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

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RE: treatment desision of igA vasculitis 12 hours 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 13 hours 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 13 hours 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 15 hours 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 15 hours 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 15 hours 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 15 hours 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day ago

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

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RE: Crescentic GN with atypical ANCA 1 day ago

He has a MGUS which is not uncommon in his age group, but a MCRS needs to be excluded, Has he had a bone marrow , that is typical in these situat...

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RE: Crescentic GN with atypical ANCA 1 day ago

Addendum- if the patient is not on Hydrakazine and kidney function is deteriorating further and you cannot evaluate for a complement activating lam...

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RE: Crescentic GN with atypical ANCA 1 day ago

If the patient is taking hydralazine, I would stop it and give a short course of steroids . Just an outside chance. -----------------------------...

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RE: Crescentic GN with atypical ANCA 1 day ago

Without any deposits by EM, Pronase digestion with LC staining for monotypism is not likely to add much but it might be done as a "lomg shot" ---...

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RE: Crescentic GN with atypical ANCA 1 day ago

Dr. Glassock, would you recommend pronase digestion? ------------------------------ M.N. Alhosaini ------------------------------

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RE: HIGH FERRIN IN HEMODIALYSIS PATINTS 1 day ago

Roxadostat HIF-prolyl hydroxylase enzyme inhibitor might be helpful in correcting the condition as its having inhibitory effect on bipcidin product...

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RE: HIGH FERRIN IN HEMODIALYSIS PATINTS 2 days ago

You are correct. Peri dental disease and chronic gingivitis is s a known reason for hypo response to erythropoietin. We don't always look into pati...

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RE: Crescentic GN with atypical ANCA 2 days ago

With a lambda LC MGUS , low C3 and C3 deposition thus might be an indirect form of MGRS with a lambda LC monoclonal Ig inhibiting Factor H activity...

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RE: HIGH FERRIN IN HEMODIALYSIS PATINTS 2 days ago

There has been a lot of mention of infections in this thread .. but often overlooked is dental and gum disease in dialysis patients that drives thi...

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RE: Iptacopan For IC- MPGN 2 days ago

While Iptacopan does not directly block the classic or Lectin pathways , it does inhibit the amplification loop , which is responsible for further ...

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Crescentic GN with atypical ANCA 2 days ago

87-year-old male with a PMH of chronic kidney disease stage IIIB with baseline eGFR of 45, h/o renal cancer s/p cryo ablation, hypertension, BPH, H...

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RE: Iptacopan For IC- MPGN 2 days ago

Since Pegcetacoplan binds to native C3 and prevents the action of the Classical, as well as the alternate pathway C3 Convertase to generate C3b wou...

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RE: bone mineral disorder 2 days ago

Agreed. Did a head CT scan show basal ganglia calcifications. If so, this case is very likely one of long standing hypoparathyroidism. , perhaps ...

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RE: bone mineral disorder 2 days ago

Findings nonspecific for ESKD except for low PTH. If chronically low PTH is suspected may one not see ectopic Ca deposits such as in the basal gang...

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RE: bone mineral disorder 2 days ago

Thank you for the two articles. ------------------------------ Anatole Besarab MD ABesarab Consulting Scottsdale AZ (734) 417-4793 --------------...

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RE: bone mineral disorder 2 days ago

The kidney outcomes in hypoparathyroidism are discussed by Gronemeyer in this recent Frontiers of Endocrinology article. ---------------------...

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RE: MPO-ANCA Vasculitis in the Setting of Infective Endocarditis - Infection triggered mimic? 2 days ago

Well said. Patience is golden ------------------------------ Anatole Besarab MD ABesarab Consulting Scottsdale AZ (734) 417-4793 ----------------...

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RE: bone mineral disorder 2 days ago

Here is a nice review of the skeletal manifestations of hypoparathyroidism by one of the world's expert Mishaela Rubin. ----------------------...

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RE: HIGH FERRIN IN HEMODIALYSIS PATINTS 2 days ago

Should a procalcitonin level be measures as an inflammatory marker. CRP does not always capture well different forms of inflammation. Any sign of a...

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RE: bone mineral disorder 2 days ago

The focus here has been on the metabolic issue of what form of bone disease is present. But the patient is quite uremic if the Cr is 20 mg/dL.I dou...

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RE: bone mineral disorder 2 days ago

Not true. In patients with this degree of CKD the urine calcium is always very low. Hypocalciuria is a feature of Advanced CKD. --------------...

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RE: bone mineral disorder 3 days ago

No nephrocalcinosis Isn't 24 h urine calcium is very low? Range is up to 250 Yahoo Mail: Search, Organize, Conquer

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