RE: MCD-IgA nephropathy 4 hours ago

I woukd agree with a provable auto-immune diffuse Podocytopathy superimposed on IgAN and stage III Diabetuc nodular glomeruloscleroisis - woild hav...

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RE: MCD-IgA nephropathy 6 hours ago

Thank you Dr. Rodby! I agree, he has mesangial deposits on EM but likely missed on the report! Would you add any of the novel treatments for I...

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RE: MCD-IgA nephropathy 6 hours ago

Thank you for your thoughts. Agreed with you about the diagnosis, he doesn't seem to have signs and symptoms of infection, diabetes was controlle...

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RE: MCD-IgA nephropathy 6 hours ago

That's very helpful, thank you.. I think he fits more into MCD-like IgA, I will take a look to the publication.. Was the type of other IS for non-M...

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RE: MCD-IgA nephropathy 6 hours ago

Thank you.. how long would you wait while on steroids, assuming DM is controlled on insulin? ------------------------------ Sarah Al Zoubi MD Oak...

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RE: MCD-IgA nephropathy 6 hours ago

That's exactly what I thought, he has mesangial hypercellularity and mesangial IF staining but no IC on EM, I think maybe missed on the report? I w...

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RE: MCD-IgA nephropathy 6 hours ago

Many good points written already Dr Venkat the EMS are there below the LM and there are impressive subendothelial deposits and mesangial deposits...

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RE: MCD-IgA nephropathy 10 hours ago

Interesting case, thanks for sharing. A few thoughts: Most likely: a minimal change–like podocytopathy superimposed on IgA nephropathy, with bac...

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RE: MCD-IgA nephropathy 11 hours ago

What is the MEST-C score of IgAN? Recently published multi-center retrospective study phenotypes patient with MCD and IgAN into 2 variants; MCD-li...

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RE: MCD-IgA nephropathy 12 hours ago

"EM showed diffuse FPE, glomerular basement membranes are thickened and contain focal subendothelial deposits with rare subepithelial deposits" D...

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RE: HSP with heavy proteinuria 12 hours ago

Only ‘patchy moderate FPE’ but that was already after ‘oral prednisone 40 mg per day tapered over 10 days’ and then ‘IV steroids followed by predni...

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RE: HSP with heavy proteinuria 12 hours ago

Thanks all for the input, much appreciated. Below is the text from the biopsy report. FPE described as patchy and moderate. Will see if I can get i...

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RE: HSP with heavy proteinuria 16 hours ago

IgAN and IgAV, shared upstream signals (Gd-IgA1) but different downstream effects (renal limited vs renal and skin). For the skin effects, there ar...

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Cheer on Semi-finalists in the FIT Bowl Today! 17 hours ago

Today at Kidney Week, please stop by the ASN Futures Theater in Exhibit Hall A, of the Colorado Convention Center, to watch the 2026 FIT Bowl! ...

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RE: MCD-IgA nephropathy 17 hours ago

continue steroids with close monitoring for diabetes control. must be sure IgA not secondary to occult infection especially with known diabetes. co...

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MCD-IgA nephropathy 19 hours ago

I want to open a discussion about one of my patients in the clinic. A 55 year old male patient with PMHx of well controlled DM and HTN, presented...

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RE: HSP with heavy proteinuria 1 day ago

This is an unexplained phenomenon, seen in (well done) observational (single arm) studies.The "effectiveness" of RTX in IgAV has not (yet) be confi...

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RE: HSP with heavy proteinuria 1 day ago

@Richard Glassock Out of curiosity , why would Rituximab show no benefit in IgA Nephropathy, but good response in igA vasculitis . I am aware that...

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RE: HSP with heavy proteinuria 1 day ago

Drs. Friedman and Venkat. A S0 lesion makes a diffuse Podocytopathy (superimposed on IgAV) less likely, but EM analysis would be of interest, I agr...

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RE: HSP with heavy proteinuria 1 day ago

Since no clinical trials have yet reported efficacy of Atacicept or Atrasentan in IgA Vasculitis, so your conclusions must be extrapolations from I...

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Cheer on your colleagues at the 2026 Fellows-In-Training (FIT) Bowl in Denver! 1 day ago

While at Kidney Week, please stop by the ASN Futures Theater in Exhibit Hall A, of the Colorado Convention Center on Friday, October 23, to watch t...

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RE: Drug-induced lupus and ANCA GN 1 day ago

Thank you Dr. Glassock ------------------------------ Pongstorn Pitiranggon MD Pee Dee Nephrology Florence SC (843) 669-6694 --------------------...

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RE: HSP with heavy proteinuria 1 day ago

I would like to take the contrarian view in that I think the Atacicept and Atrasentan are actually reducing the proteinuria. . However, on withhold...

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RE: HSP with heavy proteinuria 1 day ago

I share Dr. Friedman's impression that there must be a podocytopathy (causing severe nephrotic syndrome) + IgA vasculitis in this patient. How ab...

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2026 Fellows-In-Training (FIT) Bowl in Denver Starts Today, Oct. 22! 1 day ago

FIT Bowl starts today! Come to the ASN Futures Theater in Exhibit Hall A, of the Colorado Convention Center to cheer on your colleagues today, Thur...

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The 2026 ASN FIT Bowl is supported by Asahi Kasei Therapeutics. 1 day ago

FIT Bowl starts today! Come to the ASN Futures Theater in Exhibit Hall A, of the Colorado Convention Center to cheer on your colleagues today, Thur...

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RE: SLE Lupus nephritis Class V 1 day ago

------------------------------ [Sheng] [Kuo] MD, FASN ------------------------------

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RE: Lupus-associated TMA with no response after four weekly doses of eculizumab: withdraw or continue? 1 day ago

Following your helpful advice in August, I would like to share an update on our 29-year-old patient with SLE, lupus nephritis, and recurrent TMA. W...

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RE: Drug-induced lupus and ANCA GN 2 days ago

This is almost certainly Hydralazine -induced ANCA (anti-MPO) Vasculitis , not Lupus Nephritis. It will remit with discontinuance of the offending ...

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Cheer on your colleagues at the 2026 Fellows-In-Training (FIT) Bowl in Denver! 2 days ago

While at Kidney Week, please stop by the ASN Futures Theater in Exhibit Hall, of the Colorado Convention Center on Thursday, October 22, and Friday...

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RE: HSP with heavy proteinuria 2 days ago

She must have had significant FPE. I think the biggest contributor to her NS partial remission then was the IV f/b PO steroids. She has an E1 lesio...

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Drug-induced lupus and ANCA GN 2 days ago

86 y/o w/f with DM2, HTN, breast cancer presented with non-oligulic AKI. Serum creatinine is 3.8 ( baseline Cr 0.8 ). She has been on hydralazine w...

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RE: HSP with heavy proteinuria 2 days ago

Neither Atacicept nor Atrasentan have any established role in treatment of IgA Vasculitis. But the patient is doing well. If he can continue to rec...

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RE: HSP with heavy proteinuria 2 days ago

would continue therapy as responding to present therapy. no need to re-biopsy ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] ...

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HSP with heavy proteinuria 2 days ago

Appreciate any input on a case of HSP with unusually heavy proteinuria 42 year-old woman with no medical history barring hypothyroidism, presente...

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RE: SLE Lupus nephritis Class V 2 days ago

If EXT I/II +, I may sit tight and monitor as it pertains to good prognosis. I will try to obtain the actual EM image. --------------------------...

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RE: SLE Lupus nephritis Class V 2 days ago

Interesting idea. No data. No clinical trials to support use. Will endothelin blockers be effective for FGGS. I don't know, but I doubt it. -----...

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RE: SLE Lupus nephritis Class V 2 days ago

Any role for off label use of Endothelin blockers to reduce proteinuira, if primarily driven by sclerosis --------------------------------- Dr. H...

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RE: SLE Lupus nephritis Class V 2 days ago

How does a positive versus a negative EXT I/II change the approach in this type of patients? Has renal vein thrombosis been excluded in this pati...

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RE: SLE Lupus nephritis Class V 2 days ago

Thanks- would it be possible to post a deidentified photo micrograph of a representative glomerulus by EM?I am particularly interested in the degre...

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RE: SLE Lupus nephritis Class V 2 days ago

EM: Numerous subepithelial and intramembranous electron-dense deposits along the BM. GBM are variably thickened. No subendothelial deposit. Scatter...

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RE: SLE Lupus nephritis Class V 3 days ago

Yes- non Class V active LN is often treated with triple IS, but the 2024 KDIGO CPG did not suggest IS therapy for "pure" Class V Lupus Membranous N...

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RE: SLE Lupus nephritis Class V 3 days ago

Thanks Dr. Dastoor- in the USA OBI is not approved for "inactive " LN. It might be easier to start with RTX. Not true in UAE. -------------------...

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RE: SLE Lupus nephritis Class V 3 days ago

I think it may be best to try and go for Obi over RTX. If the patient does not respond to RTX , as it seems he won't , you will be second guessing ...

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RE: SLE Lupus nephritis Class V 3 days ago

Thanks dr Kuo Makes sense to stop volclosporin as has not worked also Ifta as you mention Make sense not to use belimumab as has not worked / o...

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RE: SLE Lupus nephritis Class V 3 days ago

Thanks prof glassock For class 3/4 in my unit I notice people using dual therapy ( mmf +obi or mmf + volclo) with steroids and hydroxychlorquine an...

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RE: SLE Lupus nephritis Class V 3 days ago

Tough question- it depends- For non-nephrotic "pure" Class V LN-MMF + low dose steroids or a CNI +iow dose steroids or RTX and no steroids, But nev...

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RE: SLE Lupus nephritis Class V 3 days ago

Since OBI is approved by the FDA only for "active" LN and your patient has an Activity Index of zero (as expected for Pure Class V Lupus Membranous...

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RE: SLE Lupus nephritis Class V 3 days ago

1. IF from 2025 still with “Full House”. I will update EM finding when I have the report in front of me again. 2. He developed or manifested LN whi...

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RE: SLE Lupus nephritis Class V 3 days ago

Thanks prof glassock for input Non nephrotic our class v what would be your starting therapy ? And if things not improving let’s say 6 month to a...

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