RE: secondary IgA Nephropathy 3 minutes ago

Final Diagnosis Kidney biopsy: IgA nephropathy. Oxford IgA nephropathy classification ( M0, S0, E0, T0, C0). Light microscopy: The renal biopsy ...

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RE: secondary IgA Nephropathy 3 hours ago

Dr. Thalla- can you post the de-deidentified kidney biopsy pathology report for this patient ?. . I think it might help to focus the discussion. ...

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RE: Dapagliflozin In Hd Patient With Diastolic Dysfunction 6 hours ago

It is interesting that u specifically mentioned dapagliflozin in ESRD patients . Is that a personal preference or is there some evidence favoring ...

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RE: Painless macroscopic hematuria 9 hours ago

I believe this the reference https://doi.org/10.1002/pbc.25592 "is important to note that this claim traces back to older case series and textb...

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RE: Painless macroscopic hematuria 10 hours ago

@K.K. Venkat I was not aware of that anatomic left renal vein predilection. Do you have the reference(s) of that report? Thank you ------------...

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RE: Painless macroscopic hematuria 10 hours ago

It has been reported that sickle cell trait is more likely to cause unilateral hematuria from the left kidney. This was attributed to the longer le...

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RE: Painless macroscopic hematuria 11 hours ago

Dr. Anand-thanks so much for follow-up on this interesting case confirming SCT which is most likely cause given the extensive workup you have share...

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RE: Painless macroscopic hematuria 12 hours ago

Dr. Anand. Thanks. We all learned from this case. urgent Cystoscopy is key and SS trait must be considered in all Black subjects with gross hematur...

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RE: Dapagliflozin In Hd Patient With Diastolic Dysfunction 12 hours ago

In large scale Observational studies SGLT2i have benefits in ESKD patients with HFrEF and HFpEF.( See Wu J-Y. et al Front Cardiovascular Med 2026; ...

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RE: secondary IgA Nephropathy 13 hours ago

A serum creatinine of 2.2mg/dL in completely unexpected in a patient with IgAN and a MEST-C score of M0, E0, S0, T0, C0 and minimal proteinuria des...

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Dapagliflozin In Hd Patient With Diastolic Dysfunction 13 hours ago

Patient is home hd Not much urine but not measured Learning disability fragile X syndrome Echo - normal lv and lv function Impaired diastolic d...

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RE: Painless macroscopic hematuria 13 hours ago

The Hb electrophoresis confirmed that he has sickle cell trait!! Thanks to all in the group for your responses. I learnt something new --------...

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RE: AL amyloidosis 17 hours ago

@Richard Glassock, no, the current ISA criteria does not require a bone marrow for a complete response assessment. However, we are borrowing from m...

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RE: secondary IgA Nephropathy 17 hours ago

I agree with @Mark Lerman "Biopsy does not explain AKI, when did creatinine rise from baseline ? if creatinine does not improve may need to consi...

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RE: secondary IgA Nephropathy 19 hours ago

for those who are skeptical regarding this patient's creatinine level-I would attempt to measure GFR directly. We in Dallas rely on Glofil-125 (...

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RE: secondary IgA Nephropathy 19 hours ago

SGLTi I started just 10 days ago. Ozempic , he started in 2024 and had lost 60 lbs. his creatinine after weight loss was 1.2-1.3 in May 2025. He ...

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RE: secondary IgA Nephropathy 19 hours ago

Thank you for Reply. That was my first thought before biopsy. Humira last dose was in November. Unfortunately no creatinine checked from May 2025 t...

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RE: Please help with renal biopsy results - vascular insult - etiology unclear 19 hours ago

""Why do I hate eGFR values so much and just prefer a serum creatinine? That is rhetorical but also editorial. " @Roger Rodby -and the answer is?" ...

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RE: secondary IgA Nephropathy 20 hours ago

There are reports of Humira-associated AKI due to acute interstitial nephritis, secondary IGA nephropathy, etc. Noted that Humira was stopped in Ja...

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RE: secondary IgA Nephropathy 21 hours ago

Thanks -thus is very helpful. Can you also clarify the timing of the prescription of SGLT2i and GLP1RA and the observed ruse in serum creatinine. W...

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RE: secondary IgA Nephropathy 23 hours ago

His BMI is 31-32. No RBC casts in tubules. No evidence of AIN or ATN in biopsy. ------------------------------ Radhika Thalla MD Physician...

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RE: secondary IgA Nephropathy 1 day ago

The very sparse clinical literature suggests (but does not prove) that patients with IBD can "hyperabsorb" creatinine, from such sources as dietary...

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RE: secondary IgA Nephropathy 1 day ago

With active Crohn's disease , I would expect this patient to be malnourished, hence a creatinine of 2.2 mg/dl , may potentially suggest a more seve...

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RE: secondary IgA Nephropathy 1 day ago

One additional measure that might be appropriate is to measure Serum creatinine after fasting. ------------------------------ Richard Glassock M...

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RE: secondary IgA Nephropathy 1 day ago

This is certainly very mild IgAN. With such minimal proteinuria there is no clear indication for SGLT2i or RASi. How obese is the patient?. Any RBC...

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RE: secondary IgA Nephropathy 1 day ago

Thank you for reply. Creatinine is increased in February. Previous creatinine was 1.2 ( in May 2025 with his physical)s. Biopsy is done in June. ...

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RE: secondary IgA Nephropathy 1 day ago

Thank you for the reply. Kidney biopsy showed LM : a total of 15 glomeruli, of which is 1 is globally sclerosed. Mild mesangial cell proliferatio...

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RE: secondary IgA Nephropathy 1 day ago

agree no indication for Budesonide, but cautious use of ARB, and SGLT2 might be considered. Biopsy does not explain AKI, when did creatinine rise f...

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RE: secondary IgA Nephropathy 1 day ago

With such minimal proteinuria and the lack of any inflammation or crescents in a kidney biopsy I would suspect a spurious elevation of serum creati...

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secondary IgA Nephropathy 1 day ago

43 yr old with PMH of Ulcerative colitis with AKI creatinine increased to 2.4 ( baseline 1.2) and hematuria. Proteinuria of 0.2 gms. BP is usally i...

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RE: AL amyloidosis 1 day ago

Is a repeat bone marrow biopsy with cytogenetic analysis required for determination of a complete response in AL Amyloid treated with autologous SC...

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RE: AL amyloidosis 1 day ago

Not detected on SPEP, SIFE, and UPEP --------------------------------- [Sheng] [Kuo] MD, FASN ---------------------------------

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RE: AL amyloidosis 1 day ago

what about her monoclonal IgM lambda. is that still positive? ------------------------------ Nelson Leung MD Mayo Clinic Rochester MN (507) 208-1...

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RE: Please help with renal biopsy results - vascular insult - etiology unclear 1 day ago

Agree with Prof Rodby. Too much reliance on serum creatinine and eGFR. Definitely pt has chronic renal ischemic damage and considering his age pro...

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RE: AL amyloidosis 2 days ago

I have been holding off on this re-biopsy, as I didn’t believe it will yield another diagnosis. However, it’s been 3 years and hematology was so co...

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RE: AL amyloidosis 2 days ago

Her initial bone marrow biopsy showed 10-15% plasma cell myeloma, lambda monotypic without amyloid (Congo Red negative). Most recent lambda free L...

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RE: AL amyloidosis 2 days ago

what is The lambda free light chain and kappa lambda ratio? IgM AL amyloidosis cases are harder to treat then non IgM cases. what did the original ...

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RE: AL amyloidosis 2 days ago

An update since last post in 2023 and hoping for additional guidance. Chinese female with history of HBV and hyperlipidemia initially presented w...

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RE: Nephrology Discussion – C3 Glomerulopathy, Immune-Mediated Encephalopathy & Rituximab 2 days ago

Thanks Dr. Kuniyil. This is very helpful information , Dobyou have any data on Brain MRI or Lumbar puncture for CSF JC virus by PCR that you can sh...

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RE: Nephrology Discussion – C3 Glomerulopathy, Immune-Mediated Encephalopathy & Rituximab 3 days ago

GABA-B receptor antibody – Negative NMDA receptor (Anti-NR1) antibody – Negative CASPR2 antibody – Negative LGI1 antibody – Negative AMPA-1 rec...

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RE: Nephrology Discussion – C3 Glomerulopathy, Immune-Mediated Encephalopathy & Rituximab 3 days ago

Great ,thanks 🙏 ------------------------------ Ramshad Kuniyil MD Hmc Doha 0097433154100 ------------------------------ [More]

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RE: Nephrology Discussion – C3 Glomerulopathy, Immune-Mediated Encephalopathy & Rituximab 3 days ago

Thank you ------------------------------ Ramshad Kuniyil MD Hmc Doha 0097433154100 ------------------------------

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RE: Nephrology Discussion – C3 Glomerulopathy, Immune-Mediated Encephalopathy & Rituximab 3 days ago

Thank you, Professor Glassock. The patient received rituximab approximately 8 years ago for biopsy-proven C3 glomerulopathy. At that time, the tr...

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RE: Nephrology Discussion – C3 Glomerulopathy, Immune-Mediated Encephalopathy & Rituximab 3 days ago

Was JC virus PCR performed on CSF fluid obtained by spinal tap in this case? Temporary improvement after PLEX as well as Parkinsonism features and ...

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RE: Nephrology Discussion – C3 Glomerulopathy, Immune-Mediated Encephalopathy & Rituximab 3 days ago

Can you share with Brain MRI findings in this case.? ------------------------------ Richard Glassock MD, FASN Emeritus Professor Geffen School of...

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RE: Nephrology Discussion – C3 Glomerulopathy, Immune-Mediated Encephalopathy & Rituximab 3 days ago

How long ago was the patient treated with Rituximab.? ,This off label regimen is not standard of care, but has been used to treat anti-Factor auto-...

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RE: Nephrology Discussion – C3 Glomerulopathy, Immune-Mediated Encephalopathy & Rituximab 3 days ago

"Could the patient's C3 glomerulopathy (or underlying complement-mediated immune dysregulation) and neurological syndrome be linked by a common imm...

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RE: Nephrology Discussion – C3 Glomerulopathy, Immune-Mediated Encephalopathy & Rituximab 3 days ago

Was anti-LGI1 included in the auto-antibody panel?, the neurological findings are very reminiscent of this auto-immune encephalopathy, but I do not...

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RE: Nephrology Discussion – C3 Glomerulopathy, Immune-Mediated Encephalopathy & Rituximab 3 days ago

No personal experience with a similar case. I posted your case on Google AI and it responded as follows (only part of response copied below): "The...

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RE: Please help with renal biopsy results - vascular insult - etiology unclear 3 days ago

Drs. Venkat, Rodby, and Campese your point is well taken in using RAAS blockade in hypertensive patients especially without significant proteinuria...

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