RE: renal limited microangiopathy 8 hours ago

No they do not-in my opinion. The C-activation may be occurring only at tissue sites or only intermittently The laboratory features asses C activat...

View Discussion

RE: Cystatin eGFR/Cr. eGFR =0.39 8 hours ago

Just curious, from what is known about this patient , other than weight loss, would anyone start RASi , with or without SGLT2i, a MRA, hypouricemic...

View Discussion

RE: Cystatin eGFR/Cr. eGFR =0.39 10 hours ago

Cystatin-C has more problems than creatinine. It is inducible gene and the bulk of the tissue producing it vary. Drugs and disease process can affe...

View Discussion

RE: renal limited microangiopathy 10 hours ago

yes, I have ordered the genetic panel but does the complement panel rule out complement mediated aHUS ------------------------------ Swathi Pulle...

View Discussion

RE: Membranous Nephropathy with Rapid Progression 10 hours ago

Is there alveolar hemorrhage? ------------------------------ Ashraf El-Meanawy , MD, MS, PHD, FASN Professor of Medicine Director of Dialysis Med...

View Discussion

RE: Membranous Nephropathy with Rapid Progression 15 hours ago

More than half of the patients with ANCA negative crescentic GN superimposed on MN (PLA2R positive or negative ) fail to respond to immunosuppressi...

View Discussion

RE: Membranous Nephropathy with Rapid Progression 18 hours ago

Creatinine seems to be between 7 and 8 and he continues to have UOP Of around 1L still. Renal Doppler is normal and PLA2R is awaited. -----------...

View Discussion

RE: renal limited microangiopathy 19 hours ago

Thank you for sharing . Do you have the results of the complement genetic panel ? What you are sharing is complement and complement split product l...

View Discussion

RE: Membranous Nephropathy with Rapid Progression 20 hours ago

Dr. Abdullah: Is the daily urine volume increasing progressively from the last posted 1.0 L /day? Are pre-dialysis SCr level's trending down? ---...

View Discussion

RE: Membranous Nephropathy with Rapid Progression 21 hours ago

Unfortunately, that was not done. No stigmata of hemolysis with normal LDH and Bilirubin as well. Current update of the patient is that he ha...

View Discussion

RE: renal limited microangiopathy 1 day ago

Update on Renal limited microangiopathy. It took quite some time for the VA to approve Ultomiris, but the patient has now received the first dos...

View Discussion

RE: Cystatin eGFR/Cr. eGFR =0.39 1 day ago

I am not sure that this patient has CKD. In the presence of thyroid disease, serum Cystatin C is a an unreliable biomarker for eGFR. Also , with ma...

View Discussion

RE: Membranous Nephropathy with Rapid Progression 1 day ago

The complement deposits are interesting. Was the IgG typing done? Any stigmata of hemolysis? I think complement inhibitors might be a last-dit...

View Discussion

RE: Cystatin eGFR/Cr. eGFR =0.39 1 day ago

ESR 32 mm/Hr (elevated) CRP 0.9 mg/dl (mild elevation) Albumin 4.0 g/dl Hemoglobin 15 g/dl ferriten 134 ng/ml ( last year check) ---...

View Discussion

RE: Cystatin eGFR/Cr. eGFR =0.39 1 day ago

ESR (sed. rate)? CRP level? Serum albumin? Hemoglobin and ferritin levels? Inflammation can increase custstin C level. ---------------------...

View Discussion

Cystatin eGFR/Cr. eGFR =0.39 1 day ago

60 year old male here with PMHx as below significant for hypothyroidism (TSH 2.7 Normal on L thyroxine) , HTN, undeffrintiated connective tissue di...

View Discussion

RE: Management of persistent amyloidosis and nephrotic range proteinuria despite Very good partial response to BMT and prior chemo 2 days ago

Thanks a lot Dr Leung. Really educational and grateful your time and effort in educating us in this area not very familiar to me and I would suspec...

View Discussion

RE: Management of persistent amyloidosis and nephrotic range proteinuria despite Very good partial response to BMT and prior chemo 2 days ago

-if you use SAP baseline and monitoring of disease and how often? I don't because it is not available to me in the U.S. None of the AL response cri...

View Discussion

RE: Membranous Nephropathy with Rapid Progression 2 days ago

Dr. Soodabar, a positive circulating anti PLA2R antibody is not an absolute contraindication to kidney transplantation Although this patients are a...

View Discussion

RE: Membranous Nephropathy with Rapid Progression 3 days ago

Dr. Soobadar- thanks for your comments on the Vargas-Brochero et al paper in KI Reports A few points of clarification concerning this seminal an...

View Discussion

RE: Membranous Nephropathy with Rapid Progression 3 days ago

ANA and Antidsdna is negative with C3 and C4 normal as well. ------------------------------ Hassan Abdullah MBBS Resident Nephrology Shaikh Zayed...

View Discussion

RE: Chronic Active Thrombotic Microangiopathy - kidney biopsy Tuesday, March 3 @ 3:25 AM

Thanks dr Bianco for great case Any update on case ? --------------------------------- Muhammad Soobadar MBChB UK ----------------------------...

View Discussion

RE: Membranous Nephropathy with Rapid Progression Tuesday, March 3 @ 1:46 AM

Thanks prof glassock for sharing educational and fascinating paper and well done study It’s really long time follow up. Proteinuria 3.5 ...

View Discussion

RE: Membranous Nephropathy with Rapid Progression Tuesday, March 3 @ 12:26 AM

Based on the biopsy, IF was positive for multiple antibodies and trace C1q but negative IgA, this along with one crescent make me wonder if you sho...

View Discussion

RE: Membranous Nephropathy with Rapid Progression Monday, March 2 @ 9:23 PM

Your assumption that "only" 60% of patients with MN and Nephrotic Syndrome achieve a remission with RTX is incorrect. Please see Vargas-Brochero MJ...

View Discussion

RE: Membranous Nephropathy with Rapid Progression Monday, March 2 @ 8:36 PM

This is a very nice discussion thanks to everyone for participation ( senior and non senior )😃 I have read the dr Nile’s cyclo- ritux protocol. I...

View Discussion

RE: FSGS conundrum Monday, March 2 @ 4:52 PM

While no RCT have addressed the issue of Steroid or CNI responsiveness in patients with FSGS lesions and 2 High risk alleles for APOL1 , observatio...

View Discussion

RE: FSGS conundrum Monday, March 2 @ 4:07 PM

The "conundrum" of treatment for Primary (as well as Genetic ) FSGS has been complicated by the results of the DUPLEX trial of Sparsentan (compared...

View Discussion

RE: Membranous Nephropathy with Rapid Progression Monday, March 2 @ 7:55 AM

Thanks Dr. Abdullah. If urine output progressively increases to 1.5 to 2.0 L daily and pre-dialysis SCr levels become progressively lower, recovery...

View Discussion

RE: Membranous Nephropathy with Rapid Progression Monday, March 2 @ 2:49 AM

Anca and GBM serologies have come back negative. Unfortunately patient developed acute Epididymoorchitis around 8-10 days after his Cyclophosphamid...

View Discussion

RE: Membranous Nephropathy with Rapid Progression Monday, March 2 @ 2:42 AM

------------------------------ Hassan Abdullah MBBS Resident Nephrology Shaikh Zayed Hospital Lahore Lahore 03074280146 ---------------------...

View Discussion

RE: Membranous Nephropathy with Rapid Progression Monday, March 2 @ 2:37 AM

Unfortunately we don't have that information as dialysis was initiated at another facility with a serum Creatinine of 13. Patient does not give his...

View Discussion

RE: Membranous Nephropathy with Rapid Progression Sunday, March 1 @ 8:32 PM

Thanks Dr. Abdullah for the additional information. Questions: 1. What was the SCr level and daily urine volume just before you started dialysis? 2...

View Discussion

RE: Membranous Nephropathy with Rapid Progression Sunday, March 1 @ 6:34 PM

Yes, the kidneys are normal sized. I'll trace the full report in a bit but no, there wasn't a suggestion of the collapsing variant fsgs. Patient ...

View Discussion

RE: Membranous Nephropathy with Rapid Progression Sunday, March 1 @ 4:40 PM

Dr. Abdullah: Please do post short-term and long-term updates on your patient. It will be very educational to know: 1. If immunosuppression aimed a...

View Discussion

RE: Refractory membranous Nephropathy Sunday, March 1 @ 3:08 PM

The current standard of care monitoring includes an anti-PLA2R antibody of [More]

View Discussion

RE: Membranous Nephropathy with Rapid Progression Sunday, March 1 @ 2:57 PM

I agree with the senior Dr. Rodby, except I might use a combination of standard dose RTX + low dose - short duration CYC ( Niles-Zonozi protocol )....

View Discussion

RE: Membranous Nephropathy with Rapid Progression Sunday, March 1 @ 9:47 AM

"Any response from the seniors would be appreciated." "Senior" is in the eye of the beholder This senior will keep it simple The clinical out...

View Discussion

RE: Membranous Nephropathy with Rapid Progression Sunday, March 1 @ 7:00 AM

SCr was already at 3.9 mg/dL by late 2025. Remnant nephron hyperfiltration may have kept SCr at 3.9 mg and this compensation may fail rapidly, and ...

View Discussion

RE: Membranous Nephropathy with Rapid Progression Sunday, March 1 @ 5:08 AM

Significance of a Single Fibrocellular Crescent: Even relatively low percentages of crescents in MN (median ~4–5% of glomeruli) are associated wit...

View Discussion

RE: Membranous Nephropathy with Rapid Progression Sunday, March 1 @ 4:08 AM

Thanks for case Did The biopsy findings suggest collapsing fsgs? ? There is no haematuria and if it’s bad crescentic case would expect microscopic...

View Discussion

RE: Membranous nephropathy Sunday, March 1 @ 3:19 AM

Currently, no large randomized trials directly testing routine combination CNI+rituximab versus rituximab monotherapy exist; most data derive from ...

View Discussion

RE: Membranous nephropathy Sunday, March 1 @ 1:58 AM

RE: Refractory membranous Nephropathy Thanks prof glassock - drop in proteinuria with weight loss / diabetes management - normal albumin - high ...

View Discussion

RE: Refractory membranous Nephropathy Sunday, March 1 @ 1:54 AM

@ prof glassock - I got confused with another case this case does not warrant CT The other case had improvement of proteinuria with weight loss a...

View Discussion

RE: Refractory membranous Nephropathy Sunday, March 1 @ 1:01 AM

https://doi.org/10.1016/j.ekir.2025.07.043 Elisa plar2 cut off at baseline and for disease monitoring --------------------------------- Muhamma...

View Discussion

RE: Refractory membranous Nephropathy Sunday, March 1 @ 12:13 AM

Thanks prof glassock -Negative serum plar2 with possible active immune disease tho initially positive - drop in proteinuria with weight loss / d...

View Discussion

Membranous Nephropathy with Rapid Progression Saturday, February 28 @ 11:57 PM

We had a patient, 20 yr old male, known case of Pla2r positive membranous (titer not known) in 2022, nephrotic range proteinuria, treated conservat...

View Discussion

RE: Refractory membranous Nephropathy Saturday, February 28 @ 9:38 PM

What is odd about this case- why would you obtain a CT (of what) ? Your reasoning is quite obscure to me- please try for greater clarity. Thanks. ...

View Discussion

RE: Refractory membranous Nephropathy Saturday, February 28 @ 8:32 PM

I think if I am allowed to guess your thought process prof glassock Is if Elisa plar2 2-14 then consider it positive I guess ( hope I am ok righ...

View Discussion

RE: Refractory membranous Nephropathy Saturday, February 28 @ 8:31 PM

< 2RU / ml is the lower limit of sensitivity of the ELiSA assay. The distinction at 14RU between a positive and a "negative" test is arbitrary and ...

View Discussion