RE: GN in post transplant 9 hours ago

That's a good point. I will discuss with my pathologist more on that Thank you

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RE: Type 1 Cryo proliferative GN without identifiable clone on treatment without improvement in proteinuria 10 hours ago

I agree that the treatments he has received would have been used for IT Glomerulopathy as well. I suppose that the next therapy would be a stem cel...

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RE: Type 1 Cryo proliferative GN without identifiable clone on treatment without improvement in proteinuria 12 hours ago

Haha, I feel the same way about C-P! But just trying to provide intelligent feedback to the patient (a colleague) and the heme-onc colleague. But I...

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RE: Transplant 14 hours ago

Mark, We have tried for years to get people to post in one of the various specific forums, AKI, Transplantion, Fellowship training, Oncology nep...

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RE: Type 1 Cryo proliferative GN without identifiable clone on treatment without improvement in proteinuria 14 hours ago

I hope this does not come across as flippant, but you have on your side one of the strongest renal pathology departments in the world at Columbia. ...

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RE: GN in post transplant 15 hours ago

My initial reaction was to make sure he did not have an infection (RF echo) and treat with Pexivas vasculitis protocol,. but then I read Dr Venkat'...

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RE: GN in post transplant 16 hours ago

In the setting of chronic/intermittent CMV viremia, and heavy proteinuria despite advanced renal dysfunction, need to consider collapsing glomerulo...

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Subnephrotic Proteinuria Unmasked by Preeclampsia: A Dual Genetic Hit of INF2 and CFHR1/CFHR3 Deletion 16 hours ago

Sorry for the long post…. Age: 36 years old. Origin: Argentina. Current Residence: Bogotá, Colombia. Occupation: Office employee. Clinical ...

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RE: NEPHROCALCINOSIS 18 hours ago

Obviously I didn't think that through. I agree that X linked seems unlikely with a paternal inheritance. Also the actual relationship of the uncles...

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GN in post transplant 19 hours ago

hello everyone Would appreciate input on this challenging case 58 year old male with hx of ESKD 2/2 anti-GBM disease, B/L native nephrect...

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GN in post transplant 19 hours ago

Hello everyone Would appreciate the input on this challenging case 58 year old male with hx of ESKD 2/2 anti-GBM disease, B/L native nephrec...

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RE: NEPHROCALCINOSIS 19 hours ago

The one unresolved issue is father to son inheritance, that should not occur in pure X-linked disease, ------------------------------ Richard Gla...

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RE: Transplantation case 20 hours ago

Thanks for posting this Very interesting case on the kidney transplantation community. It certainly appears that your patient recurrent episodes of...

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RE: NEPHROCALCINOSIS 20 hours ago

I would also put my money on Dents disease. The other X linked condition leading to possible nephrocalcinosis is X linked hypophosphatemia. Obvious...

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RE: Transplantation case 20 hours ago

Can you give us serial serum creatinine levels over the last year? Would be instructive ------------------------------ Satish Balan MD DM DNB Se...

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RE: NEPHROCALCINOSIS 23 hours ago

Thanks a lot prof glassock and dr shahzad. Much appreciated. ------------------------------ Hassan Abdullah MBBS Resident Nephrology Shaikh Zayed...

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RE: NEPHROCALCINOSIS 1 day ago

I do appreciate expert reply of Prof .Glascock, Thanks a lot ------------------------------ Ahmed Yasin, MD,FASN Saudi German Hospitals Group Mad...

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RE: NEPHROCALCINOSIS 1 day ago

X-linked inheritance and absence of a history of hypokalemia makes distal (Type 1) RTA less likely, but genetic studies should be very revealing. ...

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RE: Type 1 Cryo proliferative GN without identifiable clone on treatment without improvement in proteinuria 1 day ago

PS: And yes, he is on lisinopril 40 and Farxiga 10. ------------------------------ Jeffrey Reynolds, MD, MBA Partner/Nephrologist PACT Kidney Cen...

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RE: Type 1 Cryo proliferative GN without identifiable clone on treatment without improvement in proteinuria 1 day ago

Thank you so much, Dr. Glassock for the thoughtful response. Good point about the larger microtubules suggesting possible immunotactoid. The seru...

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Transplantation case 1 day ago

31-year-old male kidney transplant recipientwith end-stage kidney disease secondary to reflux nephropathy, previously on hemodialysis since 2009, w...

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RE: NEPHROCALCINOSIS 1 day ago

Any 24 hour urine stone profile Urine PH or ammonia With distal RTA one would expect medullary calcinosis more than cortical Distal (type 1) ren...

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RE: Type 1 Cryo proliferative GN without identifiable clone on treatment without improvement in proteinuria 1 day ago

What happened to the serum levels of the Kappa IgG paraprotein with the Dara/ velcade/ steroid therapy. I assume that the patient does not have CLL...

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Type 1 Cryo proliferative GN without identifiable clone on treatment without improvement in proteinuria 1 day ago

I would greatly appreciate your help on this case. 72 year old male (physician) in excellent health referred 2 years ago for mild proteinuria whi...

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RE: NEPHROCALCINOSIS 1 day ago

Cortical nephrocalcinosis can occur late in conditions like Dent disease and Primary hyperoxaluria . The normal urine oxalate excretion makes Prima...

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RE: NEPHROCALCINOSIS 1 day ago

Is cortical nephrocalcinosis classic for this? Things like cortical necrosis usually lead to cortical nephrocalcinosis. Any relevance of the locati...

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RE: NEPHROCALCINOSIS 1 day ago

Definitely do genetic testing. This looks like X-linked disease so he may have Dent Disease, which commonly results in Nephrocalcinosis . The hypoc...

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NEPHROCALCINOSIS 1 day ago

I have 30 year old patient with cortical nephrocalcinosis, bilateral renal stones ,creatinine 1.5 mg on potassium citrate and hydrochlorothiazide. ...

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RE: Refractory ICI-Associated Nephritis with Progressive AKI, Eosinophilia, and Rash After Nephrectomy – Looking for Management Suggestions 1 day ago

Thank you Dr Pierce. Appreciate your pointing out your experience & the similarity in histopath appearance. I do recall from a good number of years...

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Transplantation case 1 day ago

31-year-old male kidney transplant recipient with end-stage kidney disease secondary to reflux nephropathy, previously on hemodialysis since 2009, ...

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Transplant 1 day ago

The Open Forum is a great place to post cases, but I would ask in the future please post transplant related cases on the Kidney Transplantation com...

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RE: Transplant Case- can recurrent Ig A in transplant patient present without proteinuria and midly low C3 and more significant lower C4. 1 day ago

Please try to post transplant related cases on our Kidney Transplatation community - thanks ------------------------------ [Mark] [Lerman] [MD,...

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RE: Refractory ICI-Associated Nephritis with Progressive AKI, Eosinophilia, and Rash After Nephrectomy – Looking for Management Suggestions 1 day ago

I had a case many years ago, before a lot was known about treatment, except steroids. The biopsy reminded me of T cell mediated rejection of a tran...

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RE: treatment of C3GN after developing meningococcal infection with iptacopan 2 days ago

Thank you so much Dr. Glassock. The problem is that her meningococcal serotyping was non-typable, which indicates that it is a strain beyond the on...

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RE: Refractory ICI-Associated Nephritis with Progressive AKI, Eosinophilia, and Rash After Nephrectomy – Looking for Management Suggestions 2 days ago

@Mario Rubin: No personal experience. Blocking IL-5 axis has been used only for eosinophil-rich AIN. ------------------------------ K.K. Venkat M...

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RE: Refractory ICI-Associated Nephritis with Progressive AKI, Eosinophilia, and Rash After Nephrectomy – Looking for Management Suggestions 2 days ago

The group at MD Anderson in Houston has pioneered the use of infliximab (as stated in several posts) and it's benefits in the management of steroid...

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RE: Refractory ICI-Associated Nephritis with Progressive AKI, Eosinophilia, and Rash After Nephrectomy – Looking for Management Suggestions 2 days ago

Another recent approach to steroid-refractory, eosinophil-rich AIN caused by ICIs is blocking the IL-5 axis. Eosinophil activation depends on the I...

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RE: Case of intermittent Hyokalaemia with preserved kidney function 2 days ago

Serum sodium 143-145 and serum K less than 3 suggest primary hyperaldosteronism Before calling this white-coat hypertension, I would like to kno...

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RE: Refractory ICI-Associated Nephritis with Progressive AKI, Eosinophilia, and Rash After Nephrectomy – Looking for Management Suggestions 2 days ago

Hi, I am current Onco-Nephrology fellow at MD Anderson we see a lot of similar cases. We give them infliximab. I also attached the recent stu...

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RE: Refractory ICI-Associated Nephritis with Progressive AKI, Eosinophilia, and Rash After Nephrectomy – Looking for Management Suggestions 2 days ago

Murad: I attach another article on use of Infliximab, as well ------------------------------ Prem Chandran MD Adj Clinical Professor, Univ o...

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RE: Case of intermittent Hyokalaemia with preserved kidney function 2 days ago

She does have high U K/Cr and FE K suggesting renal K loss. No evidence of primary aldosteronism or Barters or Gittelman. With this BMI could she...

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RE: Case of intermittent Hyokalaemia with preserved kidney function 3 days ago

Do you have a spot urine K:creatinine ratio synchronous with a serum K that shows hypokalemia . This would be the most accurate determination of re...

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RE: Case of intermittent Hyokalaemia with preserved kidney function 3 days ago

I was implying that the HTN was obesity related, and that the K may not be part of a syndrome since it is often normal or so I interpreted the orig...

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RE: Refractory ICI-Associated Nephritis with Progressive AKI, Eosinophilia, and Rash After Nephrectomy – Looking for Management Suggestions 3 days ago

I do not have personal experience but I attach an article using infliximab. This reminds me of steroid unresponsive sarcoidosis where infliximab ca...

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Refractory ICI-Associated Nephritis with Progressive AKI, Eosinophilia, and Rash After Nephrectomy – Looking for Management Suggestions 3 days ago

I would appreciate input from colleagues regarding a challenging case. A patient with advanced right RCC and suspected left supraclavicular nodal...

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RE: treatment of C3GN after developing meningococcal infection with iptacopan 3 days ago

Addendum- according to the ACIP- only Penucillin V , Ciprofloxacin, Rifampin are recommended for meningococcalprophylaxis. Amoxicillin is not recom...

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RE: treatment of C3GN after developing meningococcal infection with iptacopan 3 days ago

Extremely complex case and a classic "between a rock and a hard place " situationist.. evidence based advice is impossible. . I know of no data on ...

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RE: nocturnal polyuria Wednesday, June 10 @ 10:36 PM

@Prem Chandran: I agree with you that the initial non-albumin dominant tubular proteinuria in a primary TI disorder can become albumin-dominant eve...

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RE: nocturnal polyuria Wednesday, June 10 @ 8:34 PM

Thank you Dr Venkat: I follow you well. In tubulopathies, there is often glomerular sclerosis & altered glomerular permeability, especially in the ...

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RE: nocturnal polyuria Wednesday, June 10 @ 8:34 PM

I fully agree. For completeness sake, let's add the diagnostic role of urinary retinol binding protein (molecular weight = 21.2 kDa) which has been...

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