RE: simultaneous liver kidney transplant 25 minutes ago

@Satish Balan Thank you for your concise clarification and the reference you provided which I will agree is more conjectural than proof of pri...

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RE: simultaneous liver kidney transplant 1 hour ago

@Mario Rubin The effect of the transplanted liver in preventing renal rejection in SLKT is primarily believed to be due to the effect of HLA Clas...

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RE: simultaneous liver kidney transplant 1 hour ago

Good idea but the issue is not that simple. This patient had a negative flow cytometry and CDC crossmatch which argues against the presence of Abs....

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RE: simultaneous liver kidney transplant 1 hour ago

If we have pre-transplant Anti Donor antibodies intensity scored by MFI , then it may be repeated post transplant to explore the effectiveness of s...

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RE: renal limited microangiopathy 2 hours ago

I agree with starting eculizumab. You will have better luck with starting ravulizumab outpatient as it is less expensive overall. It is q8 weeks ...

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RE: simultaneous liver kidney transplant 7 hours ago

Sir both the donors were negative for PH1 ------------------------------ Sunil Prakash Vice Chairman and Head, Dept of Nephrology and Renal trans...

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RE: simultaneous liver kidney transplant 7 hours ago

Respected Sir we could not repeat S ox. as it expensive and turn around time is about a week. So we blindly kept post SLKT HDF without fluid remo...

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RE: simultaneous liver kidney transplant 7 hours ago

Sir The patient was not on lumisarin. It's not freely available. In fact, getting plasma oxalate is also expensive and time consuming here. In...

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RE: simultaneous liver kidney transplant 8 hours ago

TAC LEVELS vacillated between 4.0 3.5 to ng/ml by CLIA method ------------------------------ Sunil Prakash Vice Chairman and Head, Dept of Nephro...

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RE: simultaneous liver kidney transplant 8 hours ago

Sirthe patient did not get lumisaran but we gave intensive dialysis pre and post SLKT to avoid choking of the graft by oxalate mobilizationregards

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RE: renal limited microangiopathy 12 hours ago

This is a "renal limited form of TMA without systemic features of aHUS (I.e. MAHA, Therapy of this condition is not well established, (No RCT) but ...

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RE: renal limited microangiopathy 18 hours ago

Thank you Dr. Glassock for your response. I'm concerned about approval for Eculizumab Hemoglobin was 10.2 on presentation. it is currently at 9.3...

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RE: Chronic Active Thrombotic Microangiopathy - kidney biopsy 20 hours ago

What was the platelet count with the initial episode and what is it now? Was C5b-9 performed? What are the schistocyte, LDH and haptoglobin now? ...

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RE: rise of PLA2R, nephrotic range proteinuria and cannot biopsy 21 hours ago

Dual Anti-PLA2R + another antigen (such as NELL1 or THSD7A) is very uncommon (< 2%) in MN. I agree with Dr. Rodby, I woukd treat with RTX now and f...

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RE: simultaneous liver kidney transplant 21 hours ago

@Satish Balan Thank you for your comment Dr. Balan. Can you please clarify your statement that " But the fact that this is a different donor for ...

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RE: renal limited microangiopathy 21 hours ago

This sounds like atypical HUS (renal limited). What was the hemoglobin , Reticulocyte count, peripheral blood smear (for schistocytes) - in additio...

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RE: simultaneous liver kidney transplant 22 hours ago

If you look at the literature on SLKT vs sequential LKT vs KT alone, SLKT seems to have a better prognosis than the others. At the same time as Dr ...

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RE: Thin BM 1 day ago

------------------------------ Sinasi Salman MD, FASN Owner Northlake Nephrology, PLLC Mooresville NC (704) 858-4300 ------------------------------

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renal limited microangiopathy 1 day ago

Hello Appreciate input on management of this unique case. The patient is a 58-year-old Caucasian male with HTN, rheumatoid arthritis treated ...

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RE: rise of PLA2R, nephrotic range proteinuria and cannot biopsy 1 day ago

I am also comfortable treating empirically based on sensitivity and specificity of PLA2R serum Ab, and history of MGN in the past (pre PLA2R testin...

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RE: anti gbm/mpo +ve in young female 1 day ago

If CYC is used the dose should be reduced by 50% from normal dose because of oligo-anuria- IV CyC regimens should be avoided in this setting in my ...

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RE: rise of PLA2R, nephrotic range proteinuria and cannot biopsy 1 day ago

Because o T2DM you should probably test for anti -PLA2R antibody using the more specific IFA at least once, but a FP ELISA would be hard to explain...

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RE: rise of PLA2R, nephrotic range proteinuria and cannot biopsy 1 day ago

Prior biopsy proven MN (unknown PLA2R status.) Treated with CYC and steroids. And T2DM with rising PLA2R antibody and nephrotic range proteinuria. ...

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RE: rise of PLA2R, nephrotic range proteinuria and cannot biopsy 1 day ago

Will it useful to test for other antibodies like anti-NELL antibody and thrombospondin type-1 domain-containing 7A (THSD7A)? --------------------...

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rise of PLA2R, nephrotic range proteinuria and cannot biopsy 1 day ago

White gentleman age 76, Membranous GN was found on biopsy in 1993 which is the only kidney biopsy of his life when he was started on lisinopril...

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RE: simultaneous liver kidney transplant 1 day ago

Thanks for asking Mario. I'm replying as a non-transplant expert of course. At NYU and Mayo my patients receiving SLKs for PH seem to have been tre...

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RE: simultaneous liver kidney transplant 1 day ago

@Richard Glassock @Justine Bacchetta The short answer is there is no data that lumasiran is necessary in the setting of a combined liver-kidney...

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RE: simultaneous liver kidney transplant 1 day ago

Thanks Drs. Venkat and Rubin. Your responses are very helpful. Is a short duration of Lumisarin therapy pre and post transplant indicated in this c...

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RE: Chronic Active Thrombotic Microangiopathy - kidney biopsy 1 day ago

Improvement either PLEX points to TTP. Improvdment without Warfarin points away from anti-phospholipid antibody syndrome. It is not clear to me whe...

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RE: Thin BM 1 day ago

SCIENCEINSIGHTS: Clinical Role in Autoimmune Disease Exclusion > > ------------------------------ Sinasi Salman MD, FASN Owner Northlake Neph...

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RE: Thin BM 1 day ago

My understanding (by reading this) is that anti DSF-70 are uncommon in patients with ANA positive systemic rheumatic disease and more common in hea...

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RE: Chronic Active Thrombotic Microangiopathy - kidney biopsy 2 days ago

Interesting case. the intermittently low CH50 points toward complement mediated TMA But , even in the absence of anti factor H antibodies, she se...

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RE: Chronic Active Thrombotic Microangiopathy - kidney biopsy 2 days ago

Dear Dr Dastoor, thank you! We will organize the biopsy! and I'll let you know! patricia ------------------------------ Patricia D' A...

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RE: Chronic Active Thrombotic Microangiopathy - kidney biopsy 2 days ago

Dear Dr Glassok Thank you! I am not sure if any renal unit is in this trial. It would be very good for the patient! I will find out!! ...

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RE: simultaneous liver kidney transplant 2 days ago

I assume that both live donors were genetically tested for PH1. Yes, the immunological sink concept is quite prevalent in the field of OLTX and SL...

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RE: Thin BM 2 days ago

A genetic diagnosis of Alport Syndrome Spectrum disorder at age 18 would have prognostic, therapeutic and familly planning implications, in my opin...

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RE: Thin BM 2 days ago

I wonder what a diagnosis of thin basement membrane would add to the patients current status? ------------------------------ Wael Jebur MD drwae...

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RE: simultaneous liver kidney transplant 2 days ago

Questions: Have you repeated serum oxalate level since transplant? Was the recipient HLA-sensitized pretransplant? Type of cross-match pretransplan...

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RE: simultaneous liver kidney transplant 2 days ago

Is the patient receiving Lumisarin because of high pre-transplant Oxalate tissue burden, despite the curative a liver transplant . --------------...

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RE: Young male patient with IgA nepropathy 2 days ago

All good questions. Cannot be answered by evidence, only opinion. Sibeprenlimab is preferred because it fundamentally acts on basic mechanisms of d...

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RE: simultaneous liver kidney transplant 2 days ago

What is Tacrolimus trough level ?? ------------------------------ Wael Jebur MD drwaellatif@hotmail.com Dubai ------------------------------

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RE: Young male patient with IgA nepropathy 2 days ago

Dear Prof Glassock: May I enquire why you recommend shifting to Sibeprenlimab when the patient improved and stabilized on tapering dose of cortic...

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RE: Hypercalcemia in tertiary hyperparathyroidism 2 days ago

Isn't he a candidate for ablation (RFA, MWA, alcohol) therapy? ------------------------------ Mario Rubin, M.D. Houston TX (713) 252-5539 ------...

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RE: Chronic Active Thrombotic Microangiopathy - kidney biopsy 2 days ago

Clinical improvement is remarkable but biopsy still shows active lesions. I think I might favor doing a re-biopsy in few weeks. BTW Epsyqli, generi...

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RE: Hypercalcemia in tertiary hyperparathyroidism 2 days ago

Yes US was highly suspicious for adenoma, But the patient is unfit for surgery. Some important update, PTH drop to 20 pmol/l while Ca was still e...

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RE: Chronic Active Thrombotic Microangiopathy - kidney biopsy 2 days ago

If , by chance, this proves to be TTP (low ADAMTS13 levels) then Caplacizumab might be indicated, instead of C5 , C3 or Factor B inhibition. ---...

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RE: Applications Now Open for the 2026 Kidney TREKS Program 2 days ago

Dear all, As a reminder, applications for the 2026 ASN Kidney TREKS program close next Friday, January 30, 2026. To be eligible for the 2026 Kid...

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RE: Chronic Active Thrombotic Microangiopathy - kidney biopsy 2 days ago

Intracapillary fibrin-platelet thrombi are seen in TTP- I do not beluve that these features were present n the kidney biopsy of this case, but in l...

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RE: Hypercalcemia in tertiary hyperparathyroidism 2 days ago

@Wael Jebur Have you performed an ultrasound of the neck looking for parathyroid enlargement? ------------------------------ Mario Rubin, M.D. ...

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simultaneous liver kidney transplant 3 days ago

Respected faculty, We solicit your opinion on a 28 year old female patient who underwent live simultaneous liver and kidney transplant with two li...

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