RE: minimal change disease steroid dependent 21 minutes ago

There is enough evidence of Ritux efficacy to use it as initial therapy for MCD without steroids. ritux monotherapy Ritux Monotherapy ----...

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RE: minimal change disease steroid dependent 1 hour ago

rituxaan rituxan and assuming you were still in remission at 6 months I would give another 1 gram at that point I know one Mayo MD that give...

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RE: treatment for hypophosphatemia 3 hours ago

In Europe, particularly France and Greece, eating during HD is permitted. The general concept that it should be avoided so that adverse events do n...

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RE: treatment for hypophosphatemia 3 hours ago

When hypophosphatemia is discovered after a patient's iHD treatment has commenced, we've been known to smuggle a cola product into the unit for the...

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RE: Pt with Minimal Change Disease in Remission Planning Pregnancy 3 hours ago

We have used Rituximab in the first trimester , and literature suggests you could possibly use it up to 26 weeks . That is if it is indicated . C...

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RE: Pt with Minimal Change Disease in Remission Planning Pregnancy 16 hours ago

Thanks. The 12 months use of contraception recommended in the label is not evidence based and RTX is not absolutely contraindicated in Pregnancy.. ...

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RE: Pt with Minimal Change Disease in Remission Planning Pregnancy 17 hours ago

Thank you for your quick response. The recommendations to avoid IV Rituximab is from the "manufacturer's guidelines"/FDA insert: "are pregnant or...

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RE: Pt with Minimal Change Disease in Remission Planning Pregnancy 18 hours ago

Dr. Joshi. Thanks for the post. We get a lot of similar posts as there is so little real data to guide management in such situations . I don't unde...

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Pt with Minimal Change Disease in Remission Planning Pregnancy 22 hours ago

Dear colleagues, I would like to get the ASN Communities' input on a management issue on a lovely African American of Ethiopian descent. She was ...

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RE: treatment for hypophosphatemia 1 day ago

That is interesting. Raises the concept of personalizing each dialysis run based on the directly pre-dialysis electrolyte profile. One wonders ...

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RE: minimal change disease steroid dependent 1 day ago

In this case, I think that RTX may be the best choice, but not direct head to head comparisons vs MMF or CNI have yet been conducted. Consideration...

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minimal change disease steroid dependent 1 day ago

30 yo female who i met post partum, with nephrotic proteinuria- with renal biopsy minimal change disease, gave steroids and within week- proteinuri...

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Belatcaept/Tac 1 day ago

This paper in Clinical Transplantation Longterm Outcomes Belatacept/Tac used immunosuppression discharge medications UNOS database and found superi...

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RE: Initiating Statin In Dialysis Patient 1 day ago

Many thanks units mmol/l . The lab does not give me standard reference in that particular hospital --------------------------------- Muhammad So...

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RE: C3 or IgA 1 day ago

I come late to the discussion after the dust settles. Patient has a genetic mutation increasing risk of uncontrolled activation. My guess that this...

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RE: TMA Case 1 day ago

chronic lymphocytic leukemia/small lymphocytic lymphoma representing approximately 10% of the total cellularity. So, apparently t does not take a p...

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RE: TMA Case 1 day ago

I wanted to provide some update for the community: 1) pt/family declined a trial of IV Eculizumab. 2) she was discharged and continues on outpt...

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RE: treatment for hypophosphatemia 1 day ago

In a major academic medical center, the nephrology group had an interesting policy to check phosphorus level before dialysis treatment and if phosp...

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RE: treatment for hypophosphatemia 3 days ago

I would not r/o oncogenic induced phospahe wasting and agree that a repeat FGF23 is needed. Does she have HepB and on treatment? Some other drugs c...

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RE: treatment for hypophosphatemia 3 days ago

Story more complicated than described initially. Crohn's (mod-severe), multiple sclerosis, RNP (+) connective tissue disease. What therapy? One...

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RE: treatment for hypophosphatemia 3 days ago

I agree with Prof Glassock. I would also question the assay used as I would still expect it to be much higher with the elevated urine phos and hypo...

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RE: treatment for hypophosphatemia 3 days ago

A " normal" FGF23 level in the face of hypophosphatemia is "abnormal" . It should be very low. Any features of Fanconi syndrome present? --------...

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RE: treatment for hypophosphatemia 3 days ago

pt is caucasian Good evening, pt received 1 dose of 750 mg injectafer on may 17th and has not had any more doses since. It was prescribed for...

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RE: treatment for hypophosphatemia 3 days ago

Good evening, pt received 1 dose of 750 mg injectafer on may 17th and has not had any more doses since. It was prescribed for a ferritin level ...

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RE: treatment for hypophosphatemia 3 days ago

Good evening, pt received 1 dose of 750 mg injectafer on may 17th and has not had any more doses since. It was prescribed for a ferritin level ...

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RE: Diffuse proliferative GN 3 days ago

Cryos are still pending. RF is now pending as are blood cultures and bartonella titers (Ordered after the initial work up so will be a few days to ...

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RE: Diffuse proliferative GN 3 days ago

Thank you for the response. Somehow we did not get blood cultures or RF. I will rectify this and add the borrelia, bartonella and Q fever labs. ...

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RE: Diffuse proliferative GN 3 days ago

echoing above: Few questions Cryoglobulins? Rheumatoid factor? Use of hydralazine ro Allopurinol Blood cultures Barteonella titers? ...

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RE: Diffuse proliferative GN Tuesday, June 24 @ 10:09 AM

Any medications that could be associated with autoantibodies and GN, such as hydralazine? ------------------------------ K.K. Venkat MD Troy MI (...

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RE: Diffuse proliferative GN Tuesday, June 24 @ 9:28 AM

These features are consistent with Infection/Related GN (? Bacterial Endocarditis). What is the Rheumatoid Factor level and TEE. If blood cultures ...

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Diffuse proliferative GN Tuesday, June 24 @ 8:41 AM

I have a delightful 74y.o. dentist with a history of HTN and HLD who developed a viral illness in March (malaise, fatigue and weakness) that he gra...

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RE: C3 or IgA Tuesday, June 24 @ 3:36 AM

IgAN looks like it is splitting into multiple entities in the footsteps of FSGS. The O-glycosylation deficiency seemed to be giving IgA some cohere...

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RE: treatment for hypophosphatemia Tuesday, June 24 @ 1:29 AM

I also agree with Dr Rodby, although I would check a 24 hour urine for Phos, Ca, Na and Creatinine to make she has inappropriate hyperphosphaturia ...

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RE: C3 or IgA Monday, June 23 @ 12:22 PM

Thanks Dr. Hughson for your comment. I may have been too enthusiastic about the potential utility of KN 55 staining to help sort out the conundrums...

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RE: treatment for hypophosphatemia Monday, June 23 @ 11:18 AM

Sorry for my typing errors. Yes her age and ethnicity are also importan; ferritins and TSATs run much lower in China, Korea, and Japan and in most ...

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RE: treatment for hypophosphatemia Monday, June 23 @ 10:53 AM

Could you please specify what do you mean by iron exposure and why was the patient "exposed" to iron. If the patient received IV iron, was this fe...

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RE: treatment for hypophosphatemia Monday, June 23 @ 9:32 AM

I presume IV iron has been dicontinued and which IV iron as used? What are ger current iron parameters and Hb? ------------------------------ Ana...

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RE: treatment for hypophosphatemia Sunday, June 22 @ 6:21 PM

I agree 100% with Dr. Rodby's assessment and recommendations. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) ...

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RE: treatment for hypophosphatemia Sunday, June 22 @ 6:12 PM

This seems like a board question , almost too good, so depending on the IV iron it may stimulate FGF 23 (set attached) I would get a FGF 23 l...

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treatment for hypophosphatemia Sunday, June 22 @ 2:25 PM

Good afternoon, A pt with h/o IV iron exposure has developed hypophosphatemia. Is currently on 200 mg elemental phosphorus/day PO and iv kphos...

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RE: C3 or IgA Sunday, June 22 @ 10:29 AM

This exercise is generating a lot of misinformation. At least it has been decided that CFHR variants have a positive association with IgAN, not the...

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RE: C3 or IgA Saturday, June 21 @ 12:23 PM

KN 55 staining has high specificity but lower sensitivity for identifying Primary IgAN (or IgAV) so only positive staining would have pathogenic si...

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RE: C3 or IgA Saturday, June 21 @ 11:22 AM

I think it may be available at Arkana by request,. Both of these cases were outside the USA. ------------------------------ Richard Glassock MD, ...

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RE: ANCA vasculitis with Pulmonary Hemorrhage - To Rituximab or MMF Saturday, June 21 @ 11:20 AM

I discussed with hematologist, he is of the view to err on the side of caution in view of the HBV serology and closely watch HBV serology gor 6 mon...

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RE: C3 or IgA Saturday, June 21 @ 11:03 AM

How available is KM55 in the US? Most reports are from China, Japan and India. Thanks. Mario ------------------------------ Mario Rubin, M.D. Hou...

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RE: C3 or IgA Saturday, June 21 @ 10:33 AM

Thanks for allowing me to get a little more sleep. One way to better understand the two cases would be to stain the kidney biopsy with IgA deposits...

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RE: C3 or IgA Saturday, June 21 @ 10:28 AM

With a CFHR5 mutation, the patient could have presented with C3 or IgA . I would have expected Pegcetacoplan to have the pathways leading to expres...

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RE: C3 or IgA Saturday, June 21 @ 9:56 AM

I don't think we can have a proper answer to that. There are case reports of CFH mutations with C3GN becoming HUS after kidney transplant. These ar...

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RE: C3 or IgA Saturday, June 21 @ 9:26 AM

Thank you, but am still waiting for an explanation on how he went from C3 deposits , to IgA deposits after treatment with C3 inhibitors .. no point...

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RE: C3 or IgA Saturday, June 21 @ 9:13 AM

Centogene has reported it as a VUS. I think you should get this published to add to the literature on this variant. ClinVar has reported this as be...

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