RE: Managing 'Pre-Relapse' in FSGS Tip Variant - Restart Cyclosporine or Monitor 1 minutes ago

Age of patient and current SCr/eGFR? Worsening renal function will be a concern vis-a-vis CNI use. ------------------------------ K.K. Venkat MD ...

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RE: Recalcitrant AIN 3 minutes ago

I would give him rituximab and a TNF blocker infliximab (or etanercept, adalimumab etc) gotta get him off steroids at any cost ------------...

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RE: Nephrotic syndrome in a patient with unilaterally atrophied kidney 7 minutes ago

"Full blown nephrotic syndrome" is unusual with hyper filtration FSGS from atrophic kidney which is typically a secondary FSGS. also sounds some...

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RE: Recalcitrant AIN 8 minutes ago

Identifying type(s) of cells comprising the interstitial infiltratingusing immunohistochemistry may help to select further therapy. Following ref...

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Managing 'Pre-Relapse' in FSGS Tip Variant - Restart Cyclosporine or Monitor 12 minutes ago

I'd appreciate expert insights on this case: Diagnosis: Tip-variant FSGS (biopsy-proven, 2020) Treatment History: Complete remission with ste...

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RE: Case of recurrent Glomerular disease early post transplant 51 minutes ago

Thank Dr Hayder for sharing this interesting articles . Wondering if C5 or Ct5 blockers would a therapeutic option for this patients . I am not aw...

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RE: Nephrotic syndrome in a patient with unilaterally atrophied kidney 2 hours ago

Agree with biopsying the larger kidney with 85% functions. Thats where most of the proteinuria is coming from. ------------------------------ Awa...

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Recalcitrant AIN 2 hours ago

Hello everyone, I am a pediatric nephrologist but this condition is not unique to peds, so I am soliciting any advice. I have a 13 year old mal...

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RE: Nephrotic syndrome in a patient with unilaterally atrophied kidney 3 hours ago

I agree that there is something puzzling about the split isotopic measurement of function. There was a 2.6 cm difference in longitudinal length bet...

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RE: Case of recurrent Glomerular disease early post transplant 3 hours ago

Thank you Dr. Guevera-Pineda to highlight the importance of C3 and IgM deposition and many thanks to Dr. Glassock for his interesting input. Co-de...

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RE: Transplant Case 9 hours ago

1) the rise in serum albumin may precede the fall in proteinuria , but this is not well documented in recurrent FSGS 2) i doubt that RTX will hav...

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RE: Transplant Case 12 hours ago

Just a thought 1/ In remission of podocytopathy what comes first lowering of urine acr or increasing albumin, Or they happen simultaneously ? 2/ ...

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RE: Case of recurrent Glomerular disease early post transplant 14 hours ago

See Shirai Y, et al Kidney Int 2024; 105; 608-617 and Weins A et al JASN;2023: 34;308, ( Abstract-ASN Real Week, November, , 2023) --------------...

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RE: Nephrotic syndrome in a patient with unilaterally atrophied kidney 16 hours ago

a biopsy of the smaller atrophic kidney would likely yield mostly scar tissue. For a diagnosis, you should biopsy the normal sized one. The "risk" ...

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RE: Case of recurrent Glomerular disease early post transplant 18 hours ago

I would love to read those sources as anti nephrin antibodies are not commonly seen in patients with native kidney biopsies that showed primary fsg...

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RE: Case of recurrent Glomerular disease early post transplant 18 hours ago

According to some studies anti-nephrin antibodies are implicated in in 70% or more of recurrent FSGS in kidney allografts . --------------------...

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RE: Nephrotic syndrome in a patient with unilaterally atrophied kidney 20 hours ago

Actually the "risk" of complications following a percutaneous kidney biopsy is higher with an atrophic kidney- I think you are referring to tge ris...

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RE: Case of recurrent Glomerular disease early post transplant 22 hours ago

Here is a good article from NEJM about the role of anti nephrin Ab in podocytopaties https://www.nejm.org/doi/full/10.1056/NEJMoa2314471 ----...

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RE: Transplant Case 23 hours ago

Plex was done in May post transplant ( 7 sessions ) Bw --------------------------------- Muhammad Soobadar MBChB UK ---------------------------...

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RE: Case of recurrent Glomerular disease early post transplant 23 hours ago

I wasn't aware anti-nephrin antibodies are implicated in primary fsgs, be it pre or post transplant. Can you provide a source for this? ---------...

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RE: Transplant Case 23 hours ago

I saw biopsy report . There was no EM unfortunately But biopsy proven Best wishes Belal --------------------------------- Muhammad Soobadar MB...

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RE: Transplant Case 1 day ago

thanks . i have attached albumin and urine acr transplant was done 05/10//25 and first dose rituxan was given arond 05/19/25 seems patien...

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RE: Nephrotic syndrome in a patient with unilaterally atrophied kidney 1 day ago

Thank you for your replys. Complement system is normal. The smaller sized kidney is with smooth outline and its function measured by isotope sc...

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RE: ? overlapping MPO vasculitis + idiopathic MPGN 1 day ago

A normal RF, lack of C3/C4 depression , a predominantly -MPO serology and a normal TTE makes endocarditis much less likely, but does not exclude th...

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RE: Transplant Case 1 day ago

In recurrence of Primary FSGS in a renal allograft, the finding of FSGS by LM in addition to diffuse FPE by EM is sign of a poor prognosis for full...

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RE: ? overlapping MPO vasculitis + idiopathic MPGN 1 day ago

: the possibility of culture-negative endocarditis.eg .Bartonella henselae.. Coxiella burnetii,and Brucella. , is present I recommed to perform a ...

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RE: Transplant Case 1 day ago

Was Recurrent FSGS biopsy proven ? How much proteinuria before and after Plex and RTx - creatinine ? When was last Plex and RTx ? ---------------...

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RE: ? overlapping MPO vasculitis + idiopathic MPGN 1 day ago

I raised the question about interstitial nephritis because it might focus initial therapy towards search for/interdiction of any medication that ma...

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RE: Nephrotic syndrome in a patient with unilaterally atrophied kidney 1 day ago

Agree that is most likely diagnosis is secondary FSGS due to hyperfiltration injury and no empiric steroids unless kidney biopsy EM showed diffuse ...

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RE: Nephrotic syndrome in a patient with unilaterally atrophied kidney 1 day ago

I cannot understand the gross difference in gfr on DTPA imaging where the atrophic kidney has 85 percent renal function. If that is the case one mu...

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RE: Transplant Case 1 day ago

Thanks prof glassock Best wishes --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: ? overlapping MPO vasculitis + idiopathic MPGN 1 day ago

? Multiple Issues the presence of proteinuria & haematuria & extra-renal symptoms are of note The glomerular lesion doesn't seem that active &...

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RE: ? overlapping MPO vasculitis + idiopathic MPGN 1 day ago

Important observation Dr. Venkat. The extent of interstitial inflammation is inversely correlated with eGFR, with wide variation. The composition o...

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RE: Nephrotic syndrome in a patient with unilaterally atrophied kidney 1 day ago

One would not "try" steroids if this is Secondary FSGS , due to harmful compensation for a nephron deficiency state. The Brenner doctrine. The 11 c...

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RE: Nephrotic syndrome in a patient with unilaterally atrophied kidney 1 day ago

What about renal Doppler ,there is discrepancy in renal dize ? What about complement ,C3and C4? would you like to try steroids as ptn highly su...

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RE: Transplant Case 1 day ago

I see no reason to test for strep, hemophilias or tetanus antibodies. What antibodies would you test for to decide whether RTX is indicated ? As fa...

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RE: Transplant Case 1 day ago

Post 2nd dose rituxan to carry on tac /mmf and steroid ? Best wishes --------------------------------- Muhammad Soobadar MBChB UK -------------...

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RE: Transplant Case 1 day ago

Thanks prof glassock. Would you test for strep antibodies , haemophilus and tetanus antibodies If ig g low Would you not delay ritux? And see if ...

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RE: Transplant Case 1 day ago

This patient needs RTX and PLEX. Give IVIgG if you need to. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) ...

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Transplant Case 1 day ago

Dear all, I have case of recurrent fsgs in transplant patient live donor from mum may 25.( had plex and first does ritux) Basiliximab induction (...

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RE: Kidney stones for prospective kidney donor 2 days ago

Based on current US Transplant practice patterns and KDIGO exclusion criteria for potential kidney donors with stone disease Bilateral kidney ...

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RE: ? overlapping MPO vasculitis + idiopathic MPGN 2 days ago

"ACR 300-500s" ........................ The interstitium is mildly edematous with numerous leukocytes consisting of predominantly lymphocytes and p...

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RE: Nephrotic syndrome in a patient with unilaterally atrophied kidney 2 days ago

Thanks. What are the surface characteristics of the atrophic kidney - smooth or scarred?What is the level of Blood Pressure? --------------------...

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RE: Nephrotic syndrome in a patient with unilaterally atrophied kidney 2 days ago

Thank you for your reply, Serum albumin is 2.9 gm/dl. She is a case of full blown nephrotic syndrome ------------------------------ Wael Jebu...

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RE: Nephrotic syndrome in a patient with unilaterally atrophied kidney 2 days ago

What is the serum albumin level? The normal sized kidney should be the choice for the biopsy, in my opinion. If full blown Nephrotic Syndrome is pr...

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RE: Case of recurrent Glomerular disease early post transplant 2 days ago

Thanks for the clarification. Too bad that no EM was done. Maybe you could try to reprocess the paraffin embedded specimens for EM.. I would still ...

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RE: Bartter's syndrome vs primary hyperaldosteronism 2 days ago

Follow carefully. As progesterone levels increase during pregnqncy, aldosterone synthesis may be affected. Vecchiola et al. Different effects of ...

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Nephrotic syndrome in a patient with unilaterally atrophied kidney 2 days ago

A 57 year old lady presented with bilateral leg edema and found to have nephrotic syndrome. Her kidney function was stable with creatinine of 1.1 m...

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RE: Case of recurrent Glomerular disease early post transplant 2 days ago

Post transplant biopsy did not have electron microscopy . The biopsy done ion 8/3 had light microscopy only Showed : enlarged glomeruli with mild m...

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RE: Bartter's syndrome vs primary hyperaldosteronism 2 days ago

Thank you very much for this great discussion, I learnt a lot from all the thoughts and ideas shared over this page. Just an update. This lady ...

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