RE: Complement Profile Interpretation in IgA Nephropathy 14 minutes ago

Yes, this is correct and your patient exchitis all of the characteristics known to occur with Factor B inhibition. The downstream activation of C5B...

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RE: Complement Profile Interpretation in IgA Nephropathy 2 hours ago

Thanks for the responses . The hematuria , has indeed subsided and nearly disappeared. The proteinuria as you mentioned is still existent and c...

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RE: Can severe hyperglycemia cause osmotic nephropathy 11 hours ago

I agree- the elevated Scr is no longer a consequence of hyperglycemia or ketosis. Whether it is due to "osmotic nephrosis" is still uncertain, but ...

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RE: Can severe hyperglycemia cause osmotic nephropathy 11 hours ago

@Richard Glassock His gap today was 15, our lab range is 10-15. Creatinine 6.13 BUN 75 today --------------------------------- Edwin Anand, M.D. ...

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RE: Can severe hyperglycemia cause osmotic nephropathy 12 hours ago

The lab director (Baylor-Dallas) suggested that over one-half of hospitals currently use the enzymatic technique for creatinine assay. He also opin...

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RE: Complement Profile Interpretation in IgA Nephropathy 12 hours ago

This Complement profile (normal Factor B level and low Alternate pathway C activity (Weislab) ) are compatible with therapeutic dosing of Iptacopan...

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RE: Can severe hyperglycemia cause osmotic nephropathy 13 hours ago

What is the current value of Anion Gap? ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 -----------------...

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RE: Complement Profile Interpretation in IgA Nephropathy 14 hours ago

I may be mistaken but the way I understand it is that functional assay does not measure the levels of alternate complement proteins rather measures...

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RE: Hypokalemia , what is happening! 14 hours ago

Thanks Dr Asplin for sharing the graph. ------------------------------ Awais Nauman HMC Doha ------------------------------

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RE: Complement Profile Interpretation in IgA Nephropathy 14 hours ago

A low AH50 (AH 45, ------------------------------ Dr. Hormaz Dastoor. MD, FASN Nephrology Consultant - Seha Kidney Care. Nephrology Consultant-...

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RE: Can severe hyperglycemia cause osmotic nephropathy 14 hours ago

Attached article. ------------------------------ Awais Nauman HMC Doha ------------------------------ Files Attached DocumentRE: Can seve...

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RE: Can severe hyperglycemia cause osmotic nephropathy 14 hours ago

Osmotic Nephropathy an entity characterized by isometric vacoulization of proximal tubular epithelial cells in setting of administration of adminsi...

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RE: Complement Profile Interpretation in IgA Nephropathy 15 hours ago

Not sure but the report says its a Functional Assay, so I guess low would mean it is indeed inhibited by Iptacopan. -----------------------------...

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RE: Can severe hyperglycemia cause osmotic nephropathy 15 hours ago

@Richard Glassock and Dr. Rubin Our hospital lab, as your AI assistants suggested still uses the Jaffe's method (I am attaching a picture of t...

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Complement Profile Interpretation in IgA Nephropathy 15 hours ago

40 year old male with IgAN , diagnosed by Kidney biopsy in April 2025. Biopsy revealed M1E1S1 T0 C1 lesions . uPCR around 1.5-2 grams . Urinalys...

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RE: IgAN with nephrotic syndrome 1 day ago

Very interested in your experience with treatment in IgAN. I have yet to see any treatment failure of Iptacopan in patients who have hematuria and ...

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RE: Can severe hyperglycemia cause osmotic nephropathy 1 day ago

@Richard Glassock I stand corrected. As per my AI consultant: " as of 2025 in the United States, the most common laboratory method (70%) used in ...

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RE: Can severe hyperglycemia cause osmotic nephropathy 1 day ago

My AI consultant says that the Jaffe reaction is still used by a majority of commercial comprehensive serum biochemistry platforms, but the enzymat...

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RE: Can severe hyperglycemia cause osmotic nephropathy 1 day ago

@John Schwartz Thank you John for sharing this piece of interesting/fascinating history. ------------------------------ Mario Rubin, M.D. Ho...

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RE: Can severe hyperglycemia cause osmotic nephropathy 1 day ago

@Edwin Anand To my knowledge colorimetric creatinine assay methods (The Jaffe reaction) are no longer used by most clinical laboratories. Enzymat...

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RE: Can severe hyperglycemia cause osmotic nephropathy 1 day ago

Just for fun. When was the effect of ketoacids on creatinine measurement first described? It was a lot longer ago than you might imagine. Graham in...

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RE: Can severe hyperglycemia cause osmotic nephropathy 1 day ago

I suspect that the "AKI" in this case can be attributed to spurious hypercrearininemia ( from hyperglycemia and ketonemia) ) and some degree of vol...

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RE: SGLT2i In Pure Tubulointerstitial Kidney Diseases 1 day ago

This has always been the million dollar question, and it applies to RAASi as well. Renoprotection from RAAsi correlates so strongly to glomeru...

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RE: Can severe hyperglycemia cause osmotic nephropathy 1 day ago

Even the worst case of uncontrolled diabetes does not give the glycosuria degree seen with SGLT2i (>1000 on UA when I see it it is "always" SGLT2i)...

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RE: Can severe hyperglycemia cause osmotic nephropathy 2 days ago

Thanks- Could the same type of interference cause a spurious increase in serum creatinine levels. Do you have access to an enzymatic assay for Scr ...

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RE: Can severe hyperglycemia cause osmotic nephropathy 2 days ago

Urine Na was 40. Sorry for the typo Dr. Glassock, Urine creat was indeed 751 mg/dl. As you suggest, high glucose or ketones were likely causing i...

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RE: Potential kidney donor older than 40, likely pathogenic PKD1 mutation and no cysts on CT scan of the abdomen 2 days ago

Thank you for the follow up. As Dr. Balan stated: " I think this case highlights the importance of looking for an abnormal genetic variant in the p...

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RE: Potential kidney donor older than 40, likely pathogenic PKD1 mutation and no cysts on CT scan of the abdomen 2 days ago

Follow up on this case Donor denies any family history of Gout, MODY, hypomagnesemia, hyperuricemia or GU malformations. The Mother genetic te...

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RE: Can severe hyperglycemia cause osmotic nephropathy 2 days ago

See attached ------------------------------ Mario Rubin, M.D. Houston TX (713) 252-5539 ------------------------------ Files Attached Docu...

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RE: Can severe hyperglycemia cause osmotic nephropathy 2 days ago

Dr. Anand. You triggered my curiosity as I was not aware of this phenomenon. I have attached my query to ChatGPT (very useful information i must sa...

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RE: Can severe hyperglycemia cause osmotic nephropathy 2 days ago

Urine creatinine "751" ? What are the units. With excessive glucose and ketones in urine (and serum) a colorimetric assay (Jaffe) for creatinine ca...

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RE: Can severe hyperglycemia cause osmotic nephropathy 2 days ago

YES. Look at table 1 of the attached article. ------------------------------ Mario Rubin, M.D. Houston TX (713) 252-5539 ----------------...

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Can severe hyperglycemia cause osmotic nephropathy 2 days ago

A 36 yr old male with no past medical history presented with lethargy and other non specific symptoms. Was found to be in DKA, blood glucose 2092, ...

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RE: SGLT2i In Pure Tubulointerstitial Kidney Diseases 2 days ago

I agree- The existing "evidence" ,such as it is, does not support a beneficial effect of SGLT2i on the trajectory of eGFR decline in chronic tubu...

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RE: SGLT2i In Pure Tubulointerstitial Kidney Diseases 2 days ago

Although SGLT2i have anti inflammatory and anti fibrotic effects that could theoretically help tubulointerstitial injury, there is no high quality ...

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RE: Hypokalemia , what is happening! 2 days ago

Because in the kidney stone world almost everyone gets a 24 hr urine, I do not deal with this issue often, so I do not have a "favorite" equation. ...

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RE: DKA with severe Hypernatremia 2 days ago

Earlier in my career when we used to actually hand write orders I would frequently use alternating solutions of varying tonicity. Rare to see a cas...

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RE: Collapsing Glomerulopathy in a Kidney Transplant Recipient 2 days ago

Risk of reactivation of CMV due to Belatacept in older transplant patients with poor graft function is underestimated and not widely mentioned. ...

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SGLT2i In Pure Tubulointerstitial Kidney Diseases 2 days ago

Today we present a case of Karyomegalic interstitial nephritis in our weekly zoom meeting of Iraqi Society of Nephrology and Transplantation and th...

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RE: Collapsing Glomerulopathy in a Kidney Transplant Recipient 2 days ago

I think your explanation of CG in a kidney transplant with 2 high Reiser APOL1 allekes and a "second hit" of CMV nfection is the mist provably corr...

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RE: DKA with severe Hypernatremia 2 days ago

See Dr. Mellas post above on the limited value of a low urinary Na concentration in a spot urine as indicative of volume depletion in an osmotic di...

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RE: Collapsing Glomerulopathy in a Kidney Transplant Recipient 2 days ago

Update on this patient: To recap briefly, starting a few months after deceased donor kidney transplant, slowly increasing SCr and proteinuria devel...

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RE: Hypokalemia , what is happening! 2 days ago

Dr Asplin @John Asplin which equation do you utilize to estimate 24 hour Urine volume and which one is best to use. -----------------------------...

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RE: DKA with severe Hypernatremia 3 days ago

Urine Na of 12 is indicative of severe hypovolemia with appropriate ADH and renin- angiotensin-aldosterone hyperactivation. In this situation assum...

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RE: PLA2R-membranous nephropathy 3 days ago

Thanks prof glassock appreciate your input --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: PLA2R-membranous nephropathy 3 days ago

I agree that electron lucent deposits are indicative of immunologically inactive disease The fundamental goal of therapy of PLA2R induced MN is ...

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RE: PLA2R-membranous nephropathy 3 days ago

Thanks for previous reply prof glassock --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: PLA2R-membranous nephropathy 3 days ago

@ prof glassock any comments about em and deposit characterisation for acute va chronic And also your dosing regime with ritux for maintenance in ...

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RE: Primary membranous nephropathy 3 days ago

With nodular diabetic glomerulosclerosus and persistently negative serum Anti.PLA2R it seems very unlikely that RTX therapy will have any beneficia...

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RE: Primary membranous nephropathy 3 days ago

"That is a very rapid drop in GFR from 54 to [More]

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