RE: Kidney stones for prospective kidney donor 3 hours 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 3 hours 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 5 hours 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 5 hours 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 5 hours 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 6 hours 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 6 hours 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 6 hours 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 8 hours 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 8 hours 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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RE: ? overlapping MPO vasculitis + idiopathic MPGN 11 hours ago

The pathology report does not identify any MPGN features and PGNMID was excluded. The lack of organized deposits makes FGN unlikely. This seems to ...

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RE: Kidney stones for prospective kidney donor 12 hours ago

Thank you for the reference and view regarding donation ------------------------------ Daniel Christiadi Canberra Hospital Canberra ACT ---------...

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RE: ? overlapping MPO vasculitis + idiopathic MPGN 13 hours ago

Thanks This 65 year old female ptn with MPOANCA with fibrocellular crescent and EM cellular crescents After excluding infection ,I think puls...

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RE: ? overlapping MPO vasculitis + idiopathic MPGN 14 hours ago

Rheumatoid factor was negative. Complements normal Serological workup only significant for + MPO ------------------------------ David Hwang,...

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RE: ? overlapping MPO vasculitis + idiopathic MPGN 14 hours ago

Thank you for the reply Dr Glassock and Dr Venkat DNAJB 9 stain was not completed. Final path results as below: RENAL BIOPSY: 1. CHRONIC ACTI...

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RE: ? overlapping MPO vasculitis + idiopathic MPGN 14 hours ago

EM findings? Was a DNAJB 9 stain done? ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ------------------...

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

Good points- I thought that EM the transplant biopsy showed diffuse FPE. Please clarify-,with massive proteinuria and hypoalbuminemia (Salb= 2.0 gm...

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RE: metabolic acidosis 16 hours ago

"Dr. Rodby why would she have a false positive AG? Does that happen specifically with Sjoegren? So should i order work up for Sjoegren?" W...

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RE: Case of recurrent Glomerular disease early post transplant 17 hours ago

@Richard Glassock: My understanding is that diffuse podocyte effacement was in the native kidney biopsy. In the transplant biopsy there was "podocy...

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RE: Case of recurrent Glomerular disease early post transplant 17 hours ago

Thank you so much Dr Glassock ------------------------------ Daniel Guevara-Pineda MD West Hartford CT ------------------------------

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RE: Case of recurrent Glomerular disease early post transplant 17 hours ago

Segmental deposition of IgM and C3 with evidence of C activation has been described in recurrent FSGS. The very low serum albumin, extremely high U...

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

Dear Dr Venkat all good points . They started tacrolimus in the first 2 days with sub therapeutic levels and then stopped it due to concern of D...

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

Thank you so much for your input and advice ------------------------------ Daniel Guevara-Pineda MD West Hartford CT ---------------------------...

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RE: ? overlapping MPO vasculitis + idiopathic MPGN 19 hours ago

"Differential per path includes crescenteric GN 2/2 infection vs underlying cryo" Percentage of glomeruli affected by creases? Segmental vs circu...

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RE: Case of recurrent Glomerular disease early post transplant 19 hours ago

"with robust urine out put in the first 48hrs then UOP progressively declined and became anuric" 1. Did SCr decrease during the first 48 hours ...

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RE: Steroid dependant FSGS 19 hours ago

It dropped from 4.4 to 3.2 within a 2 weeks period approximately. I will continue to check it weekly and start anticoagulation if needed. I have al...

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RE: ? overlapping MPO vasculitis + idiopathic MPGN 20 hours ago

To add more detail b/l SCr 1s as of 11/2024. Worsening from 1.3, now 1.6 ACR 300-500s, + RBC since 12/2024 ANCA 1:640, MPO 63 (positive from ...

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RE: Case of recurrent Glomerular disease early post transplant 21 hours ago

In my opinion, this is highly likely to be recurrent Primary FSGS in a renal allograft. I would treat with RTX and PLEX -------------------------...

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RE: metabolic acidosis 21 hours ago

Agree with Dr. Grimm that this is may me pre-analytical error and I face this problem many time until we solve the issue with the lab by filling th...

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? overlapping MPO vasculitis + idiopathic MPGN 22 hours ago

Hello ASN community, I am caring for a 65 y/o F. Plugged in with rheum previously for + arthralgia, myalgia. + ANCA, MPO titers (markedly elevate...

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RE: Steroid dependant FSGS 22 hours ago

What is happening with serum albumin level, if rapidly to below 2.5Gm/dL then she is at risk for a VTE and prophylactic anticoagulation might be in...

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RE: Steroid dependant FSGS 23 hours ago

Agree to initiate CNI for the hope of proteinuria reduction until RTX work and this not for 12-18 months as in case of SRNS but for few months then...

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RE: metabolic acidosis 1 day ago

Dr. Rodby why would she have a false positive AG? Does that happen specifically with Sjoegren? So should i order work up for Sjoegren? ------...

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RE: Steroid dependant FSGS 1 day ago

Thank you Dr Glassock for your very helpful inputs. In the last 5 days, her uacr has doubled from 4.5 to 9 GM. I have had her on 40 mg on steroi...

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RE: Guidance on Next Steps in the Management of AKI in CMML with Positive ANCA Screen and Thrombocytopenia 1 day ago

I recommend this review by Dr. Attieh et al in Kidney Medicine 2023 Dec 5;6(2):100769. doi: 10.1016/j.xkme.2023.100769. The differential diagnosi...

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RE: Case of recurrent Glomerular disease early post transplant 1 day ago

Dear Dr Glassock thank you for your reply , ill get back to you with C3 : 96 ( normal value > 90 ) and C4 13 ( Normal value > 10 ) , pre transplant...

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RE: Case of recurrent Glomerular disease early post transplant 1 day ago

What was the serum albumin during the pre-transolsnt course? Was the donor obese.? What are the actual values for serum C3 and C4? Was diffuse FPE ...

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RE: Kidney stones for prospective kidney donor 1 day ago

Though the criteria for excluding stone formers have changed, and generally are more liberal, I agree with Joe that "unresolved metabolic problems"...

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RE: Steroid dependant FSGS 1 day ago

1) in FRNS treated with RTX a relapse can still ocurr when RTX stopped. Observational studies have suggested that MMF can prolong the relapse free ...

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Case of recurrent Glomerular disease early post transplant 1 day ago

I am presenting this case on behalf of a pediatric transplant center in Latin America . I would appreciate your input in the etiology of primary di...

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RE: Glomerular disease with deposits, high anti MPO 1 day ago

I actually enjoy making decisions that you are force do to do with inadequate information (Inadequate biopsy, vasculitis is focal and easily missed...

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RE: Steroid dependant FSGS 1 day ago

Dr. Glassock thank you for your insightful comments. Do we really need to maintain patients with frequent relapsing podocytopathy (MCD or FSGS) on...

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RE: Guidance on Next Steps in the Management of AKI in CMML with Positive ANCA Screen and Thrombocytopenia 1 day ago

The positive IIF ANCA and negative ELISA for antiMPO and antiPR3 antibody suggests either a false positive IIF ANCA OR other Vasculitis associated ...

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RE: Glomerular disease with deposits, high anti MPO 1 day ago

Hydralazine-associated GN usually has more immune deposits than typical ANCA-associated pauci-immune GN. In your patient, I’m not sure what you wou...

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RE: Guidance on Next Steps in the Management of AKI in CMML with Positive ANCA Screen and Thrombocytopenia 1 day ago

Thanks- if the acanthoytes were over 5% of total erythrocytes in urine this is strong evidence for a Vasculitis /glomerular disease., If the albumi...

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RE: Steroid dependant FSGS 1 day ago

Thank you so much Dr Glassock! I really appreciate your guidance. Sincerely ------------------------------ Manini Vishwanath MD ----------...

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RE: Lupus Enteritis? Alport-Associated Enteritis? 1 day ago

Dicyclomine, omeprazole, zofran ------------------------------ Lawrence Kwon MD Westchester Medical Center Valhalla, NY (845) 330-3541 ----------...

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RE: Guidance on Next Steps in the Management of AKI in CMML with Positive ANCA Screen and Thrombocytopenia 1 day ago

Urine sediment showed only acanthocytes, no RBC casts. I took photos through the microscope lens (lab does not have a camera attachment); RBCs have...

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RE: Lupus Enteritis? Alport-Associated Enteritis? 1 day ago

She has seen numerous GI doctors. I have contacted rheumatology to arrange an appointment as soon as possible. ANCA negative (<1:20). -----------...

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RE: Lupus Enteritis? Alport-Associated Enteritis? 1 day ago

Negative of celiac and IBD ------------------------------ Lawrence Kwon MD Westchester Medical Center Valhalla, NY (845) 330-3541 ---------------...

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