RE: Pregnancy in Transplant patients with aHUs and on complement inhibitors 4 hours ago

Not much experience with Eculizumab or Ravulizumab in Pregancey Several reports of their use in PNH and Pregnacy and PNH indicate tgat it may be sa...

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RE: IgA With ANCA Positivity 4 hours ago

I would treat with oral systemic prednisone just as you would with a primary Podocytopathy . I do not know what to make of the serology. Has the pa...

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RE: Tip variant FSGS 4 hours ago

With these findings I would just follow the patient with repeat values about every 3 months. ------------------------------ Richard Glassock MD,...

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RE: Tip variant FSGS 5 hours ago

Serum albumin is 4.4 and stable. UPCR 0.6, albumin/cr 338 mg/gm ------------------------------ Kevin Mitchell MD Nephrologist St. Luke?s Medical ...

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RE: IgA With ANCA Positivity 5 hours ago

Thank you Dr. Glassock. Thant’s a great point. I’ll wait for the EM. Would you do do pulse and prednisone or localized such as Tarpeyo? ---------...

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RE: primary Membranous nephropathy and HBV infection 6 hours ago

I would wait several moths after successful therapy of HBV with Entecavir . Follow anti-PLA2R antibody levels, there is a fairly good chance for a ...

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RE: Tip variant FSGS 6 hours ago

What is the serum albumin level? No indication for repeat kidney biopsy. You might want to consider RTX for relapsing steroid sensitive MCD/FSGS. ...

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RE: IgA With ANCA Positivity 7 hours ago

Do you have EM to further characterize the S1 lesion-e.g. - is a diffuse Podocytopathy present. If so, oral systemic steroids are indicted, in my o...

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RE: APOL-1 mediated kidney disease 7 hours ago

Amplitude Study by Vertex pharma. Multinational study. Sure they are recruiting in your area. ------------------------------ Anurag Tikaria MD, ...

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Pregnancy in Transplant patients with aHUs and on complement inhibitors 8 hours ago

Good Afternoon, I looking to hear some experiences any of you have had in transplant patients who have a dx of aHUS and want to become pregnant....

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IgA With ANCA Positivity 9 hours ago

I have a 50-year-old male with past medical history of hypertension, obesity and prediabetes. Non smoker. Only on Lovaza and amlodipine as meds. Cr...

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RE: Tip variant FSGS 10 hours ago

I did not mean to re biopsy but wait until >1gm to treat with CNI ------------------------------ Kevin Mitchell MD Nephrologist St. Luke?s Medica...

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RE: primary Membranous nephropathy and HBV infection 11 hours ago

I would like to update regarding my patient with MN PLAR2Ab + ve and active HBV infectio . we started him on entecavir 2 months back and HBV DNA is...

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RE: Tip variant FSGS 11 hours ago

I would be hesitant to biopsy to convince mother, nor do I think doing it at a relapse would impact management. What has worked for me (sometimes) ...

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RE: FSGS Tip Variant 11 hours ago

This appeared in related content, so I thought to update community on outcome. Re-initiated Pred 1mg/kg to which he responded in 8 weeks, at which ...

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RE: candiduria after starting cephalexin while already on empagliflozin 25 mg qd for months 12 hours ago

Her 2-year Kidney Failure Risk Equation score is 9%, her 5-year score is 25%. She has time on her side for risk of progression. I would consider ce...

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RE: Renal Biopsy Post Plex 13 hours ago

We typically will use FFP for PLEX if the patient is undergoing a procedure or biopsy. Octoplas should be fine since it is used for acquired defici...

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RE: candiduria after starting cephalexin while already on empagliflozin 25 mg qd for months 13 hours ago

Such "disrespect" (haha) for aldactone! Actually, there is a lot of clinical evidence that it reliably reduces both urine protein and BP in diabeti...

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RE: Anti Gbm Case 14 hours ago

Hi prof what it they don’t have pulmonary symptoms or pulmonary haemorrhage . Can you treat in view of preventing occurrence of pulmonary haemorrha...

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Tip variant FSGS 14 hours ago

18 Y M who I treated tip variant FSGS with a longer steroid taper at the age of 16. Previous biopsy showed no tubulointerstial fibrosis also withou...

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RE: candiduria after starting cephalexin while already on empagliflozin 25 mg qd for months 17 hours ago

Does the rash occurred after antibiotic initiation? As I massively use finerenone in DKD patients and didn’t encountered this AE. I have a practic...

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RE: candiduria after starting cephalexin while already on empagliflozin 25 mg qd for months 22 hours ago

Good point! If no harms are done why not give it a try. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 -...

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RE: Anti Gbm Case 1 day ago

If a patient with anti-GBM disease has 100% glomerular crescent, oliguria and dialysis dependence, we still treat with PLEX if DAH is present and a...

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RE: candiduria after starting cephalexin while already on empagliflozin 25 mg qd for months 1 day ago

@Richard Glassock You have me there at spironolactone. There is no good clinical evidence only experimental evidence that it would be useful in ...

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RE: Anti Gbm Case 1 day ago

C3 normal. Will send echo , blood cultures , cryo and repeat ds dna, Ana. Not behaving in septic manner tho. If patient has anti gbm with renal ...

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RE: KFRE 1 day ago

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

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RE: Renal Biopsy Post Plex 1 day ago

Thanks prof --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Case 1 day ago

Thanks dr Rodby thought like you. Patient also not keen on biopsy --------------------------------- Muhammad Soobadar MBChB UK ----------------...

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RE: membranous GN with advanced CKD-treatment plan 1 day ago

Thank u dr Glassock --------------------------------- Alaa Nabih Abdalla nephrology fellow Egypt ---------------------------------

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RE: C3G case 1 day ago

Many thanks for these suggestions. I think tgat a search for concealed monoclonal Ig deposits is warranted in this case. I am very skeptical of a d...

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RE: IgA nephropathy with serum ANCA positivite ( ANA is negative) with no proteinuria 1 day ago

None of these medications are associated with crescent formation in glomeruli, as far as I know. ------------------------------ Richard Glassock ...

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RE: membranous GN with advanced CKD-treatment plan 1 day ago

Yes. Glomerular hypercellularity is not seen in MN even when active in situ formation of sub-epithelial IC is occurring. Recently formation of in s...

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RE: candiduria after starting cephalexin while already on empagliflozin 25 mg qd for months 1 day ago

I agree with local anti-fungal therapy and teaching better genital hygiene, with temporary withholding of Flozins.. I am a little more skeptical of...

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RE: candiduria after starting cephalexin while already on empagliflozin 25 mg qd for months 1 day ago

Re the candiduria it is very much likely that she has vaginal candidiasis which has shown up in the urine culture. Vaginal cotrimazole cream may be...

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RE: membranous GN with advanced CKD-treatment plan 1 day ago

Can intra -membranous deposits . . indicate active in situ formation of IC although there is no endocapilary hypercellularity or any other active l...

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RE: IgA nephropathy with serum ANCA positivite ( ANA is negative) with no proteinuria 1 day ago

Thank you for your input. He is ANA negative. No crescents in biopsy and no proteinuria. I sent repeat ANCA and MPO which is pending currently. -...

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RE: IgA nephropathy with serum ANCA positivite ( ANA is negative) with no proteinuria 1 day ago

Medications : ASA, Atorvastatin, Levothyroxine, Vit D, Coreg and Cozaar. Cozaar started recently. ------------------------------ Radhika Thalla M...

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RE: C3G case 1 day ago

Your pathologist can probably get pronase from you molecular lab. They would routinely use either pronase or proteinase K for DNA extractions. This...

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RE: C3G case 1 day ago

Thank you both dear Dr. @Richard Glassock and @Awais Nauman for your reply and clarification. ------------------------------ Rowan Zyada MSc Egy...

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RE: Drug induced ANCA disease or IgA with crescents? 1 day ago

My reckless brain wonders how "Hydralazine" or "Similarly accused meds" can induce antibody production towards histones -/+ MPO & turn the place in...

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RE: IgA nephropathy with serum ANCA positivite ( ANA is negative) with no proteinuria 2 days ago

Recent studies have shown that ANCA positivity in IgA N is seen in about 2% of patients abd tge clinical feature are similar with or without AbCA e...

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RE: IgA nephropathy with serum ANCA positivite ( ANA is negative) with no proteinuria 2 days ago

What is the full list of medications taken. The anti-MPO antibody might be drug induced. Probably of no consequence, no proteinuria, no indication ...

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IgA nephropathy with serum ANCA positivite ( ANA is negative) with no proteinuria 2 days ago

I have a 74 year old Male with only h/o HTN presented with AKI. Baseline creatinine in October 2023 is 1.2. He had physicals in Aug'24 and showed c...

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RE: candiduria after starting cephalexin while already on empagliflozin 25 mg qd for months 2 days ago

It's a judgment, but personally, I agree with aldactone here. True, there's no long term RCT looking at hard outcomes, but we do know it predictabl...

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RE: candiduria after starting cephalexin while already on empagliflozin 25 mg qd for months 2 days ago

The data on Spironolactone to slow progression of CKD in T2DM is really a mixed bag. Finerenone has a better track record. With obesity . I would p...

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RE: candiduria after starting cephalexin while already on empagliflozin 25 mg qd for months 2 days ago

Thank you.Her home blood pressure today was 142/92 and she has already stopped using hydralazine because of hives. She has difficulty tolerating ev...

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RE: Drug induced ANCA disease or IgA with crescents? 2 days ago

I would not discount the role of Hydralazine as the mist likely cause of the ANCA vasculitis. ------------------------------ Richard Glassock MD,...

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RE: membranous GN with advanced CKD-treatment plan 2 days ago

The very thick GBM may provide an partial explanation for the progressive loss of GFR. The EM describes intra -membranous deposits . Were these dep...

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RE: membranous GN with advanced CKD-treatment plan 2 days ago

Very unusual case. Progression of MN with proteinuria of this magnitude is seldom seen. Was a Congo Red stain performed . Any fibrillar deposits in...

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RE: C3G case 2 days ago

The use of IHC on paraffin sections, without Pronase digestion for epitope retreival, raises issues concerning the true diagnosis as concealed mono...

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