RE: HSP with heavy proteinuria 1 hour ago

This is an unexplained phenomenon, seen in (well done) observational (single arm) studies.The "effectiveness" of RTX in IgAV has not (yet) be confi...

View Discussion

RE: HSP with heavy proteinuria 7 hours ago

@Richard Glassock Out of curiosity , why would Rituximab show no benefit in IgA Nephropathy, but good response in igA vasculitis . I am aware that...

View Discussion

RE: HSP with heavy proteinuria 7 hours ago

Drs. Friedman and Venkat. A S0 lesion makes a diffuse Podocytopathy (superimposed on IgAV) less likely, but EM analysis would be of interest, I agr...

View Discussion

RE: HSP with heavy proteinuria 7 hours ago

Since no clinical trials have yet reported efficacy of Atacicept or Atrasentan in IgA Vasculitis, so your conclusions must be extrapolations from I...

View Discussion

Cheer on your colleagues at the 2026 Fellows-In-Training (FIT) Bowl in Denver! 8 hours ago

While at Kidney Week, please stop by the ASN Futures Theater in Exhibit Hall A, of the Colorado Convention Center on Friday, October 23, to watch t...

View Discussion

RE: Drug-induced lupus and ANCA GN 10 hours ago

Thank you Dr. Glassock ------------------------------ Pongstorn Pitiranggon MD Pee Dee Nephrology Florence SC (843) 669-6694 --------------------...

View Discussion

RE: HSP with heavy proteinuria 12 hours ago

I would like to take the contrarian view in that I think the Atacicept and Atrasentan are actually reducing the proteinuria. . However, on withhold...

View Discussion

RE: HSP with heavy proteinuria 14 hours ago

I share Dr. Friedman's impression that there must be a podocytopathy (causing severe nephrotic syndrome) + IgA vasculitis in this patient. How ab...

View Discussion

2026 Fellows-In-Training (FIT) Bowl in Denver Starts Today, Oct. 22! 16 hours ago

FIT Bowl starts today! Come to the ASN Futures Theater in Exhibit Hall A, of the Colorado Convention Center to cheer on your colleagues today, Thur...

View Discussion

The 2026 ASN FIT Bowl is supported by Asahi Kasei Therapeutics. 16 hours ago

FIT Bowl starts today! Come to the ASN Futures Theater in Exhibit Hall A, of the Colorado Convention Center to cheer on your colleagues today, Thur...

View Discussion

RE: SLE Lupus nephritis Class V 17 hours ago

------------------------------ [Sheng] [Kuo] MD, FASN ------------------------------

View Discussion

RE: Lupus-associated TMA with no response after four weekly doses of eculizumab: withdraw or continue? 18 hours ago

Following your helpful advice in August, I would like to share an update on our 29-year-old patient with SLE, lupus nephritis, and recurrent TMA. W...

View Discussion

RE: Drug-induced lupus and ANCA GN 1 day ago

This is almost certainly Hydralazine -induced ANCA (anti-MPO) Vasculitis , not Lupus Nephritis. It will remit with discontinuance of the offending ...

View Discussion

Cheer on your colleagues at the 2026 Fellows-In-Training (FIT) Bowl in Denver! 1 day ago

While at Kidney Week, please stop by the ASN Futures Theater in Exhibit Hall, of the Colorado Convention Center on Thursday, October 22, and Friday...

View Discussion

RE: HSP with heavy proteinuria 1 day ago

She must have had significant FPE. I think the biggest contributor to her NS partial remission then was the IV f/b PO steroids. She has an E1 lesio...

View Discussion

Drug-induced lupus and ANCA GN 1 day ago

86 y/o w/f with DM2, HTN, breast cancer presented with non-oligulic AKI. Serum creatinine is 3.8 ( baseline Cr 0.8 ). She has been on hydralazine w...

View Discussion

RE: HSP with heavy proteinuria 1 day ago

Neither Atacicept nor Atrasentan have any established role in treatment of IgA Vasculitis. But the patient is doing well. If he can continue to rec...

View Discussion

RE: HSP with heavy proteinuria 1 day ago

would continue therapy as responding to present therapy. no need to re-biopsy ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] ...

View Discussion

HSP with heavy proteinuria 1 day ago

Appreciate any input on a case of HSP with unusually heavy proteinuria 42 year-old woman with no medical history barring hypothyroidism, presente...

View Discussion

RE: SLE Lupus nephritis Class V 1 day ago

If EXT I/II +, I may sit tight and monitor as it pertains to good prognosis. I will try to obtain the actual EM image. --------------------------...

View Discussion

RE: SLE Lupus nephritis Class V 1 day ago

Interesting idea. No data. No clinical trials to support use. Will endothelin blockers be effective for FGGS. I don't know, but I doubt it. -----...

View Discussion

RE: SLE Lupus nephritis Class V 1 day ago

Any role for off label use of Endothelin blockers to reduce proteinuira, if primarily driven by sclerosis --------------------------------- Dr. H...

View Discussion

RE: SLE Lupus nephritis Class V 1 day ago

How does a positive versus a negative EXT I/II change the approach in this type of patients? Has renal vein thrombosis been excluded in this pati...

View Discussion

RE: SLE Lupus nephritis Class V 1 day ago

Thanks- would it be possible to post a deidentified photo micrograph of a representative glomerulus by EM?I am particularly interested in the degre...

View Discussion

RE: SLE Lupus nephritis Class V 1 day ago

EM: Numerous subepithelial and intramembranous electron-dense deposits along the BM. GBM are variably thickened. No subendothelial deposit. Scatter...

View Discussion

RE: SLE Lupus nephritis Class V 2 days ago

Yes- non Class V active LN is often treated with triple IS, but the 2024 KDIGO CPG did not suggest IS therapy for "pure" Class V Lupus Membranous N...

View Discussion

RE: SLE Lupus nephritis Class V 2 days ago

Thanks Dr. Dastoor- in the USA OBI is not approved for "inactive " LN. It might be easier to start with RTX. Not true in UAE. -------------------...

View Discussion

RE: SLE Lupus nephritis Class V 2 days ago

I think it may be best to try and go for Obi over RTX. If the patient does not respond to RTX , as it seems he won't , you will be second guessing ...

View Discussion

RE: SLE Lupus nephritis Class V 2 days ago

Thanks dr Kuo Makes sense to stop volclosporin as has not worked also Ifta as you mention Make sense not to use belimumab as has not worked / o...

View Discussion

RE: SLE Lupus nephritis Class V 2 days ago

Thanks prof glassock For class 3/4 in my unit I notice people using dual therapy ( mmf +obi or mmf + volclo) with steroids and hydroxychlorquine an...

View Discussion

RE: SLE Lupus nephritis Class V 2 days ago

Tough question- it depends- For non-nephrotic "pure" Class V LN-MMF + low dose steroids or a CNI +iow dose steroids or RTX and no steroids, But nev...

View Discussion

RE: SLE Lupus nephritis Class V 2 days ago

Since OBI is approved by the FDA only for "active" LN and your patient has an Activity Index of zero (as expected for Pure Class V Lupus Membranous...

View Discussion

RE: SLE Lupus nephritis Class V 2 days ago

1. IF from 2025 still with “Full House”. I will update EM finding when I have the report in front of me again. 2. He developed or manifested LN whi...

View Discussion

RE: SLE Lupus nephritis Class V 2 days ago

Thanks prof glassock for input Non nephrotic our class v what would be your starting therapy ? And if things not improving let’s say 6 month to a...

View Discussion

RE: SLE Lupus nephritis Class V 2 days ago

My goodness- triple therapy for non-nephrotic "pure" Class V Membranous Lupus Nephropathy. I do not think so. Other opinions welcome!! ----------...

View Discussion

RE: SLE Lupus nephritis Class V 2 days ago

I think that Dr. Rodby's suggestions are very reasonable, but not "backed up" by "hard (RCT) evidence (yet). The % global sclerosis is about 2-3 x ...

View Discussion

RE: SLE Lupus nephritis Class V 2 days ago

Was patient on mmf 1 g bd before Thanks --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

View Discussion

RE: SLE Lupus nephritis Class V 2 days ago

Thanks for case Why was volclosporin stopped? Was patient compliant ? Present mmf 1g bd was patient on this dose? Any worsening of extra renal s...

View Discussion

RE: Denovo Idiopathic MPGN of Renal Allograft 2 days ago

Yes prof glassock thanks . My question was on hypothesis pronase was negative and diagnosis as combination of rejection and idiopathic Mpgn And ...

View Discussion

RE: MPO-ANCA Vasculitis 2 days ago

Thanks for case Creatinine improved Crp improved Urine acr stuck Urine dip active sediment Have you done any repeat lung imaging to see resolu...

View Discussion

RE: MPO-ANCA Vasculitis 2 days ago

We have a large experience in completely withdrawing corticosteroids in kidney transplant recipients. Some patients develop severe myalgias/arthral...

View Discussion

RE: SLE Lupus nephritis Class V 2 days ago

Since class-V LN developed when the patient was on Benlysta, I wondered if anti-CD20 therapy will be effective in this patient. However, my AI cons...

View Discussion

RE: SLE Lupus nephritis Class V 2 days ago

He is on "MMF 1 g BID, losartan 100 mg, eplerenone 25 mg, and empaglifozin 10 mg." that is a lot of medicine I woud give him rituximab 2 gr...

View Discussion

RE: SLE Lupus nephritis Class V 2 days ago

Always a problem with "Pure" Class V LN. Proteinuria is a poor indicator of the "activity" of immune complex formation and deposition. The AI and C...

View Discussion

RE: SLE Lupus nephritis Class V 2 days ago

8/60 global sclerosis. 0/60 focal sclerosis. EXT II negative --------------------------------- [Sheng] [Kuo] MD, FASN --------------------------...

View Discussion

RE: SLE Lupus nephritis Class V 2 days ago

At the time of 2025 biopsy (and also 2021), activity score was 0. I can’t attribute the proteinuria to the chronicity based on the report and he ha...

View Discussion

RE: SLE Lupus nephritis Class V 2 days ago

How much, if any, superimposed FSGS lesions were seen in the second Kidney Biopsy in 2025? Was the biopsy stained for EXTI/II? ------------------...

View Discussion

RE: SLE Lupus nephritis Class V 2 days ago

He has normal kidney function, no RBC, normal complements , activity score 0, some chronicity , and a very mildly raised dsDNa... Would you conside...

View Discussion

RE: SLE Lupus nephritis Class V 2 days ago

Patients with Pure Class V LN were nit included in thexREGENCY trial so we cannot be certain concerning response to OBI. I probably would not chang...

View Discussion

SLE Lupus nephritis Class V 2 days ago

40-year-old Chinese male with history of hypertension, Sjogren's syndrome, and SLE complicated by lupus nephritis LN class V came to our practice f...

View Discussion