RE: salt losing nephropathy 2 hours ago

Sorry, misread the Urine k of 7 mmol/l as serum K ... Apologies --------------------------------- Dr. Hormaz Dastoor. MD, MSc, FASN Divisional He...

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RE: salt losing nephropathy 2 hours ago

Thank you for your replys. The patient is hypokalemic and hypernatremic with diuresis and natriuresia. His creatinine amounts to 3.2 mg/dl and ure...

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RE: Denovo Idiopathic MPGN of Renal Allograft 2 hours ago

Patient initially Received LKDT from her sister that lasted 2 years but failed due to CNI toxicity . she is now s/p DDKT since 2016 , Creat continu...

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RE: Denovo Idiopathic MPGN of Renal Allograft 2 hours ago

2004 Native Biopsy The tissue examined at the ultrastructural level includes one (1) glomerulus. The capillaries appear largely obsolescent, wit...

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RE: salt losing nephropathy 4 hours ago

Looks like post obstructive diuresis . How high was the urea or BUN levels . Any clue why despite the diuresis the K is high??? Is it due to obst...

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RE: Management Challenges in a Patient with C3 Glomerulonephritis 5 hours ago

thanks. Will talk to pathologist. Jingjing ------------------------------ JingJing Zhang MD, PhD [Associate professor of Medicine] Sidney Kimme...

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RE: salt losing nephropathy 5 hours ago

Most likely postobstructive diuresis , urine studies c/w osmolar diuresis . Slowly reduce fluid replacement and correct hypernatremia with hypotoni...

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salt losing nephropathy 7 hours ago

45 year old patient with a history of total cystectomy due to ca. bladder with creation of surgical pouch as an artificial kidney from bowel loop, ...

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RE: GLP -1 RA question 7 hours ago

I agree- the problem is not the GLP1RA per se but the rapidity of HBA1c fall that us the hazard for worsening pre-existing Diabetic Retinopathy. ...

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RE: GLP -1 RA question 9 hours ago

"can we start GLP1-RA in view of treated diabetic retinopathy? Yes what if diabetic retinopathy was not yet treated would colleagues start GLP-1 ...

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RE: Management Challenges in a Patient with C3 Glomerulonephritis 16 hours ago

I have encountered quite a few cases of "C3G" diagnosed by very good renal pathologists that turned out to be PGNMID with masked monoclonal deposit...

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RE: Management Challenges in a Patient with C3 Glomerulonephritis 20 hours ago

Hi, Dr. El-Meanawy, thanks for another thought. The previous pathologist retired, I will discuss with current pathologist to see if he can hel...

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RE: GLP -1 RA question 21 hours ago

8-9 % ? ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KPCOP EC [Past Medical Director Kidney Pancreas Transplant Medical...

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RE: Management Challenges in a Patient with C3 Glomerulonephritis 21 hours ago

Thank you so much for sharing the experience. I feel more confident now about using these agents if needed. best, jingjing ----------------...

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RE: GLP -1 RA question 21 hours ago

The risk of worsening retinopathy is not related to GLP-1 -, It's the rapidity of the correction of the hemoglobin A1c which is usually temporary ....

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RE: GLP -1 RA question 21 hours ago

Hb1ac 80-90 --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: GLP -1 RA question 21 hours ago

How high is Hgl A1c levels? ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KPCOP EC [Past Medical Director Kidney Pancrea...

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GLP -1 RA question 22 hours ago

1- patient has Type 2 diabetes and treated diabetic retinopathy and CKD 4 with increased BMI and HB1AC not in range can we start GLP1-RA in view ...

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RE: Management Challenges in a Patient with C3 Glomerulonephritis 1 day ago

Dr. Schwartz- thanks for the PDF's of the citations,. ------------------------------ Richard Glassock MD, FASN Emeritus Professor Geffen School o...

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RE: Management Challenges in a Patient with C3 Glomerulonephritis 1 day ago

Here are the 2024 ASN Presentation and the 2025 NEJM Publication of Valiant trial. ------------------------------ John Schwartz MD Dallas Ne...

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RE: Management Challenges in a Patient with C3 Glomerulonephritis 1 day ago

Dr. El-Meanawy raises an interesting point that requires additional consideration, I think. Although tge clinical and pathological features of tgis...

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RE: Management Challenges in a Patient with C3 Glomerulonephritis 1 day ago

The stability of creatinine through the years is interesting. I have seen IgG related GN / MN with hidden epitopes mascaraed as C3. The problem...

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RE: Management Challenges in a Patient with C3 Glomerulonephritis 1 day ago

The Sobi ERA 2026 release looks like the right lead — let me pull the full poster list. I think the poster you mean is first-authored by **Dean Wa...

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RE: Management Challenges in a Patient with C3 Glomerulonephritis 1 day ago

In terms of infections , I have used Pegcetacoplan in around 10 cases with C3G and Iptacopan for 8 patients with IgA Nephroapthy. All patients wer...

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RE: Management Challenges in a Patient with C3 Glomerulonephritis 1 day ago

Hi, Dr. Dastoor, thanks for your suggestions and reference. I am wondering if the increase of proteinuria is due to worsening kidney function s...

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RE: Management Challenges in a Patient with C3 Glomerulonephritis 1 day ago

Hi, Dr. Lerman, thank you so much for your suggestions. I will relay your opinion to our transplant team. Jingjing ------------------...

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RE: Management Challenges in a Patient with C3 Glomerulonephritis 1 day ago

Hi, Dr. Glassock, thank you so much for the reply. I am actually not sure between these two. Our pathologist reported C3GN. I did not see lipod...

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RE: Denovo Idiopathic MPGN of Renal Allograft 1 day ago

What type of donor LKD vs DD ? Tac monotherapy is unusual unless HLA identical LKD which is still uncommon not to use antimetabolites +/- low dose ...

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RE: Denovo Idiopathic MPGN of Renal Allograft 2 days ago

It depends on whether the C3 IF was interpreted from an advanced sclerotic glomeruli or not. We need to see the full (deidentified ) full biopsy re...

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RE: Denovo Idiopathic MPGN of Renal Allograft 2 days ago

Wouldn’t ‘trace’ C3, despite low serum C3, weigh heavily against both (masked) PGNMID & IRGN? C3 staining is nearly universal in PGNMID & C3 domina...

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RE: A case of a young man with a biopsy showing full house pattern on IF, with negative Lupus serology and positive MPO Antibody 2 days ago

He has not taken Hydralazine ------------------------------ Katafan Achkar MD, FASN Houston Methodist Hospital and CLS Health Webster TX (832) 46...

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RE: Denovo Idiopathic MPGN of Renal Allograft 2 days ago

What was the evidence that the disease of the native kidney was IgAN? I agree with Dr. Rodby that excluding an infection or PGNMID is very importan...

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RE: Management Challenges in a Patient with C3 Glomerulonephritis 2 days ago

Thanks Dr. Lerman Very helpful advice. I also agree with the suggestions of Dr. Dastoor, but I am not optimistic about favorable response to Pegcet...

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RE: Management Challenges in a Patient with C3 Glomerulonephritis 2 days ago

Can you please post the reference for this figure? Thank you. ------------------------------ Mario Rubin, M.D. Houston TX (713) 252-5539 --------...

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RE: Denovo Idiopathic MPGN of Renal Allograft 2 days ago

I always go back to this for MPGN and with the Igs on biopsy, you are on the left side have infections been completely ruled out? I would get...

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RE: Management Challenges in a Patient with C3 Glomerulonephritis 2 days ago

The attached image kind of summarizes what you should expect in terms of uPCR and eGFR response to therapy with a Complement blocker. Having used...

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Denovo Idiopathic MPGN of Renal Allograft 2 days ago

57-year-old woman with ESKD secondary to IgA nephropathy s/p kidney transplant in 2016, maintained on tacrolimus monotherapy, with baseline creatin...

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RE: Management Challenges in a Patient with C3 Glomerulonephritis 2 days ago

Agree no absolute contraindication to trying Iptacopan or Pegcetacoplan in this patient but patients profile suggests unlikely to prevent ESRD give...

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Applications Due 10/31: NephSIM Nephrons 2 days ago

Dear all, Applications are now open for the 2027 NephSIM Nephrons Program, a 6-month virtual mentoring and education program for medical student...

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RE: Management Challenges in a Patient with C3 Glomerulonephritis 2 days ago

Very challenging case. The posted single EM image seems to have features of DDD- how did you conclude that this was C3GN . The patients has a very ...

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Management Challenges in a Patient with C3 Glomerulonephritis 2 days ago

Dear colleagues, I would like to get some suggestions from you. Patient is a 31-year-old male. In 11/2017(age 22), he was found to have cr 2.3 a...

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RE: A case of a young man with a biopsy showing full house pattern on IF, with negative Lupus serology and positive MPO Antibody Saturday, October 10 @ 11:33 AM

Was he taking hydralazine? ------------------------------ Levi Short MD, FASN Wichita Nephrology Group PA Wichita KS ---------------------------...

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RE: NUP133 Mutation Saturday, October 10 @ 11:20 AM

Yes, it makes a lot of sense Dr Rodby. Nevertheless, this is recommended by standard practice in medical genetics. Indeed we do recommend it in our...

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RE: NUP133 Mutation Saturday, October 10 @ 11:14 AM

"Tough post-conception discussion if the stars do not align.". Powerful statement.. a life altering decision. Why take any chance. I am convinced. ...

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RE: NUP133 Mutation Saturday, October 10 @ 10:29 AM

This gets to the root of so many daily decisions we make as doctors, We dont look for everything in everybody regardless of risk, we draw the line ...

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RE: NUP133 Mutation Saturday, October 10 @ 9:45 AM

Yes, and these are wild estimates completely agnostic of population structure and cultural habits of the actual patient. Plus this is a truncating ...

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RE: A case of a young man with a biopsy showing full house pattern on IF, with negative Lupus serology and positive MPO Antibody Saturday, October 10 @ 4:16 AM

Another puzzling case of unexplained IC-GN, I would screen for infections in particular SBE. Any extraglomerular staining (TBM, vessels) that may ...

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RE: NUP133 Mutation Friday, October 9 @ 6:43 PM

Maybe I’m looking at this wrong, but if the highest population-specific allele F for this variant is 0.2372%, the estimated carrier F is 0.4733%, g...

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RE: NUP133 Mutation Friday, October 9 @ 6:03 PM

Agree is a rare form of NS/FSGS, but unfortunately this is how recessive diseases occur. This is a single variant cascade testing so it's usually i...

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RE: NUP133 Mutation Friday, October 9 @ 6:02 PM

With a gene frequency for this mutation of 1 in 16000 individuals in the general population, screening of non-non-relatives will not likely detect ...

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