RE: Role Of endothelin blockers In igA Nephropathy 1 hour ago

Yes, but in post-hoc analyses like this we need to be cautious in interpreting an association as proof of causation. ----------------------------...

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RE: Role Of endothelin blockers In igA Nephropathy 2 hours ago

this article seems to suggest that lowering proteinuria to less than 0.3 g/g is significantly renoprotective --------------------...

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RE: Do we need genetic testing in C3G (outside Cypriot ancestry)? 3 hours ago

Makes sense. Thank you. ------------------------------ B. Andre' Weinstock, PhD Scientist & Alport syndrome-COL4A5 patient Somerville, MA USA ---...

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RE: Do we need genetic testing in C3G (outside Cypriot ancestry)? 4 hours ago

In my opinion , genetic testing has limited value in Family planning for C3GN- genetics determines susceptibility, not destiny . Variable penetranc...

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RE: Do we need genetic testing in C3G (outside Cypriot ancestry)? 4 hours ago

Given incomplete and variable penetrance, except for CFHR5 nephropathy ,,a positive result can't give a child-specific risk estimate - most carrier...

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RE: Do we need genetic testing in C3G (outside Cypriot ancestry)? 4 hours ago

If readily available, genetic testing might be considered to aid in family-planning decision making of a diagnosed parent and partner. ----------...

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RE: Role Of endothelin blockers In igA Nephropathy 7 hours ago

The value of adding an ET Blocker (Atrasentan) or switching to a DEARA (Sparsentan) in such patients with IgAN to get the proteinuria below 0.3gms ...

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RE: Do we need genetic testing in C3G (outside Cypriot ancestry)? 7 hours ago

i agree- genetic testing in C3 GN is primarily of research interest- at least for now. ------------------------------ Richard Glassock MD, FASN E...

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RE: Pre-conception Strategy in CKD 3 with Proteinuria (Preserved Albumin)re: Biopsy Timing, Genetic Panel, and Pregnancy Monitoring 7 hours ago

I agree with Dr. Rodby, except I would do genetic testing first as the results may make kidney biopsy unnecessary. This will be a very high risk pr...

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RE: Role Of endothelin blockers In igA Nephropathy 7 hours ago

"However from an economic standpoint does it make sense to introduce these drugs , considering studies on ET1a was mainly in patients with more tha...

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Likely Active C3G before transplant 7 hours ago

Hello everyone we have 22y guy, ESKD on dialysis (twice weekly since august 2026). He has a long history of chronic GN with last biospy in 202...

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RE: A case of Acute Kidney Injury. 9 hours ago

I assume the sensitivity of intratubular RBCs/RBC casts decays over time in ARN. And from the dates reports were printed, it would seem at least 1 ...

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Role Of endothelin blockers In igA Nephropathy 12 hours ago

We have a couple of patients with IgA Nephroapthy, who have been treated in the past with IS therapy , some without IS therapy. But all of them on...

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RE: Pre-conception Strategy in CKD 3 with Proteinuria (Preserved Albumin)re: Biopsy Timing, Genetic Panel, and Pregnancy Monitoring 13 hours ago

I would push for a biopsy after a Natera full screen (assuming negative) I suspect she has a secondary FSGS of some sort. PCR seems a bit high fo...

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Do we need genetic testing in C3G (outside Cypriot ancestry)? 15 hours ago

In my opinion — no. Would like the community's input on this. Unlike aHUS, genotype doesn't drive diagnosis, treatment, monitoring, stopping decisi...

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RE: A case of Acute Kidney Injury. 16 hours ago

What was the patients serum albumin level when he presenterd with AKI and marked proteinuria? ------------------------------ Richard Glassock MD,...

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RE: A case of Acute Kidney Injury. 21 hours ago

"As far as anticoagulation is concerned, he had a stroke off anticoagulation 2 years ago, so he is still on it as of now. Ongoing discussion with c...

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RE: A case of Acute Kidney Injury. 23 hours ago

Dr Lerman and Dr Glassock for your valuable input. Also all others who contributed their time and expertise. I already started tapering steroi...

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RE: A case of Acute Kidney Injury. 1 day ago

Thanks, unless I'm missing something I don't see any convincing evidence for tubular obstruction from red blood cells that would explain or suggest...

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RE: A case of Acute Kidney Injury. 1 day ago

The biopsy report shows no evidence of nodular glomeruloscleroisis . No increase GBM thickness . No IgA deposits. The frequency of intratubular RBC...

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RE: A case of Acute Kidney Injury. 1 day ago

This is the second biopsy. As far as the concern for two embolic lesions, raising concern for some amorphic material used during first biopsy is ...

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RE: Resistant Rejection 1 day ago

Many thanks to all for the informative and helpful inputs. Dr. Lerman, the donor is not available now and the transplant was done at other city i...

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RE: A case of Acute Kidney Injury. 1 day ago

Thanks can you post 2nd unidentified biopsy ? ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KPCOP EC [Past Medical Direc...

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Pre-conception Strategy in CKD 3 with Proteinuria (Preserved Albumin)re: Biopsy Timing, Genetic Panel, and Pregnancy Monitoring 1 day ago

Hello colleagues I am seeking advice about a complicated pre-conception eval and CKD 39 year old female of recent West African ancestry with CKD ...

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RE: A case of Acute Kidney Injury. 1 day ago

I have attached the first biopsy report. Dr Lerman- I did ask the pathologist to check for hemosiderin in tubular epithelium. Thank you. ---...

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RE: A case of Acute Kidney Injury. 1 day ago

ASK pathologist re-examine both specimens specifically for intratubular RBC casts, RBCs in Bowman's space, acute tubular injury, and hemosiderin (P...

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RE: A case of Acute Kidney Injury. 1 day ago

Tubules did shows significant RBC. No glomerular hemorrhage though. I was hoping it to be AKI from contrast as well with subsequent recovery h...

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RE: A case of Acute Kidney Injury. 1 day ago

contrast induced AKI CAUSING aki severe enough to require RRT with baseline creatinine normal would be a huge stretch IMO. could we see the unident...

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Do we need genetic testing in C3G (outside Cypriot ancestry)? 1 day ago

In my opinion — no. Would like the community's input on this. Unlike aHUS, genotype doesn't drive diagnosis, treatment, monitoring, stopping decisi...

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RE: Iron replacement strategy in dialysis 1 day ago

I tend to agree with Dr. Rodby's position and would like to pose the question regarding the trade-off between higher ferritin tolerance vs. need fo...

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RE: A case of Acute Kidney Injury. 1 day ago

Did the kidney biopsy show extensive RBC in the tubules- if not, it will be hard to invoke "anticoagulant nephropathy " as the cause of the AKI- i ...

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RE: A case of Acute Kidney Injury. 1 day ago

He is on Apixaban. Immunofloresence showed mild IgA deposits. Once again not enough to explain his AKI. No ATN. Given RBCs with no evidence...

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RE: AA Amyloidosis of unknown origin? Idiopathic? Other ? 1 day ago

Thank you for tour valuable input. WR Zaher ------------------------------ Zaher Armaly MD Nazareth Hospital -EMMS Nazareth 97246028829 ----...

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RE: A case of Acute Kidney Injury. 1 day ago

He has AF (presumably on a DOAC or warfarin), and an episode of gross hematuria, which is a classic setup. Look for RBC casts, tubular obstruction ...

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RE: A case of Acute Kidney Injury. 1 day ago

Agree that non-diabetic nodular glomerulosclerosis cannot explain the AKI. It only accounts for the proteinuria. As I had speculated earlier, anoth...

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RE: A case of Acute Kidney Injury. 1 day ago

That's true. But how to explain such quick deterioration in GFR. ------------------------------ [Saifullah] [Kazi] [MD] [Consultant Nephrologist...

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RE: A case of Acute Kidney Injury. 1 day ago

Cigarette smoker? Non-diabetic nodular glomerulosclerosis more common in smokers. ------------------------------ K.K. Venkat MD Troy MI (248) 42...

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RE: A case of Acute Kidney Injury. 1 day ago

Yes diffuse foot process effacement. I don't have AUCR. Worth a check I guess? no dysmorphic RBC or casts. ------------------------------ [Saif...

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RE: A case of Acute Kidney Injury. 1 day ago

Thanks. Very helpful. The UPEP is not likely be normal with 3gms of proteinuria. . Do you have a uACR and uPCR?. The thickened GBM and nodular Glom...

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RE: A case of Acute Kidney Injury. 1 day ago

Free light chains normal, SPEP and UPEP are negative, including cryo. no h/o diabetes EM- open capillary loops, thickened basement membrane, p...

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RE: A case of Acute Kidney Injury. 2 days ago

The repeat kidney biopsy pretty much makes Vasculitis or Glomerulonephritis as a cause of AKI extremely unlikely, but the episodic hematuria remain...

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RE: A case of Acute Kidney Injury. 2 days ago

Unfortunate that no past urinalyses are available. Proteinuria and microscopic hematuria due to another cause might have antedated the superimposit...

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Do we need genetic testing in C3G (outside Cypriot ancestry)? 2 days ago

In my opinion — no. Would like the community's input on this. Unlike aHUS, genotype doesn't drive diagnosis, treatment, monitoring, stopping decisi...

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RE: A case of Acute Kidney Injury. 2 days ago

I would echo the statements of the Dear Professor . During my fellowship several decades ago , I was taught that in case of subacute renal failure...

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RE: A case of Acute Kidney Injury. 2 days ago

Do you have EM on the second biopsy? What is the full extent and nature of "nodular sclerosis "?. Is the patient diabetic? Do you have serum free l...

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RE: AA Amyloidosis of unknown origin? Idiopathic? Other ? 2 days ago

I would postulate that this patient (and perhaps his sister ) have inherited a high -Amyloid risk variant of the NOD2 gene associated with Crohn-s....

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RE: Iron replacement strategy in dialysis 2 days ago

The Pivotal Trial has serious limitations and should not be used to establish "Guidelines". 1) it was open-labeled. 2) it showed an ARR of only...

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RE: Iron replacement strategy in dialysis 2 days ago

Teleologically, the iron level is controlled at the entry gate, which speaks of overload harm. In dialysis patients, we bypass that gate with IV ir...

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A case of Acute Kidney Injury. 2 days ago

76-year-old male who with medical history for long standing hypertension, Atrial fibrillation who had a mechanical fall with tibia fracture needing...

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AA Amyloidosis of unknown origin? Idiopathic? Other ? 2 days ago

Dear All Good day, A 32-year-old male, Parents of Arab origin from the Galilee. In 2014, he began experiencing abdominal and diarrheal symptoms...

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