RE: Tarpeyo use in IgA Nephropathy patients with Low GFR 5 hours ago

Dear Dr Glassock I believe in surveillance biopsies at about 5 years in transplant patients doing well as that is only way to detect early calcin...

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RE: Calling All Nephrologists: What's Your Workflow Wisdom? 10 hours ago

Dr Zapata: A few things about dialysis rounds I've picked up along the way, and I believe have helped me. First, Dialysis rounding is important so,...

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RE: Tarpeyo use in IgA Nephropathy patients with Low GFR 11 hours ago

The biopsy findings would definitely change my treatment. eGFR 25 my treatment would depend on younger age, lesser fibrosis, more cellular crescent...

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RE: Tarpeyo use in IgA Nephropathy patients with Low GFR 12 hours ago

Yes , but such single arm open labels trials are more like "compassionate use" as they have doubtful utility in effecting a change in labeling of t...

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RE: Tarpeyo use in IgA Nephropathy patients with Low GFR 13 hours ago

Great suggestion or question rather . I know one study that’s going to do exactly that ( not just for low gfr pt ) I can’t reveal the details yet b...

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RE: Tarpeyo use in IgA Nephropathy patients with Low GFR 13 hours ago

Yes that’s very correct But some trials are doing exploratory group as open label ( no placebo ) Sent from my iPhone

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RE: Tarpeyo use in IgA Nephropathy patients with Low GFR 14 hours ago

Thanks for the responses. To put the question in a different way - if you performed a kidney biopsy in a patient with known IgAN and an eGFR of 25m...

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RE: active PR3 -AAV with pulmorenal involvment during the first trimaster of pregnancy 15 hours ago

She is very early in her pregnancy and it will be very difficult to get her through this But This is a life threatening disease and I would stron...

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RE: Tarpeyo use in IgA Nephropathy patients with Low GFR 15 hours ago

@Satish Balan you bring up an interesting point, the relative intolerability of steroids in IgAN compared to eg lupus and vasculitis, but these a...

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RE: Tarpeyo use in IgA Nephropathy patients with Low GFR 20 hours ago

Question- do participants in ASN Communities believe that a repeat kidney biopsy should be manadatiry for trials examining efficacy and safety of n...

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RE: Tarpeyo use in IgA Nephropathy patients with Low GFR 21 hours ago

Of course, I agree with referral of patients fulfilling inclusion/exclusion criteria to trial sites nearby. But the patient must understand they ha...

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RE: active PR3 -AAV with pulmorenal involvment during the first trimaster of pregnancy 21 hours ago

Tough question. I would probably use Steroids + AZA. If the DAH worsens, I would consider adding PLEX, which is quite safe and well tolerated in Pr...

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RE: Tarpeyo use in IgA Nephropathy patients with Low GFR 21 hours ago

All valid points but this was smaller subset analysis from larger study . The broader point is that ongoing trials are including exploratory cohort...

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RE: active PR3 -AAV with pulmorenal involvment during the first trimaster of pregnancy 22 hours ago

Thank you, prof Richard The IF and EM are still pending anti GBM negative CT chest not done she is pregnant ( 7 weeks now ) she is not de...

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RE: active PR3 -AAV with pulmorenal involvment during the first trimaster of pregnancy 1 day ago

When will IF and EM on the kidney biopsy be available? What is tge pO2 and O2 saturation.? What does the Chest CT show? did you do an antiGBM assay...

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RE: Tarpeyo use in IgA Nephropathy patients with Low GFR 1 day ago

Patients with non-RPGN and advanced chronic progressive GN represent a group unaddressed by the major "registration" trials of novel drugs for GN. ...

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active PR3 -AAV with pulmorenal involvment during the first trimaster of pregnancy 1 day ago

Dear all I need your kind expert opinion about the best approach for managing a challenging case, a 32 years old female with a background of Ty...

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RE: Tarpeyo use in IgA Nephropathy patients with Low GFR 1 day ago

Thanks for the post. Small study. No follow up eGFR, so we don't know of ESKD will be delayed. Kidney biopsy data not useful as they were performed...

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RE: Tarpeyo use in IgA Nephropathy patients with Low GFR 1 day ago

I too agree that use of steroids and, immunosuppression in general, in advanced IgAn is usually unrewarding. In fact it leads to more problems as s...

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RE: Tarpeyo use in IgA Nephropathy patients with Low GFR 1 day ago

https://linklock.titanhq.com/analyse?url=https%3A%2F%2Fmedcommshydhosting.com%2FCRM%2FRenal%2FASN%2Fpresentations%2F2024%2Fposters%2FASN2024_Safety...

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RE: Tarpeyo use in IgA Nephropathy patients with Low GFR 1 day ago

I have tried it with not much success . imo the success will depend on biopsy findings ie chronic changes as mentioned by Dr. Glassock I am not...

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RE: Tarpeyo use in IgA Nephropathy patients with Low GFR 1 day ago

Further thoughts.The TESTING trial examined the effects of oral systemic steroids in patients IgAN and an eGFR that was as low as 20Ml/min/1.73 M2....

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RE: Tarpeyo use in IgA Nephropathy patients with Low GFR 2 days ago

As stated, we have no data that can provide a useful answer to your question- only anecdotes and opinions. It might help to know more about the spe...

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Tarpeyo use in IgA Nephropathy patients with Low GFR 2 days ago

Hello Neph Community, Has anyone had good success with using Tarpeyo in patients with GFR in the 20's? The cut off in trials has been >30, so ...

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RE: Calling All Nephrologists: What's Your Workflow Wisdom? 2 days ago

In the era of the EMR, I use it when I get a consult, within five minutes reviewing the case, labs etc etc then I put in preliminary orders for wha...

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RE: Calling All Nephrologists: What's Your Workflow Wisdom? 3 days ago

I have been doing this for a long time and have a few suggestions. Never take anything for granted and question everything you are told. I firs...

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RE: atypical Anti GBM 3 days ago

This patient had findings compatible with Atypical anti-GBM disease. In this condition, the evidence (so far) for a "need" to give immunosuppresiiv...

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RE: Renal biopsy for low C4, and history of subacute cutaneous lupus, ANA positive 1: 320 and speckled but C3, urinalysis, double-stranded DNA antibody are normal , urine protein undetectable and creatinine stable > 1 year 3 days ago

Agreed No indication for a kidney biopsy in this patient. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885...

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RE: atypical Anti GBM 3 days ago

@prof glassock based on the biopsy there is an element of activity . Would not that mean we need to immunosuppress? Thanks ----------------------...

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RE: Treatment of Membranous glomerulonephritis - clinically low risk with renal biopsy showing advanced chronicity 3 days ago

Thank you 😊 --------------------------------- Alaa Nabih Abdalla nephrology fellow Egypt --------------------------------- [More]

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RE: Treatment of Membranous glomerulonephritis - clinically low risk with renal biopsy showing advanced chronicity 3 days ago

Deposits that are rarefied or becoming licentious by EM indicate ongoing reabsorption of the deposits. Small usual density deposits immediately und...

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RE: Treatment of Membranous glomerulonephritis - clinically low risk with renal biopsy showing advanced chronicity 3 days ago

Thank u dr fogo for clarification My Q in EM does deposits type radiolucent or radio dense help to distinguish non active from active disease ---...

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RE: Renal biopsy for low C4, and history of subacute cutaneous lupus, ANA positive 1: 320 and speckled but C3, urinalysis, double-stranded DNA antibody are normal , urine protein undetectable and creatinine stable > 1 year 3 days ago

No evidence of active lupus nephritis supported by normal urine ..no hematuria ..and stable ckd Only c4 is low and it happened before without clin...

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RE: Treatment of Membranous glomerulonephritis - clinically low risk with renal biopsy showing advanced chronicity 3 days ago

The spikes are a matrix reaction from podocytes to deposits. Spikes mean that the deposits have been there long enough to result in a visible matri...

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RE: ATI, Anuria post kidney transplant 3 days ago

Given nephrotic range proteinuria but low normal serum albumin - would get urine protein electrophoresis and if confirms primarily urine albuminuri...

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Renal biopsy for low C4, and history of subacute cutaneous lupus, ANA positive 1: 320 and speckled but C3, urinalysis, double-stranded DNA antibody are normal , urine protein undetectable and creatinine stable > 1 year 3 days ago

White gentleman age 76 reports having lupus for decades since 1992 but never had kidney biopsy that he can remember. Remembers biopsy of skin decad...

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RE: Hypokalaemia in dialysis patient 3 days ago

Daily urine output? Potassium concentration in urine? Medications? Laboratory method for potassium? ------------------------------ Giovanni Can...

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RE: Hypokalaemia in dialysis patient 3 days ago

Be careful- hyperlipidemia may interfere with the accurate estimation of electrolyte levels, including Potassium, in lipemic plasma. -----------...

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Hypokalaemia in dialysis patient 3 days ago

51 years old female patient known case of hypertension, medullary sponge kidney, distal RTA , severe hypertriglycerdiemia with recurrent hypokal...

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RE: Calling All Nephrologists: What's Your Workflow Wisdom? 3 days ago

I have 3 bits of advice: It is so easy to become complacent and complacency generates mediocrity. There is nothing wrong with mediocrity, almost no...

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RE: ATI, Anuria post kidney transplant Saturday, December 7 @ 5:36 PM

Encouraging that renal function has recovered in this previously anuric/dialysis-dependent patient. Increase in UPr/Cr to ~ 8 g/g from prior level...

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RE: ATI, Anuria post kidney transplant Saturday, December 7 @ 4:42 PM

No rituximab was given till now This was my question actually bases on the stable condition now apart from proteinuria -------------------------...

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RE: ATI, Anuria post kidney transplant Saturday, December 7 @ 4:40 PM

No just received 6 sessions after the 1st biopsy This was about 3 weeks before the last FUP labs --------------------------------- Ahmed Emara M...

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RE: Treatment of Membranous glomerulonephritis - clinically low risk with renal biopsy showing advanced chronicity Saturday, December 7 @ 3:09 PM

Do the spikes suggest active immunologic disease or could this still (in the absence of EM to distinguish) be Stage 4, inactive immunologically? ...

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RE: Calling All Nephrologists: What's Your Workflow Wisdom? Saturday, December 7 @ 1:01 PM

Dear Dr. Zapata, When consulting in the hospital or in the office , something that worked well for me for 40 years was: 1) take a look at the ...

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RE: ATI, Anuria post kidney transplant Saturday, December 7 @ 12:19 PM

No just received 6 sessions after the 1st biopsy This was about 3 weeks before the last FUP labs --------------------------------- Ahmed Emara M...

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RE: Treatment of Membranous glomerulonephritis - clinically low risk with renal biopsy showing advanced chronicity Friday, December 6 @ 8:23 PM

Pregnancy can be considered as a reasonable test for renal reserve. I would like to know what was the reason for the C section. If it was not relat...

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RE: Calling All Nephrologists: What's Your Workflow Wisdom? Friday, December 6 @ 8:15 PM

The answer is already inside your question. You have a good structure of thinking. You need nothing else but keep reading. I will try to attach a f...

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Calling All Nephrologists: What's Your Workflow Wisdom? Friday, December 6 @ 5:04 PM

As a newly practicing nephrologist, I find myself reflecting on the transition from fellowship to independent practice. While fellowship lays the f...

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Seeking Research Opportunities for ASN Conference Abstract Submission Friday, December 6 @ 11:37 AM

Dear Members of the ASN Community, I hope this message finds you well. My name is Amna Zaheer, and I am a 3rd-year medical student at Liaquat Nat...

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