RE: Renal denervation 3 hours ago

Fewer than 10% of patients studied had stage 3b CKD with 10–15 mmHg office SBP reduction lasting at least 3 years. Very few patients with stage 4 ...

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RE: IgA nephropathy 3 hours ago

My indication for use of Iptacopan is similar to Uptodate . This patient is classified as high risk based on . 1. Decline in eGFR that exceeds gr...

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RE: Renal denervation 4 hours ago

@Gary Singer what percent of the patients receiving this procedure had CKD 3b or more? "4–7 mmHg in ambulatory SBP and 6–10 mmHg in office SBP...

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RE: ig a v vs anca vs ctd 4 hours ago

I would ignore the IgA this appears to be pauci immune crescentic GN most consistent with a vasculitis. I would treat as such with Pexivas prot...

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RE: ig a v vs anca vs ctd 5 hours ago

and in this case if she has UTI would colleagues favour plex? would plex remove glycosylated Ig A? thanks for help ------------------------...

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ig a v vs anca vs ctd 5 hours ago

question is this ig a vasculitis ? or anca? or both or lupus? ( i dont think lupus no c1q no full house complement) CTD?? would colleagues wait...

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RE: ? C3 GN Or Not . If Yes, How To Proceed With Management 8 hours ago

Thank you very much Congo red staining is pending DNAJB9 send out, and in progress. No history of NSAIDs use except low dose Aspirin No recent hi...

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RE: IgA nephropathy 9 hours ago

Dr. Dastoor- Many thanks for sharing . So far, I have had very little experience with Iptacopan as patients with high risk IgAN respond very well t...

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RE: Renal denervation 12 hours ago

Hi-I am one of the nephrologists and HTN specialists at the Stanford HTN Center. I work closely with our center's director Vivek Bhalla and we rece...

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RE: IgA nephropathy 12 hours ago

While on the subject of IgA , it has been around 3 weeks since we started using Iptacopan on 3 patients . One patient did his labs today, and for...

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RE: ? C3 GN Or Not . If Yes, How To Proceed With Management 14 hours ago

Thanks DR. Zuckerman. Very helpful. C3GN seems very unlikely . The EM images should be informative. ------------------------------ Richard Gl...

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RE: ? C3 GN Or Not . If Yes, How To Proceed With Management 16 hours ago

My read of the clinical situation is: nephrotic syndrome (10 G protein, Alb 2.6, and edema) who also has renal failure (sCr 2.8). Microscopic hemat...

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RE: ? C3 GN Or Not . If Yes, How To Proceed With Management 16 hours ago

As could as I remember she is suffering from Nephritis ------------------------------ Sandip] [Das] [PGDHCM] [GO] [Primary Health Care] [Tamluk] ...

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RE: ? C3 GN Or Not . If Yes, How To Proceed With Management 17 hours ago

I am not an expert on C3G, but the C3 staining does not seem to be 2 OOM higher than the other stains . Regardless, if this is confirmed C3G, and...

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RE: ? C3 GN Or Not . If Yes, How To Proceed With Management 17 hours ago

Difficult case. The EM findings may help sort this out as the IF is equivocal, but suggestive of mesangial localization of C3 without Ciq. No evide...

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RE: IgA And SLE 18 hours ago

Yes- but a little MMF will not likely do any harm for extra-renal SlLE, and might even have some favorable effects. -----------------------------...

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? C3 GN Or Not . If Yes, How To Proceed With Management 18 hours ago

Good morning 65 years old white female Obese HFpEF Worsening proteinuria, about 10 GM, serum albumin of 2.6 Microscopic hematuria but no RBC casts ...

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RE: IgA And SLE 19 hours ago

just to confirm, the MMF is for IgA and hematuria , right , not for extra renal Lupus!! --------------------------------- Dr. Hormaz Dastoor. MD,...

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RE: IgA And SLE 1 day ago

In my opinion, this case is a fundamental expression of Hickams Dictum- "a patient can have as many Diseases as as they damn well please" -------...

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RE: IgA And SLE 1 day ago

I would also add Hydroxychloroquine to the regimen, with appropriate eye screening follow up. ------------------------------ Richard Glassock MD...

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RE: IgA And SLE 1 day ago

I Will add MMF and resume low dose steroids Will update the thread in 3-6 months Thank you so much --------------------------------- Ashra...

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RE: Renal denervation 1 day ago

It is great that CMS covers now. Private carriers still fight back. The cost is high and might be future barrier. Last figure I was quoted was $50,...

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RE: IgA nephropathy 1 day ago

The answer to the first question is not known due to conflicting findings in published material I have no experience with KN 55 staining in IgA dep...

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RE: Renal denervation 1 day ago

We had an opportunity to try both methods RF and Ultrasound on ESRD patients . However we did not see any benefit after 6 months . Need to realize...

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RE: IgA nephropathy 1 day ago

Academically, would KM55 staining help to differentiate Primary from secondary forms of IgA . What other features on a biopsy would help to disting...

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RE: IgA nephropathy 1 day ago

Yes, I agree. No IgM results were posted originally, IgAN with no IgG or C3 is uncommon as well. Something just does not fit in this case,. Up to 1...

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RE: IgA nephropathy 1 day ago

@Richard Glassock Non specific deposits of IgA are very uncommon. Usually IgM has non specific trappings , especially in sclerotic segments. ----...

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RE: IgA nephropathy 1 day ago

What I am interested in knowin is what was the actual measured dimension of GBM width. Does it show areas of thinning or attenuation.,? --------...

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RE: IgA nephropathy 1 day ago

Sure I will suggest with genetic testing. Thank you all ------------------------------ Sara ------------------------------

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RE: IgA nephropathy 1 day ago

Just 2+ IgA, No IgG or C3 and no electron dense deposits in mesangium by EM. Is this really IgAN , or FSGS with coincidental, non-pathogenic IgA de...

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RE: IgA nephropathy 1 day ago

There was no basement membrane thickening, alternations or spikes ------------------------------ Sara Ssa MBChB ------------------------------

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RE: IgA nephropathy 1 day ago

Thanks- What was the thickness of the GBM and were any GBM abnormalities present by EM.,? ------------------------------ Richard Glassock MD, F...

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RE: IgA nephropathy 1 day ago

Thank you Dr Glassock and Dr Dastoor for your valid inputs. Electron microscopy showed no electron dense deposits, focal mild foot process effa...

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RE: IgA nephropathy 1 day ago

Addendum- it should be noted that Omega 3 FA are no longer viewed as standard of care therapy for IgAN and that SGLT2i are not effective in non-o...

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RE: IgA nephropathy 2 days ago

In the absence of a detailed description of the EM and LM it is difficult to say if a diffuse Podocytopathy is present in this case. If the serum a...

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RE: IgA And SLE 2 days ago

My guess is that this is IgAN in a patient with SLE. I would not use RTX or OBI and Iptacopan or anti-APRIL would be second tier, at least for now,...

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RE: Renal denervation 2 days ago

Across modern sham-controlled trials and meta-analyses, renal denervation consistently produces additional, durable reductions of roughly 4–7 mmHg ...

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RE: IgA And SLE 2 days ago

Thank you Dr Glassock for your recommendation. Is this primary IgA nephropathy ? Or Lupus nephritis with IgA dominance.. Any role for the new Co...

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RE: IgA nephropathy 2 days ago

(@Richard Glassock) 2 questions for yourself 1. Do you think this could be The High Risk S1 lesions , that requires IS therapy. The lesion that i...

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RE: Transplant Centers for 100% Sensitized and Recurrent FSGS History 2 days ago

Thank you, Dr. Rubin! Regards, Dan Landry Daniel L. Landry, DO, FASN President, National Forum of ESRD Networks Chief, Division of Nephrolog...

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RE: Transplant Centers for 100% Sensitized and Recurrent FSGS History 2 days ago

She did receive PLEX back in the day, but I believe her more recent allograft failure would have pre-dated availability of Obi. To my knowledge, an...

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RE: Renal denervation 2 days ago

Gary, can you summarize those findings and recommendations, specifically which patients are recommended for renal denervation and what is the...

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RE: Transplant Centers for 100% Sensitized and Recurrent FSGS History 2 days ago

Has the patient ever been treated with PLEX or Lipid Apheresis + Obinutuzumab for recurrent FSGS.? ------------------------------ Richard Glassoc...

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RE: Transplant Centers for 100% Sensitized and Recurrent FSGS History 2 days ago

@Daniel Landry Very complicated problem. I suggest you contact any of the follwoing: Robert Montgomery at NYU Flavio Vincenti at UCSF Stanl...

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RE: Transplant Centers for 100% Sensitized and Recurrent FSGS History 2 days ago

Do you have access to measurement of Anti-nephrin auto-antibodies.? If a result was positive this would have a profound impact on management ---...

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RE: IgA And SLE 2 days ago

My first choice for treatment of this patient would be moderate oral doses of systemic glucocorticoids combined with MMfF -----------------------...

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Renal denervation 2 days ago

Since the recent publication of the updated AHA/ACC hypertension guidelines, renal denervation is “back in the news”. I have been approached by a c...

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RE: IgA nephropathy 2 days ago

What did the EM show- any Family History of CKD in cases like this with discordance between biopsy signs if inflammation and persistent hematuria I...

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RE: IgA nephropathy 2 days ago

https://www.kireports.org/article/S2468-0249(25)00606-0/fulltext This article suggests that we are still not at that stage where we can choose a t...

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IgA And SLE 2 days ago

26 yo Hispanic F with hx of SLE ( skin, joint) and strong family hx of SLE referred by Rheumatologist for proteinuria, hematuria. On HQ, oral stero...

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