RE: Iptacopan in IgA 2 hours ago

wonder if doing another biopsy would help here. ------------------------------ M.N. Alhosaini ------------------------------

View Discussion

RE: Hypertension With Impaired Natriuresis 4 hours ago

Thank you Dr. Campese, How may we explain this randome urinary sodium excretion of 15 meq/l in the phase of uncontrolled to accelerated hypertensio...

View Discussion

RE: STEC-HUS in pregnancy 5 hours ago

Yes , if the patient is not improving I would consider a short trial of Complement blockers . The fact that C3NEF , c5nef , factor h may be negati...

View Discussion

RE: Ckd 5 And Calciphylaxis 9 hours ago

Did you stop warfarin and give Vitamin K? I believe that HD would be preferred for this patient. ------------------------------ Richard Glassock ...

View Discussion

RE: STEC-HUS in pregnancy 10 hours ago

Low seum C3 levels and elevated serum C5b-C9 (MAC) levels are commonly found in severe STEC-HUS implicating terminal and alternate pathway activati...

View Discussion

RE: STEC-HUS in pregnancy 10 hours ago

What if serum and urine C5b-C9 were greatly elevated -o would you use antiC5 MoAB then. Or only if anti-Factor H antibodies , C3NEF or C5NEF were p...

View Discussion

RE: Hypertension With Impaired Natriuresis 10 hours ago

I agree with Dr. Glassock that" he use of raw urine sodium concentration in spot urine to predict 24-hour urine sodium excretion/intake is full of ...

View Discussion

RE: STEC-HUS in pregnancy 11 hours ago

I agree about complement test but if no complement antibodies / result I would be reluctant to use c5 i in pregnant patient ( humble opinion) Not...

View Discussion

Ckd 5 And Calciphylaxis 11 hours ago

67 M Huddersfield LCC patient- ADPKD, HT, Crohn’s, PAF- Previously on DOAC but switched to warfarin to enable tx listing. Initially admitted to xxx...

View Discussion

RE: Membranous Nephropathy 12 hours ago

Appreciate the replies. ANCA is negative. PLA2R 172 (2/2025) --> Received Obi x 2 doses in 5/2025 --> 18 (6/2025) --> 6 (8/2025) PLA2R started...

View Discussion

RE: STEC-HUS in pregnancy 16 hours ago

Dr. Dastoor- All very reasonable conclusions. Can we have some follow up on what was done and what happened to the patient and the pregnancy? -...

View Discussion

DEADLINE TOMORROW: Case Report Reviewer Volunteer Application Closes May 11! 17 hours ago

ASN invites ASN Fellows-in-Training members to serve as reviewers for case reports submitted by trainees for Kidney Week 2026. The reviewing/gradin...

View Discussion

RE: STEC-HUS in pregnancy 17 hours ago

This case sounds and smells like STEC HUS . But until we have the ADAMTS13 in would not count out TTP, as an alternative diagnosis, especially sin...

View Discussion

RE: Encapsulating peritonitis 18 hours ago

Thank you Dr Lerman for the all the questions. Sorry for the confusion. His FSGS recurred almost immediately and lost the graft with recurrence a...

View Discussion

RE: Encapsulating peritonitis 18 hours ago

Thank you Dr Rodby and Dr Bargman, I also will plan for a year of HD and then reassess. he is already on tamoxifen. The same concern raised by Dr...

View Discussion

RE: Post Renal Tx Chronic Steroid use and Anastomosis Leak 19 hours ago

Shiuid thus patient receive adjuvant chemotherapy? Should he be receiving Belatacept? ------------------------------ Richard Glassock MD, FASN Em...

View Discussion

RE: Post Renal Tx Chronic Steroid use and Anastomosis Leak 19 hours ago

Agree with Dr.Rodby. There are no obvious contraindications for the reversal of his colostomy. The normal daily production of cortisol is equivalen...

View Discussion

RE: Encapsulating peritonitis 19 hours ago

@Poyyapakkam Srivaths- several questions and comments if the patient is currently 17 and has been on PD for nine years and the transplant was at...

View Discussion

RE: STEC-HUS in pregnancy 20 hours ago

This does not sound benign, and assuming self limiting concerns me, but my review of eculizumb in STEC HUS is not positive (may be underpowered) se...

View Discussion

RE: Post Renal Tx Chronic Steroid use and Anastomosis Leak 20 hours ago

I am no surgeon (nor do I play one on TV) but CyA 5 bid and pred 5 sod has to be the lowest IS I have seen in a while and minimal risk if any of de...

View Discussion

Post Renal Tx Chronic Steroid use and Anastomosis Leak 21 hours ago

Thanks in advance for your input regarding following patient: 35 yrs old fit and well male LNR Renal Tx - 2003 - on CyA 50mg BD + Prednisolone ...

View Discussion

RE: Membranous Nephropathy 22 hours ago

Thanks prof glassock --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

View Discussion

RE: STEC-HUS in pregnancy 22 hours ago

Agree prof glassock . --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

View Discussion

RE: STEC-HUS in pregnancy 22 hours ago

Thanks. Unable to access the full report as it is subscription fire-walled. The abstract says that the patient with STEC- -HUS was treated with PLE...

View Discussion

RE: STEC-HUS in pregnancy 1 day ago

Ghukasyan NN, Gharibyan EE, Poghosyan AP, et al. Pregnancy and delivery in the context of hemolytic uremic syndrome: A surrogacy case report. Int J...

View Discussion

RE: STEC-HUS in pregnancy 1 day ago

https://doi.org/10.1002/ijgo.70144Digital Object Identifier (DOI) It seems that there might be genetic component . If you could speak to your comp...

View Discussion

RE: Hypertension With Impaired Natriuresis 1 day ago

Thanks Dr. Jebur- I am 100% in favor of clinical curiosity-ot the kind you are describing. Maybe your observations have pathophysiological meaning....

View Discussion

RE: Hypertension With Impaired Natriuresis 1 day ago

Thank you very much for all of your replys. In fact, I wanted to highlight here those patients with uncontrolled / accelerared hypertension with d...

View Discussion

RE: Membranous Nephropathy 1 day ago

Please disregard. I did not see the latest update on the post that PLAR2 titers were rising. --------------------------------- Rochak Varma MD O...

View Discussion

RE: Membranous Nephropathy 1 day ago

I had similar situation. My patient had developed secondary FSGS , so the proteinuria did not improve despite normalization of the PLAR2 . Will sug...

View Discussion

RE: Membranous Nephropathy 1 day ago

SLE should have been written as value. My error. See the corrected version. ------------------------------ Richard Glassock MD, FASN Emeritus Pro...

View Discussion

RE: STEC-HUS in pregnancy 1 day ago

Thanks prof glassock my experience is limited in pregnant patients with stec hus I would use it if there has been evidence of benefit ( I will loo...

View Discussion

RE: Membranous Nephropathy 1 day ago

Thanks prof glassock Sle means what sorry? --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

View Discussion

RE: Membranous Nephropathy 1 day ago

This is the absolute value -in cells per microliter of blood. It is not a percentage value. Thisis the preferred target level for full B-Cell suppr...

View Discussion

RE: STEC-HUS in pregnancy 1 day ago

Dr. Soodbadar (and others) would you use PLEX or anti-C5 MoAB in this patient? ------------------------------ Richard Glassock MD, FASN Emeritus ...

View Discussion

RE: Hypertension With Impaired Natriuresis 1 day ago

Several formulas are available to estimate 24 hour urine Sodium excretion in hypertensive subjects (and thereby Sodium intake in patients with stab...

View Discussion

RE: Membranous Nephropathy 1 day ago

Thanks prof glassock You look at absolute value as well? --------------------------------- Muhammad Soobadar MBChB UK -------------------------...

View Discussion

RE: STEC-HUS in pregnancy 1 day ago

Hi tough case. It’s usually supportive treatment in non pregnant patients but if they don’t recover can consider testing for ahus. This is stec hu...

View Discussion

RE: Membranous Nephropathy 1 day ago

The target level of B cell depletion with Anti-CD20 MoAb is < 5 CD19 + cell per microliter . ------------------------------ Richard Glassock MD...

View Discussion

RE: Membranous Nephropathy 1 day ago

Thanks for case . Can I ask what is absolute cd19 and percentage cd19 we use to say b cell repopulation . I was told percentage cd19 5% or more Bw...

View Discussion

RE: Encapsulating peritonitis 1 day ago

I'm not as optimistic as Dr Rodby. Not so much about the operative mechanics of putting in a kidney but more that he has a serious comorbidity with...

View Discussion

RE: Encapsulating peritonitis 1 day ago

I suspect if he is alive he has survived this often terminal condition. You are not going to reverse the calcifications and adhesions, is he on t...

View Discussion

RE: Membranous Nephropathy 1 day ago

because you patient was on hydralazine, I would check DS DNA, C3 C4 and RF and ANCA, Hydralazine can cause drug induced GN (can look like lupus and...

View Discussion

RE: Hypertension With Impaired Natriuresis 1 day ago

In hypokalemic HTN I would start with renin and aldo and go from there. Based on that I may pursue primary hyperaldo or the syndrome of apparent al...

View Discussion

RE: Hypertension With Impaired Natriuresis 1 day ago

In regard evaluating hypertension i would say no. The low U Na suggests hypovolemia and not necessarily impaired natriuresis. In that case the U ...

View Discussion

RE: Hypertension With Impaired Natriuresis 2 days ago

https://physoc.onlinelibrary.wiley.com/doi/full/10.1113%2Fjphysiol.2014.271676 Pressure naturesis may be impaired in patients with hypertension a...

View Discussion

RE: Hypertension With Impaired Natriuresis 2 days ago

https://www.ahajournals.org/doi/10.1161/01.hyp.11.6.724 --------------------------------- Dr. Hormaz Dastoor. MD, MSc, FASN Divisional Head of Nep...

View Discussion

RE: Hypertension With Impaired Natriuresis 2 days ago

A spot urinary sodium concentration measurement is a poor reflection of sodium excretion or sodium balance, your hypothesis of impaired natriuresis...

View Discussion

RE: Hypertension With Impaired Natriuresis 2 days ago

My idea is that this test was done in a point of time when blood pressure was elevated significantly, simultaneously sodium excretion was drastical...

View Discussion

RE: Hypertension With Impaired Natriuresis 2 days ago

Clinical guidelines do not recommend routine sodium or potassium concentration on spot random urine specimens in hypertensive subjects. The results...

View Discussion