RE: Nephrology training or job 1 hour ago

Agree with Dr. Venkat and some of my fellows have been following this track 2 clarifications 1- to find a residency program will imply going into ...

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RE: Nephrology training or job 3 hours ago

Dr. Venkat- interesting observation. I think that the ACGME actively discourages the "Reverse training pathway" but I may be wrong in this assumpti...

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RE: proliferative GN parvovirus? 11 hours ago

If this is acute GN secondary to Parvovirus B19, it should resolve spontaneously. The EM might help a bit, as massive sub-endothelial IC deposits a...

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RE: Nephrology training or job 14 hours ago

I am retired and no longer active in recruiting nephrology fellows. Given difficulty in attracting internal medicine trainees into nephrology fello...

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RE: Nephrology training or job 15 hours ago

Sad news. Can the "Supreme Court" of Brazil be petitioned to grant some form of relief to the Dialysis Industry, resulting from Congressional acts ...

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proliferative GN parvovirus? 15 hours ago

50 yo female with hx of local colon ca resected- no chemo 2008- no meds- who presented after fever 7/4- x 1 week- took nsaids, 1-2 pills, followed ...

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RE: Secondary Membranous Evaluation 16 hours ago

This case has all of the ear-marks of "lupus-like " Membranous Nephropathy. I have no idea what is the "best" choice of therapy- complete absence o...

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RE: Secondary Membranous Evaluation 17 hours ago

Interesting. As you are typically such an advocate for rituximab why MMF and steroids for this case? BC it has a lupus appearance? I can see that ...

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RE: Secondary Membranous Evaluation 19 hours ago

It this is clearly “Secondary” MN, not “Primary” MN in one of the non-PLA2R antigen forms. A role for CYC or RTX or combinations of these agents is...

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RE: Secondary Membranous Evaluation 20 hours ago

I second Dr. Rodby's screening question. Age-specific cancer screening should be done. Is the deposit both Kappa and Lambda or restricted to one?...

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RE: Secondary Membranous Evaluation 21 hours ago

Where do we draw the line on malignancy workup for PLA2R negative MGN? Age 20, 30,40, 41? I tried to see if malignancy .while may not be IgG4, can ...

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Nephrology training or job 1 day ago

Good morning, Brazil's congress recently passed a law for a minimum wage for all nursing careers, in this scenario of inflation, almost every dial...

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RE: Secondary Membranous Evaluation 1 day ago

Lupus-like MN is rather uncommon and may evolve to overt SLE over time in a minority of cases. C1q Nephropathy is a remote possibility. If a chroni...

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RE: Secondary Membranous Evaluation 1 day ago

With Sub-endothelial and mesangial ED deposits, this is not likely to be Primary MN of any antigen subtype. Can you do IgG subclass, EXTI/II staini...

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Secondary Membranous Evaluation 1 day ago

41 year old male with no significant past medical history presents with nephrotic syndrome, biopsy shows membranous nephropathy. PLA2R negative in ...

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RE: Memberanous Nohropathy With PE 2 days ago

Sheldon, I LOVE rituximab, but Ponticelli has a long history of tolerance The cumulative cyclophosphamide dose is not that much, and the steroids...

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RE: Memberanous Nohropathy With PE 2 days ago

The role of the high doses of IV MP in the CYC based "modified" Ponticelli regimen for MN is not known due to the lack of suitably designed RCT. So...

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RE: Memberanous Nohropathy With PE 2 days ago

Dr Glassock and others, do you have any experience with or thoughts about a "modified modified Ponticelli" protocol which follows the modified prot...

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RE: Memberanous Nohropathy With PE 2 days ago

Any anti-CD20 or CD38 therapy plus anti-coagulation. If he has high PLA2R antibodies, it will provide something to evaluate serologic response. T...

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RE: 20 y/o with PLA2R-ab positive Membranous - in remission after Ritux. Ab tracking? 2 days ago

Craig is quite correct that this forum serves as an invaluable reference. Keep watching. I cannot tell you how many cases of nephrotic syndrome I ...

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RE: 20 y/o with PLA2R-ab positive Membranous - in remission after Ritux. Ab tracking? 2 days ago

"She/he who knows, knows that she/he knows, is wise - learn from that person. She/he who knows not and knows that she/he knows not - teach her/him....

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RE: 20 y/o with PLA2R-ab positive Membranous - in remission after Ritux. Ab tracking? 3 days ago

To elaborate on Dr. Glassock's Donald Rumsfeld quote: To know that we know what we know, and to know that we do not know what we do not know, ...

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RE: Lupus Nephritis - now w change of class 3 days ago

So - currently she is on mmf 1.5 bid ; max ace; diuretics pcr continues 5.5; Cr 0.7 on eliquis - hx of splenic v thrombosis from last MGN -> Q1. s...

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RE: Lupus Nephritis - now w change of class 3 days ago

Dear Dr Rodby you mentioned "So what do you treat class 5 lupus relapse with anyway? I'd be fine with MMF, or rituximab alone and watch for now. I ...

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RE: Lupus Nephritis - now w change of class 3 days ago

Thanks, Dr. Glassock and Dr. Mallat. I totally agree with you two currently, however, if positive, maybe we can follow the levels, and see what ha...

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RE: SIADH - how much to pursue workup? 3 days ago

Did you consider a reset osmostat? Carlos Galvao-Sobrinho ------------------------------ Carlos Galvao-Sobrinho MD, PhD Physician All Saints Hosp...

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RE: Unexplained intermittent hypokalemia 3 days ago

I truly appreciate everyone who has taken the time to respond. I don't really know the patient's acid base status in detail because nobody has done...

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RE: Unexplained intermittent hypokalemia 3 days ago

Do you have the serum chemistries during one of these episodes? It may prove helpful. ------------------------------ John Mellas MD Nephrology and...

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RE: 20 y/o with PLA2R-ab positive Membranous - in remission after Ritux. Ab tracking? 3 days ago

You are very welcome. The “Standards of Care” are constantly in a state of evolution . Published guideline go quickly “out-of-date”. -------------...

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RE: 20 y/o with PLA2R-ab positive Membranous - in remission after Ritux. Ab tracking? 3 days ago

Thank you all for the input to my specific case and also the numerous other cases that have helped me sort out managing difficult cases or cases wh...

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RE: 20 y/o with PLA2R-ab positive Membranous - in remission after Ritux. Ab tracking? 3 days ago

The risk of a relapse is about 15-20% or a little less after 3 years of FU. A clinical relapse will most often be heralded by a reappearance and st...

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RE: 20 y/o with PLA2R-ab positive Membranous - in remission after Ritux. Ab tracking? 3 days ago

I would follow serum PLA2R Ab, serum albumin, serum creatinine, lipid profile and UPCR every 3 months till 6 months after the second dose; if every...

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RE: 20 y/o with PLA2R-ab positive Membranous - in remission after Ritux. Ab tracking? 3 days ago

"- 4/2/2021: Presented to hospital SOB, CTA multiple PE's, DVT neg. UA 4+ prot (dip), Cr 0.6, Alb 1.7 (NO RENAL CONSULT - NS diagnosis missed)" wo...

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20 y/o with PLA2R-ab positive Membranous - in remission after Ritux. Ab tracking? Tuesday, August 9 @ 9:21 AM

This is a 20 y/o woman who has no significant past medical history. - 4/2/2021: Presented to hospital SOB, CTA multiple PE's, DVT neg. UA 4+ prot ...

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RE: Memberanous Nohropathy With PE Tuesday, August 9 @ 8:35 AM

At least in the USA, IV CYC regimens are not "standard of care" for Primary MN and the data supporting efficacy and safety of IV CYC regimens is ve...

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RE: Unexplained intermittent hypokalemia Tuesday, August 9 @ 8:33 AM

Dear Dr Faber, As the above comments, I think it is important to evaluate the acid base status. The othe problem he has is that probably his arritm...

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RE: Memberanous Nohropathy With PE Tuesday, August 9 @ 4:29 AM

Report came from his counter He received pulse steroids 1 gm 8,9,10 may and endoxan 1 gm 9/5 and kept on predinslone 40 mg then presented to us by ...

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RE: Memberanous Nohropathy With PE Tuesday, August 9 @ 3:47 AM

Thank you --------------------------------- Samir Mallat Professor of Clinical Medicine American University of Beirut Beirut Lebanon ---------...

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RE: Memberanous Nohropathy With PE Tuesday, August 9 @ 3:41 AM

This is biopsy report --------------------------------- Mohamed Mahmoud MBBS NEPHROLOGIST MOH KUWAIT 00965 51377736 --------------------------...

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RE: Lupus Nephritis - now w change of class Tuesday, August 9 @ 1:40 AM

Anti-PLA2R associated LMN is so common on LMN that we do not know whether it requires some special category of treatment tegimen . OK to measure it...

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RE: Memberanous Nohropathy With PE Tuesday, August 9 @ 1:03 AM

Sorry this modified piontcelli approach contains cyclophosphamide and prednisone together from the first or cyclic any experience ??? ------------...

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RE: Memberanous Nohropathy With PE Tuesday, August 9 @ 12:50 AM

Somewhat confusing as I thought that the final report is not available and diagnosis of MN was only assumed by history. If so I will withdraw from ...

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RE: Lupus Nephritis - now w change of class Tuesday, August 9 @ 12:45 AM

Thank you Dr Liu Indeed MN can Co exist with many other lesions No harm to do anti PLA2 receptors. I believe this will not affect therapy ----...

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RE: Lupus Nephritis - now w change of class Tuesday, August 9 @ 12:14 AM

Hello everyone, I have a question. For this pt, I wonder if we should check the PLA2R antibody level since one article showed PLA2R antibodies can...

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RE: Unexplained intermittent hypokalemia Monday, August 8 @ 11:10 PM

Do you have urine Ca? ------------------------------ Song Liu MD River Forest IL (570) 594-9881 ------------------------------

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RE: Not all Hypokalemia and Hypomagnesemia in a young patient is Gitelman's or Bartter Monday, August 8 @ 9:43 PM

I recently had a patient referred to our Office for hypomagnesemia- she is in her mid 50, she was having progressive weakness and muscle aches for...

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RE: Unexplained intermittent hypokalemia Monday, August 8 @ 9:14 PM

in spite of above reasonable discussion, I would still get genetic testing for Gitelman syndrome. easily available now through Natera. this just ...

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RE: Lupus Nephritis - now w change of class Monday, August 8 @ 9:10 PM

Class 3 means a segmental lesion and it is described as segmental proliferation, not segmental necrosis, that matters to me. Assuming the Ems do no...

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RE: Unexplained intermittent hypokalemia Monday, August 8 @ 9:06 PM

Episodic hypokalemia (+/- hypomagnesemia) suggests episodes of respiratory alkalosis (panic attacks/hyperventilation), periodic paralysis (familial...

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RE: Lupus Nephritis - now w change of class Monday, August 8 @ 7:15 PM

Class III with an activity level of 1. Not much to worry about. I would treat like ClassV, perhaps exacerbated by a recent viral infection. A perlu...

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