RE: simultaneous liver kidney transplant 1 hour ago

@Richard Glassock @Justine Bacchetta The short answer is there is no data that lumasiran is necessary in the setting of a combined liver-kidney...

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RE: simultaneous liver kidney transplant 2 hours ago

Thanks Drs. Venkat and Rubin. Your responses are very helpful. Is a short duration of Lumisarin therapy pre and post transplant indicated in this c...

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RE: Chronic Active Thrombotic Microangiopathy - kidney biopsy 3 hours ago

Improvement either PLEX points to TTP. Improvdment without Warfarin points away from anti-phospholipid antibody syndrome. It is not clear to me whe...

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RE: Thin BM 3 hours ago

SCIENCEINSIGHTS: Clinical Role in Autoimmune Disease Exclusion > > ------------------------------ Sinasi Salman MD, FASN Owner Northlake Neph...

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RE: Thin BM 4 hours ago

My understanding (by reading this) is that anti DSF-70 are uncommon in patients with ANA positive systemic rheumatic disease and more common in hea...

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RE: Chronic Active Thrombotic Microangiopathy - kidney biopsy 6 hours ago

Interesting case. the intermittently low CH50 points toward complement mediated TMA But , even in the absence of anti factor H antibodies, she se...

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RE: Chronic Active Thrombotic Microangiopathy - kidney biopsy 6 hours ago

Dear Dr Dastoor, thank you! We will organize the biopsy! and I'll let you know! patricia ------------------------------ Patricia D' A...

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RE: Chronic Active Thrombotic Microangiopathy - kidney biopsy 6 hours ago

Dear Dr Glassok Thank you! I am not sure if any renal unit is in this trial. It would be very good for the patient! I will find out!! ...

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RE: simultaneous liver kidney transplant 7 hours ago

I assume that both live donors were genetically tested for PH1. Yes, the immunological sink concept is quite prevalent in the field of OLTX and SL...

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RE: Thin BM 8 hours ago

A genetic diagnosis of Alport Syndrome Spectrum disorder at age 18 would have prognostic, therapeutic and familly planning implications, in my opin...

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RE: Thin BM 8 hours ago

I wonder what a diagnosis of thin basement membrane would add to the patients current status? ------------------------------ Wael Jebur MD drwae...

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RE: simultaneous liver kidney transplant 8 hours ago

Questions: Have you repeated serum oxalate level since transplant? Was the recipient HLA-sensitized pretransplant? Type of cross-match pretransplan...

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RE: simultaneous liver kidney transplant 9 hours ago

Is the patient receiving Lumisarin because of high pre-transplant Oxalate tissue burden, despite the curative a liver transplant . --------------...

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RE: Young male patient with IgA nepropathy 9 hours ago

All good questions. Cannot be answered by evidence, only opinion. Sibeprenlimab is preferred because it fundamentally acts on basic mechanisms of d...

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RE: simultaneous liver kidney transplant 10 hours ago

What is Tacrolimus trough level ?? ------------------------------ Wael Jebur MD drwaellatif@hotmail.com Dubai ------------------------------

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RE: Young male patient with IgA nepropathy 11 hours ago

Dear Prof Glassock: May I enquire why you recommend shifting to Sibeprenlimab when the patient improved and stabilized on tapering dose of cortic...

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RE: Hypercalcemia in tertiary hyperparathyroidism 12 hours ago

Isn't he a candidate for ablation (RFA, MWA, alcohol) therapy? ------------------------------ Mario Rubin, M.D. Houston TX (713) 252-5539 ------...

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RE: Chronic Active Thrombotic Microangiopathy - kidney biopsy 14 hours ago

Clinical improvement is remarkable but biopsy still shows active lesions. I think I might favor doing a re-biopsy in few weeks. BTW Epsyqli, generi...

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RE: Hypercalcemia in tertiary hyperparathyroidism 14 hours ago

Yes US was highly suspicious for adenoma, But the patient is unfit for surgery. Some important update, PTH drop to 20 pmol/l while Ca was still e...

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RE: Chronic Active Thrombotic Microangiopathy - kidney biopsy 16 hours ago

If , by chance, this proves to be TTP (low ADAMTS13 levels) then Caplacizumab might be indicated, instead of C5 , C3 or Factor B inhibition. ---...

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RE: Applications Now Open for the 2026 Kidney TREKS Program 1 day ago

Dear all, As a reminder, applications for the 2026 ASN Kidney TREKS program close next Friday, January 30, 2026. To be eligible for the 2026 Kid...

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RE: Chronic Active Thrombotic Microangiopathy - kidney biopsy 1 day ago

Intracapillary fibrin-platelet thrombi are seen in TTP- I do not beluve that these features were present n the kidney biopsy of this case, but in l...

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RE: Hypercalcemia in tertiary hyperparathyroidism 1 day ago

@Wael Jebur Have you performed an ultrasound of the neck looking for parathyroid enlargement? ------------------------------ Mario Rubin, M.D. ...

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simultaneous liver kidney transplant 1 day ago

Respected faculty, We solicit your opinion on a 28 year old female patient who underwent live simultaneous liver and kidney transplant with two li...

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RE: anti gbm/mpo +ve in young female 1 day ago

A single course of oral cyclophosphamide would usually not cause female infertility , but I would talk to the OB people about Lupron, that should f...

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RE: anti gbm/mpo +ve in young female 1 day ago

Completely agree with Drs Glassock and Rodby. This can be a renal presentation of a (potentially) systemic disease and aggressive treatment is just...

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RE: anti gbm/mpo +ve in young female 1 day ago

I would only add that, I recently had a similar patient, double anti-GBM ANCA positive: almost identical presentation and biopsy who developed pulm...

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RE: Hypercalcemia in tertiary hyperparathyroidism 1 day ago

My mistake I did not realize that you reported the phos in mmol/liter so 1.5 mmol/l is not low ------------------------------ [Mark] [Lerman] [...

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RE: Chronic Active Thrombotic Microangiopathy - kidney biopsy 1 day ago

good point !! -although the kidney biopsy findings are not indicative if TTP. ------------------------------ Richard Glassock MD, FASN Laguna Woo...

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RE: Chronic Active Thrombotic Microangiopathy - kidney biopsy 1 day ago

ADAMTIS13 was not done? ------------------------------ Wael Jebur MD drwaellatif@hotmail.com Dubai ------------------------------

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RE: Chronic Active Thrombotic Microangiopathy - kidney biopsy 1 day ago

I think I would rebiopsy. I do not see anyvrole fir RTX therapy in a patient with aHUS and these characterustics . Why nit try tobenroll the patien...

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RE: Chronic Active Thrombotic Microangiopathy - kidney biopsy 1 day ago

The ongoing APPELHUS Phase 3 trial of Iptacopan in aHUS may provide a rationale for Factor B inhibition in Chronic CM- TMA - the results are eagerl...

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RE: Hypercalcemia in tertiary hyperparathyroidism 1 day ago

I think Hypophosphatemia is irrelevant as the patient is oliguric end stage kidney disease on regular HD. @K.K. Venkat The marginal drop in PTH r...

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RE: anti gbm/mpo +ve in young female 1 day ago

Tricky case. Although the prnisis for recivery is very poor when oligo-Abpnuria and 100% crescent (0% normal glomeruli are found on kidney biopsy ,...

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RE: Thin BM 1 day ago

Very difficult to asses GBM width on paraffin embedded material by rescue EM methids. Direct, not rescue , EM is the "gold standard" for diagnosis ...

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anti gbm/mpo +ve in young female 1 day ago

19 female Has been unwell since 17.12 Vomitting, nausea, fatigue Kept working until 2 weeks ago - but then had to stop had bloods 16/1 - eG...

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RE: Hypercalcemia in tertiary hyperparathyroidism 1 day ago

95 x 1.3 : 10 = 12.4 - am I correct? ------------------------------ Sinasi Salman MD, FASN Owner Northlake Nephrology, PLLC Mooresville NC (704) ...

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RE: Thin BM 1 day ago

I think genetics is the key in this case. I thought if the GBM is less then 200 nm is diagnostic of thinning of the GBM even on a paraffin embedde...

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RE: Thin BM 1 day ago

attached ------------------------------ Roger Rodby MD, FASN Professor of Medicine Rush University Nephrology Associates Chicago IL (773)...

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RE: Hypercalcemia in tertiary hyperparathyroidism 2 days ago

@Stuart Sprague I assume that this patient remains hypophosphatemia without phosphate binders. How often do you see a low serum phosphorus in a pat...

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RE: Chronic Active Thrombotic Microangiopathy - kidney biopsy 2 days ago

I think if a repeat biopsy still shows a smoldering chronic active vs chronic fibrotic TMA , possibly CM-TMA, there is a very good case for C5 bloc...

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RE: Thin BM 2 days ago

I would be grateful if anyone on this forum would elaborate more on DFS 70 and it's utility . --------------------------------- Dr. Hormaz Dastoo...

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RE: Young male patient with IgA nepropathy 2 days ago

I was (and still am) a member of the TESTING trial so I very much agree and support the notion (expressed in the UpToDate guidelines that oral mode...

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RE: Thin BM 2 days ago

Reprocessing of paraffin embedded renal biopsy tissue for EM examination is well known to result in "substantial " thinning of BM. Thus, the Suspic...

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RE: Young male patient with IgA nepropathy 2 days ago

Dr Glassock, I recently saw an abstract from (attached) ASN that showed TESTING IgA effects lasted 6 years. While still in abstract form, this...

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RE: Thin BM 2 days ago

My understanding as mentioned by our rheumatologist was that a Positive DFS 70 , in the presence of only a Positive ANA ( negative dsDNa) rules out...

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Chronic Active Thrombotic Microangiopathy - kidney biopsy 2 days ago

Dear all, Case for Discussion A 39-year-old previously healthy man, with a history of bioprosthetic aortic valve replacement (2022), presented...

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RE: Thin BM 2 days ago

I was not sure what the DSF-70 antibodies mean https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2022.810639/full the conc...

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RE: Young male patient with IgA nepropathy 2 days ago

I concur again, until the FIND-CKD is published we don't have a large RCT. There are however signs of efficacy from many smaller studies and case ...

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RE: Young male patient with IgA nepropathy 2 days ago

Thanks Dr. Dastoor for your concurrence with my opinions on thus case, derived from the UpToDate guideline. I have no objections to adding non-ster...

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