RE: Treatment /Management of MN 6 minutes ago

Thanks for discussion appreciate it --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: to do kidney biopsy or not 7 minutes ago

Thanks everyone for help --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: PLA2R negative Membranous Nephropathy- Management Q 13 minutes ago

Thanks for case I would wait couple of weeks and review with blood and urine acr . What about mgus? Any change in serum free light chain ratio or...

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Please help with renal biopsy results - vascular insult - etiology unclear 1 hour ago

67 year old african american female with PMH of Hypertension, Fibromyalgia, Hypothyroidism, Vitamin D Def, Neuropathy, Sjogren disease, Depression,...

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RE: Seeking Input for an NSF I-Corps Dialysis Initiative 2 hours ago

Hi all, in effort to make sure we're exhausting the opportunity to connect within this network I wanted to follow-up on this thread. If you don't ...

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RE: Bile Cast Nephropathy causing Unresolved ATI 2 hours ago

Thanks for your input. Usually, the reported bilirubin in bile cast nephropathy is 25, with it never being reported below 15. The peak bilirubin ...

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RE: Bile Cast Nephropathy causing Unresolved ATI 4 hours ago

According to AI: "Plasmapheresis is rarely effective if started 4 weeks after established acute kidney injury (AKI) from bile cast nephropathy. The...

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Bile Cast Nephropathy causing Unresolved ATI 6 hours ago

Would like the community's input regarding a difficult case. 38 year old male history of homeopathic medication intake for three years for body...

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RE: PLA2R negative Membranous Nephropathy- Management Q 17 hours ago

Dr. Kaur -thanks for the very helpful additional information. Yes, you patient might be on the cusp of a major relapse. I woukd be inclined to trea...

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RE: PLA2R negative Membranous Nephropathy- Management Q 18 hours ago

Thank you Dr. Glassock. April 2023 renal biopsy. Proteinuria upto 11 gms. July 2023: Rituximab x 2 doses = resolution of nephrotic syndrome,...

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RE: Painless macroscopic hematuria 20 hours ago

This patient most likely has an AVM till proven otherwise. A selective renal angiogram will be my next step (already mentioned by Dr. Glassock). ...

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RE: Painless macroscopic hematuria 20 hours ago

A clot in the R renal pelvis and unilateral gross hematuria (same side as the clot) makes Glomerular Disease, acquired or hereditary , very unlikel...

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RE: Painless macroscopic hematuria 20 hours ago

forgive me Dr. Glassock (for being stubborn) but @Edwin Anand did your urologist check blood from urine from contralateral ureter for microhematuri...

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RE: Painless macroscopic hematuria 23 hours ago

This important finding rules out Nutcracker syndrome , IgA Nephropathy, Alport Syndrome or other glomerular diseases but not SSTrait, a small renal...

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RE: CD19, ritux, and membranous 23 hours ago

Thanks Dr. Hirsch for initiating this very informative and in depth discussion of a contemporary topic of the ever- changing management of MN. We n...

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RE: CD19, ritux, and membranous 23 hours ago

In the not too distant future, I strongly suspect that OBI will replace RTX as the preferred initial approach to treatment of MN , and that assessm...

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RE: Painless macroscopic hematuria 23 hours ago

A follow up- I reviewed his cystoscopy. It showed blood emanating from the right ureteric orifice alone. Hence they did a ureteroscopic exam. It ...

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RE: CD19, ritux, and membranous 1 day ago

@Sheldon Hirsch "Roger, with that sort of thinking in mind...I have a patient who is now four months p the initial ritux rx, with an unchanged PL...

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RE: CD19, ritux, and membranous 1 day ago

If your patient without any change in anti-PLA2R antibody 4 months after an initial dose of RTX was found not to be peripherally depleted in CD19 B...

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RE: CD19, ritux, and membranous 1 day ago

Roger, with that sort of thinking in mind...I have a patient who is now four months p the initial ritux rx, with an unchanged PLA2r. I sent a CD19,...

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RE: PLA2R negative Membranous Nephropathy- Management Q 1 day ago

Dr. Kaur - thanks for the follow up. The fact that this patient enters into a CR with RTX therapy places herin a favorable prognostic category - ab...

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RE: Resistant hypertension 1 day ago

Thank you so much Dr. Rodby, Dr. Glassock, Dr. Dastoor for the opinion. ------------------------------ Jaison George MD, MBBS Kollam, India ----...

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RE: PLA2R negative Membranous Nephropathy- Management Q 1 day ago

Hello All, This patient from a few years ago responds to rituximab that I am not giving on a consistent maintenance basis, since her proteinuria...

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RE: CD19, ritux, and membranous 1 day ago

@Christian Kuhn writes "CD19 is usually monitored after rituximab because the drug (ritux/obi) occupies the CD20 epitope and can also induce CD20...

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RE: Persistant metabolic acidosis after cystectomy 1 day ago

Recent information --------------------------------- Conjeevaram Kesavan MD, MBBS, FASN Duluth GA (678) 699-8521 ------------------------------...

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RE: CD19, ritux, and membranous 1 day ago

As far as I am able to determine, no information exists concerning a possible interactions between Rituximab and Eculizumab, Ravulizumab , Iptacopa...

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RE: Dog with hematuria and highly unusual renal ultrasonographic findings 1 day ago

Please let us know what the final diagnosis is in fascinating canine case of the mysterious kidney ultrasound -nematodes, cancer , infection , calc...

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RE: CD19, ritux, and membranous 2 days ago

Thank you. As the immune response is quite specific, I wonder if the internalization of the FcR which follows Ritux therapy is unique to CLL cells ...

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RE: CD19, ritux, and membranous 2 days ago

There you go ------------------------------ Christian Kuhn MD Kantonsspital St. Gallen St. Gallen ------------------------------ Files At...

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RE: Dog with hematuria and highly unusual renal ultrasonographic findings 3 days ago

Great plan, Eva! I have seen a few cases where the bladder urine is sterile, but the urine in the obstructed kidney shows bacteria. It's one of the...

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RE: Dog with hematuria and highly unusual renal ultrasonographic findings 3 days ago

Thank you Mark, JD, and others who have responded! Agreed that the left and right kidney appear to have very different pathologies. For the lef...

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RE: Painless macroscopic hematuria 3 days ago

If other more likely causes for painless gross hematuria are excluded then even if NCS is diagnosed but no anemia or symptomatic varicocele , treat...

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RE: Dog with hematuria and highly unusual renal ultrasonographic findings 3 days ago

Makes sense - could also do retrograde study rt kidney and stent if obstructed , biopsy left kidney after CT. I would still recommend KUB to help e...

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RE: Dog with hematuria and highly unusual renal ultrasonographic findings 3 days ago

A CT can be done with sedation, but most frequently we do them under general anesthesia. The radiologists at my hospital certainly prefer GA when c...

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RE: CD19, ritux, and membranous 3 days ago

@Christian Kuhn Regrettably the DOI of the reference you posted appears to be incorrect. Could you please either revise it or attach the actual P...

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RE: Painless macroscopic hematuria 3 days ago

Painless gross hematuria for 2+ years- Nutcracker Syndrome unlikely but probably should be exclude with appropriate imaging studies if hemoglobin e...

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RE: Painless macroscopic hematuria 3 days ago

Although IgAN is most common disease in this age group, i would like to rule out other causes like Alport syndrome or Thin basement disease . On ...

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RE: CD19, ritux, and membranous 3 days ago

@Hormaz Dastoor II completely agree that CD20 internalization is primarily an issue with rituximab and occurs to a much lesser extent with obinutuz...

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RE: Dog with hematuria and highly unusual renal ultrasonographic findings 3 days ago

Does a CT in a dog require general anesthesia? ------------------------------ Richard Glassock MD, FASN Emeritus Professor Geffen School of Medic...

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RE: Persistant metabolic acidosis after cystectomy 3 days ago

Today only I reviewed the case presentation and hence delayed response I pulled out lot of information from resources Please pardon me for the le...

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RE: Dog with hematuria and highly unusual renal ultrasonographic findings 3 days ago

What would NSAIDs be responsible here? Would love the veterinarians on this post to explain how this canine could possibly have normal renal functi...

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RE: CD19, ritux, and membranous 3 days ago

I think the "bottom line" is that we are still learning how to interpret CD19/20 B cell monitoring in peripheral blood in patients receiving anti-C...

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RE: Dog with hematuria and highly unusual renal ultrasonographic findings 3 days ago

Hi Eva! Very weird left kidney for sure! I am worried the RK is obstructed from the nephrolith(s), potentially pyonephrosis. I'd be worried ab...

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RE: Dog with hematuria and highly unusual renal ultrasonographic findings 3 days ago

It looks like this dog is headed for surgery to obtain a definite diagnosis-, nematodes, cancer, or nephrolithiasis or some combination of these.. ...

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RE: CD19, ritux, and membranous Saturday, July 11 @ 4:04 PM

@Christian Kuhn correct me if I am wrong but CD20 internalization is something specific to Rituximab only and not Second generation Anti CD20 agent...

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RE: CD19, ritux, and membranous Saturday, July 11 @ 12:11 PM

Dr. Kuhn- I agree that many long-lived Plasma Cells secreting potentially pathogenic auto-antibodies (CD19+ and CD20 - ) are not depleted by RTX ...

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RE: Dog with hematuria and highly unusual renal ultrasonographic findings Saturday, July 11 @ 10:16 AM

Thanks for sharing -US iMO shows different process in left and rt kidney. The hematuria could be resulting from both but different pathologies. Nep...

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RE: Persistant metabolic acidosis after cystectomy Saturday, July 11 @ 9:27 AM

Thanks! My question is whether a bicarbonate of 20 mmol/L on Nephrotrans alone justifies surgical revision. The KDIGO 2024 CKD guideline gives [M...

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RE: CD19, ritux, and membranous Saturday, July 11 @ 9:12 AM

"CD20 + : expressed only on B cells and not on plasma cells . hence when anti CD20 agents such as rituximab are used , they deplete B cells directl...

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RE: Dog with hematuria and highly unusual renal ultrasonographic findings Saturday, July 11 @ 7:50 AM

Copied and pasted your post on Google AI. It responded as follows: "The left kidney findings are highly concerning for a Renal Pelvic Diverticulu...

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