RE: renal limited microangiopathy 4 hours ago

Thank you Dr. Glassock for your response. I'm concerned about approval for Eculizumab Hemoglobin was 10.2 on presentation. it is currently at 9.3...

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

What was the platelet count with the initial episode and what is it now? Was C5b-9 performed? What are the schistocyte, LDH and haptoglobin now? ...

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RE: rise of PLA2R, nephrotic range proteinuria and cannot biopsy 7 hours ago

Dual Anti-PLA2R + another antigen (such as NELL1 or THSD7A) is very uncommon (< 2%) in MN. I agree with Dr. Rodby, I woukd treat with RTX now and f...

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RE: simultaneous liver kidney transplant 7 hours ago

@Satish Balan Thank you for your comment Dr. Balan. Can you please clarify your statement that " But the fact that this is a different donor for ...

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RE: renal limited microangiopathy 7 hours ago

This sounds like atypical HUS (renal limited). What was the hemoglobin , Reticulocyte count, peripheral blood smear (for schistocytes) - in additio...

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RE: simultaneous liver kidney transplant 8 hours ago

If you look at the literature on SLKT vs sequential LKT vs KT alone, SLKT seems to have a better prognosis than the others. At the same time as Dr ...

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RE: Thin BM 10 hours ago

------------------------------ Sinasi Salman MD, FASN Owner Northlake Nephrology, PLLC Mooresville NC (704) 858-4300 ------------------------------

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renal limited microangiopathy 11 hours ago

Hello Appreciate input on management of this unique case. The patient is a 58-year-old Caucasian male with HTN, rheumatoid arthritis treated ...

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RE: rise of PLA2R, nephrotic range proteinuria and cannot biopsy 11 hours ago

I am also comfortable treating empirically based on sensitivity and specificity of PLA2R serum Ab, and history of MGN in the past (pre PLA2R testin...

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RE: anti gbm/mpo +ve in young female 19 hours ago

If CYC is used the dose should be reduced by 50% from normal dose because of oligo-anuria- IV CyC regimens should be avoided in this setting in my ...

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RE: rise of PLA2R, nephrotic range proteinuria and cannot biopsy 19 hours ago

Because o T2DM you should probably test for anti -PLA2R antibody using the more specific IFA at least once, but a FP ELISA would be hard to explain...

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RE: rise of PLA2R, nephrotic range proteinuria and cannot biopsy 23 hours ago

Prior biopsy proven MN (unknown PLA2R status.) Treated with CYC and steroids. And T2DM with rising PLA2R antibody and nephrotic range proteinuria. ...

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RE: rise of PLA2R, nephrotic range proteinuria and cannot biopsy 1 day ago

Will it useful to test for other antibodies like anti-NELL antibody and thrombospondin type-1 domain-containing 7A (THSD7A)? --------------------...

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rise of PLA2R, nephrotic range proteinuria and cannot biopsy 1 day ago

White gentleman age 76, Membranous GN was found on biopsy in 1993 which is the only kidney biopsy of his life when he was started on lisinopril...

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RE: simultaneous liver kidney transplant 1 day ago

Thanks for asking Mario. I'm replying as a non-transplant expert of course. At NYU and Mayo my patients receiving SLKs for PH seem to have been tre...

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RE: simultaneous liver kidney transplant 1 day 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 1 day 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 1 day 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 1 day ago

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

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RE: Thin BM 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day ago

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

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RE: Young male patient with IgA nepropathy 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days ago

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

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RE: Chronic Active Thrombotic Microangiopathy - kidney biopsy 2 days 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 2 days 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 2 days 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 3 days 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 3 days 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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