RE: Hepatitis D in dialysis 31 minutes ago

Thanks for the FU. Perplexing issue. No real guidelines. The only patient situation at high risk of nosocomial transmission of HDV infection in a d...

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RE: Hyponatremia Dilemma 1 hour ago

In Hyponatremia is it not necessary to check BOTH serum and urine osmolarity, urine sodium all at the same time ( virgin blood and urine sample) be...

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RE: Hepatitis D in dialysis 3 hours ago

Thanks Dr Glassock, A few in the HBV cohort are on treatment for various indications (I understand there is plenty debate in the field around pat...

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RE: PGNMID vs Primary IC- MPGN 22 hours ago

Thank you for your responses and very insightful . I have our pathologist and we dont have IgG subclass stains , he will try to procure them ( coul...

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RE: Biopsy - help needed with interpretation 22 hours ago

thank you for your detailed responses . Since the biopsy was read at a center in another country ( Kingdom of Bahrain ) - i have asked them to co...

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RE: Biopsy - help needed with interpretation 23 hours ago

It would be good to get a bit more information from the pathologists. (1) What is the nature of the IgG vs IgA staining. By IF IgG is 2+ and IgA is...

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RE: PGNMID vs Primary IC- MPGN 1 day ago

Dr Dastoor this is most likely PGNMID recent studies that performed light chain repertoire sequentiation suggest that the majority of this disea...

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RE: Ciclosporin dependent FSGS 1 day ago

I forgot the attachment. I'll also attach a 2002 article that is a bit historical. It reviews the evidence for PLEX with TTP. Notably, the one cond...

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RE: Ciclosporin dependent FSGS 1 day ago

Just a small point. In the the USA, the FDA has approved the use of Lipid Apheresis for the therapy of multi-drug resistant Primary FSGS both adult...

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RE: Ciclosporin dependent FSGS 1 day ago

I think you have raised an important issue. I had been involved in therapeutic plasmapheresis for a number of years during its early applications. ...

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RE: Biopsy - help needed with interpretation 1 day ago

The description of the biopsy won't fit IgAN since IgA is not predominant. Kappa is only 2+. As you know, kappa will be stronger than lambda. If Ka...

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RE: PGNMID vs Primary IC- MPGN 1 day ago

You succinctly discuss the recent changes in our understanding of PGNMID. It does seem that the underlying pathophysiology of this "pattern of inju...

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RE: PGNMID vs Primary IC- MPGN 1 day ago

@Richard Glassock I had a discussion with some European colleagues on this case . There seems to be a shift with PGNMID , thinking of it not as a c...

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RE: Biopsy - help needed with interpretation 1 day ago

From a frequentist standpoint this is most likely IgAN superimposed on background of DN, but your concerns about PGNMID are justified because of La...

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RE: Ciclosporin dependent FSGS 2 days ago

Dr Soobadar-This is a new case post. Please present the detailed clinical findings as a specific new post so we do not get confused with the curren...

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RE: Plar2 +ve With Stroke 2 days ago

In light of the new anti-PLA2R antibody serological information, MN is very likely, but kidney biopsy relatively contraindicated. We need to urgent...

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RE: Plar2 +ve With Stroke 2 days ago

Hi prof glassock Ifa is positive 10000 Liver team there is low risk of hcc Bw --------------------------------- Muhammad Soobadar MBChB UK -...

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RE: Ciclosporin dependent FSGS 2 days ago

Sorry similar theme question - in minimal change disease/fsgs - multiple relapse and now established on cyclosporin/steroid since June 23 and no re...

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RE: Onconeph case 2 days ago

Thanks --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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Biopsy - help needed with interpretation 2 days ago

Dear Colleagues .. I apologise for the poor quality of the attachment and the frequent requests for feedbacks and opinions . As we live in a smal...

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RE: Iptacopan Dosing issues 2 days ago

You are correct. It is actually the Complement AP functional (AH50) activity that is low should be less than 10% with proper iptacopan exposure. ...

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RE: Iptacopan Dosing issues 2 days ago

I have ordered C5b-9 and Factor Bb , as both Factor Bb and sC5b-9 would be expected to decrease from baseline due to inhibition of the alternate pa...

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RE: IgA Nephropathy with ?RPGN 2 days ago

It is such a desperate situation for sure! May take advantage of dialysis access and try few sessions of plasma exchange in between. Followed by go...

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RE: Iptacopan Dosing issues 2 days ago

I will follow it with CH50 --------------------------------- Bajinder Reen MD Etobicoke ON (905) 453-0821 ---------------------------------

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RE: Ciclosporin dependent FSGS 3 days ago

@Roger Rodby Parachute use while jumping from a plane has been studied in a randomized control trial and the study showed, as expected, that para...

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RE: Ciclosporin dependent FSGS 3 days ago

Almost everything has interobserver variability. Even something as simple as counting the number of glomeruli. Sent from my iPhone

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RE: Ciclosporin dependent FSGS 3 days ago

@Roger Rodby Contrary to what some individuals may think, we are all entitled to free speech (the first amendment of the American Constitution). ...

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RE: Ciclosporin dependent FSGS 3 days ago

@Mario Rubin Plex for FSGS: I do not mean to offend you, what i say is not directed at you. For your "Inquiry: How many RCTs have been pub...

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RE: Ciclosporin dependent FSGS 3 days ago

Thank you, Dr. Fogo, for your personal comments, which I always find highly valuable. However, in this specific topic and based on my discussions w...

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RE: Ciclosporin dependent FSGS 3 days ago

Sparsentan is not approved by FDA for Primary ( or other forms of FSGS ) yet but an application is pending (action expected in January., 2026) It c...

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RE: Ciclosporin dependent FSGS Wednesday, November 26 @ 9:54 AM

Regarding Dr. Rubio's comment about cringing whenever he sees in a kidney biopsy report estimated % IFTA stated-- renal pathologist eyeball assessm...

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RE: Ciclosporin dependent FSGS Wednesday, November 26 @ 9:06 AM

Agree genetic testing not very likely to be positive as this seems truly a primary form of FSGS. Collapsing features also not commonly seen in Mend...

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RE: Steroid Resistant FSGS treatment with Obi ? Wednesday, November 26 @ 8:54 AM

Thanks for calling me on the topic :) I agree with the overall take of the discussion toward DN being likely the main driver. The COL4A variant I...

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RE: Iptacopan Dosing issues Wednesday, November 26 @ 8:39 AM

If you can show evidence of low CH50 with once daily therapy this would mean that complement is reasonably suppressed. Omar Almasri Pediatric Neph...

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RE: Ciclosporin dependent FSGS Wednesday, November 26 @ 8:20 AM

Peds nephrogist here. Agree with suggestions to use Obi( I had impressive results using it with multiple patients who failedRituximab) it does th...

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RE: Onconeph case Tuesday, November 25 @ 4:28 PM

Not unreasonable if you think this is interstitial nephritis due to ICI rather than Direct toxic injury to nephrons. If the patient is in reasonabl...

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RE: Hyponatremia Dilemma Tuesday, November 25 @ 3:14 PM

sorry this is the right attachment ------------------------------ Dr. Hormaz Dastoor. MD, FASN Nephrology Consultant - Seha Kidney Care. Nephrol...

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RE: Hyponatremia Dilemma Tuesday, November 25 @ 3:09 PM

I use Minocycline as an alternative to Demeclocycline ,to decrease responsiveness to ADH ( in vitro models have confirmed this) The cyclines do t...

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RE: Onconeph case Tuesday, November 25 @ 2:59 PM

What about treating uti then empirical steroids ? Thanks --------------------------------- Muhammad Soobadar MBChB UK --------------------------...

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RE: Ciclosporin dependent FSGS Tuesday, November 25 @ 2:40 PM

Another point worth considering is that this patient is a poor candidate for kidney transplantation , due to a 50-70% risk of recurrent FSGS in an ...

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RE: Steroid Resistant FSGS treatment with Obi ? Tuesday, November 25 @ 2:25 PM

thanks dr Glassock maybe @Simone Sanna-Cherchi, which I have seen replying on the forum, could help sort this out! ----------------------------...

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RE: Steroid Resistant FSGS treatment with Obi ? Tuesday, November 25 @ 1:32 PM

But the morphology does not make it easy to identify Primary FSGS and a reduction in the level of proteinuria of the magnitude seen in this case wi...

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RE: Ciclosporin dependent FSGS Tuesday, November 25 @ 1:21 PM

I fully agree with Dr. Rubin that the suggestions for use of PLEX (or OBI) for multi-drug resistant Primary FSGS is not evidence (RCT ) based-but o...

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RE: Steroid Resistant FSGS treatment with Obi ? Tuesday, November 25 @ 1:07 PM

Dr Slater, reduction in Proteinuria from 10 to 3 grams on steroids suggests partial response. While it's not possible to tease out primary FSGS fro...

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RE: Hyponatremia Dilemma Tuesday, November 25 @ 1:01 PM

Dr Dastoor Gat is role of minocycline. I am only aware of some data in rodents in terms of prevention of Osmotic Demyelination but not in SIADH....

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RE: Ciclosporin dependent FSGS Tuesday, November 25 @ 12:58 PM

@Jonathan Zuckerman @Agnes Fogo Good questions but, at the end of the day, I keep wondering how valuable are these findings in a small sampl...

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RE: Ciclosporin dependent FSGS Tuesday, November 25 @ 12:46 PM

How extensive were the collapsing glomerulopathy features in affected glomeruli and what percentage of glomeruli showed collapsing changes? Extent ...

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RE: Ciclosporin dependent FSGS Tuesday, November 25 @ 12:24 PM

With the help of AI, I wanted to know if we are still (after so many years) travelling in the dark without solid guidance whatsoever regarding the ...

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RE: Ciclosporin dependent FSGS Tuesday, November 25 @ 11:22 AM

I agree that these findings indicate a Primary firm of FSGS, and genetic testing not likely to be informative. Obinutuzumab dosing is sane as for R...

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RE: risk of 3.5 parathyroidectomy in ESRD patient with PTH of 8000 Tuesday, November 25 @ 11:22 AM

Adding some photos of one of my pts ------------------------------ Stuart Sprague DO, FASN Director of Research, Division of Nephrology and...

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