RE: Membranous Nephropathy - ? Antigen undetermind 9 minutes ago

No, I don't think a few sparse deposits indicate a membranous nephropathy. In MN, podocyte foot process effacement corresponds to subepithelial dep...

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RE: Hyponatremia with recent diarrhoea, after treating CHF exacerbation 1 hour ago

Hypovolemic Hyponatremia after diarrhea + CHF/A fib treatment by cardiology. I call this "P.C.C.S." Post Cardiology Consultation Syndrome. [Am...

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RE: Hyponatremia with recent diarrhoea, after treating CHF exacerbation 1 hour ago

Dear Dr Glassock, I agree with you that most hyponatremia in situations like this is simply because of impaired diluting capacity of the kidney, ...

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RE: Hyponatremia with recent diarrhoea, after treating CHF exacerbation 2 hours ago

Thanks everyone for your highly informative response to my Fluid and Electrolyte-101 Question. It looks like there are lots of shades of grey in tg...

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RE: Membranous Nephropathy - ? Antigen undetermind 2 hours ago

Thanks-Dr. Cornell. For picking up the possible identifier #. I wonder what your views are concerning the very sparse and difficult to identify EDD...

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RE: Hyponatremia with recent diarrhoea, after treating CHF exacerbation 3 hours ago

As I understand it, if the patient has CKD and the U osm is somewhere around 300 then the CKD (plus water ingestion) is fully sufficient to explain...

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RE: Membranous Nephropathy - ? Antigen undetermind 3 hours ago

I agree from the description and the images provided it is not membranous nephropathy and instead it looks like a primary podocytopathy. When IF sh...

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RE: Hyponatremia with recent diarrhoea, after treating CHF exacerbation 3 hours ago

This answer reminds me of "electrolyte and acid-base 101". As I read the different postings on this subject, I wonder how manny still remember/use ...

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RE: Biopsy or not 4 hours ago

How long has proteinuria been present and is it increasing? SAlb level? Longer the known duration/stability of proteinuria with normal kidney funct...

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RE: Hyponatremia with recent diarrhoea, after treating CHF exacerbation 4 hours ago

"Can someone explain to me why it is necessary to hypothesize that SIADH (drug related or otherwise ) to explain the hyponatremua in thus case of C...

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RE: Biopsy or not 4 hours ago

Described in 1953! Morphology of the kidney in morbus caeruleus. AMA Arch Pathol. 1953 Nov;56(5):480-7. Authors. H MEESSEN, M A LITTON. PMID: 130...

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RE: Biopsy or not 8 hours ago

Do you know the patients birth weight, serum albumin, hemoglobin and hematocrit, UACR and UPCR and renal ultrasound findings? The likelihood that t...

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Biopsy or not 8 hours ago

31 yrs. Old male patient with history of congenital heart anomalies: tricuspid atresia, pulmonary atresia, ventricular septal defect, ASAD, PDA. Po...

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RE: Hyponatremia with recent diarrhoea, after treating CHF exacerbation 15 hours ago

Can someone explain to me why it is necessary to hypothesize that SIADH (drug related or otherwise ) to explain the hyponatremua in thus case of CK...

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RE: Hyponatremia with recent diarrhoea, after treating CHF exacerbation 17 hours ago

pmc.ncbi.nlm.nih.gov https://pmc.ncbi.nlm.nih.gov › articles › PMC4000975 Amiodarone Induced Hyponatremia Masquerading as Syndrome of ... ...

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RE: Hyponatremia with recent diarrhoea, after treating CHF exacerbation 20 hours ago

his admission weight came down by 10.9 kg from 12/11/2025 (237 pound )to 12/18/2025 (213 pound). Then the weight was 217 pound on 12/21/2025, 222 p...

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RE: Hyponatremia with recent diarrhoea, after treating CHF exacerbation 22 hours ago

As little electrolyte free water as possible ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ---------...

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RE: Hyponatremia with recent diarrhoea, after treating CHF exacerbation 22 hours ago

Am I wrong to think that advice on what to drink should center on amount ( as little as possible) and not on possible lyte composition since food w...

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RE: Hyponatremia with recent diarrhoea, after treating CHF exacerbation 22 hours ago

Then what should we advise the patient to drink? ------------------------------ Sadeem Ali MD Bridgeport WV (612) 865-9067 ----------------------...

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RE: Hyponatremia with recent diarrhoea, after treating CHF exacerbation 23 hours ago

Notably, the Urine (Na + K) has been progressively decreasing - from 80.7 (12/20/25) to 41.5 (12/22/25) to 27.9 (12/22/25) - suggesting that your i...

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Early Career Investigator Travel Grants for March 2026 Kidney Precision Medicine Project Meeting: Due January 2, 2026 1 day ago

Dear all, Please see below for an announcement regarding the application deadline for travel grants to the Kidney Precision Medicine Project (KPMP...

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Early Career Investigator Travel Grants for March 2026 Kidney Precision Medicine Project Meeting: Due January 2, 2026 1 day ago

Dear all, Please see below for an announcement regarding the application deadline for travel grants to the Kidney Precision Medicine Project (KPMP...

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Early Career Investigator Travel Grants for March 2026 Kidney Precision Medicine Project Meeting: Due January 2, 2026 1 day ago

Dear all, Please see below for an announcement regarding the application deadline for travel grants to the Kidney Precision Medicine Project (KPMP...

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RE: Hyponatremia with recent diarrhoea, after treating CHF exacerbation 1 day ago

I agree with Dr. Balan. Gatorade would be contraindicated in this case and possibly harmful. ------------------------------ Richard Glassock MD, ...

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RE: Refractory PLA2R-Positive Membranous Nephropathy – Management Options When Cyclophosphamide Is Refused 1 day ago

The study here fits your patient almost exactly - unless of course it is a monotypic disease. Obinutuzunab was extremely effective in rituximab res...

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RE: Hyponatremia with recent diarrhoea, after treating CHF exacerbation 1 day ago

The question to be asked with a urine osmolality >100 is Why is the vasopressin elevated? In this case, with your description and the low urine sod...

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RE: Hyponatremia with recent diarrhoea, after treating CHF exacerbation 1 day ago

How have daily weights varied during this? Sent from my iPhone

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RE: Hyponatremia with recent diarrhoea, after treating CHF exacerbation 1 day ago

Collection time: Dec 22, 2025@21:33 Test Name Result Units Range --------- ------ ----- ----- SODIUM 15 mmol/L POTASSIUM 12.9 mmol/L OS...

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RE: Hyponatremia with recent diarrhoea, after treating CHF exacerbation 1 day ago

For now, ordering orthostats, holding on spironolactone, reducing oral urea to once a day, giving one-time sodium chloride 1 g, suggesting alternat...

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Hyponatremia with recent diarrhoea, after treating CHF exacerbation 1 day ago

White gentleman age 74, with history of low renin hypertension probably primary hyperaldosteronism,(in 2021, potassium 4.6, renin undetectable and ...

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RE: IgA nephropathy with nephrotic syndrome 1 day ago

I agree that this patient is behaving as a case of a diffuse Podocytopathy Superimposed on glomerular IgA deposition (which may be merely co-incide...

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IgA nephropathy with nephrotic syndrome 1 day ago

Dear colleagues, would appreciate your input on this patient 70F, with T2dm, hypertension baseline creatinine 80 umol/l diagnosed with IgAN in 20...

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RE: Intradialytic hypertension 2 days ago

Today we did " Cardio- Bioimpedence" - which is similar to an external Swan Ganz , and measured SVR , based on Cardiac output and BP. Keeping in ...

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RE: Refractory PLA2R-Positive Membranous Nephropathy – Management Options When Cyclophosphamide Is Refused 2 days ago

Prof Ashraf El-Meanawy, I really thank you for your suggestions. I already spoke with the pathologist and we are starting the pronase digestion...

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RE: Refractory PLA2R-Positive Membranous Nephropathy – Management Options When Cyclophosphamide Is Refused 2 days ago

I second Dr. Glassock recommendations. CYC and MFM are modulator and not ablative therapy. The goal in these groups of diseases is to try to ablate...

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RE: Membranous Nephropathy - ? Antigen undetermind 2 days ago

Interesting idea. The LM does show a "tip" FSGS lesion. We would need to see the photos (deindentified) of the IF and EM to be sure. . ---------...

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RE: Refractory IgA Nephropathy 2 days ago

No evidence that using both is safe or more effective than either one alone. The labels permit it, but combined use is discouraged. The combined co...

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RE: Refractory IgA Nephropathy 2 days ago

Can both be used same time Sibeprenlimab and Iptacopin Thanks --------------------------------- Shahzad Safdar MD Mt. Auburn Nephrology, Inc. ...

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RE: Membranous Nephropathy - ? Antigen undetermind 2 days ago

Looking at the biopsy report - there's no spikes/holes on the silver stain, the IF only has faint (1+) positivity, and the EM has only "rare" and "...

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RE: Refractory PLA2R-Positive Membranous Nephropathy – Management Options When Cyclophosphamide Is Refused 2 days ago

Many thanks- hard to say if CYC will be helpful in this case. Only about 10% of cases of MN are refractory to RTX so we have very little data beari...

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RE: Refractory PLA2R-Positive Membranous Nephropathy – Management Options When Cyclophosphamide Is Refused 3 days ago

Dear Dr Glassock, Thank you very much for the time you spent reviewing our case. We truly appreciate your thoughtful input. Do you think that cyc...

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RE: Refractory PLA2R-Positive Membranous Nephropathy – Management Options When Cyclophosphamide Is Refused 3 days ago

Dear Prof Rodby, Thank you very much for your response regarding the challenging case I shared with you. Your guidance was extremely helpful and p...

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RE: Refractory PLA2R-Positive Membranous Nephropathy – Management Options When Cyclophosphamide Is Refused 3 days ago

Dear Professor Glassock, Thank you very much for your thoughtful, generous, and truly outstanding response to the challenging case I shared with ...

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RE: Membranous Nephropathy - ? Antigen undetermind 3 days ago

I agree with Dr. Rodby concerning the current opinion about the lack of utility of separating MM into 2 categories -Primary snd Secondary - in this...

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RE: Membranous Nephropathy - ? Antigen undetermind 3 days ago

I think it is time to abandon the primary and secondary MGN terminology? more confusing than helpful WE are entering the age of Ag definition ...

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RE: Refractory PLA2R-Positive Membranous Nephropathy – Management Options When Cyclophosphamide Is Refused 3 days ago

Even if you do pronase digestion and determine that there is not light chain restriction, you can still try Dara or Plasma cell directed therapy, s...

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RE: Refractory PLA2R-Positive Membranous Nephropathy – Management Options When Cyclophosphamide Is Refused 3 days ago

IgG 3 anti-PLA2 mediated MN is quite rare and thus nay explain the resistance to RTX. Such cases can be due an underlying gammopathy (most commonly...

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RE: Membranous Nephropathy - ? Antigen undetermind 3 days ago

Not true. PLA2R + does not define Primary- MN. Such findings can be seen in HBV, Sarcoid, IgG4/Related disease and uncommonly in LN and Cancer. The...

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Refractory PLA2R-Positive Membranous Nephropathy – Management Options When Cyclophosphamide Is Refused 3 days ago

Dear colleagues, I would appreciate your opinion on the management of a patient with high-risk, rituximab-refractory primary membranous nephropath...

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RE: Membranous Nephropathy - ? Antigen undetermind 3 days ago

Using Starlink, so am not sure if this message gets through on the flight . But isn't the definition of Primary or Secondary , now based on the ty...

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