Renal transplant with pan resistant Kelbsiella colonization 2 hours ago

This is about an ESKD sec to PKD. He underwent nephrectomy a few months ago and has recurrent growth of Pan resistant (even Carbopenam) Klebsiella ...

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RE: Rituximab for Minimal Change GN - For how long ? 10 hours ago

What genetic association have been shown in MCD? . Several candidate circulating factors and their effects on podocytes have been proposed but are ...

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RE: Rituximab for Minimal Change GN - For how long ? 12 hours ago

Dr Buhary have you considered doing Genetic testing. ------------------------------ Awais Nauman HMC Doha ------------------------------

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RE: Is this Immune complex GN or something else? 16 hours ago

So you favor 2 diseases rather than one. Per Dr Glasscock's interpretation previously, :"Dr, Hickam would be very pleased but Reverend Occam would ...

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RE: Is this Immune complex GN or something else? 16 hours ago

"IgAN nephropathy (atypical) may present with MCD like picture and it's responded to steroids." MCD and IgAN may be two independent disorders wit...

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RE: Is this Immune complex GN or something else? 20 hours ago

I see your poiint. Well taken. Theses studies have one potential drawback. Pronase digestion and paraffin IF were not performed So the possibility ...

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RE: Is this Immune complex GN or something else? 21 hours ago

My reading of the study is that IgA dominant IRGN and IgA dominant MPGN were classified separately in the cited study. --------------------------...

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RE: IgA nephropathy 1 day ago

I do not understand the origin of your statement " that those (patients with IgaN) with clones in the intestines may be better served (with Tarpeyo...

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RE: IgA nephropathy 1 day ago

Looking from different angle: What the ethnicity of this patient, her birth weight, was she premature at birth, any maternal exposure (tobacco and ...

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RE: Immunotactoid GN treatment 1 day ago

Dr. Glassock thanks for your question. I am not aware of any trial of use of combination of RTX (or Obinutuzumab) plus Daratumumab for ITG. My advi...

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RE: Is this Immune complex GN or something else? 1 day ago

Agree that NSAIDs-induced MCD doesn’t occur after their discontinuation and the remission of MCD occurs after treatment discontinuation. IgAN neph...

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RE: Is this Immune complex GN or something else? 1 day ago

Although the localisation of immune deposits is quite odd.. I agree with the experts here that the picture fits the most with IgAN or IgAVN. Does h...

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RE: Immunotactoid GN treatment 1 day ago

Thanks to everyone who responded Regarding the chronic urticaria - she has it for almost 10 years now. But the idea of a possible CLL tying every...

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RE: Is this Immune complex GN or something else? 1 day ago

Where is the infection provoking a proposed IgA dominant IRGN? ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388...

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RE: Is this Immune complex GN or something else? 1 day ago

KM55 staining might help in teasing out IgA vs IgA dominant MPGN KM55 staining in evaluation of IgA ------------------------------ Awais Nauman...

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RE: Is this Immune complex GN or something else? 1 day ago

I agree with your explanations. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 -------------------------...

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RE: Is this Immune complex GN or something else? 1 day ago

This was one of my initial thoughts for this case. What doesn't fit is that he used NSAIDS 4 months ago for about a month and then stopped. NO NSAI...

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RE: Is this Immune complex GN or something else? 1 day ago

Thanks for your input. Patient has no clinical features of scleroderma, no evidence of microangiopathic hemolytic anemia (MAHA) on his labs and ren...

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RE: Immunotactoid GN treatment 1 day ago

Dr Aleday "As Daratumumab act on CD38 positive plasma cells and B cells and not on CD19 and CD20 memory B cells" doesnt this figure imply other...

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RE: Immunotactoid GN treatment 1 day ago

Interesting idea Dr. Aledan. Thanks . Do you know of any actual trial data describing the effects of combination of RTX + Daratumumab or Obinutuzum...

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RE: Is this Immune complex GN or something else? 1 day ago

Interesting suggestion Dr. Aledan. Two diseases rather than one. Dr, Hickam would be very pleased but Reverend Occam would not. How would you treat...

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RE: Is this Immune complex GN or something else? 1 day ago

I assume you rule out scleroderma renal crisis. NSAIDs may explain severe nephrotic syndrome and possible AIN (some intestinal inflammatory cells)...

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RE: Immunotactoid GN treatment 1 day ago

Or combination of Daratumumab and RTX or preferable off-label use of Obinutuzumab to target both hidden B and plasma cell clones. As Daratumumab ac...

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Applications for the ASN Kidney Week 2025 Travel Support Programs (Including Kidney STARS) Now Open! 1 day ago

Travel support applications for the world’s premier nephrology meeting, ASN Kidney Week, will close on Wednesday, June 18, 2025. Encourage your tra...

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Applications for the ASN Kidney Week 2025 Travel Support Programs (Including Kidney STARS) Now Open! 1 day ago

Travel support applications for the world’s premier nephrology meeting, ASN Kidney Week, will close on Wednesday, June 18, 2025. Encourage your tra...

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RE: Immunotactoid GN treatment 2 days ago

This case is a fairly classical example of a MGRS and Immunotactoid Glomerulopathy.(ITG) By definition, the deposits in PGNMID are non - organized....

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RE: Is this Immune complex GN or something else? 2 days ago

Yes. Sometimes we do get lucky to get a lot of glomeruli on the biopsy. We have an interventional radiologist who does the biopsies. There is alway...

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RE: Rituximab for Minimal Change GN - For how long ? 2 days ago

Found this article that focus on electrolyte and other compound transfer ------------------------------ Anatole Besarab MD ABesarab Consulti...

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RE: Rituximab for Minimal Change GN - For how long ? 2 days ago

As I understand the action of SGLT2 inhibition, the main effects are on the proximal tubule. Reabsorption of about 66% of sodium is accomplished in...

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RE: Immunotactoid GN treatment 2 days ago

Clone directed therapy is always the way to go if you have light chain restriction, but this reminds me of what is often seen in PGNMID, clear ligh...

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RE: Immunotactoid GN treatment 2 days ago

With MPGN pattern of injury and no clinically obvious cause, I would always look for hidden malignancy. Surprisingly, malignancy may even be diagno...

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RE: Alport syndrome 2 days ago

Dr Glassock makes an important point, amicar has not been used for glomerular bleeding but Jan 18: RBC 349/HP; ultrasound confirmed left...

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RE: Rituximab for Minimal Change GN - For how long ? 2 days ago

Would love to know if he has anti-nephrin Ab induced podocytopathy, and if so, does he show increasing circulating anti-nephrin Abs before relaps...

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RE: Rituximab for Minimal Change GN - For how long ? 2 days ago

Could you post the complete metabolic panel, so we can determine the anion gap, etc. With a EFR estimate only 25% od so below expected there should...

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RE: Rituximab for Minimal Change GN - For how long ? 2 days ago

Bicarb remains between 17-19 often ------------------------------ Dr Mohamed Buhary MBBS, FRCP, FASN Consultant Nephrologist Jeddah ----------...

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RE: Is this Immune complex GN or something else? 2 days ago

Usually the pathologist would tell us , not enough glomeruli in the biopsy sent. I am ompressed by > 50. How many passes did you make and do you ha...

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RE: Rituximab for Minimal Change GN - For how long ? 2 days ago

In my clinical practice, I am not use regular RTX therapy such as every 3-6 months but instead follow up patient every 3 months for the 1st year an...

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RE: Rituximab for Minimal Change GN - For how long ? 2 days ago

I agee with Dr. Glassock assessment. Why is he so non-compliant? You mentioned CKD ( 100-120) since 2021. This is not severe enough to warrant b...

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RE: Alport syndrome 2 days ago

Thank you for the UpDate, Dr. Glassock. The cases I saw were over 30 years ago and occurred in the patients, all who presented later in life. Molec...

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RE: Rituximab for Minimal Change GN - For how long ? 2 days ago

No good answer to your question. The only way to find out if he still needs RTX is to stop it and see if he relapses. Very likely his MCD has evolv...

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Rituximab for Minimal Change GN - For how long ? 2 days ago

Hi everyone, I would appreciate your expert thoughts on my following patients please: 27 years old male Remitting and Relapsing NS since age ...

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RE: Alport syndrome 3 days ago

I would recommend that the girl undergo a B-mode ultrasound to assess for renal vein compression. Thanks ------------------------------ Junchao...

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RE: Prolyl hydroxylase enzyme inhibitor efficiency in anephric hemodialysis patient 3 days ago

Addendum. The lower rise of serum EPO after PHI in anatomically anephric subjects would predict a lower efficiency of such agents for therapy of an...

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RE: Prolyl hydroxylase enzyme inhibitor efficiency in anephric hemodialysis patient 3 days ago

Yes- prolyl hydroxylase inhibitors increase serum EPO in anatomically anephric patients with ESKD, but to a lesser extent than those patients with ...

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Prolyl hydroxylase enzyme inhibitor efficiency in anephric hemodialysis patient 3 days ago

I wonder if HIF-PHI (such as roxadustat) is effective in anephric or nephrectomised patients? which would reflect efficient hepatic HIF-PH system c...

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RE: Immunotactoid GN treatment 3 days ago

The Chronic urticaria might be a manifestation of an underlying lymphoma. i would try try Daratumumab or CyBorD next. Perhaps Dr. Leung can give us...

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Immunotactoid GN treatment 3 days ago

76/F with HTN and chronic urticaria for which she is on dupixent referred for proteinuria (nephrotic ~ 4-5 gm). Biopsy showed Immunotactoid GN: ...

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RE: Hyponatremia treatment 3 days ago

A bit off the main topic, but I agree wholeheartedly with Dr Rodby's comments, which reflect how hyponatremia treatment--meds and water restriction...

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RE: IgA nephropathy 3 days ago

Dr. Aledan- I think you are underestimating the beneficial effects of MMF in IgAN, including non-Asian subjects. Prior small , RCT of MMF in IgAN i...

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RE: IgA nephropathy 3 days ago

Thanks Dr. Glassock for your question. In my clinical practice I am not using MMF or combined MMF plus steroids as upfront therapy for proliferativ...

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