leucocytoclastic vasculitis with overlap syndrome 3 hours ago

Need further guidance on a 67-year-old patient who was seen in April 2025 for proteinuria. She has history of overlap syndrome with SLE, Sjogren's,...

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RE: Donor Risk 10 hours ago

Details from 2004 are not very clear ,but doesn't seem to have suffered any noticeable renal injury then. BP is now well controlled on the two med...

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RE: Donor Risk 10 hours ago

Amlodipine and a thiazide --------------------------------- Syed Hassan MD Assistant Professor UTMB Pearland TX (832) 455-7184 --------------...

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RE: Donor Risk 11 hours ago

Was HELLP mild , moderate, or severe ? ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KPCOP EC [Past Medical Director K...

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RE: APLS Nephropathy 11 hours ago

I understand the hope that appropriate therapy might stabilize/improve his renal state without needing a radical bilateral nephrectomy. HCM is cons...

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RE: APLS Nephropathy 12 hours ago

Prof (@Richard Glassock) In the report ..there is 150 HUS Patients C3 nephritic factor (C3NeF): 0% detected C4 nephritic factor (C4NeF): 0% detec...

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RE: heart transplant candidate with membranous nephropathy 12 hours ago

Is there a role for immunosuppressive therapy? My answer is yes. He meets criteria for immunosuppressive therapy for membranous nephropathy per KD...

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RE: C1q Nephropathy 13 hours ago

Sure we strongly suggested to send a genetic testing panel for FSGS (e.g., NPHS1, NPHS2, ACTN4, TRPC6, INF2, COL4A genes, and APOL1 risk alleles). ...

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RE: APLS Nephropathy 13 hours ago

Anticoagulation: Warfarin preferred in APLS with thrombotic nephropathy; direct oral anticoagulants (e.g., rivaroxaban) are ineffective and may be ...

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C1q Nephropathy 13 hours ago

22-year-old African American male incidentally found to have proteinuria 4.36 g. Creatinine 1.0. No hematuria. BP is 100's/60's. Serological workup...

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RE: APLS Nephropathy 14 hours ago

Thank you for the interesting Reference pointing out the rarity of C4 Nephritic Factor (and low serum C4 levels ) in C3G. But this paper does not r...

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RE: Proteinuria of unclear etiology in a pediatric patient. 15 hours ago

I agree with Prof. Glassock to proceed the investigation towards MYH9-disorder. What is the variant? Detailed reconstruction of family pedigree and...

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RE: Donor Risk 16 hours ago

What medication(s)/doses is she on now to control BP? How well controlled is her BP? During HELLP, did she have any renal impairment and how severe...

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RE: High 125 vitamin D With No Hypercalcemia Or Hypercalciuria, But Kidney Stone 19 hours ago

I do agree with Dr Asplin but despite of the normal serum phosphorus I would order phosphorus and creatinine in serum and spot urine samples to cal...

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Donor Risk 1 day ago

Question A 44 yo woman with h/o controlled HTN wishes to donate her kidney to her friend . She did have HELPP during a pregnancy in 2004 . All cur...

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RE: APLS Nephropathy 1 day ago

https://www.ajkd.org/article/S0272-6386(17)30844-2/fulltext --------------------------------- Alaa Nabih Abdalla nephrology fellow Egypt -------...

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RE: APLS Nephropathy 1 day ago

Sufficiently powered RCTs supporting every therapeutic decision cannot always be found, especially in uncommon diseases. Biological plausibility wi...

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RE: APLS Nephropathy 1 day ago

You are quite correct in stating that the existing literature suggest that C3 and C5 Nephritic factors are confined largely to patients with C3G. I...

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RE: APLS Nephropathy 1 day ago

Since this patient seems to have Primary Antiphospholipid Syndrome ( with TMA But not LN ) , of a non-catastrophic variety I am unaware of any stud...

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RE: heart transplant candidate with membranous nephropathy 1 day ago

The cerartinine is worse than the IFTA, but even then I have had a couple of patients with very advanced MGN (creatinine this high at least) th...

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RE: APLS Nephropathy 1 day ago

Dr. Victoria Sasongko: Can you please post recent levels of various APL antibodies in this patient? Dr. Glassock: Although hematological results ...

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RE: APLS Nephropathy 1 day ago

The observed low C3 and C4 levels are most likely attributable to complement consumption secondary to antiphospholipid syndrome (APLS)-associated m...

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RE: APLS Nephropathy 1 day ago

Difficult case. I agree with long term Warfarin therapy in this case. I would not use NOAC as they have been associated with increased thrombosis i...

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RE: heart transplant candidate with membranous nephropathy 1 day ago

Thanks for the post- moderator advanced non-PLA2R MN ( probably, but not sure as about 3% of cases are negative for PLA2R antigen by IIF and positi...

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RE: heart transplant candidate with membranous nephropathy 1 day ago

please see biopsy report. ------------------------------ [Jorge] [Garces] MD, FASN [Transplant Nephrology] Ochsner Transplant Center [New ...

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RE: heart transplant candidate with membranous nephropathy 1 day ago

Please see attachment for full biopsy report> ------------------------------ [Jorge] [Garces] MD, FASN [Transplant Nephrology] Ochsner Tra...

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RE: APLS Nephropathy 1 day ago

"Hb was 110 then drop to 80 then transfused and stays at high 90 appropriately" Could you post dates and Hb/Hct values, platelets and etic counts...

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RE: APLS Nephropathy 1 day ago

Hb was 110 then drop to 80 then transfused and stays at high 90 appropriately. iron deficient treated w iv iron this admission Bx 3 days ago, cle...

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RE: High 125 vitamin D With No Hypercalcemia Or Hypercalciuria, But Kidney Stone 1 day ago

I strongly agree with the assessment of Dr Asplin. There is no hypercalciuria on citrate therapy and her urine indices suggest low risk for future ...

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RE: heart transplant candidate with membranous nephropathy 1 day ago

I agree with Drs Glassock and Venkat. Bilateral nephrectomy (surgical or by infarction) would result in a heart and kidney Tx being necessary or pa...

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RE: APLS Nephropathy 1 day ago

Anaemia with normal reticulocytes, no fragments, transient initial borderline plt (115g/L) for week, spontaneously resolved. Now normal LDH, elevat...

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RE: Proteinuria of unclear etiology in a pediatric patient. 1 day ago

Agree, worth taking a closer look at this MYH9 VUS. Even though it's a VUS, does the mutation seem to be one that might lean pathogenic based on lo...

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APLS Nephropathy 1 day ago

Hi, Seeking another opinion - 48yo lady with history of APLS (multiple miscarriages and DVTs), somehow has been on Rivaroxiban (likely 2'compli...

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RE: heart transplant candidate with membranous nephropathy 2 days ago

What is the serum Anti-PLA2R results (ELISA)? Can you post the deidentified biopsy report.? ------------------------------ Richard Glassock MD, F...

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RE: heart transplant candidate with membranous nephropathy 2 days ago

Can you please post the deidentified kidney biopsy report? If this patient is being considered for heart transplantation, important to know how muc...

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RE: C1q Nephropathy - diagnosis? treatment suggestions 2 days ago

That is a good point. Thank you! ------------------------------ Jonathan Zuckerman MD, PhD UCLA Los Angeles CA (310) 794-1485 ------------------...

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RE: C1q Nephropathy - diagnosis? treatment suggestions 2 days ago

very thoughtful an complete analysis-- but I want to point out that a small number of cases that meet classical definition for fibrillary GN ( ie I...

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RE: heart transplant candidate with membranous nephropathy 2 days ago

Is the patient a candidate for Rituximab (or Obinutuzumab )therapy.? If so, I would treat with either one, Has the biopsy been sent for LD/MS analy...

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heart transplant candidate with membranous nephropathy 2 days ago

Subject: Consultation Request – Complex Case of Membranous Nephropathy in Heart Transplant Candidate I am seeking expert input on a challenging c...

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RE: High 125 vitamin D With No Hypercalcemia Or Hypercalciuria, But Kidney Stone 2 days ago

I agree with getting genetic testing rather than 24 OH metabolites. Because of the ratio, even a small error in measurement of 24 OH metabolites ca...

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RE: High 125 vitamin D With No Hypercalcemia Or Hypercalciuria, But Kidney Stone 2 days ago

Thanks Dr Glassock Will do I am surprised though no Hyperphosphatemia Hypercalcemia or hypercalciuria Not sure if lov lab can do 24,25 vit D Will s...

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RE: C1q Nephropathy - diagnosis? treatment suggestions 2 days ago

Given the high risk APOL-1 genotype, I am biased to think this is a genetic FSGS/APOL-1 nephropathy. The deposits seem somewhat underwhelming based...

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RE: Proteinuria of unclear etiology in a pediatric patient. 2 days ago

Thank you so much for the details. ------------------------------ Anatole Besarab MD ABesarab Consulting Scottsdale AZ (734) 417-4793 ----------...

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RE: Refratory nephrotic syndrome? 2 days ago

The bacteriemia resolved very quikly and it this in the context of a colonoscopy. Next monday it will have 6 weeks post rtx. We started tacrolimus ...

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RE: IgAN- ET1a Vs Complement Blockers In High Risk patients 2 days ago

Yes I agree , Iptacopan eGFR data is still awaited. But interestingly on stopping Iptacopan after 9 months , the majority will have recurrence of p...

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RE: Proteinuria of unclear etiology in a pediatric patient. 3 days ago

The EM findings might be compatible with a MYH9 related disorder. Not all such patients have megathrombopemua. What was the platelet count? Any May...

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RE: Proteinuria of unclear etiology in a pediatric patient. 3 days ago

Agree The albumin loss is 2.13 g/g Cr Agree with staering RAAS therapy to decrease the exretion. Dr Glassock, anything else that should be do...

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RE: Proteinuria of unclear etiology in a pediatric patient. 3 days ago

Thanks for the clarification. The significant albuminuria and proteinuria with normal serum albumin and minimal podocyte effacement are not compati...

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RE: Proteinuria of unclear etiology in a pediatric patient. 3 days ago

Apologies, I found the error in my original post. The lab reported the spot urine micro albumin as > 1140 ug/mL Urine creatinine was 53 mg/dL ...

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RE: Proteinuria of unclear etiology in a pediatric patient. 3 days ago

I agree with Dr. Besarab. The urinary albumin excretion value posted in this thread is not compatible with cubulin deficiency. Please repeat the te...

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