RE: difficult case ? should we treat as cx negative endocarditis Vs seronegative AAV 3 minutes ago

Dr Glassock RF was 237 Most likelyBartonella associated immune complex GN Following transcatheter aortic valve replacement (TAVR), the sensitivity...

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RE: difficult case ? should we treat as cx negative endocarditis Vs seronegative AAV 5 minutes ago

Dr Glassock RF was 237 Likely Bartonella associated immune complex GN Following transcatheter aortic valve replacement (TAVR), the sensitivity of ...

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RE: difficult case ? should we treat as cx negative endocarditis Vs seronegative AAV 2 hours ago

Addendum unfortunately TEEP has about a10-15% false negative rate , especually with small vegetations on prosthetic valves. ----------...

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RE: difficult case ? should we treat as cx negative endocarditis Vs seronegative AAV 4 hours ago

Very challenging case indeed. The very high titer of IgG antibodies to B. Henselae indicate recent and possibly active infection . IgM antibodies h...

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difficult case ? should we treat as cx negative endocarditis Vs seronegative AAV 6 hours ago

Dear colleagues and to my teachers I would like to present a challenging case which I am unsure of how to proceed 69 yo caucasian male with m...

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RE: IgAN therapy in patient desiring future pregnancy and intolerant of steroids 7 hours ago

I must admit that I never used serial renal US to monitor the course of IgAN or to help decide if a repeat kidney biopsy is needed. Maybe I have be...

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RE: membranous nephropathy 8 hours ago

Thank you all for your input. The treating doctor is aware of this discussion. I will try to get back with you with more information when it is ava...

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Clinical Specialist in Hypertension Exam 8 hours ago

Any advice for resources to study for this? ASH used to have a hypertension review course that I took for my initial certification, I will be recer...

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RE: IgAN therapy in patient desiring future pregnancy and intolerant of steroids 10 hours ago

You may want to repeat kidney ultrasound now to assess size/echogenicity/cortical thickness. ------------------------------ K.K. Venkat MD Troy ...

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RE: IgAN therapy in patient desiring future pregnancy and intolerant of steroids 12 hours ago

Inaddition to like regular CKD care in pregnancy, one aspect is that proteinuria will increase, one shouldnt panic and think of starting steroids. ...

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Retrieving a previously discussed topic in Open Forum 15 hours ago

I am not exactly uninitiated when it comes to technology but how does one locate & retrieve a previously discussed topic/chain of related posts (li...

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RE: IgAN therapy in patient desiring future pregnancy and intolerant of steroids 18 hours ago

You may want to repeat kidney ultrasound now to assess size/echogenicity/cortical thickness. ------------------------------ K.K. Venkat MD Troy ...

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RE: IgAN therapy in patient desiring future pregnancy and intolerant of steroids 21 hours ago

Thanks for all the advice! Just saw this patient in follow-up today and discussed all options. Patient really wants to try for pregnancy before she...

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RE: IgAN therapy in patient desiring future pregnancy and intolerant of steroids 21 hours ago

Kidney ultrasound from 7/24/17 was unremarkable: The right kidney measures 11.3 x 4.1 cm. There is no hydronephrosis. No definite calcifications ...

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RE: Case of FSGS 1 day ago

Ok thank you for clarifying --------------------------------- Mohamed Mahmoud MBBS NEPHROLOGIST MOH Egypt 00965 51377736 ---------------------...

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RE: Case of FSGS 1 day ago

"Negative " is a loosely applied term. Fine dusting of "podocytes"takes some experience to detect. It is frequently regarded as 'normal" ------...

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RE: Case of FSGS 1 day ago

Thank you prof Glassock IgG, IgM, C3c, C4d and C1q: All are negative --------------------------------- Mohamed Mahmoud MBBS NEPHROLOGIST MOH ...

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RE: IgAN therapy in patient desiring future pregnancy and intolerant of steroids 1 day ago

Appreciate the response. My experience is different than yours. I have not found renal ultrasound to be of much value for prognostication or therap...

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RE: Case of FSGS 1 day ago

The clinical history and laboratory finds are most consistent with Primary FSGS. But if there is a family history of kidney disease or Nephrotic Sy...

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Case of FSGS 1 day ago

• 42-year-old male • Long-standing hypertension, recently diagnosed diabetes mellitus • Presented with bilateral leg edema and nephrotic-range pr...

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RE: IgAN therapy in patient desiring future pregnancy and intolerant of steroids 1 day ago

@Richard Glassock: Preserved SCr might be from increasing hyperfiltration in remnant nephrons while (secondary) FSGS, global glomerulosclerosis in ...

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RE: AKI, urinary K Wasting and uncontrolled HTN 1 day ago

I would not have stopped the Empa, but I agree that Finerenone might have too low a benefit -risk ratio. ------------------------------ Richard G...

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RE: IgAN therapy in patient desiring future pregnancy and intolerant of steroids 1 day ago

Interesting question Dr. Venkat. With a " preserved" serum creatinine level and a long history of biopsy proven IgAN , how much prognostic and ther...

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RE: IgAN therapy in patient desiring future pregnancy and intolerant of steroids 1 day ago

Kidney size/echogenicity/cortical thickness on serial ultrasounds? ------------------------------ K.K. Venkat MD Troy MI (248) 420 7798 --------...

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RE: AKI, urinary K Wasting and uncontrolled HTN 1 day ago

Thank you so much for your time . I agree with you. we can start him on semaglutide which does not have to be renally adjusted . However, with his ...

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RE: Hypercalcemia management in a patient with Sarcoidosis 1 day ago

I think that Influximab would be 'overkill" for this patient. The main problem is hypercalcemia and hypercalciuria, not progressive organ damage. J...

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RE: IgAN therapy in patient desiring future pregnancy and intolerant of steroids 1 day ago

i suspect a kidney biopsy will not help you, I cannot imagine (just a guess admittedly) the IgA going away, and there will be chronic fibrosis. I t...

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RE: Hypercalcemia management in a patient with Sarcoidosis 1 day ago

The increased 1,25 drives the hypercalcemia ------------------------------ Stuart Sprague DO, FASN Director of Research, Division of Nephrology a...

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RE: AKI, urinary K Wasting and uncontrolled HTN 1 day ago

Thanks for the report. In my opinion , this degree of "Podocytopathy" is commonly encountered in advanced diabetic glomerulosclerosis . I see no re...

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The ACOI Dr. Malcoun Award for Fellows: Nominations Due Saturday, May 31, 2025 1 day ago

Hi all, Please see below for a message from The American College of Osteopathic Internists (ACOI)! ********************** ACOI invites nephro...

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RE: IgAN therapy in patient desiring future pregnancy and intolerant of steroids 1 day ago

I think that a repeat biopsy would show chronic changes and little inflammation . The proteinuria is indicative of these chronic scarring changes, ...

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RE: IgAN therapy in patient desiring future pregnancy and intolerant of steroids 1 day ago

Thanks to all for your comments! UA most recently (4/12/25) was neg for blood (0-2 RBC), it was also neg at the time of her 2017 biopsy. There was ...

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RE: IgAN therapy in patient desiring future pregnancy and intolerant of steroids 1 day ago

tough case, high risk CKD long term with that level of proteinuria CKD makes pregnancy more difficult moderate preeclampsia risk regardless ...

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RE: IgAN therapy in patient desiring future pregnancy and intolerant of steroids 1 day ago

This case represents a difficult dilemma. With a course of at least 17 years the major question will be how much of the proteinuria can be attribut...

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RE: IgAN therapy in patient desiring future pregnancy and intolerant of steroids 1 day ago

Dr Liang: How much microscopic hematuria/hemoglobinuria does your patient have in a clean uninfected urine. Proteinuria alone may not need immunosu...

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RE: Hypercalcemia management in a patient with Sarcoidosis 1 day ago

The answer is yes. so does lymphopenia. Morell, F et al. Chest 2002 Apr, 121 (4) 1239-44 Rohmer, J et al. Br J Ophthalmol 2020 Apr 2; 28(3) ...

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RE: AKI, urinary K Wasting and uncontrolled HTN 1 day ago

No diabetic retinopathy OU according to March, 2024 last eye examination. He denied any tingling or numbness, last time I specifically asked h...

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RE: Hypercalcemia management in a patient with Sarcoidosis 1 day ago

Does 1.25 vit D level in sarcoid correlate whether disease is active or inactive, I know ACE negative in 30% of the patient and not specific can b...

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RE: IgAN therapy in patient desiring future pregnancy and intolerant of steroids 1 day ago

Reminds me of an IgA case, who had pre-conception proteinuria ranging 0.5- 1 gram per day, eGFR of 90, over next 6 years she had three pregnancies,...

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IgAN therapy in patient desiring future pregnancy and intolerant of steroids 1 day ago

Hi! Would appreciate your expert opinions and advice on this IgAN case: 34 y.o. female with history of IgAN (biopsy-proven in 2007 at age 17 and...

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RE: AKI, urinary K Wasting and uncontrolled HTN 1 day ago

I think I can say with some degree of confidence that this is NOT MCD and that steroids are NOT indicated, at least until we learn more about the k...

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RE: AKI, urinary K Wasting and uncontrolled HTN 2 days ago

We really need to see this patients (deidentified) kidney biopsy before making any opinions about therapy. Does he have any proliferative diabetic ...

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RE: AKI, urinary K Wasting and uncontrolled HTN 2 days ago

so in summary, based on the result of the renal biopsy, need suggestion for treatment of his probable minimal change disease with uncontrolled diab...

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RE: AKI, urinary K Wasting and uncontrolled HTN 2 days ago

In March, 2025, 24-hour urine appropriately collected found protein of 13662 mg, normal results of IgG4, HIV, hepatitis B surface antigen, hepatit...

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RE: Volunteer by May 7 to serve as a case report reviewer for Kidney Week 2025! 2 days ago

Hello! Please complete this form by May 7 to serve as a fellow case report reviewer: https://www.asn-online.org/apply/?ID=21 -------------------...

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RE: membranous nephropathy 2 days ago

I second Drs Hirsch and Glassock. Rituxan only and monitor. Serologic response can be checked if PLA2R-ab positive. ----------------------------...

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RE: Hypercalcemia management in a patient with Sarcoidosis 3 days ago

I would agree with Prof Glassock and suggest ketoconazole ------------------------------ Stuart Sprague DO, FASN Director of Research, Division o...

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RE: membranous nephropathy 3 days ago

I have never been very enthusiastic about use of CNI in MN. It is a second or third class drug for producing CR - it is much weaker than RTX or CYC...

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RE: membranous nephropathy 3 days ago

Doubt there is a "right" answer but, seems to me... --the Niles protocol as described above is HUGELY more immunosuppression than the standard Ri...

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RE: membranous nephropathy 3 days ago

79 year old: I like the Niles protocol in general "Combination of Rituximab, Low-Dose Cyclophosphamide, and Prednisone" https://pubmed.ncbi.nlm....

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