RE: Atrasentan experience and first thoughts 38 minutes ago

Endothelin receptor blockers decrease blood pressure in patients with hypertension and reduce albuminuria in patients with diabetic nephropathy and...

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RE: Iptacopan For IC- MPGN 1 hour ago

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RE: Iptacopan For IC- MPGN 1 hour ago

This paper has thrown a real wrench into the onconephrology community. Untreated PGMID does not typically fare well While clones are often not ...

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RE: SLE 1 hour ago

While I think this patient needs a renal biopsy I will be surprised if this is a 3 or 4 with a negative urine dipstick for blood. --------------...

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RE: Iptacopan For IC- MPGN 1 hour ago

Although what has been called PGMID has often been thought to be an MGRS, because it stains in a clonal fashion with the antibodies used for diagno...

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RE: Iptacopan For IC- MPGN 1 hour ago

Thanks for the nice review and references ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ---------------...

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RE: SLE - When To Stop Immunosuppressives 2 hours ago

The 3 previous patients did show complete depletion of CD19. However , my query is for this current patient , who just had a repeat biopsy . Cli...

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RE: SLE 3 hours ago

Mesangial ICs-depositions activate mesangial cells leading to the release of inflammatory cytokines, complement activation (particularly C3), the i...

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RE: Iptacopan For IC- MPGN 4 hours ago

Yes, this is my approach. It Works ------------------------------ Antonio Almeida MD, PhD Salvador-Bahia 55-71-981313969 -----------------------...

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RE: SLE 4 hours ago

Agreed. Some sources point to more than 3 RNC per HPF. However, I have had the experience that at low level hematuria, one may need to do 2 to 3 ex...

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RE: Iptacopan For IC- MPGN 4 hours ago

Agree with Dr. Glassock that both C3G and IC-MPGN can shift phenotype because they shared complement dysregulation (nephritic factoid and genetic v...

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RE: SLE 4 hours ago

Somewhere- around 5 RBC per HPF. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ------------------------...

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RE: SLE 5 hours ago

If one were to compare the dipstick to a good microscopic count of RBC per HPF, at what level of RBC per HPF would the dipstick show trace hematuri...

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RE: SLE 7 hours ago

Dr. Dastoor. Thanks for your comment. In IgA N there is a high degree of correlation between the degree of hematuria in IgAN andM1, EI and C1/2 les...

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RE: SLE - When To Stop Immunosuppressives 7 hours ago

Thanks- did these three patients also show full depletion of CD19 B cells after CART cell therapy? ------------------------------ Richard Glassoc...

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RE: SLE 8 hours ago

Thank you, Dr. Venkat. Dipstick was negative for blood ------------------------------ Abdeen Farah Musa MD MD BayCare Medical Group Nephrology (S...

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RE: SLE 8 hours ago

Thank you very much for your input and contribution. I want to give you some update in this case: Kidney biopsy was done yesterday, result is pe...

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RE: Iptacopan For IC- MPGN 9 hours ago

@dr. Glassock. Is it possible to have the reverse ie C3 transforming to IC- MPGN Have attached a report on our 7th patient to start Pegcetacoplan ...

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RE: SLE - When To Stop Immunosuppressives 11 hours ago

This is the final report on the biopsy. There are still deposits on the EM . Would agree with continuing MMF . But any role for Cart -----------...

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RE: Is this extra renal ANCA vasculitis? Switch from ritux to cyc? 19 hours ago

In terms of treating IgAN in the native kidney, the non Chinese RCT cited by Dr. Rubin(and evaluated by KDIGO ) were all small and underpowered and...

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RE: Atrasentan experience and first thoughts 21 hours ago

Dr. Dastoor thanks that was exactly the poster. Unfortunately as I already said the MEST-C score in question is not (in my opinion) very valid to...

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RE: Is this extra renal ANCA vasculitis? Switch from ritux to cyc? 21 hours ago

@Richard Glassock The literature cited by Dr. Glassock is all superb animal data (see attached) which, to my knowledge has not translated into hu...

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RE: Atrasentan experience and first thoughts 23 hours ago

Good point. We need more data to support this view. What holds for Atrasentan +RASi probably also holds for Sparsentan, but I doubt that we will se...

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RE: Atrasentan experience and first thoughts 1 day ago

I was able to locate the poster as suggested by Dr. Venturelli...looking at uPCR responses in relation to the MESTC scores , it is interesting to n...

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RE: Is this extra renal ANCA vasculitis? Switch from ritux to cyc? 1 day ago

The excellent studies of non immunosuppressive actions of Rodriguez-Iturbe and colleagues performed decades age are often forgotten. These experime...

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RE: Iptacopan For IC- MPGN 1 day ago

According to the literature, genetic testing , C3NeF and AH50/CH50 do not reliably distinguish C3GN and IC-MPGN from each other. After excluding an...

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RE: Iptacopan For IC- MPGN 1 day ago

In the states, Insurance and health conglomerate providers can decide not to provide a test, a service, a treatment as part of their duty to the in...

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RE: Is this extra renal ANCA vasculitis? Switch from ritux to cyc? 1 day ago

@Miguel Uriol Rivera It must be the beautiful Malaga, its gorgeous weather, outstanding food and wines that makes your spirits so positive. The f...

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RE: Is this extra renal ANCA vasculitis? Switch from ritux to cyc? 1 day ago

Dear Mario, Thank you for your thoughtful note. I agree that renal-specific antifibrotic evidence for MMF is limited. My point was simply that MMF...

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RE: Potential donor with mild bilateral increased density of medullary pyramids 1 day ago

Hypercalciuria, urolthiasis and possible nephrocalcinosis would be enough for me exclude this donor. Other opinions welcome. -------------------...

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Potential donor with mild bilateral increased density of medullary pyramids 1 day ago

I would appreciate the community input on the following donor candidate case: 37-year-old white female with no significant past medical history wh...

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RE: Atrasentan experience and first thoughts 1 day ago

Both Atrasentan + RASi and Sparsentan have now been shown to have "anti-inflammatory " activity in IgAN. Exactly where these agents will be positio...

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RE: Membranous nephropathy 1 day ago

All of the anti-PLA2R tests X are by IFA, not ELISA. Do you not have ELISA available? . Only one test was positive by IFA and no PKA2R testing in t...

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RE: Membranous nephropathy 1 day ago

Need to verify few things first. Surprise that casts did not stain for albumin !!, yes albumin in the 3s with such proteinuria can raise suspicion ...

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RE: Iptacopan For IC- MPGN 1 day ago

Thank you, I have contacted them . However we are forbidden to use drug samples or provide medications free - of cost (FOc) under a Medical Assista...

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RE: Atrasentan experience and first thoughts 1 day ago

Just to give a 4 week follow up , after an initial improvement in eGFR from 34 to 31 ml/min the eGFR at 4 weeks is 33 ml/min The uPCR has shown a ...

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RE: Iptacopan For IC- MPGN 1 day ago

There is clinical trial going on with Iptacopan in icmpgn You can contact Novartis Our site is pRt on going trial If i can help connect with me at ...

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RE: Is this extra renal ANCA vasculitis? Switch from ritux to cyc? 1 day ago

@Miguel Uriol Rivera Thank you. You must admit that the evidence which supports an antifibrotic effect of MMF in the treatment of human diseas...

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RE: Is this extra renal ANCA vasculitis? Switch from ritux to cyc? 1 day ago

Nice to meet you Mario, The evidence is admittedly limited; however, findings from systemic sclerosis, skin involvement, pulmonary fibrosis, and ...

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RE: Is this extra renal ANCA vasculitis? Switch from ritux to cyc? 1 day ago

" add MMF as an antifibrotic agent at 500 mg twice daily " @Miguel Uriol Rivera . Please educate me by sharing the published evidence in humans t...

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RE: Is this extra renal ANCA vasculitis? Switch from ritux to cyc? 1 day ago

No CD 61 that I know of, is that to look for MAHA/TMA? The Creat is trending down, peak 4.29 (9.19.25) to 3.8 today. I'm wondering if the rituximab...

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RE: Is this extra renal ANCA vasculitis? Switch from ritux to cyc? 1 day ago

Prednisone can be tapered rapidly. The ESR is extremely high, which suggests a significant paraprotein component. Was CD61 performed on the renal b...

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RE: Is this extra renal ANCA vasculitis? Switch from ritux to cyc? 1 day ago

Update on our guy's labs Heme saw him and there was no evidence of vaculization on the bone marrow biopsy. They have low suspicion, the gene test...

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RE: Pt with AKI and low complements 2 days ago

Thank you Dr. Besarab. I know hematology will check UPEP for sure. ------------------------------ Amita Vasudeva MBBS University of Missouri-Kan...

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RE: Pt with AKI and low complements 2 days ago

Thank you everyone for their input. I will not go for renal biopsy due to negative urine and solitary kidney. But it's good to know others agree w...

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RE: Pt with AKI and low complements 2 days ago

Would no the level of urinary protein in a MGUS state depend on the concentrations of the monoclonal protein as well as the level of light chains i...

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RE: Iptacopan For IC- MPGN 2 days ago

I understand that Insurance companies have a responsibility to their stockholders to not approve therapies that do not meet the high standards of t...

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RE: Membranous nephropathy 2 days ago

Despite severe Nephrotoic syndrome, i.e. PC frequently in the > 10-12 g/g wuth serum albumins of 3.9 ro 3,3 in the past yer makes me wonder whether...

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RE: Membranous nephropathy 2 days ago

That's a big time gap, and with that level of proteinuria the half life would be cut to 3-4 months instead of 6 months --------------------------...

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RE: Membranous nephropathy 2 days ago

Rituximab given in Sept 2023, here is her CD 19 count in April 2024 ------------------------------ Reima Almarshoodi MBBS Sheikh Khalifa Medi...

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