RE: Immunotactoid GN treatment 7 hours 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? 10 hours 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 ? 12 hours 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 ? 12 hours 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 13 hours 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 13 hours 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 13 hours 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 ? 13 hours 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 ? 15 hours 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 ? 16 hours 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? 16 hours 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 ? 16 hours 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 ? 17 hours 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 17 hours 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 ? 17 hours 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 ? 18 hours 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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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RE: ANCA with full house IF (?) 1 day ago

Hi Dr Glassock Pt is under the care of one of another provider. He was given Ritux/steroids. retrospectively - the negative TEE/blood cultures an...

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

Thanks very much Dr. Rodby for your input. Our biopsies are sent to another institution. So, I am not sure if I will get access to the images but w...

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

Thanks very much Dr. Glassock. I will find out if they can do a DNAJB stain on the biopsy. ------------------------------ Shoeb Kosgi MD, FASN T...

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RE: Hyponatremia treatment 1 day ago

While the tonicity derived from salt of gatorade is only 15% of that of NS, there are a few sports drinks that, while still hypotonic, would at lea...

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RE: IgA nephropathy 1 day ago

Thank you, i have started on steroids (lower dose TESTING trial protocol) and MMF in addition to supportive care- trying to obtain sparsentan as we...

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RE: ANCA with full house IF (?) 1 day ago

How are you managing the "Immunosuppression" while awaiting the results of further evaluation of Infection -Related GN in this case? Just curious! ...

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RE: IgA nephropathy 1 day ago

Thanks Dr. Aledan. Would you also use MMF in this case ? ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885...

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RE: Alport syndrome 1 day ago

If this is all glomerular bleeding secondary to the GBM abnormalities attendant to Alport Syndrome, I doubt that Amino-caprice acid will do much to...

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

A little bit of everything here, but the one thing I think you may have to "hang your hat on" is the IgA. Sub endothelial deposits are unusual w...

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RE: Alport syndrome 1 day ago

"Does Aminocaproic acid really work for gross hematuria with normal coagulation function, and if so, does it require ethical approval?" this woul...

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RE: Alport syndrome 1 day ago

Dear professor Roger Rodby MD Does Aminocaproic acid really work for gross hematuria with normal coagulation function, and if so, does it require...

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

Puzzling case. The clinical picture and immunopathological features most likely fit within the heterogeneous nature of IgAN. The thrombopenia, lack...

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RE: Alport syndrome 1 day ago

Thank you Dr. Glassock. ------------------------------ Anatole Besarab MD ABesarab Consulting Scottsdale AZ (734) 417-4793 ---------------------...

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

49 year old male, school teacher, was seen on about 3 weeks ago on 30 April, after admission to the hospital for evaluation of severe headache and ...

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RE: IgA nephropathy 1 day ago

IgAN is considered as a CKD disease so treatment is divided into generic treatment for CKD including RAASi (or preferably sparsentan) plus SGLT2i a...

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RE: ANCA with full house IF (?) 1 day ago

Thank you for your reply Dr Rodby! you are right- Cryoglobulin came back positive.. now doing more infection work up. -------------------------...

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RE: CMV IgM +/ CMV pcr neg. Recipient 2 days ago

Thanks sir ------------------------------ Ahmed Mahedy PhD Banha Faculty of Medicine Banha ------------------------------

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RE: IgA nephropathy 2 days ago

My recommendation is that you try the UpToDate approach. It is a very well thought out management paradigm developed by some very experienced and k...

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RE: Hyponatremia treatment 2 days ago

IF THE IGNORANCE IS THAT WIDESPREAD, PERHAPS TOU SHOULD TELL THE CHIEF OF NEDICINE THAT THERE NEEDS TO AN GRAND ROUNFS ON THE SUBJECT SO PHYSICIANS...

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RE: Hyponatremia treatment 2 days ago

Dr. Gunnell- You need to bring this discussion to the attention of your Hospital leadership, so that the "rules" can be appropriately changed. ...

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RE: Calling All Rituximab and Glomerulonephritis Experts - Your Insights Needed in the ASN Artificial Intelligence Forum! 2 days ago

The Primary endpoint of clinical remission at 6 months is poorly chosen. The trail will be severely underpowered to meet this end point, in my opin...

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RE: IC-MPGN 2 days ago

The finding of positive serology pretty much locks in the diagnosis - this is yet another case of Bartonella Infective Endocarditis with a full hou...

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When to active after pregnancy? 2 days ago

Patient with CKD Stage 5D since 2023 became pregnant and underwent a preterm delivery due to preeclampsia on December 20, 2024. She was active on t...

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RE: IC-MPGN 2 days ago

Also, skin biopsy for his petechiae lesions came back consistent with leukocytoclastic vasculitis with IgA staining. On his biopsy, deposits are pr...

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RE: IC-MPGN 2 days ago

Thank you so much for the input Dr. Glassock and Dr. Rodby. Rheumatoid factor is pending. Cryoglobulins are checked twice and negative. Biopsy EM d...

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