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

Confusing data 3+ proteinuria confirmed upon multiple rechecks and first morning specimen. I prume by modern dispsticks which is specific for alb...

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RE: IgAN vs postinfectious 4 hours ago

went down a rabbit hole scrolling thru the ASN thread and came across this, any updates on this patient how they're doing? ----------------...

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RE: IgAN- ET1a Vs Complement Blockers In High Risk patients 9 hours ago

We do not have any long term data on eGFR slope with ERA( Atrasentan ) but do have such data with DEARA.(Sparsentan). No long term eGFR data isyet ...

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RE: IgAN- ET1a Vs Complement Blockers In High Risk patients 9 hours ago

Yes I agree with you... immunological driven disease ( hematuria , proteinuria , rapidly decreasing eGFR, M1 E1 C1-2) lesions probably will benefit...

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RE: C1q Nephropathy - diagnosis? treatment suggestions 10 hours ago

Current therapy is candesasrtan, dapagliflozin and rosuvastatin. Not started any immunosuppresion yet. ------------------------------ Bartlomiej ...

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RE: Resistant hypertension 18 hours ago

I think you are correct and in many younger individuals with little to no decrease in Kidney function with essential HTN. A hyperdynamic state is t...

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RE: C1q Nephropathy - diagnosis? treatment suggestions 20 hours ago

I think we could use a little help from our Renal Pathology colleagues. Drs. Fogo, Nast, Zuckerman? ------------------------------ Richard Glasso...

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RE: Resistant hypertension 21 hours ago

I would never disagree with Guyton unless I had clinical data. I believe there is data that shows that hyperdynamic state can cause HTN m...

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RE: C1q Nephropathy - diagnosis? treatment suggestions 22 hours ago

Thanks for the additional information. I still am not sure how to categorize this lesion. The evidence points to a secondary form ofcFSGS, modified...

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RE: Proteinuria of unclear etiology in a pediatric patient. 22 hours ago

With normal serum albumin and a very low UACR/ UPCR this looks like mainly tubular proteinuria. Do you have a Urine Protein Electrophoresis, serum ...

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RE: IgAN- ET1a Vs Complement Blockers In High Risk patients 22 hours ago

Why does there need to be a decision between just two drugs. Many drugs are available to treat IgAN. Steroids and MNMF may be best for some patient...

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Tablo machines 23 hours ago

We have been having problems with positive water cultures in our tabllo machines that have been used for a good number of years as the main machine...

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Proteinuria in IgA nephropathy- practice patterns 1 day ago

Error..apologies

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RE: X linked Alport syndrome In Female 1 day ago

I completely agree with Dr. Glassock that the study by Yamaguchi M, et al. raises a red flag, but because is done in mice, it provides no evidence ...

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

Greetings, I have a pediatric nephrology case I would appreciate some adult nephrology perspective on. 3 year old female presented with incid...

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RE: IgAN- ET1a Vs Complement Blockers In High Risk patients 1 day ago

From Uptodate - " The eGFR two-year chronic slope (from weeks 6 to 110) was -2.7 mL/min/1.73 m2/year with sparsentan and -3.8 mL/min/1.73 m2/year w...

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RE: IgAN- ET1a Vs Complement Blockers In High Risk patients 1 day ago

Neither studies of ERA (Atrasentan ) or Complement Factor B inhibitors have reported (published) any results with GFR endpoints in IgAN . See the l...

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RE: C1q Nephropathy - diagnosis? treatment suggestions 1 day ago

Genetic testing shows G1/G2 haplotype. The APOL1 G1 haplotype is c1024A>G, p.(Ser342Gly) and c.1152T>G, p. (Ile384Met) in cis (rs73885319 and rs609...

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IgAN- ET1a Vs Complement Blockers In High Risk patients 1 day ago

For patients with High Risk IgAN, we have new FDA approved drugs . The question hence arises , for these high risk group , what should we use 1....

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RE: X linked Alport syndrome In Female 1 day ago

The results of Yanaguchi et al study (referenced by Dr. Campese ) are very intriguing ( and potentially very worry provoking) but exclusively carri...

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RE: Resistant hypertension 1 day ago

The search strategyin the ref cited comparing hydralazine to placebo did not yield any randomized controlled trials for inclusion in this review. T...

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RE: X linked Alport syndrome In Female 1 day ago

The article by Gross et al in KI (thanks to Agnes for pointing this out), included only 20 patients in the randomized arm, and it failed to demonst...

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RE: Resistant hypertension 1 day ago

My question to the group is what is the evidence that hydralazine is a better BP med than CCB? Has the safety, tolerability, efficacy been studie...

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RE: X linked Alport syndrome In Female 2 days ago

Agree completely with Dr. Glassock's points- hopeful apparent benefit for "progression"- but hit is not based on long-term follow-up ------------...

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RE: X linked Alport syndrome In Female 2 days ago

Many Thanks Dr. Fogo for pointing out this important Phase 3 RCT of Ramipril in Alport's. "Progression" in this study was based on change in albumi...

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RE: X linked Alport syndrome In Female 2 days ago

The phase 3 trial in children with Alport- Early-PROTECT- did give ACEI (ramipril) early- with lesser proteinuria and appeared to decrease progress...

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RE: X linked Alport syndrome In Female 2 days ago

Dr. Campese is absolutely correct that the evidence concerning a long term beneficial effects of RAS inhibition in Alport Syndrome is not based on ...

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RE: MPGN/Lupus/DKD - biopsy. 2 days ago

I would wager a bet that the proteinuria response is probably due to Foundational CKD therapy. Having said that only a repeat biopsy would conclusi...

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RE: MPGN/Lupus/DKD - biopsy. 2 days ago

Apologies for delayed response. In terms of timeline: I first met her in Dec 2023 - already on max Perindopril, Dapa with Cr 111umol/L, Urine...

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RE: Role of Acthar in secondary FSGS 2 days ago

Thank you Dr. Glassock and Dr. Rodby. Appreciate your valuable input. ------------------------------ Zakir Shaik MD MHA FACP Beaumont, TX 409-89...

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RE: Resistant hypertension 2 days ago

Thank you all for suggestion. And healthy discussion. His bp is now maintaining 130 80 reducing oral antihypertensive, iv is off . We don't ha...

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RE: Role of Acthar in secondary FSGS 2 days ago

You probably will have to ask the pathologist who reviewed the biopsy and ask for an evaluation of glomerular size. I know of no study , in humans,...

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RE: Role of Acthar in secondary FSGS 2 days ago

Renal biopsy: RENASIGHT: Negative Referred to bariatric surgeon already. GLP1-A in my understanding very hard to get approved if pt is not a d...

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RE: Resistant hypertension 2 days ago

SO THE RULE OF THIRDS APPLIES. IF EXTRAPOLATED TP DIALYSIS PATIENT, EDW IS WRONG 2/3 OF THE TIME ------------------------------ Anatole Besarab M...

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RE: Role of Acthar in secondary FSGS 2 days ago

I think that is a good point, glomerulomegaiy as the tie breaker. ------------------------------ Roger Rodby MD, FASN Professor of Medicine R...

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RE: Role of Acthar in secondary FSGS 2 days ago

If glomerulomegaly is present in the kidney biopsy and the Family History is negative for kidney disease I probably would not do genetic testing . ...

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RE: Resistant hypertension 2 days ago

We did a study in new transplant patient when they had stable and good creat at 2 weeks we assumed the correct DW was with a good functioning ki...

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RE: X linked Alport syndrome In Female 2 days ago

Thanks Still not clear why like any proteinuric condition ACEI/ ARBS are used to reduce hyperfiltration and proteinuria Why in Alport only ACEI me...

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RE: Resistant hypertension 2 days ago

the statement that the most ardent supporters are " .mainly from those who are eager to sell it in my country" A true statement if ever I heard one...

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RE: Resistant hypertension 2 days ago

What is the gold standard for total body volume Is it Watson volume again?. ------------------------------ Anatole Besarab MD ABesarab Consultin...

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RE: Resistant hypertension 2 days ago

Thanks for the response. I would presume that at low levels or renal disease when there is no Significant accumulation of extracellular Na and W...

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RE: Resistant hypertension 2 days ago

I agree. Thanks

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RE: Resistant hypertension 3 days ago

I have also heard about this coming publication ...mainly from those who are eager to sell it in my country. I am afraid that even the most a...

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RE: The patient who keeps on giving 3 days ago

------------------------------ Dr. Hormaz Dastoor. MD, FASN Nephrology Consultant - Seha Kidney Care. Nephrology Consultant- SSMC,PureHealth LLC. A...

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RE: X linked Alport syndrome In Female 3 days ago

The alleged benefits of ACEi and ARBs in Alport's syndrome are based primarily on animal studies. The evidence in humans is based on retrospective ...

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RE: Resistant hypertension 3 days ago

In terms of the Calf bioimpedance I don't believe they validated their total body water results with other bio Impedance devices There are no d...

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RE: Resistant hypertension 3 days ago

The study was in a primary care setting, so likely a very low incidence of CKD They are in the process of publishing the data and hopefully analyzi...

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RE: Resistant hypertension 3 days ago

Not to keep going on the same subject, but I believe it is an important area of pathophysiology…when I eyeball the abstract you attached I see that...

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RE: Resistant hypertension 3 days ago

Yes I do. Volume is the most important variable and we are terrible at estimating the ideal EDW for our patients. . Mu experience is that blood ...

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RE: Role of Acthar in secondary FSGS 3 days ago

19 seems a bit young for ORG? Maybe get genetic testing looking for podocin mutation? Or is that silly given BMI of 40. UPToDate: Indi...

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