RE: Col4A5 mutation pt - Would you biopsy? 1 hour ago

Dr. Rodby and Dr. Glassock, is there any chance that she may not have Alport? There is some data showing other types of pathology such as IgA or FS...

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RE: Col4A5 mutation pt - Would you biopsy? 1 hour ago

Thanks to everyone for your input! very helpful. ------------------------------ Yongen Chang MD, PhD, FASN University of California Irvine Orang...

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RE: Col4A5 mutation pt - Would you biopsy? 4 hours ago

Here is the viewpoint of a provider treating young patients: With a confirmed COL4A5 mutation and preserved kidney function, biopsy is unlikely to...

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RE: Col4A5 mutation pt - Would you biopsy? 18 hours ago

I fully agree with Dr. Rodby. With these clinical and genetic findings a kidney biopsy would be redundant. She should be treated for X-linked Alpor...

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RE: Col4A5 mutation pt - Would you biopsy? 19 hours ago

I would not, a clearer diagnosis without a biopsy cannot exist IMO. She will probably do OK, but bc she is only 27, I think I would still treat ...

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RE: lupus podocytopathy 23 hours ago

Or unlikely --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: lupus podocytopathy 23 hours ago

47 pregnancy less likely --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: lupus podocytopathy 23 hours ago

Thanks dr zineb. This is systemic sle and lupus podcytopathy I would treat with mmf an steroids ( more for extra renal) I would not only focus o...

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Col4A5 mutation pt - Would you biopsy? 1 day ago

Hi, just wondering everyone's take on this - I have a 27 year old female patient with strong family history of presumed Alport's in her two brother...

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RE: Terlipressin Use and hepatorenal syndrome–AKI 1 day ago

I suppose you don't know if the patient responded to albumin as volume or a specific HRS treatment independent of volume (HRS by definition has to ...

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RE: Looking to decode this allograft biopsy 1 day ago

I do have Black and white but not colored pictures, same read on 2nd opinion. Crescents are likely pseudo as mentioned. Could be CNI but see a...

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RE: Looking to decode this allograft biopsy 1 day ago

See attached Allosure levels Never crossed 0.2 MFI was 1800 for Cw and just below 5000 for DR ------------------------------ Sandee...

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RE: Terlipressin Use and hepatorenal syndrome–AKI 1 day ago

.Appreciate your thoughtful comments. Appreciate your comments on usage of albumin I participated on the ATTIRE trial. the pendulum swing appropr...

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RE: Looking to decode this allograft biopsy 1 day ago

Dr. Magoon, I still have a couple of questions and comments you gave us the DSA with their MFI and said that these have been consistently decrea...

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RE: Looking to decode this allograft biopsy 1 day ago

The lack of the actual histological pictures makes a possible diagnosis very uncertain. Nonetheless, I will "dare" to suggest that he has a de-novo...

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RE: Terlipressin Use and hepatorenal syndrome–AKI 1 day ago

Interesting question about rebound. It has been observed in a substantial minority of patients, perhaps as much as 20%, depending on the initial re...

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RE: Looking to decode this allograft biopsy 1 day ago

Dr Glassock albumin3.8 how do you explain this degree of hematuria. That is the puzzling part. I will see if I can get the images --------...

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RE: Looking to decode this allograft biopsy 1 day ago

This looks like FSGS secondary to ischemia or CNI toxicity. (The Venkat hypothesis) .The lack of a diffuse Podocytopathy (by EM) makes an APOL1 (do...

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RE: lupus podocytopathy 1 day ago

If the patient relapses after a CR from steroids I would not re-biopsy, but I would prefer RTX or OBI for a second remission inducing therapy, and ...

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RE: Looking to decode this allograft biopsy 2 days ago

I do not have pictures. He is on Prograf/MMF and low dose steroids ------------------------------ Sandeep Magoon MD Nephrology Associates of Tide...

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RE: Terlipressin Use and hepatorenal syndrome–AKI 2 days ago

i read this -- very good table on HRS reversal with various agents including current ones Based on the data on the appropriate patient selection ...

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RE: Terlipressin Use and hepatorenal syndrome–AKI 2 days ago

Bp was 85 systolic close to his baseline Una was less than 5 before and after 25g albumin IV for 4 doses ------------------------------ Part...

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RE: Terlipressin Use and hepatorenal syndrome–AKI 2 days ago

Systemic blood pressure went up from an average of 90 systolic to 120s systolic and sustained after stopping Terlipressin Systemic blood pressure w...

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RE: Looking to decode this allograft biopsy 2 days ago

Would it be possible to post the actual LM, IF and EM pictures? What is the ongoing IS regimen? ------------------------------ Mario Rubin, M.D....

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RE: Looking to decode this allograft biopsy 2 days ago

Patient has 50-100 RBCs inevery single specimen. with 4 g of proteinuria, the origin is kidney. There is no urological cause, it has been rolled ou...

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RE: lupus podocytopathy 2 days ago

she went into remission with steroids, never argue with success. I would use an alternate medication going forward to GET HER OFF steroids I wo...

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RE: Terlipressin Use and hepatorenal syndrome–AKI 2 days ago

AS I understand it the patinet got better with Albumin and terlipressin Albumin may have a couple mechanisms, volume and binding some liver relat...

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RE: Looking to decode this allograft biopsy 2 days ago

Regarding microscopic hematuria: Approximately 50% of FSGS patients have microscopic hematuria. More common in primary than secondary/maladaptive F...

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RE: Looking to decode this allograft biopsy 2 days ago

Thanks, Dr. Rubin. ------------------------------ K.K. Venkat MD Troy MI (248) 420 7798 ------------------------------

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RE: Looking to decode this allograft biopsy 2 days ago

Very interesting case how is the patient's BP , how many antihypertensive medications needed to control BP . Did you do an allograft US with dopp...

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RE: Looking to decode this allograft biopsy 2 days ago

@K.K. Venkat A very thorough post which addresses every single point. KUDOS to you. ------------------------------ Mario Rubin, M.D. Houston T...

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RE: Looking to decode this allograft biopsy 2 days ago

At the bottom of the first page attachment Dr Lerman ------------------------------ Sandeep Magoon MD Nephrology Associates of Tidewater, LTD and...

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RE: Looking to decode this allograft biopsy 2 days ago

Albumin 3.8 No edema Donor kidney was great. No information on mate kidney and will not be able to get it. APOl1 is on the recipient DS st...

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RE: Looking to decode this allograft biopsy 2 days ago

SAlb level? Edema present or absent? Was donor African American? Donor weight vs recipient weight? How is the mate kidney from this donor doing? An...

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RE: Terlipressin Use and hepatorenal syndrome–AKI 2 days ago

See reference JASN 37: 370–381, 2026. doi: https://doi.org/10.1681/ASN.0000000920 ------------------------------ John Mellas MD Nephrology and ...

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RE: Looking to decode this allograft biopsy 2 days ago

Cw10 1741 DR 3554 unchanged for over a year allosure negative no evidence of rejection of any form on biopsy and it was a good sample ---...

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RE: Looking to decode this allograft biopsy 2 days ago

Sorry can’t find IF results ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KPCOP EC [Past Medical Director Kidney Pancr...

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RE: Looking to decode this allograft biopsy 2 days ago

Can you share the results of DSA including titers ? Would get dd-cfDNA ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KP...

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RE: Terlipressin Use and hepatorenal syndrome–AKI 2 days ago

Cannot be certain your patient did not have a reversible prerenal azotemia due to hypovolemia. If it was HRS recurrence risk is quite high. ---...

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RE: Looking to decode this allograft biopsy 2 days ago

Please find attached the biopsy reports. If you click on the arrow light microscope, IF and EM reports are there ------------------------------ S...

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RE: Looking to decode this allograft biopsy 2 days ago

------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KPCOP EC [Past Medical Director Kidney Pancreas Transplant Medical City Dall...

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RE: lupus podocytopathy 2 days ago

I am following one case of lupus podocytopathy. 14 year old female. Steroid responsive but frequent relapser despite MMF. Now relapse free with Rit...

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Looking to decode this allograft biopsy 2 days ago

57y/o AAM with transplant in 1/2024 has been having hematuria and proteinuria for a while and last UPCR was upto 4g. Has DSA but never had a reject...

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RE: Chronic TMA 2 days ago

No he is not involved in heavy weight lifting. Thank you for inputs Professor. ------------------------------ Payal Gaggar MD, DM Nephrology Asst...

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RE: Chronic TMA 2 days ago

I think you may be misinterpreting the Figures . The serum creatinine was 1.7mg/dL in April 2025 , before starting the Anti C5 therapy. The serum c...

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RE: Chronic TMA 2 days ago

I wish we have a test to confirm that TMA is caused by complement activation, but there is none. Serum C5B9 will likely be equivocal but worse gett...

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RE: lupus podocytopathy 2 days ago

In this case , I do not think that EM is required, especially if a complete remission develops with steroid monotherapy . Several cases of "lupus P...

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lupus podocytopathy 2 days ago

Dear colleagues, I would like to seek your opinion regarding a 47-year-old female patient with no significant past medical history, who was hospita...

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RE: Terlipressin Use and hepatorenal syndrome–AKI 3 days ago

How much did systemic BP increase during terlipressin treatment? Monitoring for recurrence of hypotension will obviously be important after stoppin...

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Terlipressin Use and hepatorenal syndrome–AKI 3 days ago

Wanted to get an opinion usage of terlipressin and hepatorenal syndrome. We have started using this in our institution after getting approval from ...

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