RE: Rituximab for "maintenance " of a CR in PLA2R related MN 3 hours ago

Selection bias aside! volume 5, pages469–479 (2009) ------------------------------ Tiago Cerqueira, MD, MSc, MBA, FASN Evangelical Hospital ...

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RE: Rituximab for "maintenance " of a CR in PLA2R related MN 3 hours ago

Well, I do agree it should be uncommon, but there are some data that draws attention to relapses after CR: Late relapses (in 10 years) occurs in ...

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RE: Rituximab for "maintenance " of a CR in PLA2R related MN 3 hours ago

The relapse rate of MN after a spontaneous complete remission is very low, probably around 10% or less. The relapse rate after a treatment induced ...

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RE: Rituximab for "maintenance " of a CR in PLA2R related MN 6 hours ago

Great discussion. In my practice, I've also had experience with "frequent relapsing MN", especially when MN at presentation was at very high risk...

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RE: difficult case ? should we treat as cx negative endocarditis Vs seronegative AAV 10 hours ago

Thank you Dr. Glassock and Dr. Safdar your inputs are greatly appreciated as it helps to formulate a plan based on evidence -----------------...

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RE: Retrieving a previously discussed topic in Open Forum 11 hours ago

Thank you Tahsin. PremChandran

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RE: AKI, urinary K Wasting and uncontrolled HTN 11 hours ago

I confirmed again with him today that he does not have anything or numbness anywhere at all. Home blood pressure 120/60s Home blood glucose one hun...

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RE: difficult case ? should we treat as cx negative endocarditis Vs seronegative AAV 12 hours ago

If you eliminate the antigen, an immune complex disease should get better. ------------------------------ Richard Glassock MD, FASN Laguna Woods ...

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RE: 24 hours Urine Collection better or Serum Cystatin C, in a patien with high BUN. 12 hours ago

An eGFR- creatinine by the 2021 CKD Consortium equation will consistently and substantially over-estimate true GFR in elderly, malnourished, sarcop...

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24 hours Urine Collection better or Serum Cystatin C, in a patien with high BUN. 13 hours ago

We are managing an elderly patient with low muscle mass whose mental status is waxing and waning. His BUN is persistently elevated above 110. He is...

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RE: Clinical Specialist in Hypertension Exam 13 hours ago

Thanks! ------------------------------ Brian Cronin MD, FASN Hypertension Nephrology Associates, P.C. Huntingdon Valley PA (215) 947-4533 -------...

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RE: difficult case ? should we treat as cx negative endocarditis Vs seronegative AAV 13 hours ago

thank you for all the input . I did convince ID to start him on antibiotics for endocarditis. He is on dialysis and I do worry about renal recov...

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RE: Clinical Specialist in Hypertension Exam 14 hours ago

Hi Brian Suggested resources: ESC/ESH Guidelines AHA/ACC Guidelines (Similar,but older) Also know about the important RCts in HTN ...

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RE: Retrieving a previously discussed topic in Open Forum 15 hours ago

On the top right side next to your prolife logo or pic in Search Box enter key word. It will show results by All Contents, Discussion threads. You ...

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RE: difficult case ? should we treat as cx negative endocarditis Vs seronegative AAV 16 hours ago

Bartonella Endocarditis CAN CAUSE IMMUNE COMPLEX ANCA POSITIVE GLOMERULONEPHRITIS also --------------------------------- Shahzad Safdar MD Mt. ...

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RE: difficult case ? should we treat as cx negative endocarditis Vs seronegative AAV 20 hours ago

Thanks for picking up the RF result. I do not know why I mussed it. I agree with your conclusion 100%. False negative TEE. Anti-micribisls only, no...

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RE: difficult case ? should we treat as cx negative endocarditis Vs seronegative AAV 23 hours ago

Serologic testing using either an indirect immunofluorescence assay (IFA) or an enzyme-linked immunosorbent assay (ELISA). A titer for IgG antibodi...

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RE: difficult case ? should we treat as cx negative endocarditis Vs seronegative AAV 23 hours 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 23 hours 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 1 day 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 2 days ago

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

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RE: Case of FSGS 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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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