RE: Case of FSGS 2 hours ago

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

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RE: Case of FSGS 5 hours 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 6 hours 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 7 hours 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 7 hours 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 8 hours 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 8 hours 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 8 hours 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 9 hours 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 10 hours 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 10 hours 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 11 hours 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 11 hours 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 11 hours 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 11 hours 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 12 hours 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 12 hours 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 13 hours 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 14 hours 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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RE: IgAN therapy in patient desiring future pregnancy and intolerant of steroids 15 hours ago

This case represents a difficult dilemma. With a course of at least 17 years the major question will be how much of the proteinuria can be attribut...

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RE: IgAN therapy in patient desiring future pregnancy and intolerant of steroids 15 hours ago

Dr Liang: How much microscopic hematuria/hemoglobinuria does your patient have in a clean uninfected urine. Proteinuria alone may not need immunosu...

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RE: Hypercalcemia management in a patient with Sarcoidosis 15 hours ago

The answer is yes. so does lymphopenia. Morell, F et al. Chest 2002 Apr, 121 (4) 1239-44 Rohmer, J et al. Br J Ophthalmol 2020 Apr 2; 28(3) ...

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RE: AKI, urinary K Wasting and uncontrolled HTN 17 hours ago

No diabetic retinopathy OU according to March, 2024 last eye examination. He denied any tingling or numbness, last time I specifically asked h...

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RE: Hypercalcemia management in a patient with Sarcoidosis 17 hours ago

Does 1.25 vit D level in sarcoid correlate whether disease is active or inactive, I know ACE negative in 30% of the patient and not specific can b...

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RE: IgAN therapy in patient desiring future pregnancy and intolerant of steroids 18 hours ago

Reminds me of an IgA case, who had pre-conception proteinuria ranging 0.5- 1 gram per day, eGFR of 90, over next 6 years she had three pregnancies,...

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IgAN therapy in patient desiring future pregnancy and intolerant of steroids 22 hours ago

Hi! Would appreciate your expert opinions and advice on this IgAN case: 34 y.o. female with history of IgAN (biopsy-proven in 2007 at age 17 and...

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RE: AKI, urinary K Wasting and uncontrolled HTN 23 hours ago

I think I can say with some degree of confidence that this is NOT MCD and that steroids are NOT indicated, at least until we learn more about the k...

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RE: AKI, urinary K Wasting and uncontrolled HTN 1 day ago

We really need to see this patients (deidentified) kidney biopsy before making any opinions about therapy. Does he have any proliferative diabetic ...

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RE: AKI, urinary K Wasting and uncontrolled HTN 1 day ago

so in summary, based on the result of the renal biopsy, need suggestion for treatment of his probable minimal change disease with uncontrolled diab...

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RE: AKI, urinary K Wasting and uncontrolled HTN 1 day ago

In March, 2025, 24-hour urine appropriately collected found protein of 13662 mg, normal results of IgG4, HIV, hepatitis B surface antigen, hepatit...

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RE: Volunteer by May 7 to serve as a case report reviewer for Kidney Week 2025! 1 day ago

Hello! Please complete this form by May 7 to serve as a fellow case report reviewer: https://www.asn-online.org/apply/?ID=21 -------------------...

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RE: membranous nephropathy 1 day ago

I second Drs Hirsch and Glassock. Rituxan only and monitor. Serologic response can be checked if PLA2R-ab positive. ----------------------------...

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RE: Hypercalcemia management in a patient with Sarcoidosis 2 days ago

I would agree with Prof Glassock and suggest ketoconazole ------------------------------ Stuart Sprague DO, FASN Director of Research, Division o...

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RE: membranous nephropathy 2 days ago

I have never been very enthusiastic about use of CNI in MN. It is a second or third class drug for producing CR - it is much weaker than RTX or CYC...

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RE: membranous nephropathy 2 days ago

Doubt there is a "right" answer but, seems to me... --the Niles protocol as described above is HUGELY more immunosuppression than the standard Ri...

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RE: membranous nephropathy 2 days ago

79 year old: I like the Niles protocol in general "Combination of Rituximab, Low-Dose Cyclophosphamide, and Prednisone" https://pubmed.ncbi.nlm....

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RE: membranous nephropathy 2 days ago

Albumin 1.5. I need to check with the treating doctor about the UPCR. ------------------------------ Steven Rosenblatt MD, FASN South Texas Re...

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RE: Rhabdomyolysis-Associated AKI with NSAID Exposure: Is Biopsy Warranted? 2 days ago

"Presented with creatinine 1495 µmol/L, ur 31 oliguric AKI" "Creatinine plateaued at ~600 µmol/L" none of this really matters but there is som...

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RE: membranous nephropathy 2 days ago

You must mean serum albumin of 1.5gms/dL. What is the UPCR? ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-88...

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RE: membranous nephropathy 2 days ago

Need levels of anti-PLA2R (by ELISA ) . If > 150 RU/ml I would go with RTX plus low dose CYC and very moderate dose of oral steroids (Niles Protoco...

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membranous nephropathy 2 days ago

We have a 79 yo Korean woman with severe NS, protein 1.5, creatinine 2 with eGFR 25. wt 119 with anasarca. Biopsy MGN and positive PLA2R (titer pen...

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RE: Rhabdomyolysis-Associated AKI with NSAID Exposure: Is Biopsy Warranted? 2 days ago

If anuric the GFR was zero on presentation. Assuming the creatinine can rise as much as 3 mg/dl/day in a muscular person with muscle injury, the ev...

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RE: Rhabdomyolysis-Associated AKI with NSAID Exposure: Is Biopsy Warranted? 2 days ago

"Creatinine plateaued at ~600 µmol". In recovering AKI, SCr plateaus first before it starts improving . What is the trend in urine output? Is it in...

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RE: Rhabdomyolysis-Associated AKI with NSAID Exposure: Is Biopsy Warranted? 2 days ago

This patient presented with a creatinine of 17 mg/dl so whatever happened did so a while back, even if still taking into account that Cr may rise m...

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RE: Hypercalcemia management in a patient with Sarcoidosis 2 days ago

Infliximab is a great idea for refractory Sarcoidosis. I'm nnot sure if isolated hypercalcemia qualifies, I could easily argue that it does and tha...

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RE: Hypercalcemia management in a patient with Sarcoidosis 2 days ago

Prathap: Infliximab is another option in recalcitrant sarcoidosis. How leukopenic is your patient? There's is significant correlation between disea...

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RE: Rhabdomyolysis-Associated AKI with NSAID Exposure: Is Biopsy Warranted? 2 days ago

A bit unusual with this level of CK what is the patient background , what was his uric acid level ? : renal hypo uricemia with excercise induced AK...

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Reminder: Volunteer by May 7 to serve as a case report reviewer for Kidney Week 2025! 2 days ago

If you are interested serving as a reviewer, please complete this form by May 7: https://www.asn-online.org/apply/?ID=21 ASN invites ASN Fellow...

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Reminder: Encourage fellows to apply to be case report reviewers by May 7! 2 days ago

ASN invites ASN Fellows-in-Training members to serve as reviewers for case reports submitted by trainees for Kidney Week 2025. The reviewing/gradin...

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RE: Rhabdomyolysis-Associated AKI with NSAID Exposure: Is Biopsy Warranted? 2 days ago

Give it a little more time. Should see gradual onset of increasing urine output with eventual recovery. ------------------------------ John Mella...

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