RE: PGNMID vs Primary IC- MPGN 11 hours ago

@Richard Glassock I had a discussion with some European colleagues on this case . There seems to be a shift with PGNMID , thinking of it not as a c...

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RE: Biopsy - help needed with interpretation 12 hours ago

From a frequentist standpoint this is most likely IgAN superimposed on background of DN, but your concerns about PGNMID are justified because of La...

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RE: Ciclosporin dependent FSGS 15 hours ago

Dr Soobadar-This is a new case post. Please present the detailed clinical findings as a specific new post so we do not get confused with the curren...

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RE: Plar2 +ve With Stroke 15 hours ago

In light of the new anti-PLA2R antibody serological information, MN is very likely, but kidney biopsy relatively contraindicated. We need to urgent...

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RE: Plar2 +ve With Stroke 16 hours ago

Hi prof glassock Ifa is positive 10000 Liver team there is low risk of hcc Bw --------------------------------- Muhammad Soobadar MBChB UK -...

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RE: Ciclosporin dependent FSGS 18 hours ago

Sorry similar theme question - in minimal change disease/fsgs - multiple relapse and now established on cyclosporin/steroid since June 23 and no re...

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RE: Onconeph case 1 day ago

Thanks --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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Biopsy - help needed with interpretation 1 day ago

Dear Colleagues .. I apologise for the poor quality of the attachment and the frequent requests for feedbacks and opinions . As we live in a smal...

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RE: Iptacopan Dosing issues 1 day ago

You are correct. It is actually the Complement AP functional (AH50) activity that is low should be less than 10% with proper iptacopan exposure. ...

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RE: Iptacopan Dosing issues 1 day ago

I have ordered C5b-9 and Factor Bb , as both Factor Bb and sC5b-9 would be expected to decrease from baseline due to inhibition of the alternate pa...

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RE: IgA Nephropathy with ?RPGN 1 day ago

It is such a desperate situation for sure! May take advantage of dialysis access and try few sessions of plasma exchange in between. Followed by go...

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RE: Iptacopan Dosing issues 1 day ago

I will follow it with CH50 --------------------------------- Bajinder Reen MD Etobicoke ON (905) 453-0821 ---------------------------------

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RE: Ciclosporin dependent FSGS 1 day ago

@Roger Rodby Parachute use while jumping from a plane has been studied in a randomized control trial and the study showed, as expected, that para...

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RE: Ciclosporin dependent FSGS 2 days ago

Almost everything has interobserver variability. Even something as simple as counting the number of glomeruli. Sent from my iPhone

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RE: Ciclosporin dependent FSGS 2 days ago

@Roger Rodby Contrary to what some individuals may think, we are all entitled to free speech (the first amendment of the American Constitution). ...

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RE: Ciclosporin dependent FSGS 2 days ago

@Mario Rubin Plex for FSGS: I do not mean to offend you, what i say is not directed at you. For your "Inquiry: How many RCTs have been pub...

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RE: Ciclosporin dependent FSGS 2 days ago

Thank you, Dr. Fogo, for your personal comments, which I always find highly valuable. However, in this specific topic and based on my discussions w...

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RE: Ciclosporin dependent FSGS 2 days ago

Sparsentan is not approved by FDA for Primary ( or other forms of FSGS ) yet but an application is pending (action expected in January., 2026) It c...

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RE: Ciclosporin dependent FSGS 2 days ago

Regarding Dr. Rubio's comment about cringing whenever he sees in a kidney biopsy report estimated % IFTA stated-- renal pathologist eyeball assessm...

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RE: Ciclosporin dependent FSGS 2 days ago

Agree genetic testing not very likely to be positive as this seems truly a primary form of FSGS. Collapsing features also not commonly seen in Mend...

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RE: Steroid Resistant FSGS treatment with Obi ? 2 days ago

Thanks for calling me on the topic :) I agree with the overall take of the discussion toward DN being likely the main driver. The COL4A variant I...

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RE: Iptacopan Dosing issues 2 days ago

If you can show evidence of low CH50 with once daily therapy this would mean that complement is reasonably suppressed. Omar Almasri Pediatric Neph...

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RE: Ciclosporin dependent FSGS 2 days ago

Peds nephrogist here. Agree with suggestions to use Obi( I had impressive results using it with multiple patients who failedRituximab) it does th...

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RE: Onconeph case 3 days ago

Not unreasonable if you think this is interstitial nephritis due to ICI rather than Direct toxic injury to nephrons. If the patient is in reasonabl...

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RE: Hyponatremia Dilemma 3 days ago

sorry this is the right attachment ------------------------------ Dr. Hormaz Dastoor. MD, FASN Nephrology Consultant - Seha Kidney Care. Nephrol...

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RE: Hyponatremia Dilemma 3 days ago

I use Minocycline as an alternative to Demeclocycline ,to decrease responsiveness to ADH ( in vitro models have confirmed this) The cyclines do t...

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RE: Onconeph case 3 days ago

What about treating uti then empirical steroids ? Thanks --------------------------------- Muhammad Soobadar MBChB UK --------------------------...

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RE: Ciclosporin dependent FSGS 3 days ago

Another point worth considering is that this patient is a poor candidate for kidney transplantation , due to a 50-70% risk of recurrent FSGS in an ...

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RE: Steroid Resistant FSGS treatment with Obi ? 3 days ago

thanks dr Glassock maybe @Simone Sanna-Cherchi, which I have seen replying on the forum, could help sort this out! ----------------------------...

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RE: Steroid Resistant FSGS treatment with Obi ? 3 days ago

But the morphology does not make it easy to identify Primary FSGS and a reduction in the level of proteinuria of the magnitude seen in this case wi...

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RE: Ciclosporin dependent FSGS 3 days ago

I fully agree with Dr. Rubin that the suggestions for use of PLEX (or OBI) for multi-drug resistant Primary FSGS is not evidence (RCT ) based-but o...

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RE: Steroid Resistant FSGS treatment with Obi ? 3 days ago

Dr Slater, reduction in Proteinuria from 10 to 3 grams on steroids suggests partial response. While it's not possible to tease out primary FSGS fro...

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RE: Hyponatremia Dilemma 3 days ago

Dr Dastoor Gat is role of minocycline. I am only aware of some data in rodents in terms of prevention of Osmotic Demyelination but not in SIADH....

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RE: Ciclosporin dependent FSGS 3 days ago

@Jonathan Zuckerman @Agnes Fogo Good questions but, at the end of the day, I keep wondering how valuable are these findings in a small sampl...

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RE: Ciclosporin dependent FSGS 3 days ago

How extensive were the collapsing glomerulopathy features in affected glomeruli and what percentage of glomeruli showed collapsing changes? Extent ...

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RE: Ciclosporin dependent FSGS 3 days ago

With the help of AI, I wanted to know if we are still (after so many years) travelling in the dark without solid guidance whatsoever regarding the ...

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RE: Ciclosporin dependent FSGS 3 days ago

I agree that these findings indicate a Primary firm of FSGS, and genetic testing not likely to be informative. Obinutuzumab dosing is sane as for R...

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RE: risk of 3.5 parathyroidectomy in ESRD patient with PTH of 8000 3 days ago

Adding some photos of one of my pts ------------------------------ Stuart Sprague DO, FASN Director of Research, Division of Nephrology and...

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RE: Ciclosporin dependent FSGS 3 days ago

Obi is typically prescribed like rituximab, 1 gram followed by one gram in 2 weeks. PLEX for primary FSGS is not standardized , but if you did op...

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RE: Ciclosporin dependent FSGS 3 days ago

His serum albumin at initial presentation was 23 g/L. Yes there was extensive podocyte effacement affecting more than 90 percent of peripheral c...

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RE: PGNMID vs Primary IC- MPGN 3 days ago

In my opinion , this very, very likely a case of PGNMID and not Primary IC-MPGN. Further confirmation with paraffin IF and Pronase digestion or LD/...

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RE: Ciclosporin dependent FSGS 3 days ago

What was his serum albumin at initial presentation.? Did the initial kidney biopsy show diffuse FP effacement? Has genetic testing ever been perfor...

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RE: Hepatitis D in dialysis 3 days ago

Addendum- a preventative effect of antiHBV on HDV superinfection would only occur if HBs antigen production was eliminated, since HDV intention has...

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Ciclosporin dependent FSGS 3 days ago

27 year old man presented with nephrotic syndrome and biopsy found primary FSGS with collapsing features. There is no family history of kidney di...

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PGNMID vs Primary IC- MPGN 3 days ago

Dear Colleagues, Would appreciate input on this case of a 50 year old male ,who presented with Renal failure ( Creatinine 300 umol/l or 3.4 mg/dl...

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SEMA3B-associated MN 3 days ago

Would like to ask some help with the following case 27 year old healthy Hispanic patient seen for the first time in November 2024 for nephrotic sy...

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RE: Hepatitis D in dialysis 3 days ago

what is the HBV DNA viral load in your HVV infected cohort? Are they receiving antiviral therapy? If so, I doubt that HDV nosocomial transmission o...

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RE: SEMA3B- associated MN 3 days ago

I would probably treat with OBI but close observation and a wait and see approach would be OK as well. Opinion only. No evidence. --------------...

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RE: SEMA3B- associated MN 3 days ago

ELECTRON MICROSCOPY: Survey sections from the two blocks of tissue submitted for electron microscopic examination contain a total of three glomerul...

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RE: SEMA3B- associated MN 3 days ago

ELECTRON MICROSCOPY: Survey sections from the two blocks of tissue submitted for electron microscopic examination contain a total of three glomerul...

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