Nishanth Girija Kumar MD

This was a difficult but good teaching case. Easy to call idiopathic MPGN but… LM: Membranoproliferative Glomerulonephritis (MPGN) pattern IF- dull minimal IgG IgM C3 kappa lambda EM- massive deposits. Pronase IF/IgG subclass all negative. At this point I had an idea- FIBRONECTIN GLOMERULOPATHY Did mass spectrometry. Confirmed the diagnosis=Large amounts of fibronectin. 55 yr old with proteinuria and declining renal function.

Is the use of nondialyzable vs dialyzable beta-blockers associated with different cardiovascular outcomes among patients initiating hemodialysis? Find out in #ASNJASN twp.ai/4hqlUo

Membranous nephropathy is no longer just “primary vs secondary” disease — it is now an ANTIGEN-SPECIFIC podocytopathy. 🔬 Newer antigens are redefining diagnosis & prognosis: ▪️ NELL1 → malignancy/drug-associated MN ▪️ EXT1/EXT2 & NCAM1 → lupus/autoimmune MN ▪️ SEMA3B → pediatric MN ▪️ FAT1 → post-HSCT MN ▪️ CNTN1 → neuropathy-associated MN ▪️ PCDH7 → indolent MN phenotype ⚡ Emerging concept: Dual-antigen MN (NELL1+PLA2R, NCAM1+EXT1/2 etc.) suggesting complex autoimmune evolution. 🧪 Mass spectrometry-based antigen mapping is becoming the future gold standard for PLA2R-negative MN. #GSR #BuddingNephros #MembranousNephropathy #RenalPathology #NephTwitter #MedTwitter

🚨 BREAKING: German researchers treated 15 severe lupus patients with CAR-T therapy. All 15 went into complete remission. Many stopped ALL medication. Now a larger trial just confirmed it — across 3 autoimmune diseases. This might be the biggest shift in autoimmune medicine in decades. 🧵

#Quiz: A 16-year-old patient presented to an emergency department with a 3-week history of progressive headaches, nausea, vomiting, and bilateral blurry vision. Over the past 3 days, he developed chest pain and shortness of breath. bit.ly/3WsjM9T

Novel Treatment Paradigms: #Complement #Inhibition in Antineutrophil Cytoplasmic Autoantibody Vasculitis doi.org/10.1016/j.ekir… #KIRReview #ANCA

Review by Anthony Bleyer et al: Autosomal Dominant Tubulointerstitial Kidney Disease: A Review bit.ly/3VgPMNS (FREE)

🆕📜🚨 Mechanisms of diabetic kidney disease and established and emerging treatments rdcu.be/eGxZ6 Very proud of my @PennKidney fellow Victor Martinez — he poured endless energy into writing this review. Long nights, hard work, and persistence turned into a fantastic piece for the field. @NatureRevEndo Check it out 👇

Patients with CKD G3b-G5 have a higher risk of kidney disease progression due to higher blood pressure, emphasizing the importance of maintaining optimal blood pressure over time. kidney.pub/CJASN0760 #ASNCJASN

When a low-income patient receiving home dialysis misses the bus to the clinic, his nephrologist makes a decision that launches a long-term relationship and brings unexpected meaning into his own life. Read the Perspective by Rajeev Raghavan, MD (@jeevsmd): nej.md/3YN2ru1

...🧵This is a thread about 8.4% sodium bicarbonate (aka bicarb amp) in critical care. This the first part in a series of three about sodium bicarbonate 🧂in critical care: 🧐I will get in deep to complexities, benefits, risks and clinical implications of this (overused) drug.

1/12 - Mystery #1 You are seeing a patient recently diagnosed with heart failure and started on GDMT. You notice that their hemoglobin (HGB) has increased (12 → 13 g/dL) in the intervening weeks. 🤔Which medication is the likely cause of this increase in HGB?

In recognition of #WorldKidneyDay on March 14, the editors present a collection of AJKD articles that highlight kidney disease research across the world: buff.ly/3uDNTyG (FREE)

Anti–Phospholipase A2 Receptor 1 and Anti–Cysteine Rich Antibodies, Domain Recognition and Rituximab Efficacy in Membranous Nephropathy: A Prospective Cohort Study buff.ly/3RAXmk6 @ariela_benigni #VisualAbstract

Take a look at the amazing #visualabstract made by @divyaa24 🎨 @goKDIGO LN guideline has already started some controversies. ⚔️ If curious or if you'd add some perspective, come to #NephJC chats 💬Chat 1: 9 pm EDT, Feb 6 💬Chat 2: 9 pm IST, Feb 7

Lupus nephritis treatment

Oct-Nov 2023 @KidneyNews --@NephRodby brings @ASNKidney communities special case kidneynews.org/view/journals/… Unexplained, Recurrent AKI in a Young Man—It Takes a Community