Nephrology School UNIMI

Official account of the UNIMI Nephrology School, University of Milan, Italy.

[Sanjeev Sethi @SethiRenalPath]

Don’t forget Syphilis as a cause of Membranous Nephropathy (MN).

Kidney biopsy showed a MN, with full house Ig, suggesting lupus MN.

Later, revealed that patient had history of syphilis.

Mass spectrometry showed NDNF, confirming MN associated with syphilis.

https://t.co/EiiuPJmgSo

[Sanjeev Sethi @SethiRenalPath]

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.

[Sanjeev Sethi @SethiRenalPath]

Kidney biopsy: Great teaching case

Severe inflammation and necrosis with abscess formation.

Look carefully=you see cells with large nuclei in the mix of inflammatory cells.

IHC= Positive staining for ADENOVIRUS.

DX: Adenovirus-associated interstitial nephritis.

55-yr old with kidney &
heart transplant, fevers, rise in serum creatinine.

[Nephrology School UNIMI @NephroUnimi]

@SethiRenalPath Thanks for sharing highly interesting cases.

[Sanjeev Sethi @SethiRenalPath]

Finding the etiology of membranoproliferative glomerulonephritis https://t.co/OHHlnZPmGT

My review of evaluation of MPGN on kidney biopsy is out.

Take home messages:
1. Idiopathic/primary immune complex (IC)-MPGN is very rare.
2. Careful evaluation of IC-MPGN will invariably reveal the etiology. Always rule out monoclonal Ig.
3. Beware of entrapment of Ig in cases of C3GN, as you might label these as IC-MPGN.
4. Consider infection related GN in cases of C3GN, even if IC is sparse/absent, in the right clinical scenario.

[Nephrology School UNIMI @NephroUnimi]

@SethiRenalPath Very interesting case, thank you for sharing.
Any tubular proteinuria?

[Edgar V. Lerma 🇵🇭 @edgarvlermamd]

Acute eGFR Changes and Their Mediation of Albuminuria Reduction with Empagliflozin and Finerenone ca. 2026 from @asnpublications @AgarwalRajivMD @HeerspinkHiddo @mvaduganathan @P_Rossing @sankarnava
#ISNWCN 🇯🇵 #WCN26 🇯🇵 #WCN2026 🇯🇵
#Nephpearls

👉 https://t.co/kwpCV6e1N7

[Kelly Haughton, MD @kidneydoctorpa]

IgA nephropathy progresses to kidney failure in up to 50% of patients within 10–20 years.

On March 29th, the NEJM published the final 24-month data from APPLAUSE-IgAN and the results change the treatment landscape.

Here’s what every nephrologist needs to know 🧵

Barratt J et al. NEJM 2026. DOI: 10.1056/NEJMoa2600743

[Nephrology School UNIMI @NephroUnimi]

In occasione della Giornata Mondiale del Rene, oggi a Roma si è svolta la conferenza stampa degli "Stati Generali della Dialisi Peritoneale ", con presentazione dell'analisi HTA che ha dimostrato i vantaggi clinici ed economici di questa modalità di trattamento domiciliare

[Carlo Alfieri @carlo_alfieri]

🗓 Jan 29 🕟 4:30 PM CET
🎓 @LaStatale Nephrology Journal Club
We’ll critically dissect the study:strengths, pitfalls, and future impact.
🎙️ Moderated by Prof. Carlo Alfieri
🔗 https://t.co/oONiRGu7vO @NephroUnimi

#KidneyTransplant #Nephrology #TransplantResearch #JournalClub

[Nephrology School UNIMI @NephroUnimi]

This NEJM Stats, STAT! animated video explores the minimal clinically important difference — the smallest change in a score, scale, or outcome that has been established as clinically meaningful.

https://t.co/s0RkouiUFA

[Maurizio Gallieni @MGallieni]

NEJM: Qual è il migliore schema di dialisi nei pazienti con insufficienza renale acuta? https://t.co/Igo4LgBPFx via @YouTube

[Arkana Laboratories @arkanalabs]

Beautiful hyaline thrombi in a case of cryoglobulinemic glomerulonephritis. This patient has active hepatitis C. #renal #pathology #renalpath #pathx #pathtwitter #kidneypath

[PKD Foundation @PKDFoundation]

In March, Regulus shared early results from its Phase 1b clinical trial of their lead compound, farabursen. This drug works by targeting the microRNA miR-17, increasing the amount of a protein called polycystin, which is important for healthy kidneys.

[Nephrology School UNIMI @NephroUnimi]

Farabursen, a novel oligonucleotide targeting miR-17 therapy is very promising for people affected by adult dominant polycystic disease. We look forward to the results of pivotal clinical studies and to its future availability in clinical practice.

[PKD Foundation @PKDFoundation]

In people who received the highest dose of farabusen in the Phase 1b trial, it stopped their kidneys from getting larger. Phase 3 clinical trials are expected to start later this year.

[PKD Foundation @PKDFoundation]

In people who received the highest dose of farabusen in the Phase 1b trial, it stopped their kidneys from getting larger. Phase 3 clinical trials are expected to start later this year.

[Nephrology School UNIMI @NephroUnimi]

@PKDFoundation Farabursen, a novel oligonucleotide targeting miR-17 therapy is very promising for people affected by adult dominant polycystic disease. We look forward to the results of pivotal clinical studies and to its future availability in clinical practice.

[Arkana Laboratories @arkanalabs]

The image shows a glomerulus on PAS stain with global endocapillary hypercellularity and numerous intracapillary hyaline pseudothrombi. This pattern of injury is most commonly seen in the setting of cryoglobulinemic glomerulonephritis or in lupus nephritis when subendothelial deposits become large enough to protrude into the intracapillary space. In this case the patient had underlying cryoglobulinemia and the immunofluorescence panel showed IgG, IgM, C3, kappa and lambda which are compatible with a mixed (type II) cryoglobulinemia. While the patient did not have lupus or hepatitis C (a common etiology of mixed cryoglobulinemia), they are being worked up for Sjögren syndrome, which is also known to be an etiology of cryoglobulinemia.

[Piero Carninci @carninci]

Pubmed is down. NCBI is down. I do not know what this is but is horrible, what happens is unforgivable. Europe and Asia have to do more to be independent.

[Sanjeev Sethi @SethiRenalPath]

This is difficult & rare.
Suspicion is key.

LM-large glomeruli, appear hypercellular, but a closer look & you see foam cells.

Stain for CD68 & glomerular capillaries light up & are filled with CD68+ macrophages.

IF/EM essentially negative.

Dx: Histiocytic glomerulopathy
1/3