AngelaVallejos

M.D

[Mayo Clinic Nephrology @MayoClinicNeph]

Protocol kidney biopsy in the management of proliferative (class III/IV) lupus nephritis: barking up the wrong tree!

@LadanZand @GianMarcoB65728 @AnilaCara @SethiRenalPath @fervenzaf

https://t.co/lyzrTinS8j

[Ladan Zand @LadanZand]

In this article we critically appraise the data regarding the role of repeat kidney biopsy in management of lupus nephritis. @fervenzaf you are always ahead of the curve! Challenging convention and moving the field forward. Forever grateful 🙏🏼

https://t.co/NoySHDg8j9

[Anila Cara @AnilaCara]

Sometimes progress is not about finding a new biomarker, but learning how to read an old one. As hematuria resurfaces in IgAN trials, it is time to reconsider it as a dynamic marker of glomerular inflammation and disease activity. https://t.co/OVrjHDv0fb

[Ladan Zand @LadanZand]

In this article we review predictors of response to sparsentan in patients with IgA nephropathy. Higher systolic BP and hematuria at baseline increased likelihood of response to therapy at 9months! @AnilaCara @mvargas07 @fervenzaf @CristianJuanet

https://t.co/Z5WNWbN4Ld

[Fernando Fervenza @fervenzaf]

A benchmark study on dipstick hemoglobinuria as a better marker for inflammation in IgAN. Validating it’s use in clinical trials.

A multi-center cohort study evaluated hemoglobinuria as a marker of inflammation in IgA nephropathy - Kidney International https://t.co/TubWOHCnw5

[Ladan Zand @LadanZand]

Excellent detailed review by @CristianJuanet on data regarding sparsentan in FSGS @PepaSolerR @fervenzaf

https://t.co/53oufjZZuV

[Sanjeev Sethi @SethiRenalPath]

Explosion💥- A glomerulus on fire 🔥.

Light microscopy- Fibrinoid necrosis in the middle of capillary tufts rupturing the glomerular capillary walls (blowing up the tufts), with massive efflux of RBCs into Bowman’s space.

Dx: Necrotizing glomerulonephritis, associated with MPO/pANCA vasculitis (hydralazine/clinical)

Note many uninvolved glomeruli. Only severe systemic disease with focal involvement on LM. 🤔

50 yr old with AKI, ➕pANCA/MPO. History of hydralazine use.

[Mayo Clinic Nephrology @MayoClinicNeph]

Advances in Immune-Mediated Podocytopathies: New Insights and Clinical Implications

@LadanZand @fervenzaf @MayoProceedings

https://t.co/sBQ9I4xe4f

[Ladan Zand @LadanZand]

In this perspective we review the new advances in immune-mediated podocytopathies. Hope you enjoy it! @fervenzaf @MayoProceedings

https://t.co/nLKsMZlcBx

[Sanjeev Sethi @SethiRenalPath]

Long day of weekend cases today:

1. Necrotizing and crescentic glomerulonephritis, Hydralazine-associated MPO/pANCA
2. Acute interstitial nephritis
3. IgA nephropathy, Crohns disease associated
4. ATN/diabetes
5. Transplant with perivenular inflammation
6. Myeloma kidney
7. Necrotizing arteritis, MPO-associated
8. FSGS (obesity), transplant glomerulopathy
9. Protocol bx: normal
10. IgA nephropathy, very active, M1E1S0TOC1
11. IgA, with chronic changes M1E0S0T1C0
12. GBM abnormalities? in patient with hematuria.

And nephrectomy from life source for transplant.

Thank you @AnilaCara for sitting with me and going through the cases.

[Dr. FEVI🫀🩺 @javier20ch]

Tratamiento Farmacológico de la Insuficiencia Cardíaca de FEVI Preservada. 💊💉🫀
🟦Los 2 pilares:
1️⃣iSGLT2 (Dapagliflozina [DELIVER trial], Empagliflozina [EMPEROR-PRESERVED trial] 💊): los que cuentan con mayor evidencia de beneficio CV (⤵️🫀☠️🏥).
2️⃣ARM no esteroideo (finerenona [FIENARTS-HF trial] 💊), el que mayor evidencia sólida tiene; si el costo o la tolerancia son prohibitivos, un ARM esteroideo (espironolactona [TOPCAT trial]) pueden ser alternativa razonable.
🟦Otros/comorbilidades:
🔷️Obesidad (IMC ≥30 kg/m²): incretinas (semaglutida [STEP-HFpEF trial], tiezepatida [SUMMIT trial] 💉), beneficio en sintomas, calidad de vida, capacidad funcional y reducir 🏥.
🔷️ARNi (sacubitril-valsartán [PARAGON-HF trial] 💊): los beneficios son más claramente evidentes en personas con FEVI en el límite inferior bajo (<55-57%) y en mujeres.
🔷️ARA-2 (candesartán [CHARM trial], ibersartán [I-PRESERVE] 💊): en pacientes con HTA se pueden considerar como alternativa al ARNi. El de mejor evidencia es Candesartan (demostró reducción en la 🏥).
🔷️Diureticos (ASA, tiazidicos, acetazolamida 💉💊): solo para aliviar congestión y síntomas asociados según sea necesario.
🚫B-bloqeadores: no hay ningún beneficio en dar BB en este grupo de pacientes, a menos que exista indicación precisa (cardiopatía isquémica, arritmia), de hecho, pueden aumentar morbi-mortalidad. ⚠️🙅🏻‍♂️

🧾🆓️⤵️ 2026 ACC Expert Consensus @JACCJournals 💯👌🏻
https://t.co/yUmp5Od1CF
https://t.co/WKZ7cfWFOT

[Ladan Zand @LadanZand]

Don’t forget to register for our very first Mayo Clinic GN course happening Oct 2nd and 3rd! We have an amazing lineup of expert with many case-based sessions. @fervenzaf @LeticiaRolonMD @SethiRenalPath
Link below:

https://t.co/Sa07n8rhS0

[Jose Arriola-Montenegro @josearriolam]

Excited to share our new publication in Kidney International Reports! 👏🏽🙌🏼🔥🎉@KIReports

Congratulations to my friend and colleague Dr. Cristián Juanet, who led this important study evaluating rituximab with or without avacopan in ANCA-associated vasculitis with severe renal involvement, under the mentorship of Dr. Ladan Zand @LadanZand and Dr. Fernando Fervenza @fervenzaf

Grateful to have contributed to this work and especially thankful to the Mayo Clinic Nephrology Fellowship @MayoClinicNeph for the mentorship, collaboration, and opportunities to grow as a clinician and researcher. @MayoClinic

https://t.co/KWzP14990R

[Edgar V. Lerma 🇵🇭 @edgarvlermamd]

Lupus Nephritis Treatment from @fervenzaf
☑️ Target Goals
☑️ Approach to discontinuation of immunosuppression
#Nephpearls #GlomConHawaii 🌊

[alaN Vargas @alaNBrait]

🧵 HILO | Mi regular experiencia con @VW_es
Compré un Volkswagen confiando en la marca y, precisamente por esa confianza, he realizado todas las revisiones en servicio oficial y he mantenido activa la suscripción Long Drive.
Abro este hilo porque creo que merece ser conocido.

[NefroGetafe @NefroGetafe]

💧❤️ IC + fallo renal = ¿Diurético no funciona?
👉 Inicia: furo 40-80 mg IV (o x2 la habitual).
✅ A 2 h: Na o &gt;50-70 o diuresis &gt;100 ml/h = sigue igual
❌ ¿No responde? ↑ o combina (acetazolamida/tiazida/MRA) o… ¡ultrafiltra! @SENefrologia @SOMANEorg https://t.co/EmnWQ1Z1Qr

[AngelaVallejos @angva26]

@numaturcatti @FilmBayona Ojalá #LaSociedadDeLaNieve 🙌

[Jonathan Chávez @JonathanNefro]

¿Alteraciones en los electrolitos?

Antes de tomar una decisión, descarta las causas de anormalidades falsas. Aquí las más frecuentes👇🏼

#ISNyoung

AJKD 2023
doi: 10.1053/ j.ajkd.2023.01.441

[Sociedad Valenciana de Nefrología @SVNefro]

Os invitamos a participar a una jornada sobre neoplasia en trasplante.

📅 8/06/2023 a las 16:30

Formato hibrido: @IICOMV y 📺

Inscripción gratuita:
https://t.co/bsIy6dyqU1

@SENefrologia @SOMANEorg @nefrocat @senjoven @nefrologicos @SETrasplante @ONT_esp

[Jonathan Chávez @JonathanNefro]

Infección de catéter de diálisis peritoneal, Guía 2023:

•Relacionada a colocación (&lt;30 días de inserción)
•Refractaria (no responde a 2 sem)
•mupirocina/gentamicina diario
•en peritonitis, no retiró y colocación inmediata, hacerlo en 2 sem

PDI 2023
10.1177/08968608231172740