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Taiseer Renal Medicine " From A to Zee Nephrology is easy"

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Taiseer Renal Medicine " From A to Zee Nephrology is easy"

بسم الله الرحمن الرحيم " واذا مرضت فهو يشفين "
أخصائي أم?

23/11/2025

📌 If you find all or most of the 𝔽𝔸ℝ𝔼𝕊 criteria (named it after my son ,Fares Ahmad Taiseer ) on managing a case of Renal failure then it is very likely to be due to a 𝗚𝗘𝗡𝗘𝗧𝗜𝗖 / 𝗛𝗘𝗥𝗘𝗗𝗢𝗙𝗔𝗠𝗜𝗟𝗜𝗔𝗟 𝗸𝗶𝗱𝗻𝗲𝘆 𝗱𝗶𝘀𝗲𝗮𝘀𝗲 ..

📌 In the 𝓐𝓻𝓪𝓫𝓲𝓬 𝓵𝓪𝓷𝓰𝓾𝓪𝓰𝓮 this word has two meanings , the first is the Knight who know how to ride a horse in a good professional way , & the second is someone who is very good at doing something , being talented or so ..

F : 𝔽𝕒𝕞𝕚𝕝𝕪 𝕙𝕚𝕤𝕥𝕠𝕣𝕪 𝕚𝕤 𝕡𝕠𝕤𝕥𝕚𝕧𝕖 𝕗𝕠𝕣 𝕒 𝕤𝕚𝕞𝕚𝕝𝕒𝕣 𝕔𝕠𝕟𝕕𝕚𝕥𝕚𝕠𝕟 𝔽𝕒𝕞𝕚𝕝𝕪 : 𝕔𝕠𝕟𝕤𝕒𝕟𝕘𝕦𝕚𝕟𝕚𝕥𝕪

A : 𝔸𝕘𝕖 𝕚𝕤 𝕪𝕠𝕦𝕟𝕘

R : ℝ𝕖𝕤𝕚𝕤𝕥𝕒𝕟𝕥 𝕥𝕠 𝕥𝕣𝕖𝕒𝕥𝕞𝕖𝕟𝕥

E : 𝔼𝕥𝕚𝕠𝕝𝕠𝕘𝕪 𝕦𝕟𝕜𝕟𝕠𝕨𝕟

S: 𝕊𝕪𝕟𝕕𝕣𝕠𝕞𝕚𝕔 𝕡𝕣𝕖𝕤𝕖𝕟𝕥𝕒𝕥𝕚𝕠𝕟 ( 𝕞𝕦𝕝𝕥𝕚𝕠𝕣𝕘𝕒𝕟 𝕒𝕗𝕗𝕖𝕔𝕥𝕚𝕠𝕟 , 𝕥𝕙𝕠𝕦𝕘𝕙 𝕤𝕖𝕖𝕞𝕤 𝕟𝕠𝕥 𝕝𝕚𝕟𝕜𝕖𝕕 𝕥𝕠 𝕖𝕒𝕔𝕙 𝕠𝕥𝕙𝕖𝕣 ) !!

🎯 The Clinical Tip about this point is the necessity to do 🧬 for this patient ¸¸♬·¯·♪·¯·♫¸¸ 𝓖𝓮𝓷𝓮𝓽𝓲𝓬 𝓽𝓮𝓼𝓽𝓲𝓷𝓰¸¸♫·¯·♪¸♩·¯·♬¸¸ especially if reached ESKD & going for Tx ..

The value of this is the Following =>

🩺 Knowing the patient's 𝗡𝗮𝘁𝗶𝘃𝗲 𝗱𝗶𝘀𝗲𝗮𝘀𝗲 & 𝗶𝘁𝘀 𝗶𝗻𝗰𝗶𝗱𝗲𝗻𝗰𝗲 𝗳𝗼𝗿 𝗣𝗼𝘀𝘁 𝗧𝘅 𝗥𝗲𝗰𝘂𝗿𝗿𝗲𝗻𝗰𝗲 ..

🩺 Avoid selecting a 𝗗𝗼𝗻𝗼𝗿 who may 𝗰𝗮𝗿𝗿𝘆 𝘁𝗵𝗲 𝘀𝗮𝗺𝗲 𝗴𝗲𝗻𝗲𝘁𝗶𝗰 𝗱𝗶𝘀𝗲𝗮𝘀𝗲, eventually Avoiding Risking the donor (developing CKD later).

=>𝖳𝗁𝖾 𝖺𝗍𝗍𝖺𝖼𝗁𝖾𝖽 𝗉𝗂𝖼𝗍𝗎𝗋𝖾 𝗂𝗌 𝗈𝖿 𝗆𝖾 𝗁𝗈𝗅𝖽𝗂𝗇𝗀 𝖺 𝖭𝖺𝗍𝗂𝗏𝖾 𝗄𝗂𝖽𝗇𝖾𝗒 𝗐𝗂𝗍𝗁 𝖠𝖣𝖯𝖪𝖣 𝖿𝗈𝗅𝗅𝗈𝗐𝗂𝗇𝗀 𝖭𝖾𝗉𝗁𝗋𝖾𝖼𝗍𝗈𝗆𝗒..

NephroTube
Taiseer Renal Medicine " From A to Zee Nephrology is easy"

28/10/2025

🤔

When you measure serum IgA in patient with ESM (Episodic Synpharyngetic Macroscopic) Hematuria to Diagnose IgA Nephropathy..! though it is a Histopathological diagnosis 🔬

📌 Note that Serum IgA is increased in only 1/3 of cases of IgA Nephropathy..

📌 The pathogenesis of IgA Nephropathy is about changes in the Physiochemical properties or structure of IgA , rather than an ABSOLUTE increase in amount of IgA ..

NephroTube
Taiseer Renal Medicine " From A to Zee Nephrology is easy"

13/10/2025

Time for our Quiz ..

🚑🚑🚑🚑...

🔬🔬..

📌 For this coming case of 45 -year-old female patient presented with Full Blown Nephrotic syndrome..

📌 Eventually you requested Serology, Autoimmune, and Malignancy markers and work up ..

💡 From the above Bx pictures , Which etiologies you would consider more likely , Primary MN or 2nry MN ??

NephroTube
Taiseer Renal Medicine " From A to Zee Nephrology is easy"

05/09/2025

📌 IgA Nephropathy is the most Common primary GN ..

📌 TMA ( HUS) is a rare disease..

Yet so many cases of TMA and very small number of IgAN cases ..

🤔 ???

=> Diagnostic Tools ? 🔬

=> Misdiagnosis ?

=> Epidemiological and Environmental changes ??

What's your feedback and explanation about this ?

Taiseer Renal Medicine " From A to Zee Nephrology is easy"
NephroTube

21/08/2025

Time for our Weekly Quiz..

🧠..

Solve the Riddle !

💡💡..

🍔🍔🍔...

1.What's the disease ?
2.Cause of the Disease ?
3.Management ?

Taiseer Renal Medicine " From A to Zee Nephrology is easy"

NephroTube

18/08/2025

📌 Always Keep in mind that PIGN / IRGN in Children is of good self limiting and of Good Prognosis ..

👶🏻
And Remember this Rule ..

" Rule of 1️⃣ for the Typical Classic PIGN in Children "

💡 💡

🎯 Within or After 1️⃣ week UOP will improve much ..

🎯 Within or After 1️⃣ Fortenight , Azotemia will improve much ..

🎯 Within or After 1️⃣ Month , Hypocomplementemia will Normalize ..

🎯 Less than 1️⃣ % will Develop Rapidly Progressive Crescentic GN ( but around 50 % will show small number of Crescentic & Necrotic lesions)

🎯 Less than 1️⃣ % will develop ESKD ..

🎯 UP to 1️⃣ year post Resolution, Mild Proteinuria ( < 500 mg / day) and Microsvopic Hematuria might Persist without affecting the Long term outcome..

Taiseer Renal Medicine " From A to Zee Nephrology is easy"
NephroTube

13/08/2025

📌Speaking of Cyclophosphamide, it is both Gonadotoxic & Tertatogenic as well ..

📌 its Gonadotoxicity , as I remember is both , gender dependent , s*x dependent, ie :

👉🏻 the minimum needed dose to cause Gonadal Toxicity is as follows:

100mg/ kg in Mature Males

200 - 300 mg / kg in Mature Females and Prepubertal Males

400 mg/ kg in Prepubertal Females

And I used to believe that is part of
رحمة ربنا

"Allah Mercifulness "

Because most of the patients needing Endoxan ( in SLE in particular) are
" Prepubertal Females ",

eventually they need the highest dose to develop Gonadotoxicity ..

📌 And because of its Tertatogenicity ,it has to be stopped 3 months before conception...

💡and that's why putting the patient on CONTRACEPTION has 2 main reasons ..

1️⃣ Stabilization of the condition and Avoidance of any Lupus flare ..

2️⃣ To AVOID the teratogenic side effects of the medications commonly used ,such as ( MMF and Endoxan)

Taiseer Renal Medicine " From A to Zee Nephrology is easy"
NephroTube

11/08/2025

The Answer of the " Riddle " ... 🚑🚑🚑🚑

Okay ..

Time is up !

💪🏻 Actually all the answers were totally right, yet very close .. but incomplete..

So let me tell the story that would give you the answer of our

" Riddle "

📌 It is about a Clinical study in India 🇮🇳

that revealed something which is very strange..

It revealed that patients diagnosed with Bx Proven

" NELL 1 ass Memb Nephropathy" were very high

3️⃣5️⃣% of total Patients with Memb Neph...which is very high , when you compare it

to the US studies that showed that

"NELL 1 ass Memb Neph"

were only about 8️⃣ % ..

🤔🤔

Eventually they studied this Phenomenon

🥼..

and they knew the reason .. 💡💡

📣📣..
The majority of these patients ( almost 90%) were using Traditional Medicines and Skin Whitening creams , that are contaminated with

👇🏻👇🏻👇🏻

🎯 Mercury ... Hg .

And when they stopped these Medications and Creams , Proteinuria much subsided ..

👉🏻 so here is another

" Heavy Metal "

Causing

NELL1 ass Membranous nephropathy...

06/08/2025

Solve the Riddle ..

🧠

💡

Taiseer Renal Medicine " From A to Zee Nephrology is easy"
NephroTube

02/08/2025

💊 The SGLT2 INHIBITORS this magical

group of medications 🎩 are " ALMOST" indicated in most of the CKD conditions ( in some of them as off label) ..

the Diabetic and the Non Diabetic ..

💡 but there was a " Single" Contraindication for this group to be used which is

ADPKD ...

☠️ Actually it was an Exclusion criterion in both studies of SGLT2 INHIBITORS ( DAPA CKD , & EMPA KIDNEY)..

🚑 🚑 🚑

It looks like that there is growing " Evidence " 🔬 and studies that has showen a beneficial effect of

Adding SGLT2 INHIBITORS as an " ADD on" therapy to Tolvaptan ..

📌 But still to the Moment , Tolvaptan is the only approved Drug for ADPKD..

Here is a RCT from Japan 🇯🇵 supporting its use .. ( note the photo)

By the End of May 2027 we will get the results of the " EMPA PKD " German 🇩🇪 trial ...

Taiseer Renal Medicine " From A to Zee Nephrology is easy"

NephroTube

27/05/2025

The points I always remind myself about Recurrent Nephrolothiasis in general are :

1️⃣ 🔽 Na ( Eventually decreasing Calciuria and subsequently lesser stones formation) ..
🧂

2️⃣

🔼 K ( K citrate ) to lower urinary pH

🍊 🍋..

3️⃣
Water therapy .. 💧

Finally always remember that

" Water therapy " is indicated in 2 patients ( provided they are not having Renal insufficiency)

🎯 ADPKD ..

🎯 Recurrent Nephrolithiasis. .

Taiseer Renal Medicine " From A to Zee Nephrology is easy"
NephroTube

18/05/2025

📣📣📣

Picture of the week ..

Get ready ..

Answer will be posted after 72 hours ..

📌 We have Mr S S ,who is a 55-year-old gentleman who was referred to your OPD because of having Nephrotic range Proteinuria and Renal impairement..

👉🏻 His medical background is significant for , HTN , Dyslipidemia and heavy smoking..

HE IS NOT DIABETIC

HE IS NOT DIABETIC

HE IS NOT DIABETIC

🎯 Eventually you decided to do a Kidney Bx for this patient ..

So get your cup of coffee ☕️ and answer the Questions below ..

🔦 As of note..

=> Congo Red stain was - VE ..

=> IF wise : - VE

=> EM : - VE ..

🔬🔬🔬..

See the 2 slides ..

And answer the Questions

1️⃣ What's your Diagnosis?

2️⃣ Name the stains used in the 2 slides??

Taiseer Renal Medicine " From A to Zee Nephrology is easy"
NephroTube

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