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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?

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

06/05/2025

📣 Picture of the week !

📌 What's your comment and what's your next step ?!

Answer will be posted after 24 hours.

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

24/03/2025

Q1 : Full comment Diagnosis ?
Q2: What's the next step ??

18/03/2025

SPARSENTAN ; an oral Dual Endothelin AngII Receptor anatgonist , is very close to be Officially FDA approved for FSGS as a result of DUPLEX study ( comparing SPARSENTAN vs IRBESARTAN) ..

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

11/03/2025

📌 A 28-year- old gentleman is being investigated for unexplained Renal impairment ( Creatinine 2.1 mg/dl) .His past medical history is unremarkable for any comorbdities , his drug history is significant for Regular intake of Vitamins .

📌 A Kidney was done.( See illustrated picture of tissue Bx)

📌 Question: Full Diagnosis and Management.???

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

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