#ECNeph
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theisn.org
"#ECNeph-transforming clinical education through engaging social media content," by Priya John et al, was awarded with #ISNWCN Education: Top Scored Abstract.

Visual abstract by Manish Lalwani, available for download here: https://bit.ly/4rMB27f
March 27, 2026 at 1:48 AM
theisn.org
Welcome, Brammah! We are looking forward to learning today 🤓 #ECNeph #NephSky
July 31, 2025 at 12:16 PM
theisn.org
📣 Join us tomorrow at 2 pm CEST for the #ECNeph session on Flares and Flames in Lupus.

🗣️ ‪@kidneying.bsky.social‬
👤 @acssjr.bsky.social

Use #ECNeph in your posts to engage in the session 🙌 @dilushiwijay.bsky.social

#NephSky
July 30, 2025 at 9:11 PM
theisn.org
Final Diagnosis
#ECNeph
@dramiliflores.bsky.social @karnephro.bsky.social @myadla.bsky.social @dilushiwijay.bsky.social
June 30, 2025 at 4:44 PM
theisn.org
Yes, some tests came after biopsy #ECNEPh
June 30, 2025 at 4:39 PM
theisn.org
A positive anti-PLA2R antibody test is “virtually” diagnostic of a lesion of MN (but may not always be able to reliably distinguish primary and secondary forms) #ECNeph #MedSky #NephSky @kdjhaveri.bsky.social @dramiliflores.bsky.social @karnephro.bsky.social

June 30, 2025 at 4:29 PM
theisn.org
🔬 The characteristic histopathologic features of MN, light microscopy, IF, EM, are falling into place.
So… where are we in this case? Granular IgG, GBM thickening, no crescents...
What do you think?
#ECNeph @dramiliflores.bsky.social @karnephro.bsky.social

www.ajkd.org/action/...
June 30, 2025 at 4:27 PM
theisn.org
Primary vs Secondary Membranous Nephropathy #ECNeph
http://springer.com/...
@dramiliflores.bsky.social @karnephro.bsky.social
June 30, 2025 at 4:25 PM
theisn.org
A new conceptual review for Secondary Membranous Nephropathy
Always think broader when the puzzle doesn’t fit perfectly.
#ECNeph @dramiliflores.bsky.social @karnephro.bsky.social
www.emjreviews.com/w...
June 30, 2025 at 4:23 PM
theisn.org
Membranous Nephropathy 2021 Update
1️⃣ Primary
2️⃣ Secondary
3️⃣ Allo-immune (transplant-related)
#ECNeph #MedSky #NephSKy
So… where are we in this case? what do you think?
@dramiliflores.bsky.social @karnephro.bsky.social

www.ajkd.org/article...
June 30, 2025 at 4:21 PM
theisn.org
📍IF findings: IgG: 2+ (GBM), C3: trace, Kappa: 2+, Lambda: 3+
➡️ Granular pattern along GBM
🩺 Diagnosis: Membranous Nephropathy (MN)
Is this the final word?
#ECNeph @dramiliflores.bsky.social @karnephro.bsky.social
June 30, 2025 at 4:20 PM
theisn.org
The biopsy is in! #ECNeph
No segmental sclerosis. No crescents.
🔬 Basement membrane: Irregular thickening (seen on silver stain)
🧩 Mild interstitial fibrosis + tubular atrophy (~10%)
= Any classic pattern emerging?
#ECNeph @dramiliflores.bsky.social @karnephro.bsky.social
June 30, 2025 at 4:19 PM
theisn.org
Across 16 studies, the top reasons are:
1️⃣ Acute Kidney Injury (12–73%)
2️⃣ Nephrotic Syndrome with rapid onset (13–68%)
🧠 Histology? Highly variable — especially in the very elderly.
#ECNeph @dramiliflores.bsky.social @karnephro.bsky.social
June 30, 2025 at 4:18 PM
theisn.org
🔬 Renal biopsy in the elderly?
📌 Despite comorbidities, studies show comparable complication rates to younger adults.
📌 Individualization always #ECNeph @dramiliflores.bsky.social @karnephro.bsky.social

karger.com/ajn/artic...
June 30, 2025 at 4:17 PM
theisn.org
Now comes the key clinical question:
👉 What’s next for this 80-year-old with nephrotic-range proteinuria?
👉 Time to decide: More labs? Imaging? Biopsy?
#ECNeph @dramiliflores.bsky.social @karnephro.bsky.social
June 30, 2025 at 4:16 PM
theisn.org
So what should always be on the radar especially with nephrotic-range proteinuria and minimal serologic clues? #ECNeph @dramiliflores.bsky.social @karnephro.bsky.social
June 30, 2025 at 4:15 PM
theisn.org
Some more of the approach to nephrotic syndrome in the elderly #ECNeph #NephSky #MedSky http://cjasn.asnjour...
June 30, 2025 at 4:14 PM
theisn.org
👀 What’s really behind the nephrotic picture in the elderly?
Classic? Secondary? Something more sinister?
#ECNeph
@dramiliflores.bsky.social @karnephro.bsky.social
Check this VA @sibbek.bsky.social
June 30, 2025 at 4:13 PM
theisn.org
🕵️‍♀️ We’ve walked through the labs, imaging, serologies, lipid profile, and even SPEP...
Do you have a diagnosis yet❓

#ECNeph @dramiliflores.bsky.social @karnephro.bsky.social
June 30, 2025 at 4:12 PM
theisn.org
Let see the immunological panel #ECNeph 🧫
🧬 Serum free light chains:
kappa:lambda = 1.45 (within normal range)

@dramiliflores.bsky.social @karnephro.bsky.social
June 30, 2025 at 4:11 PM
theisn.org
🧪 In older adults with nephrotic proteinuria, serum protein electrophoresis (SPEP) can uncover any ideas? Are we getting a more likely pattern? #ECNeph
@dramiliflores.bsky.social @karnephro.bsky.social
June 30, 2025 at 4:10 PM
theisn.org
Lipid Profile AddeD #ECNeph
🧠 Notice a classic nephrotic dyslipidemia pattern: elevated total cholesterol, LDL, and triglycerides
✅ Next Step @dramiliflores.bsky.social @karnephro.bsky.social
June 30, 2025 at 4:09 PM
theisn.org
🧬 Would genetic testing help at this stage?
Or is it something we reserve for younger patients with nephrotic syndrome?
Let’s take a closer look to the UK RaDaR Registry #ECNeph
@dramiliflores.bsky.social @karnephro.bsky.social
June 30, 2025 at 4:08 PM
theisn.org
🤔 What’s running through your differential right now?
Drop your thoughts ⬇️
#ECNeph #MedSky #NephSky
@dramiliflores.bsky.social @karnephro.bsky.social
June 30, 2025 at 4:07 PM
theisn.org
🧬 24h Urine Protein: 11.44 g
📌 Severe proteinuria + hypoalbuminemia
Kidneys look fine… but clearly, something’s brewing.
@dramiliflores.bsky.social @karnephro.bsky.social #ECNeph
June 30, 2025 at 4:06 PM