Did you know inadequate renal biopsies are on the rise? Recently, Dr. Shree Sharma and @glombandit.bsky.social sat down with Dr. Vandana Niyyar, @nephrowhitt.bsky.social, and @juancarlosqvelez.bsky.social to discuss renal biopsy adequacy and understand why it matters. Listen to the conversation:

In the latest episode of Visiting Joel, our visiting scholar, Dr. Evgeniya Pasternak, works with @glombandit.bsky.social  on a research article. #pathresident #renalpath #renalrotation Here's a link to the latest episode: 

Up next! ☀️📚 We're taking a short break from trials, but don’t go far— #NephJC Summer Book Club is back! We’ll be diving into “Everything is Tuberculosis”—a powerful, thought-provoking read. Join the conversation soon! 📖

T3j 🧘 eGFRdiff is weakly/not affected by 🚫 Fat free lean muscle mass 🚫 Inflammation 🚫 Shrunken pore syndrome 🚫 Obesity 💡 This lack of alteration due to systemic issues makes eGFRdiff attractive for use in a wide variety of patients. #NephJC

Inflammation—> increase CRP —-> CRP affects Cystatin C —> reduced Cystatin C eGFR —> negative eGFRdiff #NephJC

T2f Let's deep into the prospective analysis 🥽 For each 10 mL/min ↑ in eGFRdiff 🚨20% ↓ mortality risk (AHR 0.80 [95% CI: 0.74–0.88]) 🚨17% ↓ HF risk (AHR 0.83 [95% CI: 0.73–0.94]) ✅ Association held after adjustment for muscle mass & filtration markers. What do we think? #NephJC

T0f So why does this matter? A more negative eGFRdiff (eGFRcr > eGFRcys) is linked to: 🫀 Cardiovascular disease 🧬 Frailty 💓 Heart failure ⚰️ Mortality #NephJC

T0e But muscle mass isn’t the whole story. 🧨 Factors contributing to eGFRdiff include: Chronic inflammation Endothelial dysfunction Shrunken pore syndrome Obesity Smoking Corticosteroids Which others do you consider? #NephJC

T0c eGFRdiff is now recognized by KDIGO 2024, which recommends using both creatinine & cystatin C to estimate GFR (practice point 1.2.3.1). But why do these values differ in the first place? Let’s dig in. 🔍 #NephJC

On 7/22/25 at 9pm EST only on Bluesky! #NephSky #MedSky join us for a lively discussion. We're debating eGFRdiff (the gap that is sometimes present between the eGFR of cystatin C and creatinine). What does it mean, what causes it and what you should do about it. #NephJC www.nephjc.com/news/egfrdiff

Lupus nephritis - this one is going out to Rush Nephrology 🎨@nephrowhitt.bsky.social

Mass Spectrometry With Data-Independent Acquisition for the Identification of Target Antigens in Membranous Nephropathy bit.ly/4ccCs4H #OpenAccess #VisualAbstract

Urine CXCL-9, now in immune checkpoint inhibitor AIN! In @kidneyint.bsky.social www.kidney-international.org/article/S008...

Felzartamab (antiCD38) now in IgAN www.kidney-international.org/article/S008... #NephSky

T3f: #NephJC 👉Effective nudges require personalization + clear action steps ⚠️ Risk of becoming full "change-oriented" interventions ♻️ Change models: Create urgency → Communicate → Implement → Sustain

👉We all need little nudges to do the right thing. Join us 6/24/25 at 9pm EST as we chat about E-Nudges to improve goal directed medical therapy (GDMT) in CKD. #NephJC #NephSky Blog by @nephroseeker.medsky.social @dramiliflores.bsky.social @husamjz.bsky.social www.nephjc.com/news/nudge-ckd

Check the insightful #NephJC summary by @nephroseeker.medsky.social @dramiliflores.bsky.social, http://www.nephjc.co...#NephJC

🤩Check out the spectacular #visualabstract for tonight´s #NephJC by @priti899.bsky.social http://www.nephjc.co...

Tomorrow, on #NephJC we discuss the @nejm.org trial on #lorundrostat in uncontrolled hypertension

Some conclusions from a great talk on monoclonal gammopathies of renal significance from Dr. Nasr at @glomcon.org today:

New MGRS entity in the IKMG classification - intracapillary monoclonal IgM glomerulopathy From Dr. Nasr at @glomcon.org

Most monotypic fibrillary glomerulopathy is not a MGRS lesion and is being removed from the MGRS classification. An exception though is heavy chain fibrillary GN, which can be driven by a monoclonal paraprotein. By Dr. Nasr at @glomcon.org

The majority of crystalglobulinemic nephropathy cases have extrarenal manifestations. The clinical presentation is often robust with severe AKI. By Dr. Nasr at @glomcon.org

Ancillary techniques used in the diagnosis of MGRS lesions. By Dr. Nasr at @glomcon.org

Atypical anti-GBM disease can either be monotypic or polytypic. By Dr. Nasr at @glomcon.org

The majority (but not all) cryoglobulinemic GNs have organized deposits. The morphology of the ultrastructural deposits can sometimes have overlap with the appearance of deposits of other entities (such as fibrillary and immunotactoid GN).

Pathophysiology of various MGRS lesions: By Dr. Nasr at @glomcon.org

More than one MGRS lesion is not uncommon on biopsy. By Dr. Nasr at @glomcon.org

There is a spectrum of crystalline nephropathies that represent monoclonal gammopathies of renal significance. Paraffin immunofluorescence for kappa and lambda light chains are often required in diagnosis for detection. By Dr. Nasr at @glomcon.org

Join us tonite 5/13/25 9pm EST only on #Bluesky #NephSky #NephJC We are discussing 2 studies on the use of desmopressin/ddAVP prophylactically to prevent post kidney biopsy bleeding. Biopsy Blood🩸, ddAVP Sweat💦 and Nephrologist Tears😢 www.nephjc.com/news/ddavp

Save the Date for the 6th International Renal Pathology Conference in Antigua, Guatemala, February 11-14, 2026! Chair:Carmen Avila @asnkidney.bsky.social @theisn.org @kidney.org @csnscn.bsky.social @ukkidney.org @senefrologia.bsky.social @sfndt.bsky.social @oegn.bsky.social #pathsky #nephsky #medsky

Some take home messages from an inspiring talk by @nephrorock.bsky.social at @kidneycon.bsky.social !

Thrombotic microangiopathy following scorpion envenomation doi.org/10.1016/j.kint.2024.10.033 #KINephrologyImage #NephSky #MedSky #SkyNeph

Let’s decode inflammation to guide innovation. 🧬💊 #NephJC

🎨Beautiful visual abstract by Divya Bajpai #NephJC www.nephjc.com/news/...

📜 Banff 2019 required both DSA and C4d for AMR diagnosis. Evidence grew: 🧪 MVI predicts graft loss — even without these markers. That evidence pushed forward the Banff 2022 reclassification Ready to explore how biopsy findings now map to clinical outcomes? #NephJC pubmed.ncbi.nlm.nih....

Tomorrow 4/29/25 at 9pm EST #NephSky on #Bluesky 🔬Renal pathologist house call! 🔥 Isolated microvascular inflammation 🔥 in kidney transplant recipients & the new Banff 2022 criteria. Read the summary here by @dramiliflores.bsky.social & @glombandit.bsky.social: www.nephjc.com/news/mvi-allografts

SGLT2 inhibitors can have a complement inhibition effect. By @changucanspare.bsky.social at @glomcon.org

Scleroderma renal crisis only impacts ~10% of those with scleroderma and may be complement mediated. By @changucanspare.bsky.social at @glomcon.org

In clinical laboratory studies for TMA, you may have relative (rather than absolute thrombocytopenia) and often do not see schistocytes on peripheral smears (or require serial measurements). By @changucanspare.bsky.social at @glomcon.org

Triggers of complement activation: By @changucanspare.bsky.social at @glomcon.org

#Kidney dysfunction and nephromegaly related to kidney Aichi virus infection doi.org/10.1016/j.kint.2024.09.025 #KINephrologyImage #OpenAccess #NephSky #MedSky #nephrology

Hey #NephSky and #MedSky Check out the VA for our discussion 4/15/25 at 9pm EST Metformin-Should I Stay or Should I Go (in patients with advanced CKD) VA by @nephroseeker.medsky.social www.nephjc.com/news/metformin-ckd-va

CALL FOR SUBMISSIONS: How has #kidneydisease impacted your life? Consider sharing your experience to our "In A Few Words" feature. We welcome submissions from patients/health professionals/family members. Details on the #AJKDBlog: bit.ly/4kM1xr1

🚨 Abstract Submissions Are Open for ASN Kidney Week 2025! 🚨 Have groundbreaking research? Share it with 12,000+ kidney professionals—from posters to oral presentations. Be part of the conversation. 🗓️Submit your abstract by 2:00 P.M. EDT on May 21. 🔗 asn.kdny.info/Ua4u50Vw40R

Thanks @nephmadness.bsky.social and all the @nephjc.bsky.social crew for all the great learning with the podcasts and scouting reports! My brackets have never been even close before, so feels exciting 😊

Beautiful autobiography of a patient's journey with PKD. 💚

Learning about this Chromogranin Nephropathy for the first time. #ECNeph you beauty! So much to learn! Thank you @drsumanbehera.bsky.social and @myadla.bsky.social

Another ‘oxalate offender’ to add to the list, yellow rice wine bmcnephrol.biomedcentral.com/articles/10.... #NephMadness

Concurrent AL amyloidosis and fibrillary glomerulonephritis doi.org/10.1016/j.kint.2024.08.036 #KINephrologyImage #NephSky #MedSky #SkyNeph #RenalPath #KidneyPath @mayoclinicpath.bsky.social