Dialysis Recovery and Sustained Remission After Biopsy-Informed Multimodal Immunosuppression in Steroid Refractory Adult Minimal Change Podocytopathy (KIDNEY WEEK 2026) - Oct 2, 2026 - Abstract #PUB183; "Given biopsy-defined minimal chronicity, tacrolimus, mycophenolate, and three doses of rituximab were initiated with prednisone. In NEPTUNE, median IFTA in MCD was 1%, and each 10% fibrosis increase predicted eGFR decline (HR 1.29); ~5% IFTA here indicated recoverable disease, contradicting imaging. Teaching points: (1) biopsy-defined chronicity may be more decisive than diagnostic classification when imaging suggests irreversibility; (2) MCD onset during chronic corticosteroid therapy represents functional steroid refractoriness, not addressed by KDIGO definitions —early steroid-sparing escalation is rational; (3) anti-nephrin–suggestive IgG dusting may support B-cell–targeted therapy, extending biopsy from diagnostic to theranostic; (4) renal recovery in MCD-AKI tracks proteinuric remission."
Biopsy • Clinical • Fibrosis • Glomerulonephritis • IgA Nephropathy • Immunology • Inflammatory Arthritis • Nephrology • Renal Disease • Rheumatoid Arthritis
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Diego Tijerina; Yassin EL-Najjar; Mary-Joe Touma; Mourad Alsabbagh
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