Anthony Chang, MD

🚦 The long-awaited #AJKD Core Curriculum update is here!

Join Drs. Susie Hu & Anthony Chang on Kidney Commute: Pitstop as they unpack what this means for nephrologists.

🎧 Don’t miss it: www.kidney.org/podcasts/kid...

Kidney Commute

The @nkf-professionals.bsky.social podcast for this article was released today. Had a great time discussing this topic with Osama El Shamy and Susie Hu

www.kidney.org/podcasts/kid...

The Nephrologist’s Perspective in Evaluation and Management of Localized Renal Masses: Core Curriculum 2025 The evaluation and management of renal masses, predominantly of the clear cell renal cell carcinoma subtype, have been evolving over the past several …

Kristen Tillquist, @nephrosage.bsky.social, me, and Susie Hu wrote this onconephrology topic for AJKD Core Curriculum

www.sciencedirect.com/science/arti...

C3G and IC-MPGN: The Past and Pathology (Roundtable) | Docwire News A roundtable panel discusses the history of C3G and IC-MPGN, the heterogeneity of glomerulonephritis, and how new, specific disease definitions have come into focus.

We recently hosted our first roundtable event! In the first segment, the panel discusses the history of C3G and IC-MPGN, the heterogeneity of glomerulonephritis, and how new, specific disease definitions have come into focus. #nephsky #nephrology buff.ly/543raB8

Tony Chang, renal pathologist at UChicago

Big John Green fan. I think I've read all his books

#NephJC

Was fun to be a part of this amazing session. Doing my best to rep the renal pathologists

We hosted our first live event on Friday, and look forward to sharing the videos soon! Thank you to @kidneyboy.bsky.social, @changucanspare.bsky.social, Roger Rodby, Cybele Ghossein, and Fernando Fervenza for participating. #nephrology #nephsky

What an amazing year with our renal path fellow, Teo Feuerhake! He returns soon to Chile with his expertise as one of the few fellowship-trained renal pathologists. We'll miss him tremendously but glad for all the kidney dz pts who will benefit

Fantastic to have Hayde Ramos from Mexico spend 3 months with our renal path service. Formed a great team with our renal path fellow, Teo Feuerhake. Times flies when you get to work with these amazing people

Our department is expanding and looking for an additional renal pathologist and another GI pathologist

Apply here: t.co/ZF8Y1uhQzi and t.co/SsDNqVlIBC

Congratulations to Dr Maria Picken for being the recipient of the John Gruhn Lifetime Achievement Award!

20 years ago we would have diagnosed this as IgA nephropathy

We need to train more nephropathologists to provide the correct diagnosis so that the nephrologists can properly manage these complex patients

6/10
Give me something clever to say

“I think of a smoldering AMR like a slowly growing leiomyoma/uterine fibroid. We don't use chemo and using it still might not stop its growth” by @changucanspare.bsky.social

If it takes 25-30 years to lose your first half of nephrons, it won’t take another 25-30 years to lose the second half

A serum creatinine of 1.3 mg/dL is not alarming until you realize that it probably represents ~50% nephron loss, because that's what your creatinine would be if you donated a kidney

Chronic kidney disease enhances alternative pathway activity: a new paradigm www.jci.org/articles/vie...

Voclosporin nephrotoxicity: a myth debunked? Click on the article title to read more.

My editorial on the importance of this study design with repeat bxs. Some questions cannot be answered otherwise.

acrjournals.onlinelibrary.wiley.com/doi/abs/10.1...

Effect of long‐term voclosporin treatment on renal histology in patients with active lupus nephritis with repeat renal biopsies Objective This study characterized the impact of voclosporin on kidney histology in patients with lupus nephritis (LN) who had protocolized repeat kidney biopsies in the AURORA clinical trials. Me...

"If you are only going to do 1 biopsy, do the second" - Gary Hill

Rovin et al get the 2nd kidney bx in this lupus nephritis study using voclosporin and did not find CNI toxicity

acrjournals.onlinelibrary.wiley.com/doi/abs/10.1...

Someone needs to look at a maintenance dose of complement inhibitors. I believe this is essential if we want xenotransplantation to go anywhere

#NephJC

Yet C4d PTC deposition in ABO-incompatible transplants doesn't seem to result in bad outcomes so it's hard to wrap our heads around this complexity.

#NephJC

Definitely possible, but then does this result in overtreatment (if/when we have good treatment)?

I think of a smoldering AMR like a slowly growing leiomyoma/uterine fibroid. We don't use chemo and using it still might not stop its growth

#NephJC

I don't think we know. Presumably there are other non-HLA abs that also fix complement and trigger the same injury pathway

Tony Chang
Renal pathologist at U of Chicago
1st #NephJC on BlueSky for me, will be lurking
Disclosure: I think active AMR mostly smolders and of course I worry that complement potentiates the pts who have worse outcomes as their DSAs fix complement

Bob Colvin, Lynn Cornell and I received our copies of the Chinese translation of our textbook

Bob said he didn’t find any typos but I haven’t given up yet

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

OMG - we read the kidney bxs for Brown Medicine and have interacted on several occasions with Dr. Rasha Alawieh. She's an integral member of their busy transplant nephrology team. Need to bring her back ASAP as kidney transplant patients will be harmed by this