Dense deposit disease doesn't usually make news. It is a rare and dangerous glomerulonephritis. Last we heard about it was when it lost its perch at MPGN type II nad was recast as one of a pair of C3 glomerulopathies, along side of C3 glomerulonephriotis. 

But dense deposit disease is back in the news because the identitiy of those dense deposits has finally been discovered. It is apolipoprotein E. This was discovered by using laser capture microdissection along with confocal microscopy. Another nephrology mystery solved. 

Nice editorial on the discovery of ApoE in DDD. The authors speculate that the discovery will not only allow better diagnosis but likely will yield clues to this pathogenesis of this rare and unusal glomerulonephritis. 

The nephrology journal club discussed the kidney International manuscript describing this discovery about the nature of the dense deposit in DDD. Great summary and visual abstract.

The senior author of this discovery, Sanjeev Sethi, of the Mayo Clinic, discussed the eureka moment of this discovery while giving an update on MPGN at the Wolrd Congress of Nephrology in Buenos Aires. 

At the recently concluded International Society of Nephrology World Congress of Nephrology (#ISNWCN24) there was simultaneous presentation and publication of a new risk calculator for chronic kidney disease. I am a big fan of the Tangri Kidney Failure Risk Calculator. It is the rare calculation that has changed my practice. I use it regularly in counseling my patients and guiding my decision making. But the hole in Tangri's calculation is it doesn't take into account the competing risk of death. I'm not sure how often this will change wht I do, but it seems like an important gap that needed filling. Enter the Liu formula. 

Editorial discussing the new risk formula.

Here is an online formula that predicts death and dialysis using the same inputs we have for the Tangri formula. I love that it doesn't change the inputs, this will help operationalize using this formula, since we don't need to change what we collect while seeing patients. The website is a bit slow, but it does have a nice "Presentation" tab which provides a visual abstract-like presentation of the results. 

This is an excellent thread where Dr. Hiremath looks at multiple examples and the results generated by the old standard KFRE compared to the new KDpredict. Dr. Nav Tangri, creator of the KFRE, pops in to express skepticism. Pretty interesting.