RE: AKI, urinary K Wasting and uncontrolled HTN 1 hour ago

so in summary, based on the result of the renal biopsy, need suggestion for treatment of his probable minimal change disease with uncontrolled diab...

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RE: AKI, urinary K Wasting and uncontrolled HTN 1 hour ago

In March, 2025, 24-hour urine appropriately collected found protein of 13662 mg, normal results of IgG4, HIV, hepatitis B surface antigen, hepatit...

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RE: treatment for MCD 2 hours ago

The atypical feature for MCD is the absence of complete remissions after steroid, CYC or RTX therapy. I suppose that the T-cell cutaneous Lymphoma ...

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RE: treatment for MCD 3 hours ago

I assume that the highest UPr was 10 g/day, lowest was 1.1 g and most recently 1.8 g with well preserved renal function over past 20 years. Questi...

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RE: treatment for MCD 6 hours ago

Addendum- i suppose it might be worthwhile trying Obinutuzumab , especially if anti-chimeric antibodies are present and rendering RTX ineffect...

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RE: treatment for MCD 6 hours ago

These pathological findings suggest a diffuse Podocytopathy, possible of an auto-immune Type. . A role for the cutaneous T-cell lymphoma in this pr...

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RE: Volunteer by May 7 to serve as a case report reviewer for Kidney Week 2025! 8 hours ago

Hello! Please complete this form by May 7 to serve as a fellow case report reviewer: https://www.asn-online.org/apply/?ID=21 -------------------...

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RE: treatment for MCD 9 hours ago

Biopsy ------------------------------ Lalita Thatte MD Charlotte Nephrology Associates, P.A. Port Charlotte FL (941) 629-4676 -----------...

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RE: treatment for MCD 9 hours ago

Despite his age, this patient qualifies for genetic testing using a large Exome sequencing panel. Thus is a very "atypical" course for Primany MCD....

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treatment for MCD 10 hours ago

75 a year's old gentleman with history of hypertension and atrial fibrillation. Patient had Kidney biopsy in 2002 and was noted to have hyperten...

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RE: membranous nephropathy 11 hours ago

I second Drs Hirsch and Glassock. Rituxan only and monitor. Serologic response can be checked if PLA2R-ab positive. ----------------------------...

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RE: Hypercalcemia management in a patient with Sarcoidosis 22 hours ago

I would agree with Prof Glassock and suggest ketoconazole ------------------------------ Stuart Sprague DO, FASN Director of Research, Division o...

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RE: membranous nephropathy 1 day ago

I have never been very enthusiastic about use of CNI in MN. It is a second or third class drug for producing CR - it is much weaker than RTX or CYC...

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RE: membranous nephropathy 1 day ago

Doubt there is a "right" answer but, seems to me... --the Niles protocol as described above is HUGELY more immunosuppression than the standard Ri...

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RE: membranous nephropathy 1 day ago

79 year old: I like the Niles protocol in general "Combination of Rituximab, Low-Dose Cyclophosphamide, and Prednisone" https://pubmed.ncbi.nlm....

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RE: membranous nephropathy 1 day ago

Albumin 1.5. I need to check with the treating doctor about the UPCR. ------------------------------ Steven Rosenblatt MD, FASN South Texas Re...

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RE: Rhabdomyolysis-Associated AKI with NSAID Exposure: Is Biopsy Warranted? 1 day ago

"Presented with creatinine 1495 µmol/L, ur 31 oliguric AKI" "Creatinine plateaued at ~600 µmol/L" none of this really matters but there is som...

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RE: membranous nephropathy 1 day ago

You must mean serum albumin of 1.5gms/dL. What is the UPCR? ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-88...

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RE: membranous nephropathy 1 day ago

Need levels of anti-PLA2R (by ELISA ) . If > 150 RU/ml I would go with RTX plus low dose CYC and very moderate dose of oral steroids (Niles Protoco...

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membranous nephropathy 1 day ago

We have a 79 yo Korean woman with severe NS, protein 1.5, creatinine 2 with eGFR 25. wt 119 with anasarca. Biopsy MGN and positive PLA2R (titer pen...

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RE: Rhabdomyolysis-Associated AKI with NSAID Exposure: Is Biopsy Warranted? 1 day ago

If anuric the GFR was zero on presentation. Assuming the creatinine can rise as much as 3 mg/dl/day in a muscular person with muscle injury, the ev...

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RE: Rhabdomyolysis-Associated AKI with NSAID Exposure: Is Biopsy Warranted? 1 day ago

"Creatinine plateaued at ~600 µmol". In recovering AKI, SCr plateaus first before it starts improving . What is the trend in urine output? Is it in...

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RE: Rhabdomyolysis-Associated AKI with NSAID Exposure: Is Biopsy Warranted? 1 day ago

This patient presented with a creatinine of 17 mg/dl so whatever happened did so a while back, even if still taking into account that Cr may rise m...

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RE: Hypercalcemia management in a patient with Sarcoidosis 1 day ago

Infliximab is a great idea for refractory Sarcoidosis. I'm nnot sure if isolated hypercalcemia qualifies, I could easily argue that it does and tha...

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RE: Hypercalcemia management in a patient with Sarcoidosis 1 day ago

Prathap: Infliximab is another option in recalcitrant sarcoidosis. How leukopenic is your patient? There's is significant correlation between disea...

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RE: Rhabdomyolysis-Associated AKI with NSAID Exposure: Is Biopsy Warranted? 1 day ago

A bit unusual with this level of CK what is the patient background , what was his uric acid level ? : renal hypo uricemia with excercise induced AK...

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Reminder: Volunteer by May 7 to serve as a case report reviewer for Kidney Week 2025! 1 day ago

If you are interested serving as a reviewer, please complete this form by May 7: https://www.asn-online.org/apply/?ID=21 ASN invites ASN Fellow...

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Reminder: Encourage fellows to apply to be case report reviewers by May 7! 1 day ago

ASN invites ASN Fellows-in-Training members to serve as reviewers for case reports submitted by trainees for Kidney Week 2025. The reviewing/gradin...

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RE: Rhabdomyolysis-Associated AKI with NSAID Exposure: Is Biopsy Warranted? 1 day ago

Give it a little more time. Should see gradual onset of increasing urine output with eventual recovery. ------------------------------ John Mella...

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RE: Volunteer by May 7 to serve as a case report reviewer for Kidney Week 2025! 1 day ago

I am excited to be a reviewer for case report in ASN forum ------------------------------ Afsana Jahan MBBS Fellow Northwell health LONG ISLAND N...

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RE: Rhabdomyolysis-Associated AKI with NSAID Exposure: Is Biopsy Warranted? 1 day ago

Pure exertional Rhabdo unless profound and pt dehydrated or compartment syndrome usually does not cause AKi Here I suppose contribution of NSAID by...

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RE: Volunteer by May 7 to serve as a case report reviewer for Kidney Week 2025! 2 days ago

Good evening This is Mugdha, I am second year nephrology fellow at University of Cincinnati. it is an awesome opportunity and I would love to vol...

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RE: Rhabdomyolysis-Associated AKI with NSAID Exposure: Is Biopsy Warranted? 2 days ago

Agree I presume that the exertion/NSAID was some time ago and that the CPK was much higher several days ago, we're just catching it on its way do...

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RE: Hypercalcemia management in a patient with Sarcoidosis 2 days ago

Thank you both for the prompt response. I appreciate it. I will present both options to the patient and decide. Thank you -----------------...

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RE: Rhabdomyolysis-Associated AKI with NSAID Exposure: Is Biopsy Warranted? 2 days ago

I would not biopsy, Myoglobinuric AKI can take a while to recover. Although I am a little surprised of this level of AKI with this level of CK. ...

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RE: Hypercalcemia management in a patient with Sarcoidosis 2 days ago

HydroxyChloroquin has also been used see attached ------------------------------ Roger Rodby MD, FASN Professor of Medicin...

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RE: High dose Rosuvastatin and non glomerular proteinuria 2 days ago

"Tubular damage is increased in patients receding high-dose Rosuvastatin. " Do we have anything other than an association? Do we have any idea...

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RE: High dose Rosuvastatin and non glomerular proteinuria 2 days ago

Few comments: Love "Cardiologists have tunnel vision, there is nothing they wont do to decrease CV risk. We need to temper them a bit". Tubule ...

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RE: Hypercalcemia management in a patient with Sarcoidosis 2 days ago

The addition of ketoconozole to therapy in this patient may help to ameliorate the hypercalcemia due to beneficial effects on Sarcoidosis itself an...

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Hypercalcemia management in a patient with Sarcoidosis 2 days ago

I have a 69-year-old Caucasian male with biopsy-proven pulmonary sarcoidosis, diagnosed after he initially presented with acute kidney injury and h...

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RE: Rhabdomyolysis-Associated AKI with NSAID Exposure: Is Biopsy Warranted? 2 days ago

I see no need for a kidney biopsy based on the information provided , other opinions welcome. ------------------------------ Richard Glassock MD,...

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RE: Rhabdomyolysis-Associated AKI with NSAID Exposure: Is Biopsy Warranted? 2 days ago

What about urinary myoglobin and serum electrolytes. He must receive large amount of IV fluids (3-4L) and iv calcium.. ---------------------...

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Rhabdomyolysis-Associated AKI with NSAID Exposure: Is Biopsy Warranted? 2 days ago

Patient: 31-year-old previously healthy male Presentation: • Prolonged exertion (2h swimming in heat) • Took Cataflam (diclofenac, NSAID) prior ...

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RE: follow up case 2 days ago

Thank you. ------------------------------ M Kaisar Nephrologist Brisbane ------------------------------

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RE: High dose Rosuvastatin and non glomerular proteinuria 2 days ago

Dr. Campese . I fully agree with your warnings about use of high dose rosuvastatin but the distinction between hematuria, hemoglobinuria and myoglo...

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RE: High dose Rosuvastatin and non glomerular proteinuria 3 days ago

The PLANET II trial (NCT00296400) studied rosuvastatin and atorvastatin in patients with proteinuria but without diabetes. It found that atorvastat...

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RE: Follow up on patient with lupus nephritis 3 days ago

Thanks so much for your kind words. I was very surprised too. ------------------------------ Deborah Fein MD Nephrologist Pattner and Grodstein ...

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RE: Follow up on patient with lupus nephritis Sunday, April 27 @ 4:56 PM

This anecdote represent support for the use of Benlysta to control both renal and extra-renal Lupus,especially to allow for steroid-free management...

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RE: Follow up on patient with lupus nephritis Sunday, April 27 @ 2:21 PM

Since she had many others lupus related symptoms (alopecia, discoid skin changes, fatigue and arthralgias) it seemed that Benlysta would be a benig...

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RE: Follow up on patient with lupus nephritis Sunday, April 27 @ 1:18 PM

Dr. Fein- It is interesting that you chose to add Benlysta, as the RCT involving thus drug did not show any benefits in use of Benlysta Class ...

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