ASN represents more than 21,000 kidney health professionals working to help people with kidney diseases and their families. Comprised of all of ASN's focus areas, the ASN Alliance for Kidney Health allows the society to continue its growth and work towards the goal of a world without kidney diseases.
The latest Nephrology Self-Assessment Program (nephSAP) issue, Volume 23: Issue 1 (May 2024): Pediatric Kidney Disease is now available online.
RE: persistent post infectious GN 4 minutes ago
Thanks for the follow up. Good news. Of course, this might be "spontaneous, related to anti-microbial therapy or to steroids or all three in some m...
View Discussion
RE: persistent post infectious GN 27 minutes ago
11g proteins and 2.3 g creatinine- with a clearance of 47.4 ------------------------------ Viswanathan Iyer MD,FACP,FASN Harrisburg PA 717342 47...
View Discussion
RE: persistent post infectious GN 29 minutes ago
Truly thank the messages. Updates are echo is clean I had him in house for a day- and got a 24-hour urine too. it's reassuring-there seems to ...
View Discussion
RE: O K dialysate 29 minutes ago
It's interesting to note the irony in discussing O K bath in CRRT when unlike HD, CRRT almost by definition is used in patients with cardiac instab...
View Discussion
RE: persistent post infectious GN 42 minutes ago
Thanks Dr. Aledan. How well documented is the claim that lambda LC predominance is not seen in IgA-IRGN.? I am unable to find any published literat...
View Discussion
RE: persistent post infectious GN 1 hour ago
The biopsy IF results is suggestive for IgA dominant infection related GN (3+ C3 and 2+ IgA), but predominance of Lambda light chain 3+ compared to...
View Discussion
RE: TCM in dialysis 1 hour ago
My understanding is that you can in fact bill TCM in dialysis unit, but need separate note (can't have one note for both MCP visit and TCM). You do...
View Discussion
RE: TCM in dialysis 1 hour ago
In our DIALIZE study we had pre- and post-HD K results. HD lowers K by > 2meq/L and the MID study showed the large number of intra-dialytic and per...
View Discussion
Leucopenia Posr Valgancyclovir 3 hours ago
A 50 y F 3 months post LRKT with stable graft function has got recent high grade fever, pneumonia with CMV viremia ( CMV PCR 3500) treated with val...
View Discussion
RE: Transplant Question 5 hours ago
2 renal transplant us pre biopsy good perfusion, mild Hydronephrosis nil acute 3 calcium 2.47 ( 2.14-2.56) always normal albumin 53 (35-50) always...
View Discussion
RE: Transplant Question 5 hours ago
@dr lerman 1 - azathioprine 75 mg od, famotidine 20 mg od, lansoprazole 30mg od , prednisolone 5 mg od, beclometasone , amlodipine 10 mg of atorva...
View Discussion
RE: persistent post infectious GN 8 hours ago
..use of ”canonical” here may be a little boisterous, one was impressed in the way the timeline appears to march sequentially through the three con...
View Discussion
RE: persistent post infectious GN 9 hours ago
Dr. Tijani - what do you consider canonical evidence of PSGN? Everything in the patients history, laboratory findings and pathology points toward a...
View Discussion
RE: persistent post infectious GN 9 hours ago
In my view, there are at least three independent conditions in this case, all bridged by a complex inflammatory response. -first is the AKI, indu...
View Discussion
RE: O K dialysate 12 hours ago
@J. Pedro Teixeira in a patient with AKI on vasopressors in the ICU and on mechanical ventilation with a serum K of 6.5 mmol/l and above, what moda...
View Discussion
RE: O K dialysate 12 hours ago
In IHD, we can augment K removal by using 0 glucose dialysate and low HCO3 profile as both of these factors may cause shift of K intracellularly af...
View Discussion
RE: O K dialysate 16 hours ago
Even when the potassium is 7 or 8, I will use the 4K bath to prevent rapid lowering of potassium. If I get it to 5.5 from severe high K, I think th...
View Discussion
Board review courses 17 hours ago
As a general nephrologist most of my time is spent taking care of patients . I update myself by KSAP and Nephsap although neither are meant to be r...
View Discussion
RE: O K dialysate 18 hours ago
I agree with the concept that if rapid lowering of K is needed, of course, HD is superior. However, I definitely have used CRRT to treat life-threa...
View Discussion
RE: ABMR In Kidney After Liver TX 18 hours ago
This is an interesting case which provides an opportunity to observe that ABMR should not be considered as a Yes/No phenomenon. It is an entire spe...
View Discussion
RE: ABMR In Kidney After Liver TX 18 hours ago
Did the patient received antibiotics or NSAIDs before the observed increase in serum creatinine. Tubulointerstitial nephritis may be misinterpreted...
View Discussion
RE: ABMR In Kidney After Liver TX 20 hours ago
Given absence of C4d PTC positive and low level (? Pathological ) DSA and clinical improvement with out PLEX/IVIG , is this ABMR? You might conside...
View Discussion
TCM in dialysis 21 hours ago
Hello forum members, This forum has been a great resource to address questions. I learn something new each day ! Had a question about billing...
View Discussion
RE: O K dialysate 23 hours ago
Has anyone ever seen or heard of a hyperkalemic patient die of hyperkalemia AFTER starting dialysis (at least after the first couple minutes, which...
View Discussion
RE: O K dialysate 1 day ago
Questions. Do we know the risk of arrythmias when CRRT with a zero K concentration in fluid replacement is used for treatment of hyperkalemia? Wouk...
View Discussion
RE: O K dialysate 1 day ago
I generally agree with the previous comments. Having said that, I have used a 0 K bath in life threatening hyperkalemia (K 9 or even greater) durin...
View Discussion
RE: O K dialysate 1 day ago
Agree with Dr. Rodby that rapid K lowering with a risk of arrhythmia occurs in 4 hr HD, while in CRRT the removal is slow and depend mainly on effl...
View Discussion
RE: persistent post infectious GN 1 day ago
This us not an easy question to answer, as many bacterial and viral infections can exacerbate an acute relapse of pre-existing Primary IgA N, whils...
View Discussion
RE: persistent post infectious GN 1 day ago
Staphylococcal infection is most common but streptococcus pyogenes is the offending organism is up to about 15-20% of cases, so it is not rare. ...
View Discussion
RE: persistent post infectious GN 1 day ago
How common is IgA dominant post infectious GN associated with Strep? It must be uncommon? ------------------------------ Roger Rodby MD, FASN Pr...
View Discussion
RE: O K dialysate 1 day ago
NxStage (and likely all the other companies) makes a CVVHD 0K dialysate for CRRT. The risk of 0K is too rapid reduction of serum K , and is assoc...
View Discussion
RE: m-Tor In Premalignant Skin Cancer 1 day ago
Thanks for bringing up Kaposi sarcoma. Yes, reduction/discontinuation of CNI should occur first and mycophenolate subsequently in Kaposi. For other...
View Discussion
RE: O K dialysate 1 day ago
Agree with Dr. Glassock that 0 K bath is associated with high risk of arrhythmia and SCD and the risk is escalated with higher predialysis plasma K...
View Discussion
RE: ABMR In Kidney After Liver TX 1 day ago
Surprising that an ABMR responded to just adjustment in maintenance immunosuppression. What was the cyclosporine level before it was changed to tac...
View Discussion
RE: O K dialysate 1 day ago
I agree. The risks of inducing arrhythmias from sudden K shifts is too great.. I have used low K , but not Zero K , dialysate in patients with late...
View Discussion
RE: persistent post infectious GN 1 day ago
The IF showed 1-2+ IgG, 2+ IgA, 3+ C3 and a slight predominance of lambda LC . Ciq and IgM were negative. The EM showed ED deposits in many locatio...
View Discussion
O K dialysate 1 day ago
O K dialysate is no longer used by most or all nephrologists as far as I know. I was asked by an intensivist in another hospial about using using...
View Discussion
RE: persistent post infectious GN 1 day ago
Dr. Glassock, I would like to learn from your thought process, how did you conclude from path report "a diagnosis of IgA dominant infection relate...
View Discussion
RE: 17q12 deletion syndrome 1 day ago
this appears to be part of the HFNB1 autosomal dominant tubuointerstital disease with variable MODY, renal cysts, CKD, hypoMg syndrome. You co...
View Discussion
RE: AKI and low C3 1 day ago
Most hypocomplementemia related renal disease has much more pronounced hypocomplemetemia. What does the urine look like? Blood, Protein, RBCs, W...
View Discussion
AKI and low C3 1 day ago
45 yo Female with history of ulcerative colitis diagnosed 1.5 years ago and started on Mesalamine.One year after that she developed acute kidney in...
View Discussion
17q12 deletion syndrome 1 day ago
Could you share any experience on how to manage this case of 45 yo male with history of recurrent severe hypomagnesemia, started or diagnosed about...
View Discussion
RE: membranous nephropathy 1 day ago
This will sort itself out with time I would not biopsy unless he develops repeatedly nephrotic range proteinuria I would still follow serum PLA...
View Discussion
RE: ABMR In Kidney After Liver TX 1 day ago
MFI was 2000 No access to cf-DNA --------------------------------- Ahmed Emara MD, MBChB, FASN Ain shams University Cairo 00201006721401 -------...
View Discussion
RE: membranous nephropathy 1 day ago
Dr. Hirsch- all good questions- very insightful and challenging , as expected. I will try to answer them, and I hope tgat others will add their own...
View Discussion
RE: Reversible nephrotic range proteinuria during AKI due to biopsy-proven ATN 1 day ago
This patient has albuminuria and proteinuria which seems quite significant. There are no glomerular lesions in the biopsy to explain the protein lo...
View Discussion
RE: membranous nephropathy 1 day ago
Dr Glassock I have accepted and followed the guideline that increases in proteinuria down the line in initially PLA2R positive membranous should ...
View Discussion
RE: Reversible nephrotic range proteinuria during AKI due to biopsy-proven ATN 2 days ago
The following reference is relevant to the patient I posted. The authors report an obstetric ATN case with significant albuminuria. Interestingly, ...
View Discussion
RE: ABMR In Kidney After Liver TX 2 days ago
What was MFI for DSA? Do you have access to cf- DNA ? If so would get to assess any of allograft injury. Depending on MFI and cf-DNA would decide r...
View Discussion
RE: membranous nephropathy 2 days ago
The points about auto-antibody affinity , the "immunological sink" hypothesis " and very low but detectable levels of anti-PLA2R antibody by ELISA ...
View Discussion