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 24: Issue 2 (May 2025): Hypertension is now available online.
RE: Natural History of treated IgAN 1 hour ago
With borderline THin BM and unexplained persistent hematuria , I would recommend Genetic testing for Alport Spectrum disorder in this patient. Whil...
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RE: GFR measurement in AKI with stable serum creatinine 1 hour ago
I will take a somewhat different position compared to Dr. Rodby- defining a "steady state" by a stable plateau of Scr during recovery from AKI can ...
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RE: sglt2 1 hour ago
We need to know the value of eGFR and UACR . What were the indications for a kidney biopsy? . Is the patient still receiving Lithium? . In the abse...
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RE: (another) Refractory Minimal Change Disease (Dialysis dependent and I promised patient I would submit) 3 hours ago
This is a bit odd "fairly normal appearing kidneys, 30% fibrosis". Is he a liver patient? I would not do PD. Did he get PLEX? You can try Obi...
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sglt2 4 hours ago
posting for colleague, 41y w htn, no dm, lithium for bipolar, bmi mid 30s Diagnosis: Focal and segmental glomerulosclerosis, perihilar varia...
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RE: GFR measurement in AKI with stable serum creatinine 5 hours ago
If you are in steady state, creatinine stable, I dont think it matters if it is CKD or AKI , and a 24 hour urine should give you a reliable creatin...
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RE: Refractory Vasculitis in a young woman 5 hours ago
unreal story. poor woman! Seems she has had CYC 3 times, a large cumulative CYC amount, but this is life threatening disease and I believe warra...
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Refractory Vasculitis in a young woman 6 hours ago
I would really appreciate input for this tough caseā¦. 21-year-old female under follow-up for ESRD on peritoneal dialysis, secondary to ANCA vasculi...
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GFR measurement in AKI with stable serum creatinine 8 hours ago
Greetings to all community members If a patient developed AKI and serum creatinine stabilised at certain level for 3 days, is it valid to measure...
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RE: Natural History of treated IgAN 8 hours ago
Here is the message I received from the nephropathologist: "I took 100 measurements of GBMs with a mean of 269 nm, range = 126-384 nm. This is ...
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RE: Treatment Of Sarcopenia In HD 9 hours ago
Great question. As far as I know, nutritional supplementation and exercise ( *often intra-dialytic) are the main recommendations. Pharmacologic the...
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RE: Bartter's syndrome vs primary hyperaldosteronism 10 hours ago
the ARR in the review paper cited by Dr. Balan to distinguish PA in pregnancy is a threshold 40 using picomoles per L for serum aldosterone and dir...
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RE: Bartter's syndrome vs primary hyperaldosteronism 10 hours ago
Dear. Dr. Besarab, I have attached a good review article on the subject, I hope it helps ------------------------------ Vito M Campese Pro...
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RE: Another hypokalemia case 11 hours ago
What is unique i this case is the very high Aldo level, high aldo/renin ratio, yet K+ almost overcorrected while 16 mEq/day taken 4h. So the dose i...
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RE: Natural History of treated IgAN 11 hours ago
To my eye, some of the GBM appear "thin". I would request that pathology conduct a formal morphometric analysis of GBM thickness and if abnormally ...
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RE: Bartter's syndrome vs primary hyperaldosteronism 11 hours ago
Here is the article ------------------------------ Satish Balan MD DM DNB Senior Consultant Department of Nephrology Kerala Institute of ...
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RE: Bartter's syndrome vs primary hyperaldosteronism 11 hours ago
Dear Dr. Campese Could not find the refrence on he Journal website and PYb Med is down. Would you have a pdf of the article to share? ---------...
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RE: Natural History of treated IgAN 13 hours ago
Here are the anonymized EM pictures ------------------------------ Prem Chandran MD Adj Clinical Professor, Univ of Iowa Associates In Kidney Car...
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RE: Bartter's syndrome vs primary hyperaldosteronism 14 hours ago
I think a final diagnosis at this stage is very difficult. The renin above 5, the low ARR ratio and the normal BP (although this could be explained...
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RE: Bartter's syndrome vs primary hyperaldosteronism 22 hours ago
50 posts in the thread- second highest for 2025-so far.!! Great participation and a fantastic learning opportunity. Thanks to Dr. Jebur for startin...
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RE: Another hypokalemia case 1 day ago
Thank you both, that is the current plan. ------------------------------ Graham Rodwell MD Palo Alto Medical Foundation Palo Alto CA -----------...
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RE: Another hypokalemia case 1 day ago
I agree with Dr. Rodby. Stop the K supplemental Oral K and repeat the PRA and serum Aldosterone once the hypokalemia recurs, if it does at all.. ...
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RE: Natural History of treated IgAN 1 day ago
I wonder what segmental attenuation means. Can you post a de- identified EM photomicrograph showing the structure of GBM? With such a relatively fa...
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RE: Natural History of treated IgAN 1 day ago
Thx very much.....these days so much emphasis is placed on persistence of hematuria (as an indicator of persisting glom inflammation) in IgAN pts e...
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RE: Natural History of treated IgAN 1 day ago
https://qxmd.com/calculate/calculator_499/international-igan-prediction-tool-at-biopsy-adults# ------------------------------ Roger Rodb...
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RE: Another hypokalemia case 1 day ago
can you say anything about an aldo level when the K is this "high" (not low)? -6/4/2025: aldo 106, PRA 1.06, K 5 -6/13/2025: aldo 133, PRA 1....
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RE: Another hypokalemia case 1 day ago
Proven Prinary Hyperaldosteronism (in non-pregnant patients) without hypertension is very uncommon but numerous case reports have well documented t...
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RE: Natural History of treated IgAN 1 day ago
Below is the EM part of the Bx: One block is prepared. Ultrastructural evaluation of a glomerulus reveals basement membranes that are segmentally...
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RE: Refractory MCD 1 day ago
Secondary steroid and RTX resistance implies a poor prognosis and a very high risk of recurrent Disease post -transplant . He likely has Prinary FS...
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Another hypokalemia case 1 day ago
Wonder where others might go with workup for the following case, hypokalemia without HTN, initially normal aldo followed by rpt in the 100 range, w...
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RE: Refractory MCD 1 day ago
https://www.kireports.org/article/S2468-0249(25)00389-4/fulltext ------------------------------ Marwan Abu Minshar MD, FASN Essentia health Fa...
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RE: ANCA Neg NCGN with Membranous- treatment advice 1 day ago
Like Dr Rogby, I have seen several cases of cANCA and pANCA ELISA negative necrotizing GN biopsies and one autopsy case of necrotizing GN with diff...
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RE: Bartter's syndrome vs primary hyperaldosteronism 1 day ago
Thank you for your illuminating discourse. ------------------------------ Anatole Besarab MD ABesarab Consulting Scottsdale AZ (734) 417-4793 --...
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RE: Treatment Of Sarcopenia In HD 1 day ago
I have attached a LONG review on this Assuming you are not missing a diagnosis (endocrine, cancer etc) which I will assume you are not, M...
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RE: Refractory MCD 1 day ago
did you check CD 19 to see if rituximab did what it is supposed to do? If so and CD 19 were deleted with rituximab, I wonder about the advantage...
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RE: Refractory MCD 1 day ago
Hodgkin's disease in a sibling increases the risk of Hodgkin's disease 6 fold for thus patient, but it is still a rare cause of treatment resistant...
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Treatment Of Sarcopenia In HD 1 day ago
We have seen many patients with ESKD on maintenance HD developed profound sarcopenia. Any helpful treatments?
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RE: (another) Refractory Minimal Change Disease (Dialysis dependent and I promised patient I would submit) 1 day ago
Thanks for the FU. Very challenging case!! The repeat biopsy revealed the expected findings of moderately advanced Primary FSGS The eGFR of 13ml/mi...
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RE: Bartter's syndrome vs primary hyperaldosteronism 1 day ago
Many thanks, Dr. Glassock. Yes, your assumption is absolutely correct. In a pregnant patient with either Conn or Gitelman syndrome, eplerenone woul...
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Refractory MCD 1 day ago
An 18-years-old male patient presented with severe nephrotic syndrome at Jan 2025 who was treated empirically with high dose steroids that showed c...
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RE: Bartter's syndrome vs primary hyperaldosteronism 1 day ago
Many thanks. This is very helpful. Your analysis , would also suggest that the use of Eplerenone would be be preferred over spironolactone in a Pre...
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RE: Bartter's syndrome vs primary hyperaldosteronism 1 day ago
Thank you, Dr. Glassock, for your thoughtful question and kind feedback. If genetic testing were to confirm a pathogenic SLC12A3 mutation consisten...
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RE: (another) Refractory Minimal Change Disease (Dialysis dependent and I promised patient I would submit) 1 day ago
Some Follow up (now 8 months after my original post). Patient remains dialysis dependent but only 2 days a week primarily for volume management wit...
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RE: Bartter's syndrome vs primary hyperaldosteronism 1 day ago
Dr. Filler -great Summary and analysis. One thing-would you manage her Pregnancy any differently if Genetic Testing was positive for a pathogenic G...
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RE: Natural History of treated IgAN 1 day ago
The more "modern approach" to prognostication in IgAN is the International IgA Nephropathy Risk Prediction tool (see QxMD for an online version). I...
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RE: ANCA Neg NCGN with Membranous- treatment advice 2 days ago
In 2017 an International Consensus Group recommend abandoning IIF-based screening tests for ANCA ( due to high variability of results and lack of s...
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RE: Bartter's syndrome vs primary hyperaldosteronism 2 days ago
This makes 3+ of us emphasizing the importance of time on many cases in reaching a diagnosis. Ass i wrote in this bog, I could not get a definitive...
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RE: Natural History of treated IgAN 2 days ago
from what I understood the question that you (your patient) is trying to pose is even if proteinuria improves with current management and reaches t...
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RE: Bartter's syndrome vs primary hyperaldosteronism 2 days ago
"As King Solomon might have said, sometimes the true diagnosis is revealed not by the test result, but by time." "I teach this to trainees all th...
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RE: Bartter's syndrome vs primary hyperaldosteronism 2 days ago
Dr.Filler had an excellent point here with diagnostic humility. It was very interesting discussion , I definitely learned alot. in pregnancy it ...
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