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 22: Issue 4 (Feb 2024): Pregnancy and Kidney Disease is now available online.
RE: Hyponatremia and misdiagnoses in a dog 4 hours ago
five things polycystic kidneys on USound polyuria polydipsia - original complaint hyperk HTN hypoNa with a dilution defect PHA1 should...
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RE: Hyponatremia and misdiagnoses in a dog 17 hours ago
Hi everyone, An update on this canine patient who had hyperkalemia and hyponatremia that didn't improve with corticosteroid and mineralocorticoid...
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RE: Recurrent MPGN with PGNMID 18 hours ago
Thank you @Roger Rodby and @Richard Glassock. I will ask our transplant department to refer him to our local myeloma specialist. ----------------...
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RE: Peritoneal dialysis in a patient with anaphylaxis to iodinated contrast dye 19 hours ago
A bird tells me this topic has been discussed before. To my knowledge there is no relationship between radio-contrast allergy & betadine allergy. B...
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RE: Peritoneal dialysis in a patient with anaphylaxis to iodinated contrast dye 20 hours ago
Please accept this in the most honest of sentiment. we really need to find ways to keep patients on home RRT as opposed to looking for ways that...
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RE: Peritoneal dialysis in a patient with anaphylaxis to iodinated contrast dye 21 hours ago
Thank you for your kind guidance. Its great that the cross reactivity is remote/minimal. I have made the patient referral to an allergist and will ...
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RE: Recurrent MPGN with PGNMID 21 hours ago
I agree, in fact if this was convincingly a PGNMID I would use dara as per more recent reports. but each of these treatment options depend on ...
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RE: Recurrent MPGN with PGNMID 23 hours ago
I would treat the recurrent PGNMID with daratumunab or CyBorD. It may not respond to RTx ------------------------------ Richard Glassock MD, FASN...
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RE: FSGS 1 day ago
I agree with Dr. Glassock that MCA infection seems to be the most likely etiology. At this age and with this proteinuria, I would also consider isc...
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RE: Peritoneal dialysis in a patient with anaphylaxis to iodinated contrast dye 1 day ago
crash cart and my lawyer :) I think the likelihood of cross reactivity anaphylaxis is remote, but I would prefer a professional opinion, from ...
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RE: Recurrent MPGN with PGNMID 1 day ago
The initial biopsy was not completely light chain restricted, but this one is very suggestive that it is, and the whole case depends on that. You...
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Recurrent MPGN with PGNMID 1 day ago
This is a 60 yr old White male whom I am co managing with our transplant nephrologist. 10 yrs ago, he was diagnosed with primary membranous nephrop...
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RE: FSGS 1 day ago
That is correct, he is not on any of antiproteinuric meds. and UPCR is ~1g/g ------------------------------ Ayaa Zarm MD Harvey LA (347) 757-711...
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RE: FSGS 1 day ago
Collapsing glomerulopathy (CG) is typically associated with heavy/nephrotic range proteinuria which is lacking in this patient (assuming he is not ...
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RE: FSGS 1 day ago
What is the serum albumin level? If normal (as is likely) this is probably not Primary FSGS. Several cases of Collapsing glomerulopathy have been a...
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FSGS 1 day ago
I have a 72-year-old man sent from nephrology clinic for AKI work up. He has had previous AKI work up around six years ago with proteinuria and pos...
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RE: Peritoneal dialysis in a patient with anaphylaxis to iodinated contrast dye 2 days ago
It might be reasonable to do an unusual experiment: in the dialysis unit, with a crash cart and epi available, deliberately expose the patient to a...
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RE: Peritoneal dialysis in a patient with anaphylaxis to iodinated contrast dye 2 days ago
See below. No relationship between radio contrast "anaphylaxis " and povidione hypersensitivity. Povidine allergy and radiocontrast reactions - h...
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RE: Peritoneal dialysis in a patient with anaphylaxis to iodinated contrast dye 2 days ago
This is the perfect time for an Allergy and Immunology consult. I would hate to exclude a patient from PD for some reason unless I was certain it...
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RE: Peritoneal dialysis in a patient with anaphylaxis to iodinated contrast dye 2 days ago
It is true that IgE mediated hypersensitivity to iodine itself is largely regarded as a "myth" and that anaphylactic reactions to IV contrast rmedi...
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RE: Peritoneal dialysis in a patient with anaphylaxis to iodinated contrast dye 2 days ago
Hello Quite a problem indeed. Can I suggest you speak with your radiologist and allergist. Not sure if the cross reactivity is very high....
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RE: Peritoneal dialysis in a patient with anaphylaxis to iodinated contrast dye 2 days ago
you could try to find a PD fluid supplier that does not use Betadine caps. Alternatively you could premedicate (steroids and anti-histamines) and h...
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Peritoneal dialysis in a patient with anaphylaxis to iodinated contrast dye 2 days ago
I have a ESRD patient with hx of anaphylaxis to contrast dye who is about to start peritoneal dialysis. Its unclear if the allergic reaction was re...
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RE: Nephrectomy VS other options 3 days ago
I had a long chat with pt's dad yesterday. According to the dad the urologist was not in favour of ureteral stent of PCN due to altered uroepitheli...
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RE: Hypereosinophilic Syndrome causing TMA? 3 days ago
Thanks for everyone's timely input. A bone marrow biopsy was performed today and the patient was started on steroid 3 days ago (after a negative st...
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RE: Hypereosinophilic Syndrome causing TMA? 3 days ago
Thank you for sharing, this patient has a combination of renal and hematological manifestations, TMA sharing common hit with avery diverese etiolog...
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RE: safety of Immunosuppression start for possibly GPA with history if bacteremia still in utine culture 3 days ago
So it was Strep faecalis several years ago and is now enterococcus faecalis I believe that this is the same organism with a new name. I would ...
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RE: proteinuria. ? timing of biopsy. 3 days ago
Fascinating story. Thanks. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ------------------------------
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RE: proteinuria. ? timing of biopsy. 3 days ago
25 years ago, infants born at less than 1 kg often had an umbilical artery catheter for nutrition and monitoring, sometimes for many weeks. Many ne...
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RE: Nephrectomy VS other options 3 days ago
Yes, I will update all. Thanks ------------------------------ Anil Sheth MD Houston 832-630-1940 ------------------------------
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RE: Nephrectomy VS other options 3 days ago
Let us know what you decide. This is a tough case without a clear treatment mandate. ------------------------------ Roger Rodby MD, FASN Pr...
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RE: proteinuria. ? timing of biopsy. 3 days ago
Fro what I can tell, this study does not require a renal biopsy https://clinicaltrials.vrtx.com/phase-23-adaptive-study-vx-147-adult-and-pedia...
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RE: proteinuria. ? timing of biopsy. Monday, March 25 @ 9:59 AM
Addendum- I too am puzzled by the discrepancy in kidney size. Low Nephron endowement. Obesity or APOL1 risk alleles do not explain this. If the cor...
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RE: proteinuria. ? timing of biopsy. Monday, March 25 @ 9:40 AM
Like Dr. Venkat , I strongly suspect that low Nephron endowment , obesity and APOL1 risk alleles are responsible for the CKD in this patient . If t...
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RE: proteinuria. ? timing of biopsy. Sunday, March 24 @ 8:28 PM
Serum albumin level? PLA2R-ab (even though MN is less likely in this age group, may avoid need for biopsy if definitely +ve)? Genetic testing for h...
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proteinuria. ? timing of biopsy. Sunday, March 24 @ 7:53 PM
23-year-old African-American female with a history of ADHD not on medications, history of morbid obesity with BMI of 48, patient was born premature...
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RE: safety of Immunosuppression start for possibly GPA with history if bacteremia still in utine culture Sunday, March 24 @ 3:14 PM
Thank you . . ------------------------------ Sadeem Ali MD Bridgeport WV (612) 865-9067 ------------------------------
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RE: safety of Immunosuppression start for possibly GPA with history if bacteremia still in utine culture Sunday, March 24 @ 2:52 PM
I do not see a pressing need for a kidney biopsy as the constellation of findings (GN, high RF, anti-PR3 antibody and bacteremia so strongly point ...
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RE: safety of Immunosuppression start for possibly GPA with history if bacteremia still in utine culture Sunday, March 24 @ 11:58 AM
Patient transferred to another hospital was found to be having blood cultures positive for pansensitive E faecalis and started on antimicrobial tre...
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RE: to treat or not to treat that is the question Sunday, March 24 @ 9:00 AM
------------------------------ Sinasi Salman MD, FASN Northlake Nephrology Mooresville NC (704) 858-4300 ------------------------------
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RE: to treat or not to treat that is the question Sunday, March 24 @ 8:59 AM
Diabetes related kidney diseases may be also associated with other genetic disorders which causes conundrums in diagnoses. -------------------...
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RE: Nephrectomy VS other options Sunday, March 24 @ 8:30 AM
Drs Rodby, Goldfarb, and Balan, I truly appreciate your comments. Will discuss with the urologist all the suggestions. Thanking you, Anil S...
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RE: Nephrectomy VS other options Sunday, March 24 @ 12:45 AM
Would suggest to try PCN , repeat nuclear scan after interval, if found ,may be considered for pyeloplasty etc --------------------------------- S...
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RE: Seeking Insights on Advanced MPO-ANCA Vasculitis Case Saturday, March 23 @ 7:07 PM
The Perils of Hydralazine- a modern day version of the Perils of Pauline. But it keeps us busy on the Open Forum. Thanks Drs. Rodby, Hirsch, Masud ...
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RE: Seeking Insights on Advanced MPO-ANCA Vasculitis Case Saturday, March 23 @ 5:48 PM
I think of hydralazine like vermin: all over the place and you grimace every time you see it. And you try to get rid of every one you see. Maybe th...
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RE: Nephrectomy VS other options Saturday, March 23 @ 5:01 PM
Dr Hirsch, Thank you so much for your insightful comments. If possible, I will try and get this information. Thanks. ------------------------...
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RE: Nephrectomy VS other options Saturday, March 23 @ 4:34 PM
There is a big issue here. CT in Feb 2023 was reported as no hydronephrosis but in Jan 2024 had severe hydronephrosis. In this case, even if there ...
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RE: to treat or not to treat that is the question Saturday, March 23 @ 4:00 PM
"severe arteriolonephrosclerosis" in biopsy. This severe pre-glomerular vascular pathology may be causing progressive glomerular ischemia and wor...
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RE: Nephrectomy VS other options Saturday, March 23 @ 1:55 PM
My gut says the questions about this "kidney" will never go away until you remove it. He is 15 and has a lot of life left that one event after the ...
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RE: Seeking Insights on Advanced MPO-ANCA Vasculitis Case Saturday, March 23 @ 1:42 PM
Dr. Rodby's comments should be directed to Cardiologists who prescribe Hydralazine for HFrEF or hypertension, and do so at the patients peril (unwi...
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