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 3 (Aug 2024): Acute Kidney Injury and Critical Care Nephrology is now available online.
RE: SIADH in a patient with SAH 1 hour ago
@Tunde Tijani Interesting hypothesis! Is there published data to back it up? If so, please provide the references. Thank you ------------------...
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RE: SIADH in a patient with SAH 1 hour ago
Typo: please substitute ‘intracellular’ for intercellular. Sent from my iPhone > On Sep 18, 2024, at 4:31 PM, Tunde Tijani wrote: > > “.. is ...
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RE: SIADH in a patient with SAH 1 hour ago
“.. is it possible for intracellular osmolality to drop due to lack of solute? ..” Plausibly, if in the context of marked malnutrition/inanition, ...
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RE: Persistent Hyperkalemia 2 hours ago
First presentation with high K - (not sure if you were looking for a specific chemistry) - Thanks Na 137, K 9.3, Cl 110, HCO3 22, BUN 8, creat 0...
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RE: IgA Nephropathy 2 hours ago
As always great questions Dr. Hirsch. Thanks. Unfortunately, the answers are speculative and not evidence based. Recent data (e.g. RADAR from UK) s...
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RE: Persistent Hyperkalemia 3 hours ago
Thank you. Any reason to suspect fluoride intoxication or trans-cellular K+ redistribution? Can you plz track down the very fist chem-10 panel for ...
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RE: Persistent Hyperkalemia 4 hours ago
Thanks-normocytic normochrimic anemia. Unexplained. Any splenomegaly.? Peripheral blood smear will be very helpful for RBC morphology . ---------...
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RE: Renal Cystic Kidney Disease 4 hours ago
Do you have a birth weight on this patient? Adaptive hyperfiltration injury seems to be a likely explanation for the proteinuria. ---------------...
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RE: Renal Cystic Kidney Disease 4 hours ago
Thank you @Fouad Chebib Patient has proteinuria since age of 16 years, almost 30 years. His albumin is normal and has no oedema, does have mild H...
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RE: Persistent Hyperkalemia 4 hours ago
Calcium 7.8 to 9.2 (bicarb and diuretics for treatment may have caused some fluctuation) - but not high. ------------------------------ Dilip Un...
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RE: Persistent Hyperkalemia 5 hours ago
Was your patient ever hypercalcemic?... ------------------------------ Prem Chandran MD Adj Clinical Professor, Univ of Iowa Associates In Kidney...
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RE: Spontaneously elevated Hb despite iron deficiency in a HD patient with heart disease 5 hours ago
Thanks for your prompt response. I am going to answer your questions: - The patient maintains Hb levels between 10 and 12 g/dL without requiring Ep...
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RE: Persistent Hyperkalemia 5 hours ago
This did cross my mind many times, although patient refused. Still, I am just surprised that if renal functions are normal someone can take enough ...
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RE: Persistent Hyperkalemia 5 hours ago
WBC 4.7 - Hb 10.4 - Hct 32.3 - MCV 93.6, MCH 30.1, RDW 13, Plts 227 (all within range except H/H) Retic count 1.9 (0-2.8%), LDH 245. I will ge...
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RE: Persistent Hyperkalemia 5 hours ago
No family history. Thanks. ------------------------------ Dilip Unnikrishnan MD Nephrology Associates LLC Newburgh IN (812) 479-3125 -----------...
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RE: Persistent Hyperkalemia 5 hours ago
Can you post the full hematological indices and a peripheral smear? Rarely spherocytosis can cause Pseudohyperkalemia (fragile erythrocytes) . - wi...
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RE: Persistent Hyperkalemia 6 hours ago
This is not Addison's disease. The Urine [K] is rather generous suggesting this is not related to decreased renal K excretion. Hemolysis has be...
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Apply today!! Travel Support Scholarship for Nephrology Fellows to attend Annual Dialysis Conference, Las Vegas 2025. 6 hours ago
Annual Dialysis Conference (ADC) is thrilled to announce its dedication to advancing Nephrology fellows' education through a comprehensive program,...
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Apply today!! Travel Support Scholarship for Nephrology Fellows to attend Annual Dialysis Conference, Las Vegas 2025. 7 hours ago
Annual Dialysis Conference (ADC) is thrilled to announce its dedication to advancing Nephrology fellows' education through a comprehensive program,...
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RE: IgA Nephropathy 7 hours ago
Dr Glassock and others: It was observed long ago that IgA patients with [More]
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RE: Persistent Hyperkalemia 7 hours ago
I suppose tgat surreptitious consumption of potassium salts also needs to be considered. If ------------------------------ Richard Glassock MD, F...
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RE: Duration of PKD treatment with tolvaptan 8 hours ago
There is currently no KFRE equivalent calculator to estimate natural history vs treatment effect for each patient. There is ongoing research in thi...
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RE: Duration of PKD treatment with tolvaptan 8 hours ago
The short answer is up to age 65 (see which subset /rationale below). Tolvaptan treatment in patients with ADPKD is indicated for those at risk o...
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RE: Duration of PKD treatment with tolvaptan 8 hours ago
Thank you Dr. Klein. The upcoming KDIGO guidelines will be helping to sort the nuances between the US and European practices. Stay tuned. Keep an e...
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RE: Renal Cystic Kidney Disease 8 hours ago
I agree with Dr. Glassock. Although blocking V2R could be a therapeutic strategy in ARPKD, the human data is lacking. I would not prescribe tolvap...
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RE: Persistent Hyperkalemia 8 hours ago
Although it is a long shot, i would do generic testing (SCN4A gene). The hypoglycemia and mild anemia ate puzzling . Low AM cortisol with normal AC...
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RE: Persistent Hyperkalemia 9 hours ago
Any family history of potassium problems? Sometimes with Anderson syndrome you can see fluctuating hypokalemia and hyperkalemia. ---------------...
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Persistent Hyperkalemia 10 hours ago
I have a 40 year old female patient who has hyperkalemia - requiring dialysis on three different admissions for potassium of 8.5 and over. (the thr...
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RE: SIADH in a patient with SAH 12 hours ago
Based on the records, he was. But, there is always the chance. I was wondering if others had noticed this as well. -----------------------------...
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RE: Recurrent convulsion in hemodialysis patient 15 hours ago
Thank you dr weal for sharing this case with a very fruitful discussion and learning points ------------------------------ Saja Mohammed MD, MB...
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RE: urine alkalinization in rhabdomyolysis 17 hours ago
Combined with inconclusive data on efficacy and the very real risk of doing harm, I agree with Dr. Rodby that the practice of routinely administeri...
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RE: SIADH in a patient with SAH 17 hours ago
Was he in the hospital, so that compliance with the fluid (water restriction) could be verified? Otherwise, excess water intake cannot be excluded....
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RE: SIADH in a patient with SAH 19 hours ago
Agree, he was on a fluid restriction plus he was dialyzing frequently . Redistribution of fluid to maintain isosmotic conditions was the considerat...
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RE: SIADH in a patient with SAH 19 hours ago
The commonest cause of recalcitrant hyponatremia in an anuric patient on hemodialysis is too much free water intake. I cannot understand how your p...
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RE: SIADH in a patient with SAH 20 hours ago
Thank you for the explanation, Dr. Glassock. i never recognized the relevance of potassium and phosphorus depletion until I had a patient recentl...
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RE: SIADH in a patient with SAH 20 hours ago
Low solute excretion (having nothing directly to to do with "intracellular solute depletion) is strongly associated with hyponatremia as it impairs...
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RE: SIADH in a patient with SAH 21 hours ago
Thank you for the insight, Dr. Glassock. I was referring to situations where post op patients are sometimes very malnourished due to poor intake /...
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RE: urine alkalinization in rhabdomyolysis 21 hours ago
alkalization for TLS and rhabdo has gone a bit out of favor (the former more than the later) , because if you have a lot of cellular breakdown, you...
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RE: Spontaneously elevated Hb despite iron deficiency in a HD patient with heart disease 22 hours ago
Assuming the rest of the CBC parameters are normal, nothing suggesting a myeloproliferative disease such as P vera, with 20 years of ESRD, I would ...
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RE: Spontaneously elevated Hb despite iron deficiency in a HD patient with heart disease 1 day ago
What was the baseline hemoglobin level before it rose to 12 g/dL? Was he requiring ESA to maintain baseline hemoglobin levels (ESA must have been d...
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RE: interesting case 1 day ago
I did qualify my suggestion regarding viral infection-associated FSGS with "If MN can be confidently excluded" I do agree that reexamination of t...
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RE: interesting case 1 day ago
Interesting, very Hickam's Dictum slanted, suggestion Dr. Venkat. In this instance I am in a Reverend Occam's camp. We need more information, but i...
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RE: SIADH in a patient with SAH 1 day ago
Could you specify what you mean by "intracellular solute depletion." The major intracellular solutes are magnesium, organic phosphorous , potassium...
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Spontaneously elevated Hb despite iron deficiency in a HD patient with heart disease 1 day ago
A 42-year-old patient with chronic kidney disease on hemodialysis for 20 years due to neurogenic bladder, presented an Hb level of 12 g/dL spontane...
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RE: SIADH in a patient with SAH 1 day ago
Great discussion! How was the nutritional status of the patient? Can Intracellular solute depletion prevent the correction of serum osmolality...
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RE: urine alkalinization in rhabdomyolysis 1 day ago
Very inconclusive data on efficacy of NaHC03 in preventing AKI from Rhabdomyolysis from a recent Systematic Review and Meta-analysis . Lots of vari...
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RE: RAAS inhibition in a patient with bilateral renal artery stenosis s/p bilateral stent placement 1 day ago
Thanks for input Dr. Venkat You rightfully pointed out to cardiovascular benefit which my patient can get with RAAS inhibition although I will ha...
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urine alkalinization in rhabdomyolysis 1 day ago
Is there any bensefits of urine alkainazation or just theoretical one ?
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RE: Renal Cystic Kidney Disease 1 day ago
Sorry missed that 'homozygous pathogenic variant'. That seems rather conclusive. In that case one has to look for Carolis disease as already stated...
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RE: Renal Cystic Kidney Disease 1 day ago
The clinical presentation in this case is at variance with the genetic diagnosis. Was this mutation reported as pathogenic or likely pathogenic? An...
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