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: LN not in remission 1 hour ago
The optimum therapy for Lupus Membranous Nephropathy, with or without concomitant Class III or IV Lupus Nephritis is an unresolved enigma. We have ...
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RE: hyperaldosteronism without symptoms 1 hour ago
Plasma aldosterone levels > 100 ng/ml are commonly seen in hypertensive patients receiving spironolactone therapy. When was the blood sample drawn ...
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RE: Hypertension in pregnant patient 1 hour ago
It is essential to know the family history and whether blood pressure normalized after the first gestation. The most critical diagnosis to rule o...
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RE: Hypertension in pregnant patient 1 hour ago
Following is a good review on PA in pregnancy and eplerenone (vs. spironolactone) use in this setting. https://link.springer.com/article/10.1007/...
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RE: Possible hydralazine associated ANCA vasculitis/lupus,/treat or not 1 hour ago
Hi Dr. Rodby, We have a case with suspected hydral associated ANCA now. Pending biospy, s/p pulse + ritux, how often are you checking serologi...
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RE: Subacute to chronic thrombotic microangiopathy , what to do ? 1 hour ago
Proliferative GN with MID .(lambda restriction) --------------------------------- Alaa Nabih Abdalla nephrology fellow Egypt -------------------...
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RE: hyperaldosteronism without symptoms 1 hour ago
Does he have LV hypertrophy or hypertensive retinopathy? Renin level or activity? Home BP or ambulatory BP? Masked hypertension? ----------------...
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RE: hyperaldosteronism without symptoms 1 hour ago
That aldo measurement seems like "TMI" (too much information). I would not chase an aldosterone level--especially not with an invasive procedure-- ...
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RE: LN not in remission 2 hours ago
You "could" add RTX for the MN component but the evidence for efficacy is lacking. I do not believe that this approach is currently recommended by ...
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hyperaldosteronism without symptoms 2 hours ago
I have a curious case of 66 yo with aldosterone level 300, no hypokalemia, mild hypertension, No adenoma, or hyperplasia on MRI adrenal. Has sig h/...
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RE: LN not in remission 3 hours ago
Thanks . In our case we have chose mmf steroid/ hydroxychloroquine . Because of class v element could we add rituximab as part of induction togethe...
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RE: LN not in remission 4 hours ago
I think in this case you just pick an induction NIH IV CYC (monthly CYC for many months) Eurolupus IV CYC (500 q 2 weeks for 3 months, 3 gm t...
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RE: LN not in remission 4 hours ago
Ok thanks and why not rituximab? --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------
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RE: Hypertension in pregnant patient 5 hours ago
I agree. I would pursue genetic testing in this patient, now. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 3...
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RE: LN not in remission 5 hours ago
Wait and see. Slowly increase MMF to between 2 and 3gms per day.and be sure of compliance .Feasses in 3-6 months.? Add Belimumab. Just an opinion. ...
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RE: LN not in remission 5 hours ago
Thanks . What would people treat with lupus nephritis class3/4 and class 5 in 67 male Egfr 40/80 , positive Ana, low c3/c4 positive Ds dna. Albumin...
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RE: Hypertension in pregnant patient 7 hours ago
Renasight genetic testing by Natera is basically free and if more than $150, they will provide financial assistance program. --------------------...
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RE: Hypertension in pregnant patient 9 hours ago
The history of early onset of hypertension in childhood suggests GRA.(as pointed out by Dr. Alhosaini) Do you know the sex of the fetus? In most ca...
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RE: Hypertension in pregnant patient 9 hours ago
Would you use eplernone in pregnancy? My options r limited regarding genetic testing bc she is uninsured charity care. Refusing further imaging due...
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RE: Hypertension in pregnant patient 11 hours ago
The elevated Plasma Aldosterone rules out Geller and Liddle syndrome, but Primary Aldosteronism, apparent excess meralocorticoidusm and glucocortic...
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RE: Subacute to chronic thrombotic microangiopathy , what to do ? 12 hours ago
There is discrepancy between IF and EM results in terms of immune complex deposits. While EM showed rare electron dense deposits, IF revealed stron...
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RE: Hypertension in pregnant patient 13 hours ago
This might be a very long shot but worth mentioning, glucocorticoid remediable hypertension present at early age and sometimes get worse with pregn...
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RE: Management of glomerulonephritis secondary to low grade non-Hodkin lymphoma/CLL 16 hours ago
Tough case. The absence of detectable circulating cryoglobulins and extra-renal manifestations of Cryoglobulinemia are a bit atypical but the EM fi...
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Hypertension in pregnant patient 16 hours ago
23 y/o F, G2P1001 at 9 weeks gestation, with pmhx of chronic HTN (since 13 years old) and pre-eclampsia in previous pregnancy ( 2016 ), presented t...
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Management of glomerulonephritis secondary to low grade non-Hodkin lymphoma/CLL 18 hours ago
Dear all, I would like your opinion on managing this case of glomerulonephritis caused by cryoglobulin from a low-grade lymphoma/CLL. 60-year-ol...
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RE: Lupus, Albuminuria, and persistently positive serologies: 20 hours ago
So fast forward, she's on MMF 250 mg BID, and steroids free. 2 questions: 1) At this level of Immune suppression, can she get a live attenuate...
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RE: NSAIDS and CKD 21 hours ago
Thanks to this forum I have learned a great deal and become more open minded in the use of NSAIDS in kidney disease. I have utilized some of the ...
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RE: IgG4 related disease with slowly rising IgG4 levels 1 day ago
I would point you to the "IgG4-RD Responder Index" for guidance on disease activity: Development of an IgG4-RD Responder Index - PubMed PubMe...
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RE: Possible hydralazine associated ANCA vasculitis/lupus,/treat or not 1 day ago
Patience repeat complement now normal Creatinine down to 3 from 3.6 Repeat ANCA pending Asked pathologist look again if any if there was any evide...
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RE: IgG4 related disease with slowly rising IgG4 levels 1 day ago
If no contraindication to renal biopsy, maybe a repeat one can give more information about the ''activity'' of the interstitial nephritis. -----...
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RE: Refractory Hypercalcemia of Malignancy with hypophosphatemia (elevated 1,25-OH VitD and PTHrP) 1 day ago
Thank you, everyone, for your kind replies. I have two updates: I had ordered an FGF-23 level a few weeks ago, which has now just shown up...
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RE: Refractory Hypercalcemia of Malignancy with hypophosphatemia (elevated 1,25-OH VitD and PTHrP) 2 days ago
? Try a MAP Kinase inhibitor for palliation? ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ------------...
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RE: IgG4 related disease with slowly rising IgG4 levels 2 days ago
See the data of Choi SJ et al PLoS One. 2023; 18: e0282852) - a rising level of IgG 4 can be associated with relapse, but no one has shown improved...
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RE: IgG4 related disease with slowly rising IgG4 levels 2 days ago
I don't think that anyone has a good evidence based answer to your Challenging question. I would watch and wait.. ------------------------------...
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RE: IgG4 related disease with slowly rising IgG4 levels 2 days ago
Another suggestion : Checking UAlb/Cr and UPr/Cr on same sample of urine or U-protein electrophoresis for tubular proteinuria. ------------------...
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RE: IgG4 related disease with slowly rising IgG4 levels 2 days ago
Doubling of IgG4 level is worrisome. You may want to check CRP and sedimentation rate (elevated in 40 - 50%of patients) and PET-CT scanning. If the...
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RE: Refractory Hypercalcemia of Malignancy with hypophosphatemia (elevated 1,25-OH VitD and PTHrP) 2 days ago
Here’s what may be considered plausible: -The recalcitrant Hypercalcemia is likely from a combination of elevated PTHrp (paraneoplastic), bone met...
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IgG4 related disease with slowly rising IgG4 levels 2 days ago
A 73 yr old male presented to me 2 years ago with an acute deterioration of renal function and his creatinine peaked at 4.5. His renal biopsy showe...
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RE: Volunteer by May 8 to serve as a case report reviewer for Kidney Week 2024! 2 days ago
Thanks for your question! Full details on the scoring system will be explained upon receiving reviewer assignment. If you haven't already, please c...
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RE: Volunteer by May 8 to serve as a case report reviewer for Kidney Week 2024! 2 days ago
Thank you for your interest! Please complete this form by May 8 to be considered: https://www.surveymonkey.com/r/65T5VW5 ------------------------...
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RE: Request for Expert Opinions on Chronic Interstitial Nephritis Management 2 days ago
we had a reference yesterday for interstitial disease associated with ANCA but that is unusual and pt was on hydralazine and much higher MPO. Thi...
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RE: Request for Expert Opinions on Chronic Interstitial Nephritis Management 2 days ago
The + PR3 ANCA is highly unusual for a drug induced Interstitial nephritis, except Hydralazine. I suspect that this is an auto-immune disease. It m...
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RE: Refractory Hypercalcemia of Malignancy with hypophosphatemia (elevated 1,25-OH VitD and PTHrP) 2 days ago
It would be interesting to know if this patient's renal phosphate wasting is due to elevated FGF-23. The very high 1,25-D level is interesting and ...
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RE: LN not in remission 2 days ago
A "response" to RTX (or any anti-CD20 MoAb) is going to be very difficult to judge, short of a near complete remission, due to the possible superim...
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RE: Access to dialysis morbid obese non mobile 2 days ago
Thanks a lot Dr for that clarification I totally agree with your opinion about the need of blood clearances And if the problem of PD in such pati...
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RE: LN not in remission 2 days ago
Hi thanks for case. This patient is on a lot of medication . Is he compliant ? If we think rituximab is not working in general then not related t...
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RE: Refractory Hypercalcemia of Malignancy with hypophosphatemia (elevated 1,25-OH VitD and PTHrP) 2 days ago
I have seen that article ( appreciate you sending it ). It appears my pt was somewhat different in that 1. He never had an elevated PTHrp... only 1...
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RE: Refractory Hypercalcemia of Malignancy with hypophosphatemia (elevated 1,25-OH VitD and PTHrP) 2 days ago
Dr. Qualheim: Regarding your patient with ? sarcoma and 1-25 D3-related hypercalcemia, simultaneously elevated PTHrp and 1-25 D3 with hypercalcemia...
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RE: Refractory Hypercalcemia of Malignancy with hypophosphatemia (elevated 1,25-OH VitD and PTHrP) 2 days ago
Has MAP kinase inhibitor ever been used in this patient? According to my reading (not experience) such agents may be effective in controlloibg the ...
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RE: Refractory Hypercalcemia of Malignancy with hypophosphatemia (elevated 1,25-OH VitD and PTHrP) 2 days ago
In regards to my earlier post about ketoconazole and HCM; the pt I was alluding to had a Paraneoplastic syndrome presumed from a LUQ mass ( surgeon...
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