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: Primary FSGS 18 minutes ago
Was the mutation described as pathogenic or likely pathogenic? ------------------------------ Satish Balan MD DM DNB Nephrologist Kerala Institu...
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RE: Primary FSGS 1 hour ago
Good morning everyone! I have an update on this patient. Stopped calcineurin inhibitor. 3/2024: SCr is 2.8 to 3 mg/dl [eGFR 24ml/min]; Seru...
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RE: Chronic active Antibody mediated rejection 17 hours ago
Besides acute vs. chronic changes in the biopsy and magnitude of proteinuria, in my experience two factors strongly influence outcomes following tr...
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RE: Antibiotic Lock For Temporary Dialysis Cath 19 hours ago
Any evident that antibiotic lock in temporary dialysis Cath has role after removal of infected tunneled dialysis Cath? ---------------------------...
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RE: Antibiotic Lock For Temporary Dialysis Cath 21 hours ago
Options: Citrate lock Citrate + gentamicin lock Chlorhexidine wick ------------------------------ Ashraf El-Meanawy , MD, MS, PHD, FASN Pro...
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RE: Chronic active Antibody mediated rejection 21 hours ago
Let's agree that chronic active Antibody mediated rejection is very challenging and most evidence are limited yet we don't have consensus guideline...
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RE: SELPERCATINIB and ckd 1 day ago
Hi . would consider the case of a " false AKI " due to the TKI also inhibiting MATE 1 ( multidrug extrusion transporter ) and go for a cistatin c d...
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RE: Proteinuria with inconclusive biopsies x 2 1 day ago
Agree- an antiPLA2R antibody test will be non- informative. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-88...
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RE: Myeloproliferative disease and CKD 1 day ago
Here is one citation. Smith ER, et al NDT 2012; 27:1534 ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 -...
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RE: Proteinuria with inconclusive biopsies x 2 1 day ago
I will proceed with genetic testing Thanks for all your help and sorry for the late reply ------------------------------ Asjad Sardar MD SOUTHW...
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RE: Proteinuria with inconclusive biopsies x 2 1 day ago
Hi Dr Venkat His BP has been under the target of < 130/80. Patient is compliant and as per his home logs, BP has generally been in 120s/70s but I...
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RE: Myeloproliferative disease and CKD 1 day ago
Would you kindly give the article that validate use of uacr/upcr for gn and tubular disease? --------------------------------- Youngho Kim MD Pac...
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RE: Proteinuria with inconclusive biopsies x 2 1 day ago
Thanks Dr Hirsch Both kidneys are normal in size and echogenicity I agree with your assessment that despite having significant protienuria whil...
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RE: Proteinuria with inconclusive biopsies x 2 1 day ago
Thanks Dr Glassock There were scattetred immune deposits with some increase in cell activity. Patchy effacement of foot processes in 30% of capil...
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SELPERCATINIB and ckd 1 day ago
56 yo female h/o M EN 2A , medullary thyroid carcinoma s/p total thyroidectomy in 2004 , received radiation therapy in 2008-2009, was on surveillan...
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RE: Myeloproliferative disease and CKD 1 day ago
Jakafi is a very rare "cause" of progressive CKD/AKI . See Strohben S, et al. Am J Hematol 2020; 95:e181-e183 ------------------------------ Ric...
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RE: Chronic active Antibody mediated rejection 1 day ago
"Urine dipstick was neg for protein long ago (6/22) but ACR at the same time was 78.52" I assume that the ACR of 78.52 is mg albumin/g UCr. Genera...
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RE: Myeloproliferative disease and CKD 1 day ago
Dr. Venkat is quite correct to bring up the possibility of a tubulo-interstitial disease. Examining a UACR/UPCR ratio or a urine retinol binding pr...
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RE: Chronic active Antibody mediated rejection 2 days ago
Thanks. He is not wheel chair bound anymore. Unfortunately, ACR requested multiple times over the past almost 2 years but was not done. Urine dipst...
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RE: Myeloproliferative disease and CKD 2 days ago
What medications is he on for hypertension? Complete list of medications? Serum IEP, kappa:lambda light chains, uric acid, calcium? Bland urine s...
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RE: Myeloproliferative disease and CKD 2 days ago
Proteinuria CKD is a well described complication of myelodysplastic syndromes, due to concomitant bleeding disorders kidney biopsy identification o...
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Myeloproliferative disease and CKD 2 days ago
hope to get some comments on this case. 65 y/o man, with Myeloproliferative disease initially presented with leukocytosis, polycythemia ver...
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RE: alport syndrome+Ig A nephropathy + podocytopathy 2 days ago
no edema at all, with normal lipid profile ------------------------------ Ahmed Mahedy PhD Banha Faculty of Medicine Banha ----------------------...
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RE: IgA 2 days ago
"One last shot" or "beyond the point of no return" - the great dilemma of clinical Nephrology and glomerular disease- someday, probably with the he...
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RE: alport syndrome+Ig A nephropathy + podocytopathy 2 days ago
I am going to acquiesce to my (many) colleagues opinions above and retract my steroid consideration advice. I think their opinions are sound ...
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RE: IgA 2 days ago
Agree with Dr Venkat, the ultrasound is a poor man's biopsy, and if it shows small echo-dense kidneys c/w a high fibrosis score on biopsy, that wil...
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RE: SLE cFSGS and Apol1 2 days ago
Collapsing Glomerulopathy due to high-risk APOL1 alleles in a patient who co- incidentally has SLE vs a Patient with SLE and a Lupus Podocytopathy ...
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RE: alport syndrome+Ig A nephropathy + podocytopathy 2 days ago
6 grams of proteinuria per day is high but with a normal serum albumin not high enough to make a primary (non-genetic ) Podocytopathy likely. In st...
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RE: IgA 2 days ago
Serial kidney ultrasound results (size, echogenicity, cortical thickness)? ------------------------------ K.K. Venkat MD Troy MI (248) 420 7798 ...
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RE: alport syndrome+Ig A nephropathy + podocytopathy 2 days ago
Let us ignore the GBM ultrastructural abnormalities and the IgA deposits. The presentation in this patient with only 6 g proteinuria and near norma...
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Antibiotic Lock For Temporary Dialysis Cath 3 days ago
Hi all I want your opinion in patient on dialysis with permicath infection Entrrobacter cloacae tunneled catheter remove bed kept on fortium anti...
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RE: alport syndrome+Ig A nephropathy + podocytopathy 3 days ago
I am attaching the reference Dr Glassock referred to which implies that Alport variants and IgA coexistence may not be totally coincidental. ...
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RE: SLE cFSGS and Apol1 3 days ago
It is hard to ignore the SLE serology and symptoms. SLE and APOL1 high risk genotypes have been associated with such a presentation - see atta...
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RE: SLE cFSGS and Apol1 3 days ago
My guess is that this is APOL1 Nephropathy (Collapsing GN) in a patient that happens to have SLE and who is a elaborating an excess of Interferon...
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SLE cFSGS and Apol1 3 days ago
#1 biopsy FINAL DIAGNOSIS: A-C) Kidney biopsy: Focal and segmental glomerulosclerosis (FSGS), collapsing variant (see Comment). Extensive global gl...
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RE: alport syndrome+Ig A nephropathy + podocytopathy 3 days ago
thank u sir, L/M : 12 glomeruli, 2 global sclerosed, 3 segmental sclerosed, the other glomeruli with moderate increase in mesangial cellularity a...
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RE: IgA 3 days ago
With a slowly progressive disease , in the absence of hematuria and a current eGFR in the low 30's this patient is approaching a "point of no retur...
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RE: alport syndrome+Ig A nephropathy + podocytopathy 3 days ago
With an M1, E0, CO lesion and only moderate hematuria (easily explained by background Alport's Syndrome lesions) I do not see much of a role for st...
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RE: Chronic active Antibody mediated rejection 3 days ago
As Dr Venkat and Dr Glassock have pointed out, the prognosis is poor. With a wheelchair bound patient and severe osteodystrophy, I would suggest op...
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RE: IgA 3 days ago
I find it hard to combine the pulmonary fibrosis with IgAN as much as I respect Occam. IgAN is common enough that I think coexistence with many thi...
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IgA 3 days ago
58 yo man has a history of pulmonary fibrosis and IgA nephropathy. Pertinent history: - he was told to have microscopic hematuria since age 22. - 2...
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RE: alport syndrome+Ig A nephropathy + podocytopathy Thursday, March 14 @ 10:54 PM
Thank you I would be careful regarding using steroids and I would recommend going for genetic testing as his EM is suggestive for the possibili...
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RE: PR3 Vasculitis - input appreciated! Thursday, March 14 @ 9:22 PM
Interesting, thank you for sharing! Its though that he doesn't exhibit any symptoms similar to serum sickness , Symptoms wise from vasculitis stan...
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RE: PR3 Vasculitis - input appreciated! Thursday, March 14 @ 9:21 PM
This is very likely RISS , with platelet consumption and worsening glomerular disease due to the effects of serum sickness. I would switch to a CYC...
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RE: Chronic active Antibody mediated rejection Thursday, March 14 @ 9:17 PM
Agree with Dr. Venkat. Very poor prognosis as therapy for chronic ABMR is relatively ineffective. If possible, would try to enroll the patient in a...
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RE: PR3 Vasculitis - input appreciated! Thursday, March 14 @ 9:13 PM
Thank you for the response Dr.Glassock. couple of added info per your comment Immunofluorescence staining is performed using antibodies to Ig...
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RE: PR3 Vasculitis - input appreciated! Thursday, March 14 @ 9:11 PM
Great information. Many thanks Dr. Friedman . This, I think, solves the mystery surrounding this case- this is RISS. ----------------------------...
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RE: Chronic active Antibody mediated rejection Thursday, March 14 @ 8:33 PM
Current urine albumin:creatinine or urine protein:creatinine ratio? Is serum creatinine is now stable (at what level) or is it still fluctuating up...
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RE: PR3 Vasculitis - input appreciated! Thursday, March 14 @ 8:28 PM
https://pubmed.ncbi.nlm.nih.gov/26199061/ ‘Most episodes of…RISS [rituximab-induced serum sickness] occurred…[after] the second dose…57.9%.’ ----...
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Chronic active Antibody mediated rejection Thursday, March 14 @ 7:16 PM
29 years old gentleman, cadaveric transplant in 2015, cellular rejection in 2018, treated elsewhere with Steroid and ATG (details not known). Creat...
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