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: A case of nephrocalcinosis 2 hours ago
Great pathophysiological explanations, but how confident are we that K citrate will be beneficial (and not harmful ) in incomplete distal RTA with ...
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RE: Diagnosis of ADPKD 3 hours ago
Assuming a height of 1.7m and HtTKV of 750 ml he is Class IB by the Mayo System at not at risk for rapid progression and therefore not eligible for...
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RE: Diagnosis of ADPKD 5 hours ago
Thank you all for your replies.Just for my clarification, would he be class II on the Mayo classification because of the paucity of cysts?
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RE: Diagnosis of ADPKD 5 hours ago
I agree that even if genetic testing confirmed ADPKD (without a family history) he would not be a candidate for Tolvaptan therapy. --------------...
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RE: Diagnosis of ADPKD 8 hours ago
His eGFR is 98 ml/min and is stable since 03/2019. He has no known family history as I mentioned earlier. ------------------------------ Syed Ali...
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RE: Diagnosis of ADPKD 9 hours ago
That's a huge left kidney for only two cysts. I guess the two cysts must be quite large. Does he have a family history? Genetic test is required i...
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RE: Diagnosis of ADPKD 9 hours ago
What is the current eGFR and its trajectory over the 12 previous months ? ------------------------------ Richard Glassock MD, FASN Laguna Woods C...
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Diagnosis of ADPKD 9 hours ago
Hello I have a 47 year old male and I am suspecting he has ADPKD. The issue is that he only has 1 cyst in the right kidney and 2 cysts in the lef...
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RE: sero negative Anti-GBM disease 10 hours ago
Addendum- A connection between RCC and anti-GBM Disease has been noted in the literature. Does your patient have metastatic RCC? (See Rivedal ...
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RE: sero negative Anti-GBM disease 10 hours ago
I will express my opinion on this interesting case. It is NOT "Atypical Anti-GBM disease, The patient has RPGN with extensive crescents and DAH. Th...
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sero negative Anti-GBM disease 10 hours ago
Esteemed colleagues, I would like you opinion on an interesting case. I have a 62 year old male with a PMH of RCC s/p R nephrectomy, CKD III (bl...
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RE: A case of nephrocalcinosis 11 hours ago
My understanding is this: The nephrocalcinosis/stones from D-RTA is because of a daily positive H+ balance and a resultant negative HCO3 balance....
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RE: A case of nephrocalcinosis 11 hours ago
The current literature does not support the use of K Citrate to prevent Calcium Phosphate nephrolithiasis. Is K citrate beneficial in Nephrocalcino...
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RE: A case of nephrocalcinosis 12 hours ago
Thank you everyone for your replies. @John Asplin, I apologize the pictures didn't show up. I edited the post to add the images again and it's sup...
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RE: A case of nephrocalcinosis 16 hours ago
Is K Citrate an effective therapy for Calcium Phosphate medullary nephrocalcinosis due to incomplete Distal RTA?. That is the question in this case...
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RE: A case of nephrocalcinosis 16 hours ago
@John Asplin Lets assume this is D-RTA, and while mild (perhaps incomplete as suggested, may be harder to tell bc HCO3 may be a bit lower than fr...
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RE: A case of nephrocalcinosis 17 hours ago
I like Dr Rodby's analysis. I don't see any 24 hr urine data in the attachment (only radiology images). Perhaps I am missing something. Just a qu...
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RE: A case of nephrocalcinosis 1 day ago
Nice analysis Dr. Rodby. How would you go about "proving " that this is an incomplete distal RTA secondary to Primary Biliary Cirrhosis. Any "dia...
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RE: A case of nephrocalcinosis 1 day ago
I suspect the medullary sponge diagnosis comes from the nephrocalcinosis, but we have another potential etiology. Diarrhea should have a lower U...
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RE: AL Amyloid & Serologic tests 1 day ago
AL (lambda) amyloid should show staining for lambda only by IF. If there is additional staining for other immunoglobulins, then I wouldn't trust it...
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RE: AL Amyloid & Serologic tests 1 day ago
Interesting discussion The sensitivity of bone marrow clone detection for AL amyloid is 100%, I think the question of the biopsy pathophysiology ...
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RE: AL Amyloid & Serologic tests 1 day ago
Dr. Cornell- thank you for making an important point about the pitfalls present in the use of standard IF for making a confirmed diagnosis of AL Am...
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RE: positive anti Ro 60 1 day ago
Might be I have to learn how to deal with massive info ------------------------------ Zvi Barnea MD ------------------------------
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RE: positive anti Ro 60 1 day ago
Sorry , I think you mean the other patient I , posted today with monoclonal iGM , yes I thought that she may have her ckd due to monoclonal deposit...
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RE: positive anti Ro 60 1 day ago
As far as I remember , her Cr is around 1 mg/dl. Protein in urine not that high. What about Serum & urine protein EF And you can give her a small...
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RE: positive anti Ro 60 1 day ago
Thanks for your time if the biopsy come diagnostic of lupus nephritis mostly class 3 or 4 I will give both MMF and steroid . if it shows interst...
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RE: positive anti Ro 60 1 day ago
Watch her clinical & lab status closely, react to abrupt change . What can a biopsy bring in terms of treatment that you do not do now? Sincerely...
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RE: positive anti Ro 60 1 day ago
What you suggest sir for next step ------------------------------ Ahmed Abdelfattah MD, MBChB, MSc Assistant professor (Internal medicine hospita...
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RE: positive anti Ro 60 1 day ago
She will have no benefit from a biopsy ------------------------------ Zvi Barnea MD Senior Physician, Nephrology Barnea -----------------------...
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RE: AL Amyloid & Serologic tests 1 day ago
I think makings diagnosis on biopsy & blood test is good to a certain point (especially if the disease read the textbook). In rare cases, I am not ...
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A case of nephrocalcinosis 1 day ago
A 47-year-old female patient with PMHx of primary biliary cirrhosis was referred to me for suspected medullary sponge kidney and nephrocalcinosis s...
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RE: monoclonal IgM kappa in ckd patient 1 day ago
Thanks for your time , I will follow up her with Flc , and update ------------------------------ Ahmed Abdelfattah MD, MBChB, MSc Assistant prof...
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RE: monoclonal IgM kappa in ckd patient 1 day ago
Thank you for your reply , I refred her to hematologist for work up . I will follow her and update thanks ------------------------------ Ahm...
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RE: monoclonal IgM kappa in ckd patient 1 day ago
According to the latest criteria for FLC levels adjusted for eGFR ( Long TE, et al Nature -Blood Cancer Journal 2022 12: 133) this patient FLC rati...
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RE: AL Amyloid & Serologic tests 1 day ago
I am concerned that this is NOT AL type amyloidosis. According to the immunofluorescence report, "There is capillary loop staining with IgG (2+), I...
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RE: monoclonal IgM kappa in ckd patient 1 day ago
at 80, with a stable creatinine for the most part minimal albuminuria and proteinuria, nl k/l ratio I would not so a renal biopsy her, at le...
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RE: Metabolic alkalosis 1 day ago
Laxative and diuretic abuse is so hard to diagnose, patients are clever and not going to be forthright. Sometimes the only way to prove it is ...
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RE: case of hypokalemia and hypomagnesemia 1 day ago
excellent thought. Hopefully @Mustafa Saidi can get genetic testing for this (as well as other tubular diseases). HNF1B is included in Natera'...
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RE: Metabolic alkalosis 1 day ago
Would the low renin not be expected given metoprolol? I wonder whether she’s abusing laxatives (‘chronic diarrhea…normal colonoscopy’). UCl may n...
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RE: case of hypokalemia and hypomagnesemia 1 day ago
Would the low aldo not be expected given hypoK + lisinopril (‘was on lisinopril’ I assume included when aldo was checked)? The hypoMg severity + ...
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monoclonal IgM kappa in ckd patient 1 day ago
An 80-year-old woman with a history of essential thrombocytosis is currently on a medication regimen that includes 500 mg of hydroxycarbamide, 20 m...
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RE: case of hypokalemia and hypomagnesemia 2 days ago
Dr. Saidi: Was hyponatremia documented before or after starting amiloride? ------------------------------ K.K. Venkat MD Troy MI (248) 420 7798 -...
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RE: Budenoside for IgA Nephropathy 2 days ago
Very limited Data , and no RCT, but generic delayed release Budesonide seems to reduce proteinuria ink Primary IgAN. No long term eGFR slope studie...
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RE: case of hypokalemia and hypomagnesemia 2 days ago
The PRA is at the lower limit of normal and the serum aldosterone is definitely suppressed. Hypomagnesemua can be observed in licorice induced pseu...
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RE: positive anti Ro 60 2 days ago
Thanks for the information- with hematuria, proteinuria and progressive loss of nephrons now is the time to make a decision on empiric treatment (w...
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RE: case of hypokalemia and hypomagnesemia 2 days ago
Dr. Glassock to correct myself, there is a urine spot chloride of 33 mmol/L ------------------------------ Mustafa Saidi MD Nephrology Departm...
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RE: case of hypokalemia and hypomagnesemia 2 days ago
Dr, Madan, bicarb ranges from 27 to 35, so does have some alkalosis The hypomagnesemia irritated me too. We do not have an ABG Aldo was supp...
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RE: case of hypokalemia and hypomagnesemia 2 days ago
Dr. Rodby she is not on PPI ------------------------------ Mustafa Saidi MD Nephrology Department Albert Einstein Philadelphia PA -------------...
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RE: case of hypokalemia and hypomagnesemia 2 days ago
I was not aware that these can also cause a low mag. The renin activity was not suppressed, was in nl range. The Aldo and renin were drawn at 5 a...
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RE: positive anti Ro 60 2 days ago
Thanks for time. He has a history of occasional right parotid enlargement, but there is no clinical evidence of parotid swelling. I recommended a ...
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