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 5 (Dec 2024): Transplantation is now available online.
RE: Refractory membranoproliferative glomerulonephritis 5 hours ago
In my opinion, LC staining and Pronase digestion with Paraffin IF is appropriate in this case. It could be a MRGS. ------------------------------...
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RE: Perstistantly high Anti-GBM titre 5 hours ago
Dr. Venkat-I agree- I assumed that crescentic disease with linear IgG deposits would be present. With a positive serum aGBM , using an ELISA assay ...
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RE: Perstistantly high Anti-GBM titre 5 hours ago
@Christian Kuhn: did your patient's kidney biopsy show a linear IMF pattern consistent with anti-GBM antibody disease? Have you tested for serum an...
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RE: Perstistantly high Anti-GBM titre 6 hours ago
Thanks for putting it. I have a similar patient. Received 3 months of Immunosuppression after PP but no recovery. Now planned for transplant, anuri...
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RE: Refractory membranoproliferative glomerulonephritis 7 hours ago
Dear all, Due to the patient's history as well as the laboratory results LC staining has not been performed . Neither has been a Pronase digeste...
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RE: Perstistantly high Anti-GBM titre 8 hours ago
Dr. Kuhn - a very rare example of persistent anti-GBM antibody production . In over 50 years experience with this disease, I can only remember 2 or...
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Perstistantly high Anti-GBM titre 12 hours ago
A 44-year-old previously healthy woman presented to the ER in October 2024 with fatigue and a subfebrile temperature. Workup revealed anti-GBM dise...
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RE: AKI. Clinic 13 hours ago
Very intriguing idea. The purpose seems more like a statement of a hypothesis. How will you test the efficacy of your AKI clinic in achieving its a...
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RE: Primary Hyperparathyroidism 19 hours ago
Typically, adynamic bone disease results in hypercalcemia with low PTH. However, if preceding secondary HPT was marked, subsequent adynamic bone di...
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RE: lupus and RCC 19 hours ago
Current SCr/eGFR? Clear cell RCC is an aggressive type of RCC. Despite him being "cleared" from the RCC perspective, given his past heavy immunosup...
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RE: FSGS with mesangial IC "full house" 20 hours ago
Pathologist didn’t notice any glomerulomegaly. --------------------------------- Prakrati Acharya MBBS, FASN CHANDLER AZ (774) 826-7062 -------...
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RE: AKI. Clinic 21 hours ago
1. Purpose To ensure structured post-AKI follow-up that facilitates kidney recovery, optimizes medication adjustments, and prevents the progression...
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RE: AKI. Clinic 22 hours ago
What are your goals and objectives? How will you measure the success of the enterprise? ------------------------------ Richard Glassock MD, FASN ...
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AKI. Clinic 23 hours ago
I am planning to start AKI clinic And I need help and share ideas and suggestions About that
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RE: lupus and RCC 1 day ago
I would guess that a triple therapy regimen , MMF+Belimumab + lowest dose steroids (5mg/day or less) would be my choice. Ithe Hydroxychloroquine sh...
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lupus and RCC 1 day ago
Good afternoon, I have a 49 y/o Caucasian male with stage 4 lupus nephritis diagnosed 2014 -> received 2 doses of rituximab -> did not respond...
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RE: Primary Hyperparathyroidism 1 day ago
Good question. In my experience, tertiary hyperparathyroidism associated with CKD most commonly presents with multiple nodules, resembling adenomas...
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RE: FSGS with mesangial IC "full house" 1 day ago
Dr. Jebur - Good question. The subtype of the FSGS lesion called "Peri-hilar FSGS" commonly underlies ORG, but nearly always marked glomerulomegaly...
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RE: FSGS with mesangial IC "full house" 1 day ago
Was the FSGS lesions perihilar type secondary to hyperfiltration of morbid obesity? I think the presentation of this patient is consistent with s...
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RE: Primary Hyperparathyroidism 1 day ago
is detection of parathyroid adenoma consistent with primary hyperparathyroidism rather than secondary hyperparathyroidism? what is the cause of h...
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RE: FSGS with mesangial IC "full house" 1 day ago
@Richard Glassock Thank you very much for your input. With the concern of C1q I had discussed with patient about MMF but then he had 2 brief hospit...
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RE: FSGS with mesangial IC "full house" 1 day ago
Dr. Angioi- many thanks for your interesting, bold statement and prediction- my clinical experience and the published literature suggests a differe...
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RE: FSGS with mesangial IC "full house" 1 day ago
Thank you for sharing. Despite normal albumin and nephrotic-range proteinuria, I note an extensive foot-process effacement on EM. I expected a sign...
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RE: Proteinuria 1 day ago
Diffuse podocyte effacement can be seen in DN per se. Increase in SCr from 1.2 mg to 3.2 mg over ~ 21 months can also be explained by DN. Unless ve...
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RE: FSGS with mesangial IC "full house" 1 day ago
The normal serum albumin and severe nephrotic range proteinuria makes Primary FSGS very unlikely. The IF and EM point toward C1q Nephropathy. With ...
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RE: FSGS with mesangial IC "full house" 1 day ago
SAlb and lipids level? ANA, C3, C4, anti D.S.-DNA ab? Extent of edema? ------------------------------ K.K. Venkat MD Troy MI (248) 420 7798 -----...
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RE: IgA nephropathy case in a young Caucasian female 1 day ago
60-70% IFTA ------------------------------ Janis Lawrence-Jackson DO, FASN Sarasota FL (941) 917-8722 ------------------------------
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RE: IgA nephropathy case in a young Caucasian female 1 day ago
severe IFTA ------------------------------ Janis Lawrence-Jackson DO, FASN Sarasota FL (941) 917-8722 ------------------------------
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RE: IgA nephropathy case in a young Caucasian female 1 day ago
cystatin C 1.77 ------------------------------ Janis Lawrence-Jackson DO, FASN Sarasota FL (941) 917-8722 ------------------------------
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RE: IgA nephropathy case in a young Caucasian female 1 day ago
severe epithelial foot process effacement; tubular basement membranes are without deposits ------------------------------ Janis Lawrence-Jackson ...
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RE: Is It LN?? 2 days ago
Prof glassock another question if I may Aki and nephrotic syndrome ( efgr 30 from 90 with urine pcr>10 g lets say and primary membranous do you use...
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FSGS with mesangial IC "full house" 2 days ago
Would appreciate input regarding next steps in management. 52 yo M with obesity (BMI - 58), HTN on Lisinopril, gout was referred to our practice...
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RE: Is It LN?? 2 days ago
Thanks prof glassock . Appreciate your input and helpful as always --------------------------------- Muhammad Soobadar MBChB UK ---------------...
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RE: Timings for stoping Mycophenolate after Rituximab 2 days ago
If MMF therapy was failed and you want to initiate RTX, I will stop MMF abruptly and I see that RTX works faster in MCD compared to MN. ----------...
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RE: IgA nephropathy case in a young Caucasian female 2 days ago
Any data that microscopic hematuria is a risk factor for CKD progression? Any thoughts about this slide from the ISN academy lecture about utility...
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RE: Primary Hyperparathyroidism 2 days ago
I agree with prof Glassock and find sestamibi to be of limited value in this situation ------------------------------ Stuart Sprague DO, FASN Dir...
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RE: Proteinuria 2 days ago
My thoughts were strive to not to discontinue SGLT2i in patients with recurrent UTI as treat them empirically with ABX and recurrent to use long-te...
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RE: IgA nephropathy case in a young Caucasian female 2 days ago
Dr. Alhosaini. The 2021 KDIGO CPG for IgAN are very out of date and largely obsolete. New final revised CPG are expected to be released this summer...
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RE: IgA nephropathy case in a young Caucasian female 2 days ago
What is the current level of hematuria? If minor, and with a prior biopsy showing a T2 lesion, I doubt that steroids (in any form ) will delay the ...
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RE: IgA nephropathy case in a young Caucasian female 2 days ago
I look at this differently, She is headed for ESRD and I could not sit back and watch this without trying something. I'm not sure how to know wh...
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RE: IgA nephropathy case in a young Caucasian female 2 days ago
While l agree with the Ckd lowering methods describe above as well as a tight BP control , given the level of proteinuria and relative low creatini...
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RE: IgA nephropathy case in a young Caucasian female 2 days ago
Her serum creatinine may underestimate her eGFR so can you do eGFR Cr-cystatin-c? Because her serum creatinine doesn’t fit with severe IFTA on bio...
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RE: IgA nephropathy case in a young Caucasian female 2 days ago
What signs of active inflammation are present at this time. Steroids are not useful in treating FSGS secondary to IgAN, unless a diffuse Podocytopa...
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RE: Refractory membranoproliferative glomerulonephritis 2 days ago
Positive RF, MPGN pattern of injury and marked predilection for IgM deposition suggests old burnt out HCV infection with a monoclonal IgM Kapoa MGR...
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RE: Central diabetes insipidus with a nephrogenic component? 2 days ago
Bright spot imaging by MRI has reported low sensitivity and specificity for Central DI in polyuria states. ------------------------------ Richar...
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RE: Primary Hyperparathyroidism 2 days ago
In my limited experience, Sestamibi scan is of little utility in for guiding management in this situation. Any opinions Dr.s Venkat and Sprague.? ...
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RE: Central diabetes insipidus with a nephrogenic component? 2 days ago
The MRI was shown suspension of high intensity (bright spot) on T1-weighted image, doesn’t this suggestive of central DI? New DDAVP test suggestiv...
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RE: Central diabetes insipidus with a nephrogenic component? 2 days ago
Was the water deprivation just 3 hours or overnight plus 3 hours? Was a copeptin sent when the s Osm was 299 and U osm 115? If so, is it back yet...
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Proteinuria 2 days ago
Hello all. I would appreciate your help with this case - 62YOF with long standing T2DM, HTN. In 5/2023 SCr was 1.2 with 10gram of albuminuria- R...
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RE: Primary Hyperparathyroidism 2 days ago
Postransplant hypercalcemia is common and with excellent graft function, hypophosphatemia is also common which tend to perpetuate and intensify hyp...
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