ASN represents more than 21,000 kidney health professionals working to help people with kidney diseases and their families. Created with input from all of ASN's constituencies, the new ASN logo allows the society to continue our growth and work toward a goal of a world without kidney diseases.
The latest Nephrology Self-Assessment Program (nephSAP) issue, Volume 22: Issue 2 (Aug 2023): End-Stage Kidney Disease is now available online.
Renal Transplant Biopsy 54 minutes ago
I have a renal transplant patient transplanted 7 years ago . Primary disease unknown . Had rejection first month of transplant . Kidney function ...
View Discussion
RE: Target Weight In New HD Starter 1 hour ago
My vintage in dialysis therapy for ESKD was when "probing dry weight" by aggressive ultrafiltration was the rule. We did believe, very passionately...
View Discussion
RE: Denosumab in Chronic kidney disease patients 1 hour ago
Thanks. Like Dr. Sprague , I do not believe that Denosumab is contra-indicated in advanced CKD, but case selection and monitoring are very importan...
View Discussion
RE: Target Weight In New HD Starter 3 hours ago
The French have more culture than we. They even wine and dine during HD in Tassin. In a review I recently submitted, my co-authors took issue that ...
View Discussion
RE: Target Weight In New HD Starter 3 hours ago
Attached is an excellent review on the topic of dry weight by @Jennifer Flythe. My two cents on this: "All" ESKD patients with HTN are overloa...
View Discussion
RE: Hypertension in athletic healthy patient 3 hours ago
Totally agree with you Had to set and read through the articles process all that talk to him we both agreed to go with confirmation test...
View Discussion
RE: Hypertension in athletic healthy patient 4 hours ago
"I will try to convince him to go for CT abdomen (it was a huge win to get him to do his labs) " I think you have answered the debate on wheth...
View Discussion
RE: Denosumab in Chronic kidney disease patients 4 hours ago
..dose reduction of Prolia (from the standard of 60mg SQ qmonthly) theoretically, wouldn’t work, since the monoclonal agent is not renally cleared....
View Discussion
RE: Denosumab in Chronic kidney disease patients 5 hours ago
Dr. Malluche and his group at the University of Kentucky might be able to provide us with insight if the service is still active. They received a h...
View Discussion
RE: membranous with excellent but not 100% response 5 hours ago
Good choice. . It does take time for the kidney manifestations to resolve after immunotherapy. SLE is another disorder that takes time for the urin...
View Discussion
RE: Steroids before a renal biopsy 5 hours ago
Interesting discussion. I too think this is drug induced. I presume patient is in the ICU? I would use steroids ad depending on the results requ...
View Discussion
RE: Steroids before a renal biopsy 5 hours ago
@Richard Glassock I appreciate your concern. My own feeling is that with this degree of renal dysfunction we must put in early, aggressive effort...
View Discussion
RE: Timeline to use a new AV graft 5 hours ago
I think a lot of education is needed. There is "value" in doing things right.Can it be applied to the Vascular access? Both AVF and AVG can devel...
View Discussion
RE: membranous with excellent but not 100% response 5 hours ago
Thanks guys, I will do nothing (but watch) ------------------------------ Sheldon Hirsch MD Lakeside Nephrology Wilmette IL (312) 986-0110 ------...
View Discussion
RE: Steroids before a renal biopsy 6 hours ago
I was also putting my bet on hydralazine! ------------------------------ Lynn Cornell MD, FASN Mayo Clinic Rochester MN (507) 538-4356 ----------...
View Discussion
RE: Steroids before a renal biopsy 6 hours ago
Agreed- but I am not convinced about the need for PLEX and its use will also increase the risk of a serious infection. --------------------------...
View Discussion
RE: Denosumab in Chronic kidney disease patients 6 hours ago
Excellent summary by Professor Glassock, I could not have stated it better. we have to be real careful in patients with advanced CKD stage 4/5 and ...
View Discussion
RE: Steroids before a renal biopsy 6 hours ago
I think I will paraphrase Dr Rodby. PLEX and pulse steroids, PEXIVAS be damned. This is DAH unless proved otherwise. If there is sputum you can che...
View Discussion
RE: Clinical trials for patients with Familial FSGS 7 hours ago
An excellent resource is NephCure's clinical trials gateway. https://kidneyhealthgateway.com/trials-research/ While not specific to NPHS2 it does...
View Discussion
RE: Denosumab in Chronic kidney disease patients 10 hours ago
Because of concerns about overall efficacy (fracture prevention) and safety if Denosumab in Advanced CKD (especially categories 4, 5 and 5 D) use o...
View Discussion
RE: Denosumab in Chronic kidney disease patients 11 hours ago
Thank you very much for your reply's. Alkaline phosphatase was within normal range , no bone alkaline phosphatase was not requested. DEXA scan ...
View Discussion
RE: Denosumab in Chronic kidney disease patients 14 hours ago
Thanks, Drs. Venkat and Sprague. Dr. Jebur, have we answered your questions with sufficient clarity ? ------------------------------ Richard Glas...
View Discussion
RE: membranous with excellent but not 100% response 16 hours ago
"The usual thinking about this is that the negative serum PLA2R means that immunologic activity has resolved and that the remnant proteinuria is du...
View Discussion
RE: Steroids before a renal biopsy 16 hours ago
Dr Glassock's questions are all important but I will opine in an answer void. It may sound like I am being flippant, or disrespectful with my bet...
View Discussion
RE: Denosumab in Chronic kidney disease patients 16 hours ago
It is a tough question, but as pointed out by Professor Glassock a diagnosis of osteoporosis can not be made in a patient with advanced CKD and sol...
View Discussion
RE: Timeline to use a new AV graft 17 hours ago
Thanks to all for this highly educational and enlightening series of posts. The thread should be read by all vascular surgeons performing AVF and A...
View Discussion
RE: Clinical trials for patients with Familial FSGS 17 hours ago
Thanks. Good luck with the ACTION3 trial in patients with Primary and Genetic FSGS lesions. previously, the Lumina-1 trial of CCX140 (an orally eff...
View Discussion
RE: Timeline to use a new AV graft 17 hours ago
You are asking for data that does not exist. Medicine is more than numbers. There are many predictors of AVF maturation. For AVG, less so. The ar...
View Discussion
RE: Steroids before a renal biopsy 19 hours ago
What are the C3/C4 levels? What do's the urine sediment exam show? Have you attempted to detect cryoglobulins in serum? . what is the HCV and HBV s...
View Discussion
RE: membranous with excellent but not 100% response 19 hours ago
An immunological remission in PLA2R related MN is defined as a negative serum IFA test or and ELISA of [More]
View Discussion
RE: Timeline to use a new AV graft 20 hours ago
I have attached a number of summaries of papers published in the past few years. They talk about what happens to cardiac remodeling when an AV Acce...
View Discussion
RE: Timeline to use a new AV graft 21 hours ago
If patient is volume-overloaded, low EF may improve after adequate ultrafiltration and volume optimization. "Uremic cardiomyopathy" may be another ...
View Discussion
RE: Denosumab in Chronic kidney disease patients 21 hours ago
Stage-4 CKD with calcium on high normal side (10 mg/dl) and PTH of only 70 despite phosphate of 5.0 mg/dl suggests possibility of adynamic bone dis...
View Discussion
RE: Timeline to use a new AV graft 1 day ago
Thank you Dr. Wasse I need your opinion and experiences for optimal time to use AVG Minimal EF% that allow to do AVG --------------------------...
View Discussion
Steroids before a renal biopsy 1 day ago
Hello everyone I have a patient,77 year old caucasian lady, who has AKI, proteinuria and hematuria and is currently inpatient. Her serologies ...
View Discussion
membranous with excellent but not 100% response 1 day ago
53 yo white male with no medical history developed nephrosis (6 gms, alb 2.9) with normal GFR about 18 months ago. Extensive serology negative exce...
View Discussion
RE: Timeline to use a new AV graft 1 day ago
A few points, IMO, worth emphasizing: --As Dr Besarab aptly notes, there are significant differences between grafts and fistulas and between uppe...
View Discussion
RE: Timeline to use a new AV graft 1 day ago
Monnie You always could say it in a few words where as I always need a page Well Said. The issue of adequate training of surgeons ...
View Discussion
RE: Hypertension in athletic healthy patient 1 day ago
I frankly believe it is a good test but it takes 6-8 weeks to see the effect on serum K adf BP. Men hate it because of the gynecomastia. Oddly I ha...
View Discussion
RE: Clinical trials for patients with Familial FSGS 1 day ago
thank you for the correction Dr Glassock you are correct, the ACTION3 study is the proper name of the trial (DIMERIX is the company) yes, we, a...
View Discussion
RE: Clinical trials for patients with Familial FSGS 1 day ago
Many thanks for your post . i assume you are referring to the ACTION3 international trial of DMX-200 (a CCR2 receptor antagonist.) Like the recentl...
View Discussion
RE: Timeline to use a new AV graft 1 day ago
No, it does not.
View Discussion
RE: Timeline to use a new AV graft 1 day ago
Good response Dr. Wasse. Does any data exist concerning the effect of a forearm AVG on hospitalizations for CHF (or CV mortality) in hemo- dialysis...
View Discussion
RE: Clinical trials for patients with Familial FSGS 1 day ago
Hello Dr Karimi yes, the DIMERIX study is currently enrolling patients with genetic FSGS (although, not specific to NPHS2). Based on what you hav...
View Discussion
RE: Timeline to use a new AV graft 1 day ago
Several excellent points have been made already, but please indicate whether the patient is on already dialysis, and whether this may be the reason...
View Discussion
RE: Denosumab in Chronic kidney disease patients 1 day ago
Tough question. Bottom line- do not trust a "diagnosis" of osteoporosis made by DEXA scansonly in zny patidnt with advanced CKD. Adding serum bioma...
View Discussion
RE: Hypertension in athletic healthy patient 1 day ago
Thank you for the article and the input. Let me see if he is interested in doing more blood work (post- salt load) and a CT ---------------------...
View Discussion
RE: Hypertension in athletic healthy patient 1 day ago
Thanks for sharing! ------------------------------ Sarah Aloudat ------------------------------
View Discussion
RE: Hypertension in athletic healthy patient 1 day ago
The Melby test- you previously suggested I treat one of my patients with HTNsive crisis (Stroke, ESRD), He was 49 when we started Spironolactone...
View Discussion
RE: Hypertension in athletic healthy patient 1 day ago
Thank you, this is very important, I have couple of patients in this program, one is screaming a hyperaldo (her K is low, Na is high and HCO3 is...
View Discussion