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 21: Issue 2 (Jun 2022): Chronic Kidney Disease is now available online.
increasing rituximab from maintenance dose for Rise of c ANCA in GPA 3 hours ago
#White gentleman age 80, renal biopsy done in March, 2020, found -CRESCENTIC ANCA-RELATED PAUCI-IMMUNE GLOMERULONEPHRITIS; CONSISTENT WITH MIC...
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RE: A 60 year old kidney donor with diabetes 4 hours ago
"Due to financial issues, she is receiving only one to two sessions per week and has been so for the last 3 months." Given the above problem, does ...
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A 60 year old kidney donor with diabetes 6 hours ago
Hello, I hope this message finds you well. I have a 60 year old man who has come forward as a potential donor to his daughter. He has been healthy...
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RE: Renal Physiology For Fellows 8 hours ago
Our program is also starting a series based on Koepen and Santon's book from September. We haven't done this before but we have used Koepen and Sta...
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RE: Maintenance therapy for MPO nephritis 9 hours ago
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6007352/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5678839/ Dr Glassock, what do we know about C...
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RE: Maintenance therapy for MPO nephritis 9 hours ago
Thank you @dr Rodby the issue of CD19 is not clear in my mind since it is not followed in all situations. As an example the CD 19 was not part of ...
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RE: Renal Physiology For Fellows 13 hours ago
Our program read Burton Rose, Channel Your Enthusiasm style but is switching to a different book as Rose was considered too much of a time commitme...
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Renal Physiology For Fellows 1 day ago
Hello, big question: Do any programs still teach a longitudinal physiology course during fellowship? If you do, how long is it? (I am a HUGE FAN of...
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RE: Maintenance therapy for MPO nephritis 1 day ago
If it normalizes there is a much less risk of relapse, but it is unknown if treating those longer or more aggressively that did not normalize will ...
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RE: Maintenance therapy for MPO nephritis 1 day ago
Thank you for your reply.Is there any role for measuring MPO titers in MPO vasculitis? ------------------------------ Syed Ali,MD ----------------...
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RE: Maintenance therapy for MPO nephritis 1 day ago
The hard question for MPO vasculitis is how long do you continue maintenance for. Something between never and forever. I tend to continue for year...
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RE: Maintenance therapy for MPO nephritis 1 day ago
I have seen it vary from 500 mg every 6 months to 1 g every 4 months. I think 500 q6 is probably fine but initially at least I would follow CD 19 c...
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Maintenance therapy for MPO nephritis 1 day ago
Hello everyone I wanted to confirm the rituximab dosing regimen for maintenance therapy for MPO positive nephritis I understand that for maintenan...
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RE: Recalcitrant FSGS case 2 days ago
Thank you for your help.
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RE: Recalcitrant FSGS case 2 days ago
If a response to pheresis is going to ocurr it will usually happen within 4 weeks of 3x week sessions- 12 sessions. If lipid Apheresis is available...
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RE: Recalcitrant FSGS case 2 days ago
Thank you Dr. Glassock. I was afraid that this would lead to unfamiliar territory for me. Family history is negative. I will look into genetic tes...
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RE: Recalcitrant FSGS case 2 days ago
Tough case. Unfortunately, these kind of multidrug resistant, slowly progressive cases of “FSGS” are not uncommon. I presume that the family histor...
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RE: SGLT2 inhibitors and Urine sodium Osm 2 days ago
Agree with Dr Radhakrishnan in that SGLT2-I's have been described in the treatment of SIADH, where glycosuria would enhance renal free water cleara...
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RE: SGLT2 inhibitors and Urine sodium Osm 2 days ago
TSH Cortisol were normal. No known meds that can cause SIADH. CT chest negative. Urine sodium 75 and Urine Osm around 300-350. clinically did not a...
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RE: ANCA vasculitis after mRNA COVID vaccine - any experiences? 2 days ago
I have seen one case too. Dr. Anurag Tikaria Lansing, MI ------------------------------ Anurag Tikaria MD MD Sparrow Health System Lansing MI ...
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Argatroban as an anticoagulant for HD in outpatient clinic 2 days ago
Does anyone has experience in using long term Argatroban as an anticoagulant for HD in outpatient clinic? What kind on monitoring is required? Once...
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Recalcitrant FSGS case 2 days ago
Hello I have a stubborn FSGS case that I would like your opinion on. This Hispanic gentleman is now 40 yo but his renal problems were discovere...
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RE: ANCA vasculitis after mRNA COVID vaccine - any experiences? 2 days ago
Here is study Dr Glassock was referring to (attached) ------------------------------ Roger Rodby MD, FASN Professor of Medicine Rush Unive...
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RE: ANCA vasculitis after mRNA COVID vaccine - any experiences? 2 days ago
Yes . It is very hard to prove causation. However, can it cause flare up of underlying known GN? There are several reports suggestive flaring up af...
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RE: ANCA vasculitis after mRNA COVID vaccine - any experiences? 2 days ago
A recent study from Switzerland has shown no increase in GN cases , except possibly MCD, during the COVID era, supporting the notion that most of t...
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RE: SGLT2 inhibitors and Urine sodium Osm 2 days ago
As with everything, there are always two sides to pathogenesis. 1. Solute diuresis (similar to urea) may improve serum sodium in SIAD https://pubm...
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RE: Marked hyperuricemia 2 days ago
Many thanks . Very helpful information. ------------------------------ Richard Glassock MD, FASN Emeritus Professor David Geffen School of Medicin...
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RE: Marked hyperuricemia 2 days ago
. Another thought on this challenging problem - if the gout attacks are equal or less than 2 per year, maybe they could be handled with medrol d...
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RE: ANCA vasculitis after mRNA COVID vaccine - any experiences? 2 days ago
SARS-CoV-2 vaccines are exceptionally common, with hundreds of millions of doses in the United States alone. By pure chance, a rare disease is like...
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RE: Marked hyperuricemia 2 days ago
From what I've seen the Co-Pay is typically covered in full by the company that distributes Krystexxa Horizon. ------------------------------ Barr...
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RE: Marked hyperuricemia 2 days ago
Just curious. What are the typical co-payments for Pegloticase in non-Medicare patients with employee sponsored insurance ? ----------------------...
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RE: Marked hyperuricemia 2 days ago
For those like me that didn’t know the difference. “In contrast to rasburicase, pegloticase is pegylated to increase its elimination half-life fro...
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RE: SGLT2 inhibitors and Urine sodium Osm 2 days ago
May be similar to diuretics (loops mainly) they can cause hypoNa and they can be used to treat hypona , all depends on water intake. ------------...
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RE: SGLT2 inhibitors and Urine sodium Osm 2 days ago
Interesting and challenging We need more details on the results TSH, urine osmolarity and urine sodium and status of his volemia but I would think...
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RE: Marked hyperuricemia 3 days ago
Such a valid point the cost is quite high roughly 20,000 USD per dose. luckily Pegloticase is typically covered by insurance including Medicare....
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RE: Marked hyperuricemia 3 days ago
I like the drug Desensitization approach by dr Rudnick . I would make sure it was someone well versed however you don’t want a DRESS syndrome… ---...
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RE: SGLT2 inhibitors and Urine sodium Osm 3 days ago
I don’t know how you could assess endogenous kidney function on an SGlT2i. I would discontinue as well as diuretics and reassess. How low was PNa,...
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SGLT2 inhibitors and Urine sodium Osm 3 days ago
Appreciate your thoughts on this. Recently came across a hyponatremia patient, Urine labs consistent with SIADH (UNa, UOsm) with no particular pre...
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RE: Marked hyperuricemia 3 days ago
Nice idea, but what is the cost for 6 months of therapy. --------------------------------- Richard Glassock MD, FASN Emeritus Professor David Ge...
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RE: Marked hyperuricemia 3 days ago
This is a perfect case for Pegloticase. It's the Uricase enzyme with a PEG to help evade immunogenicity and prolong the half life. The dose is 8 mg...
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RE: Marked hyperuricemia 3 days ago
Thanks Dr. Rudnick. Very impressive list of new drugs in the pipeline. Maybe one of them we’ll help this patient or one’s like it, eventually. ---...
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RE: Marked hyperuricemia 3 days ago
The only realistic option for this patient is to try Probenicid- but it will likely not work. Peglotidase is very expensive and I wonder if the eff...
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RE: Marked hyperuricemia 3 days ago
Attached is an article describing successful desensitization for febuxostat over a 28 d period. I also attached a 2022 update article on gout manag...
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RE: Marked hyperuricemia 3 days ago
Is this hyperuricemia new? How was the patient managed over the years ? --------------------------------- Samir Mallat Professor of Clinical Med...
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RE: Marked hyperuricemia 3 days ago
You can consider IV pegloticase if with severe symptomatic hyperuricemia and if insurance approves it. Need to screen her for g6pd deficiency first...
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RE: Marked hyperuricemia 3 days ago
Sorry. Missed the history gout and diuretics . Are her attacks frequent ------------------------------ Michael Rudnick MD University of Pennsylvan...
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RE: Marked hyperuricemia 3 days ago
Can you provide some additional information. Has she had symptomatic gout or uric acid stones? Is she on diuretics? Have you obtained a fractional ...
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RE: Primary Membranous Nephropathy 3 days ago
@dr Glassock Thank you for your clarifications. Great discussion
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Marked hyperuricemia 3 days ago
Hello All I would appreciate your help with this case 59YOF with CKD stage IV/ eGFR 23 gout with marked hyperuricemia with uric acid of 11---> 14 ...
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RE: Prostrate Ca and NELL1 positive Membranous nephropathy Sunday, June 26 @ 9:10 PM
Thank you ASN community for all the responses and guidance regarding this case 1.I had discussed with patient regarding anticoagulation with DOAC A...
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