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 5 (Dec 2022): Primary and Secondary Glomerular Diseases is now available online.
RE: Acute Antibody Rejection With Mild Biopsy Findings 10 minutes ago
Before lowering tacrolimus dose/levels in such cases, tests such as DSA, cf-dd-DNA and follow-up biopsy should ideally be done to exclude evolving ...
View Discussion
RE: PGNMID with no MGUS 2 hours ago
80-year-old with EF of 15% and eGFR of 15-19 ml/min. Rituximab and daratumumab may be of questionable benefit and risky. How much did SCr/eGFR, UPr...
View Discussion
RE: PGNMID with no MGUS 3 hours ago
THank you Dr Glassock! ------------------------------ Bhavika Gandhi MD Nephrology Fellow Baylor Scott and White Bhavika[LastN[CompanyName] --...
View Discussion
RE: PGNMID with no MGUS 3 hours ago
Thank you Dr Rodby! ------------------------------ Bhavika Gandhi MD Nephrology Fellow Baylor Scott and White Bhavika[LastN[CompanyName] ------...
View Discussion
RE: Acute Antibody Rejection With Mild Biopsy Findings 3 hours ago
Thank you for your input, I'll keep that in mind. and if you're interested I can share any new cases with few changes in transplant biopsy withou...
View Discussion
cresenteric Ig A case 3 hours ago
60 y male pmhx of BPH PTSD, alcohol abuse admitted with SoB , new onset HTN and elevated cr 2. New onset lower ext edema for 3 weeks. Cola colored ...
View Discussion
RE: Acute Antibody Rejection With Mild Biopsy Findings 4 hours ago
After steroid blouse SCR 146, now 135 micromols post PLEX + IVIG. No significant change yet. If after another 2 weeks no significant change in SCr,...
View Discussion
Nephrolithiasis and Osteoporosis 4 hours ago
Hi everyone, I have a 31 year old with CaPO4 kidney stones, nephrocalcinosis and osteoporosis. Serum Ca, Phos and PTH normal. Urine PH on spot samp...
View Discussion
RE: Acute Antibody Rejection With Mild Biopsy Findings 4 hours ago
Thank you for your answers, The patient received 5 sessions of PLEX, and 5 doses of IVIG (total of 90grams). Her tacrolimus level was 9 and 8 in 2...
View Discussion
RE: PGNMID with no MGUS 5 hours ago
I agree with Dr. Rodby, that Daratumumab may be the preferred initial therapy in this patient, due to high response rate and freedom from a risk of...
View Discussion
RE: Canine hyponatremia, proteinuria and some urine clearance calculations 5 hours ago
Would this help quide fluid restriction • Insensible losses (not readily measured losses from respiratory evaporation and the passage of norm...
View Discussion
RE: Canine hyponatremia, proteinuria and some urine clearance calculations 5 hours ago
I dont know about fluid restriction in an animal that cannot express thirst. I would prefer treating it with an increase in solute intake. I wond...
View Discussion
RE: PGNMID with no MGUS 5 hours ago
If you could use daratumumab I think it has the best response rate. see attached also this https://scholar.google.com/s...
View Discussion
RE: PGNMID with no MGUS 7 hours ago
A word of caution. RTX has rarely been associated with a cardiomyopathy. I have no idea if this risk is enhanced by a prior drug induced cardiomyop...
View Discussion
RE: PGNMID with no MGUS 8 hours ago
In PGNMID without an identified clone, the initial preferred therapy is RTX, 1000mg X2 one or two weeks apart, and a repeat dose of 1000mg at 6 mon...
View Discussion
PGNMID with no MGUS 14 hours ago
Hello all I have a 80 yo patient with PMHx of breast Ca treated with doxorubicin who first came to me for AKI and anasarca. She was found to ...
View Discussion
RE: IgA nephropathy with ANCA vasulitis 17 hours ago
"Its a tough one but i am prefering over treating - will decide with patient." Please do post serial SCr levels before and after treatment. ---...
View Discussion
RE: IgA nephropathy with ANCA vasulitis 17 hours ago
Only have a couple of lab readings (only recent AKI) so not sure if there will be some improvement in his kidney function to see serial readings. ...
View Discussion
RE: Canine hyponatremia, proteinuria and some urine clearance calculations 19 hours ago
"one thought is to restrict water and follow serum sodium and urine osmolality" from my earlier post " here is the reference -https://doi.org/...
View Discussion
RE: IgA nephropathy with ANCA vasulitis 20 hours ago
Dr. Rodby said it very well. There are a lot of nuances in cases like this that can be interpreted in various ways. For example, the 56% global Glo...
View Discussion
RE: Canine hyponatremia, proteinuria and some urine clearance calculations 20 hours ago
Yes- this hereditary nephropathy is Alport. Affected males die pretty fast. Females usually show azotemia around age 5 or so. Kidney biopsy has b...
View Discussion
RE: Canine hyponatremia, proteinuria and some urine clearance calculations 21 hours ago
well this doesn't sound (no pun intended) like Alport anyway. What diseases do English Cocker Spaniels get that cause nephrotic range proteinuri...
View Discussion
RE: Canine hyponatremia, proteinuria and some urine clearance calculations 21 hours ago
Urine uric acid was not performed. Most dogs have very low uric acid concentrations in urine due to uric oxidase activity, which humans lost along ...
View Discussion
RE: Canine hyponatremia, proteinuria and some urine clearance calculations 22 hours ago
We have very minimal genetic testing available. We can test for mutations in nephrin that are associated with podocytopathy (not ICGN) in soft coat...
View Discussion
RE: Canine hyponatremia, proteinuria and some urine clearance calculations 23 hours ago
I know you do renal biopsies on dogs, but is genetic testing even available? Are there any nephrotic/blind syndromes in dogs? ---------------...
View Discussion
RE: IgA nephropathy with ANCA vasulitis 1 day ago
I am trying to be practical, lots of glomerular sclerosis, with fibrocellular crescents, and while there is clearly IgAN, i do not want to take the...
View Discussion
RE: IgA nephropathy with ANCA vasulitis 1 day ago
Dr. Rodby- interesting that you would select a "PEXIVAS " protocol for this patient. I presume that you did not mean to use PLEX in this patient. A...
View Discussion
RE: Canine hyponatremia, proteinuria and some urine clearance calculations 1 day ago
"Chemistry: Na 128 (L), Cl 96 (L), rest WNL" BUN and SCr are normal, doesn't this make euvolemic hyponatremia (such as SIADH) more likely and vol...
View Discussion
RE: Bile nephrosis with normal creatinine 1 day ago
A while ago , I saw a patient with a normal serum creatinine, oliguria and a serum Total Bilirubin of >40mg /dL due to fulminant Acute Hepatitis A....
View Discussion
RE: Canine hyponatremia, proteinuria and some urine clearance calculations 1 day ago
I think the core of this case is the presence of Nephrotic syndrome and blindness. Would do a kidney biopsy (with IF and EM) and / or genetic testi...
View Discussion
RE: Canine hyponatremia, proteinuria and some urine clearance calculations 1 day ago
electrolyte free water clearance is more correct than solute free water clearances and in one study of normal subjects was positive until urinary o...
View Discussion
RE: Canine hyponatremia, proteinuria and some urine clearance calculations 1 day ago
Twitter question: "Consult on 9 yr dog with 2yrs of neuro signs and 2 months of hypoNa. UNa 45 UK 42 Uosm 322, UPC 5.4. PNa 128 POsm 268. Was asked...
View Discussion
RE: IgA nephropathy with ANCA vasulitis 1 day ago
Is this patient a diabetic as small number of crescents can be present in diabetic. Which has no prognostic value --------------------------------...
View Discussion
Canine hyponatremia, proteinuria and some urine clearance calculations 1 day ago
Hello everyone, Would appreciate any thoughts you may have on this consult. I haven't seen the patient, but this was the information sent to me: ...
View Discussion
RE: IgA nephropathy with ANCA vasulitis 1 day ago
Lots of chronicity , but a relatively small sample. Clearly long standing IgAN. Does the urine sediment contains RBC casts and acanthocytes? What i...
View Discussion
RE: IgA nephropathy with ANCA vasulitis 1 day ago
"B/G of obesity, Asthma, Gout, HTN." Dr. Rodby: I agree with you that it is difficult to decide whether ANCA-associated crescentic GN is a pathog...
View Discussion
RE: Bile nephrosis with normal creatinine 1 day ago
I'm curious as to the indication for dialysis. While various albumin based forms of dialysis (MARS, SPAD) or a system like PROMETEUS can remove bil...
View Discussion
RE: IgA nephropathy with ANCA vasulitis 1 day ago
Please repost with the patient's name blocked, we can still see it in several places. I would be careful not to make a treatment decision base...
View Discussion
RE: IgA nephropathy with ANCA vasulitis 1 day ago
Has mild AKI (eGFR 50 ml) resolved? Did he have gross hematuria? UPr trend? ------------------------------ K.K. Venkat MD Troy MI (248) 420 7798 ...
View Discussion
IgA nephropathy with ANCA vasulitis 1 day ago
54 year old presented with mild AKI (eGFR dropped to 50 from a baseline > 90). B/G of obesity, Asthma, Gout, HTN. work up because of active urine...
View Discussion
RE: Bile nephrosis with normal creatinine 2 days ago
My apologies to Juan Carlos. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ------------------------------
View Discussion
RE: Bile nephrosis with normal creatinine 2 days ago
Patients such as yours can have many etiologies of AKI, Hepatorenal syndrome, ATN, and the vague condition of bile cast nephropathy , a diagnosis s...
View Discussion
RE: Renal Biopsy In Lupus Nephritis With Thrombocytopenia 2 days ago
Cylophosphamid given after PRES finding by imaging --------------------------------- Mohamed Mahmoud MBBS NEPHROLOGIST MOH KUWAIT 00965 513777...
View Discussion
RE: Renal Biopsy In Lupus Nephritis With Thrombocytopenia 2 days ago
Does anyone think that the cyclophosphamide given could be a cause of PRES? Not sure how you would be able to tell. -----------------------------...
View Discussion
RE: Bile nephrosis with normal creatinine 2 days ago
Juan Carlos Velez (Ochsner Clinic) is one of the world's experts on BCN. ------------------------------ John Schwartz MD Dallas Nephrology Assoc...
View Discussion
RE: Belimumab Vs Retuximab In Lupus Nephritis 2 days ago
Yes ,till now the question is not answered. We need more studies on large number if patients for long periods --------------------------------- N...
View Discussion
RE: Treatment Of Anti Gbm And Anca Disease 2 days ago
With such a very high anti-GBM level, I think I would add PLEX, at least until the findings on kidney biopsy are available (% normal glomeruli). If...
View Discussion
RE: Treatment Of Anti Gbm And Anca Disease 2 days ago
Pulsed --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------
View Discussion
RE: Treatment Of Anti Gbm And Anca Disease 2 days ago
Hi the team have pushed him and given him cyclophosphamide but no plex due to Anuria. He will have rituximab too . Has tunelled line over weekend ...
View Discussion
RE: Bile nephrosis with normal creatinine 2 days ago
Bile cast Nephropathy, cholemic nephrosis, bile nephrosis and Icteric Nephropathy are different names for same, typically underdiagnosed entity wit...
View Discussion