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: A interesting hyponatremia case 3 hours ago
Wondering if this is “sick cell syndrome” --------------------------------- Edgard Wehbe MD, FASN Wichita Nephrology Group Wichita KS (316) 99...
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RE: A interesting hyponatremia case 4 hours ago
Thank you, Dr. Glassock. No, I did not check paraprotein. Just added light chain ratio to tomorrow's lab. Thought about hyperproteinemia as the und...
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RE: A interesting hyponatremia case 4 hours ago
Just curious. Did you look for circulating monoclonal paraprotein?. There are some features suggestive of Clarkson syndrome of enhanced vascular pe...
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RE: Membranous with GFR 15 ml and bx not consistent with severity 4 hours ago
True. Thank you for your response Dr Glassock ------------------------------ Biresh Kumar MD Temple TX (269) 598-9324 ------------------------------
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RE: Membranous with GFR 15 ml and bx not consistent with severity 4 hours ago
It would depend on serum albumin and the extent of symptoms related to Nephrotic Syndrome. RASi has a relatively small effect on spontaneous remiss...
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A interesting hyponatremia case 5 hours ago
I would like to share an interesting hyponatremia case. I apologize in advance for the lengthy presentation. A 67 year-old female had anterior lum...
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RE: Membranous with GFR 15 ml and bx not consistent with severity 5 hours ago
Dr Glassock, if the renal function was normal in this patient would you still you RTX as first line or give try with ACEi/ ARB first for 3-6 months...
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RE: Crescentic IgAN 6 hours ago
Asian patient May consider mycophenolate (https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2800997). ------------------------------ K....
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RE: Crescentic IgAN 7 hours ago
What is the ANCA ? I would likely treat with oral steroids (Moderate dose TESTING regimen) despite the normal Scr. I know this goes against KDIGO r...
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RE: Membranous with GFR 15 ml and bx not consistent with severity 8 hours ago
your responses are greatly appreciated ------------------------------ Jukaku Tayeb MD St. Clair Nephrology Detroit MI (313) 886-8787 -------------...
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Crescentic IgAN 9 hours ago
42 y/o Asian female, found to have proteinuria in insurance physical 7/22. Creatinine 0.5, PCRatio at that time, 2.3 g/g, we started losartan 6 mo...
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Calculation of creatinine clearance 11 hours ago
------------------------------ Ahmed Akl MD, MBChB, PhD, FASN MISHRIFAH DIST. ------------------------------
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Using icodextran for manual exchanges 13 hours ago
Icodextran is typically used for the last fill/long dwell for patients on CCPD. I have a patient who does CAPD 5 x 3 L with inadequate UF and very ...
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RE: MMF Monotherapy In IgA Nephropathy? 15 hours ago
IgA nephropathy is thought to be more prevalent in Oriental ethnic populations, at least that is what I have been told. Could there be an ethnic di...
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RE: MMF Monotherapy In IgA Nephropathy? 1 day ago
This reply is wonderful just to read Prof Glassock now include SGLT2i aka flozins as part of standard of care in IgA nephropathy! (Arguably this tr...
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RE: severe hyperphosphatemia and calcinosis in a dialysis patient 1 day ago
This is a very unusual and unfortunate case. I do think a biopsy to determine if this is ca oxalate as opposed to ca phosphate would be key in this...
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RE: How to diagnose hyperaldo. in ESRD? 1 day ago
I am not sure if its over-collection, but his spot UCr correlated with his 24 hour UCreatinine. PD training w/ a 500 cc Starbucks... -------------...
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RE: MMF Monotherapy In IgA Nephropathy? 1 day ago
Issues- 1) single center 2) open label 3) all Chinese 4) no SGLT2 inhibitors 5) no stratification for Oxford-MEST will similar results be found i...
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RE: MMF Monotherapy In IgA Nephropathy? 1 day ago
Mmf has some beneficial effects in Chinese population. This study is also from China Need data for other countries ------------------------------...
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RE: severe hyperphosphatemia and calcinosis in a dialysis patient 1 day ago
I have read that calcium phosphate can be identified by the von Kossa stain as silver-containing black deposits. Calcium oxalate shows birefringenc...
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RE: MMF Monotherapy In IgA Nephropathy? 1 day ago
I can predict the response, and it is hard to criticize (even though I have used MMF in some cases of IgAN in the past especially if there were pro...
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RE: Use of both ACE inhibitors and ARBS in comination 1 day ago
Having any medication available is sometimes not an option in underdeveloped countries; taking into account the adverse effects (hyperkalemia) that...
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MMF Monotherapy In IgA Nephropathy? 1 day ago
The MAIN trial has been just published. Link: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2800997 (And attached). KDIGO guideli...
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RE: severe hyperphosphatemia and calcinosis in a dialysis patient 1 day ago
Calcium oxalate tissue deposition can be distinguished from calcium phosphate deposion by staining with Alizirin Red at two different pH (4.2 and 7...
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RE: severe hyperphosphatemia and calcinosis in a dialysis patient 1 day ago
you say Ca Phosphate calcification, is this biopsy proven? this degree of calcification is unusual no matter what the Po4 and Ca Are? Any possibili...
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RE: Unusual case of apparent SIADH with suprasellar mass 1 day ago
Problem solved. Thanks Dr. Venkat. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 -----------------------...
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RE: Unusual case of apparent SIADH with suprasellar mass 1 day ago
This is certainly SIADH. It may be a consequence of the (hormone inactive) adenoma and there is no way to predict the response with resection. In t...
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RE: ESRD incidence 1 day ago
I estimated a while back (and this is probably somewhere in an ASN online in 2019), that flozins will likely clamp the ESRD incidence to 2016-2017 ...
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RE: severe hyperphosphatemia and calcinosis in a dialysis patient 1 day ago
I would be fearful about using kayexalate with the history of ischemic colitis, and bowel resections ------------------------------ Lawrence Klein...
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RE: severe hyperphosphatemia and calcinosis in a dialysis patient 1 day ago
He has a short bowel syndrome. Is he scrumptiously taking large doses of Vitamin C that is being converted to oxalate? Being on dialysis , one woul...
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RE: Unusual case of apparent SIADH with suprasellar mass 1 day ago
Please see following reference. There are several other similar case reports in PubMed. Nothing is new under the sun! https://pubmed.ncbi.nlm.nih.g...
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RE: Unusual case of apparent SIADH with suprasellar mass 1 day ago
Has a hypothalamic tumor secreting ADH ever been described? I can't find any reports of this paraneoplastic event causing SIADH. But I suppose that...
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RE: Unusual case of apparent SIADH with suprasellar mass 1 day ago
Am cortisol 18 Thanks for all the references --------------------------------- Brendan] [Mielke] [MD] [Kootenai Clinic] [Coeur d Alene] [ID] [2...
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RE: Membranous with GFR 15 ml and bx not consistent with severity 1 day ago
Renal dysfunction is likely multifactorial including cardiac element, ? ATN, ? renal edema. As mentioned by others, cancer screening is needed wi...
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RE: How to diagnose hyperaldo. in ESRD? 1 day ago
Wow! why is he polyuric? 5 L? ------------------------------ Anatole Besarab MD ABesarab Consulting Bend OR (734) 417-4793 -----------------------...
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RE: Membranous with GFR 15 ml and bx not consistent with severity 1 day ago
Is the BUN:SCr ratio disproportionately high suggesting pre-renal azotemia? ------------------------------ K.K. Venkat MD Troy MI (248) 420 7798 -...
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RE: How to diagnose hyperaldo. in ESRD? 1 day ago
Yes, urine output 5L ------------------------------ Sarah Aloudat ------------------------------
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RE: How to diagnose hyperaldo. in ESRD? 1 day ago
All great questions! - Indeed, I was really not sure how to interpret his Aldo and renin, My usual cases are clear cut straightforward, I never h...
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RE: Unusual case of apparent SIADH with suprasellar mass 1 day ago
I agree with Dr. Rodby. SIADH is very rarely reported in pituitary adenine's and all of the cases seen had some manifestation of a hypopituitary st...
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RE: How to diagnose hyperaldo. in ESRD? 1 day ago
Can you please explain the first column? ------------------------------ Sarah Aloudat ------------------------------
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RE: How to diagnose hyperaldo. in ESRD? 1 day ago
Yes, Indeed, my calculation was wrong, the units are different To use ARR, first Renin - should be [More]
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RE: Unusual case of apparent SIADH with suprasellar mass 1 day ago
That cortisol level may not be normal, the easiest explanation is he is hypo cortisol from a prolactinoma. https://www.ncbi.nlm.nih.gov/pmc/artic...
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Unusual case of apparent SIADH with suprasellar mass 2 days ago
Was hoping to get some help understanding the physiology of an unusual SIADH in a 45 yo man with no medical hx and no meds but occasional marijuana...
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RE: Membranous with GFR 15 ml and bx not consistent with severity 2 days ago
The renal failure portends a bad prognosis, I suspect there is some ATN. Did you look for RV thrombosis, and PE? Pt needs good cancer workup And I...
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RE: ESRD incidence 2 days ago
Indeed dialysis has improved a lot since I was a fellow with Al toxicity, acetate dialysate, fluid removal dependent on UF coefficient and TMP, but...
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RE: ESRD incidence 2 days ago
Dr. Sekhon- Thanks for your post. I can resonate with your wishes about diet and exercise forestalling progressive CKD . It is just so disappointi...
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RE: ESRD incidence 2 days ago
Yes lot of excitement in nephrology with newer home dialysis machines in the horizon which are easy to carry and manage. I think we really need t...
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RE: ESRD incidence 2 days ago
Roger: The implantable kidney is one thing on the horizon. Maybe xenografting; both might be game changers. Probably other things we might not even...
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RE: Membranous with GFR 15 ml and bx not consistent with severity 2 days ago
What is the patients serum albumin level. Prohykzctic anti-coagulation my be required if S alb [More]
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RE: Membranous with GFR 15 ml and bx not consistent with severity 2 days ago
"Presents with SOB and Creatinine 2.7 11/22, new Atrial Fib." With this presentation, either inadequately treated CHF or over-diuresis with pre-ren...
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