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 22: Issue 4 (Feb 2024): Pregnancy and Kidney Disease is now available online.
RE: Management of glomerulonephritis secondary to low grade non-Hodkin lymphoma/CLL 18 minutes ago
Tough case. The absence of detectable circulating cryoglobulins and extra-renal manifestations of Cryoglobulinemia are a bit atypical but the EM fi...
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Hypertension in pregnant patient 28 minutes ago
23 y/o F, G2P1001 at 9 weeks gestation, with pmhx of chronic HTN (since 13 years old) and pre-eclampsia in previous pregnancy ( 2016 ), presented t...
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Management of glomerulonephritis secondary to low grade non-Hodkin lymphoma/CLL 2 hours ago
Dear all, I would like your opinion on managing this case of glomerulonephritis caused by cryoglobulin from a low-grade lymphoma/CLL. 60-year-ol...
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RE: Lupus, Albuminuria, and persistently positive serologies: 4 hours ago
So fast forward, she's on MMF 250 mg BID, and steroids free. 2 questions: 1) At this level of Immune suppression, can she get a live attenuate...
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RE: NSAIDS and CKD 5 hours ago
Thanks to this forum I have learned a great deal and become more open minded in the use of NSAIDS in kidney disease. I have utilized some of the ...
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RE: IgG4 related disease with slowly rising IgG4 levels 13 hours ago
I would point you to the "IgG4-RD Responder Index" for guidance on disease activity: Development of an IgG4-RD Responder Index - PubMed PubMe...
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RE: Possible hydralazine associated ANCA vasculitis/lupus,/treat or not 13 hours ago
Patience repeat complement now normal Creatinine down to 3 from 3.6 Repeat ANCA pending Asked pathologist look again if any if there was any evide...
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RE: IgG4 related disease with slowly rising IgG4 levels 21 hours ago
If no contraindication to renal biopsy, maybe a repeat one can give more information about the ''activity'' of the interstitial nephritis. -----...
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RE: Refractory Hypercalcemia of Malignancy with hypophosphatemia (elevated 1,25-OH VitD and PTHrP) 1 day ago
Thank you, everyone, for your kind replies. I have two updates: I had ordered an FGF-23 level a few weeks ago, which has now just shown up...
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RE: Refractory Hypercalcemia of Malignancy with hypophosphatemia (elevated 1,25-OH VitD and PTHrP) 1 day ago
? Try a MAP Kinase inhibitor for palliation? ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 ------------...
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RE: IgG4 related disease with slowly rising IgG4 levels 1 day ago
See the data of Choi SJ et al PLoS One. 2023; 18: e0282852) - a rising level of IgG 4 can be associated with relapse, but no one has shown improved...
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RE: IgG4 related disease with slowly rising IgG4 levels 1 day ago
I don't think that anyone has a good evidence based answer to your Challenging question. I would watch and wait.. ------------------------------...
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RE: IgG4 related disease with slowly rising IgG4 levels 1 day ago
Another suggestion : Checking UAlb/Cr and UPr/Cr on same sample of urine or U-protein electrophoresis for tubular proteinuria. ------------------...
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RE: IgG4 related disease with slowly rising IgG4 levels 1 day ago
Doubling of IgG4 level is worrisome. You may want to check CRP and sedimentation rate (elevated in 40 - 50%of patients) and PET-CT scanning. If the...
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RE: Refractory Hypercalcemia of Malignancy with hypophosphatemia (elevated 1,25-OH VitD and PTHrP) 1 day ago
Here’s what may be considered plausible: -The recalcitrant Hypercalcemia is likely from a combination of elevated PTHrp (paraneoplastic), bone met...
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IgG4 related disease with slowly rising IgG4 levels 1 day ago
A 73 yr old male presented to me 2 years ago with an acute deterioration of renal function and his creatinine peaked at 4.5. His renal biopsy showe...
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RE: Volunteer by May 8 to serve as a case report reviewer for Kidney Week 2024! 1 day ago
Thanks for your question! Full details on the scoring system will be explained upon receiving reviewer assignment. If you haven't already, please c...
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RE: Volunteer by May 8 to serve as a case report reviewer for Kidney Week 2024! 1 day ago
Thank you for your interest! Please complete this form by May 8 to be considered: https://www.surveymonkey.com/r/65T5VW5 ------------------------...
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RE: Request for Expert Opinions on Chronic Interstitial Nephritis Management 1 day ago
we had a reference yesterday for interstitial disease associated with ANCA but that is unusual and pt was on hydralazine and much higher MPO. Thi...
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RE: Request for Expert Opinions on Chronic Interstitial Nephritis Management 1 day ago
The + PR3 ANCA is highly unusual for a drug induced Interstitial nephritis, except Hydralazine. I suspect that this is an auto-immune disease. It m...
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RE: Refractory Hypercalcemia of Malignancy with hypophosphatemia (elevated 1,25-OH VitD and PTHrP) 1 day ago
It would be interesting to know if this patient's renal phosphate wasting is due to elevated FGF-23. The very high 1,25-D level is interesting and ...
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RE: LN not in remission 1 day ago
A "response" to RTX (or any anti-CD20 MoAb) is going to be very difficult to judge, short of a near complete remission, due to the possible superim...
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RE: Access to dialysis morbid obese non mobile 1 day ago
Thanks a lot Dr for that clarification I totally agree with your opinion about the need of blood clearances And if the problem of PD in such pati...
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RE: LN not in remission 1 day ago
Hi thanks for case. This patient is on a lot of medication . Is he compliant ? If we think rituximab is not working in general then not related t...
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RE: Refractory Hypercalcemia of Malignancy with hypophosphatemia (elevated 1,25-OH VitD and PTHrP) 1 day ago
I have seen that article ( appreciate you sending it ). It appears my pt was somewhat different in that 1. He never had an elevated PTHrp... only 1...
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RE: Refractory Hypercalcemia of Malignancy with hypophosphatemia (elevated 1,25-OH VitD and PTHrP) 1 day ago
Dr. Qualheim: Regarding your patient with ? sarcoma and 1-25 D3-related hypercalcemia, simultaneously elevated PTHrp and 1-25 D3 with hypercalcemia...
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RE: Refractory Hypercalcemia of Malignancy with hypophosphatemia (elevated 1,25-OH VitD and PTHrP) 1 day ago
Has MAP kinase inhibitor ever been used in this patient? According to my reading (not experience) such agents may be effective in controlloibg the ...
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RE: Refractory Hypercalcemia of Malignancy with hypophosphatemia (elevated 1,25-OH VitD and PTHrP) 1 day ago
In regards to my earlier post about ketoconazole and HCM; the pt I was alluding to had a Paraneoplastic syndrome presumed from a LUQ mass ( surgeon...
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RE: Volunteer by May 8 to serve as a case report reviewer for Kidney Week 2024! 1 day ago
I am willing to review the case report. Regards Anant S Pilawan ------------------------------ Anant Pilawan MD, MBBS DEPARTMEN...
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RE: Volunteer by May 8 to serve as a case report reviewer for Kidney Week 2024! 1 day ago
Thanks for your response. Kindly give me an idea of your scoring criteria. Thank you
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RE: Possible hydralazine associated ANCA vasculitis/lupus,/treat or not 2 days ago
Thanks Dr Venkat and Dr Nauman Dr Venkat patient has been on spironolactone 50 mg since 9/2023 Dr Nauman her DSDNA. Was negative ----------------...
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RE: Kidney Showing Severe Arteriosclerosis With Patient Has No HTN 2 days ago
Moderate to severe arteriosclerosis can be seen in kidney biopsies with familial dysautonomia (characterized by low blood pressure, impaired kidney...
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RE: Kidney Showing Severe Arteriosclerosis With Patient Has No HTN 2 days ago
No diabetes and no clinical signs suggestive of scleroderma also his BP has been very low in the clinic --------------------------------- Ali Ayes...
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Request for Expert Opinions on Chronic Interstitial Nephritis Management 2 days ago
Patient Profile: - Age/Sex: 60-year-old South Asian male - Past Medical History: - Type 2 Diabetes Mellitus (managed with insulin) - Depression/A...
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RE: Kidney Showing Severe Arteriosclerosis With Patient Has No HTN 2 days ago
Normal kidney aging can be associated with arterio-and arteriolo- sclerosis, even in the absence of elevated blood pressure but this degree of prot...
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RE: Proteinuria, hypoalbunimia management during pregnancy 2 days ago
Dr Ahmed if Cr does not come down after cessation of CNI, at what point would you consider delivery. ------------------------------ Awais Nauman ...
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RE: Kidney Showing Severe Arteriosclerosis With Patient Has No HTN 2 days ago
Senile arteriolosclerosis ------------------------------ Awais Nauman HMC Doha ------------------------------
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RE: Proteinuria, hypoalbunimia management during pregnancy 2 days ago
Thanks everyone. Dr Rodby, after the urine being negative for hematuria, we found more analyses showing micro-hemaruria. will stop CNI as...
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Kidney Showing Severe Arteriosclerosis With Patient Has No HTN 2 days ago
Would Appreciate your input : 78-year-old male patient was referred to me by my clinic 6 months ago for abnormal renal function test, his creatini...
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RE: Possible hydralazine associated ANCA vasculitis/lupus,/treat or not 2 days ago
Is it Hydralazine induced Lupus Interstitial Nephritis rather than Hudralazine induced AAV associated Interstitial Nephritis? In this study 5 pati...
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RE: Volunteer by May 8 to serve as a case report reviewer for Kidney Week 2024! 2 days ago
Thank you for your interest in reviewing trainee case reports! For time commitment, ASN's goal is to assign no more than 60 case reports (abstracts...
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RE: Volunteer by May 8 to serve as a case report reviewer for Kidney Week 2024! 2 days ago
Good evening. I am willing to serve as a reviewer. Thank you for the opportunity.Dr. Onu Ugochi Chika
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RE: Refractory Hypercalcemia of Malignancy with hypophosphatemia (elevated 1,25-OH VitD and PTHrP) 2 days ago
Regarding the mechanism(s) of hypercalcemia and hypophosphatemia in this patient: 1. It has been suggested that hypercalcemia may directly cause re...
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RE: Volunteer by May 8 to serve as a case report reviewer for Kidney Week 2024! 2 days ago
Hi What is the time commitment and expectations on this? Thanks ------------------------------ Jose Agraz PhD postdoctoral fellow university ...
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RE: Possible hydralazine associated ANCA vasculitis/lupus,/treat or not 2 days ago
I assume spironolactone is being used for BP control since proteinuria is not severe. What is the dose of spironolactone? Some of the recent increa...
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RE: Refractory Hypercalcemia of Malignancy with hypophosphatemia (elevated 1,25-OH VitD and PTHrP) 2 days ago
Agree with Dr Rodby's comments. I would not use fluconozole as elevated 125 would like increase and not decrease the phosphate. It could be from PT...
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RE: Possible hydralazine associated ANCA vasculitis/lupus,/treat or not 2 days ago
Thanks a lot Dr Glassock and Dr Rudby Very helpful No Eosinophilia IF on Bx negative Don’t have IgG4 will check I was thinking to treat with ste...
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RE: Refractory Hypercalcemia of Malignancy with hypophosphatemia (elevated 1,25-OH VitD and PTHrP) 2 days ago
That 1-25 is crazy high but I dont see how that causes the hypoPO4 and PO4 wasting. FGF23 is rare in breast cancer but not unheard of https://p...
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RE: Refractory Hypercalcemia of Malignancy with hypophosphatemia (elevated 1,25-OH VitD and PTHrP) 2 days ago
You might ask your Medical Oncologists if a MAP kinase inhibitor (like Trametinib ) would have any palliative value as these agents may help to all...
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RE: LN not in remission 2 days ago
Do you? 1) rebiopsy and see if that helps you decide - I think you will find a mixture of old and new MGN, I doubt it will be only old MGN as pro...
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