RE: Indications of dialysis in ESLD 2 hours ago

Dr. Mellas has stated the practical point which takes the guess out of the equation, get 24 urine for creatinine and urea clearance. Cystatin-C val...

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Applications Open for the 2025 ASN-NMRI Travel Support Award 2 hours ago

Applications are open for the 2025 ASN-Network of Minority Health Research Investigators (NMRI) Travel Support award. The Network of Minority Heal...

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Applications are open for the 2025 ASN-Network of Minority Health Research Investigators (NMRI) Travel Support award. 2 hours ago

Applications are open for the 2025 ASN-Network of Minority Health Research Investigators (NMRI) Travel Support award. The Network of Minority Heal...

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ASN Acute Kidney Injury: From Bench to Bedside Conference! 2 hours ago

Please spread the word to your trainees and colleagues. The ASN Acute Kidney Injury: From Bench to Bedside conference will be held in Leesburg, VA ...

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Applications are open for the 2025 ASN-Network of Minority Health Research Investigators (NMRI) Travel Support award. 2 hours ago

Applications are open for the 2025 ASN-Network of Minority Health Research Investigators (NMRI) Travel Support award. The Network of Minority Heal...

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RE: Indications of dialysis in ESLD 2 hours ago

Thank you for your clear answer. ------------------------------ Bijan Roshan MD, FASN Scripps Clinic Solana Beach CA (858) 824-5494 ------------...

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RE: Indications of dialysis in ESLD 2 hours ago

Frequently when patients have "stable" renal function and we suspect the serum creatinine may not be indicative of real GFR IUs mathematical averag...

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RE: Indications of dialysis in ESLD 2 hours ago

By the way mistakenly wrote that the CMV and BK PCR came positive but actually CMV and EBV PCR (do not know why her right BK?) were positive, when ...

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RE: Potential Donor with TRPC6 inactivating mutation 3 hours ago

Thank you at Dr Rubin. Your voice is heard. To conclude, I have been a strong advocate of "genetic for all and genetic first" but this comes with p...

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RE: Potential Donor with TRPC6 inactivating mutation 3 hours ago

@Simone Sanna-Cherchi Your post underscores what I stated earlier: We must have a medical genetic expert such as yourself, Dr. Gharavi and severa...

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RE: Potential Donor with TRPC6 inactivating mutation 4 hours ago

ACMG criteria are classification criteria applied automatically. It's then up to us interpret them at the next level. ACMG criteria heavily weigh o...

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RE: Potential Donor with TRPC6 inactivating mutation 5 hours ago

Curiosly the genetic report of the patient states that this is a truncating mutation and leads to loss of function. Though gain of function mutatio...

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RE: Indications of dialysis in ESLD 6 hours ago

To answer to your question, I would not start dialysis when creatinine is decreasing on daily basis and not knowing the baseline. too. If you had...

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RE: Potential Donor with TRPC6 inactivating mutation 6 hours ago

Thank you! ------------------------------ Mario Rubin, M.D. Houston TX (713) 252-5539 ------------------------------

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Applications Open for 2025 ASN-NMRI Travel Support Award 6 hours ago

Dear Kidney Educators, Applications are open for the 2025 ASN-Network of Minority Health Research Investigators (NMRI) Travel Support award. ...

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RE: Potential Donor with TRPC6 inactivating mutation 6 hours ago

Valid points! True that often time the disease manifests earlier, but the variability is very high so we can't exclude late onset. Moreover, wome...

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RE: Dialysis Questions 8 hours ago

One set of opinions: Q1: I don't know of an exact number, people will differ. IMO, the urine output should be enough so that you can take off sig...

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RE: Potential Donor with TRPC6 inactivating mutation 8 hours ago

@Simone Sanna-Cherchi Thank you for your educational post. As absence of evidence is not evidence of absence, should this donor (wisely rejected,...

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RE: Indications of dialysis in ESLD 8 hours ago

One can measure the creatinine clearance in such a case. The values for creatinine production and serum concentration will be lower than usual due ...

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RE: Low value care in nephrology 8 hours ago

Roger: I have long wondered the same thing:" imagine if the 7.5 PO4 group has no more morbidity or mortality than the 5.5 group!". The effort to re...

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RE: Potential Donor with TRPC6 inactivating mutation 9 hours ago

That's a tough question Professor Glassock. If I had at hand a biopsy of the brother that read classic nodular diabetic nephropathy, possibly yes. ...

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RE: Potential Donor with TRPC6 inactivating mutation 9 hours ago

Am I to understand that you would have accepted this donor , as the mutation detected is likely nob-pathogenic? ------------------------------ R...

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RE: Low value care in nephrology 9 hours ago

Urine eosinophils Daily lab on non ICU patients daily inpt consults which in many cases can be less frequency not doing DRE in older pts pr...

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RE: Potential Donor with TRPC6 inactivating mutation 10 hours ago

When discussing inactivating mutations it is important to differentiate between missense (and maybe late truncating variants) that then result in i...

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RE: Potential Donor with TRPC6 inactivating mutation 12 hours ago

Thank you Dr. Rubin We decided to decline her as a donor looking forward to Dr. Pollak's response and input ------------------------------ ...

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RE: Potential Donor with TRPC6 inactivating mutation 21 hours ago

@Katafan Achkar What did you decide? Today I had the opportunity to briefly present this case to Dr. Ali Gharavi @Ali Gharavi and he had 2 sugges...

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RE: Low value care in nephrology 23 hours ago

Sheldon, nice additions, I read the question as what do we do as conventional wisdom when there is little to no wisdom behind it. As for PO4 bind...

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RE: Indications of dialysis in ESLD 23 hours ago

I don't think your case is complicated enough, multiple causes for pericardial effusion, rapidly changing GFR, and an unreliable eGFR even when cre...

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Indications of dialysis in ESLD 1 day ago

The question of initiation of dialysis in patients with liver disease and reduced muscle mass is always intriguing, Esp when the baseline ins unkno...

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RE: Low value care in nephrology 1 day ago

Dr. Hirsch raises an important question. Determining "value" (benefit/cost ) depends on whether you practicing Population -based medicine vs Person...

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Dialysis Questions 1 day ago

Dear all , Couple of questions and would be grateful for input. Question 1: what is the minimum urine output in dialysis patient to consider him o...

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RE: Microscopic Haematuria 1 day ago

Thanks so much team ASN --------------------------------- Muhammad Soobadar MBChB UK ---------------------------------

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RE: Low value care in nephrology 1 day ago

Thank you all for these ideas. Dr. Hirsch I completely agree this discussion hinges on the definition of low value care or maybe should focus on wh...

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RE: Nephrology Certification Exam 1 day ago

Thank you all for your thoughtful replies. I know that I will start reading through resources and solving questions as early as possible. What is t...

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RE: Low value care in nephrology 1 day ago

Roger, I appreciate the "ask", thinking about this was kinda fun, thanks. But, not easy: what exactly is meant by "not beneficial at the public hea...

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RE: Microscopic Haematuria 1 day ago

To me the reason to do genetic testing in such an individual is to AVOID a renal biopsy. Interesting that the gender phenotype is reversed here....

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RE: Soliciting recommendations for disability guidelines (US) 1 day ago

Dear Dr. Vishnepolky : Saw your posting on ASN Open Forum about bony pains in CKD. I am a living fossil, involved in  Nephrology since 1969, caus...

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RE: Nephrology Certification Exam 1 day ago

I mean't to say I am certified in IM and Nephrology but maintain MOC in both but grandfathered for recertification in both. I strongly believe in c...

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RE: Microscopic Haematuria 1 day ago

I don't think kidney biopsy is required for genetic testing in any case I this case family history is positive , generic test is appropriate nex...

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RE: Low value care in nephrology 1 day ago

I like the corrected Ca example how about treating K 5.5-6.0 in stable CKD? or sending a patient to the ED the same for an EKG. Baseline PET t...

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RE: Immune complex GN in patient with untreated RA 1 day ago

that is one high RF and makes me think of cryoglobulinemia or endocarditis but I think these have been eliminated by the biopsy and other tests. ...

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RE: Low value care in nephrology 1 day ago

Hi Muna, You may find these two papers helpful. Amir 1) Misapplications of Commonly Used Kidney Equations: Renal Physiology in Prac...

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RE: Immune complex GN in patient with untreated RA 2 days ago

Rheumatoid factor is 1299 (0-29). Seems a skosh a high. will discuss rituximab with patient as next visit. also, there is concern regarding medic...

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RE: Nephrology Certification Exam 2 days ago

Thank you for this fruitful discussion. @Hithem Fargaly Asked how to most efficiently study and many suggestions have been given. The literature su...

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RE: Global glomerulosclerosis vs. FSGS 2 days ago

I share the view that this histological picture of focal global glomerulosclerosis + IFTA is primarily seen in disorders that effect tubulointersti...

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Soliciting recommendations for disability guidelines (US) 2 days ago

I was asked to speak to a conference of administrative law judges who adjudicate all SSA disability cases in the US. They are asking me to talk abo...

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RE: Nephrology Certification Exam 2 days ago

Of course, I should have added a disclosure that I have no ongoing affiliation with the American Board of Internal Medicine (ABIM) and my comments ...

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RE: Microscopic Haematuria 2 days ago

In my opinion, this is an ideal case for genetic test first and avoiding an unnecessary kidney biopsy. This patient very likely has an Alport Spect...

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Microscopic Haematuria 2 days ago

Dear all , 28 male years hx of microscopic haematuria , no proteinuria preserved kf. Mum has col4a35 and is on dialysis brother has visible haemat...

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RE: Nephrology Certification Exam 2 days ago

Having some experience with Certifying Boards and Accreditation agencies and having written hundreds of questions fro Certifying examinations, I fe...

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