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 23: Issue 2 (Jun 2024): Electrolytes and Acid-Base Disorders is now available online.
RE: Transplant Question 3 hours ago
s: CDC crossmatch is less sensitive than the flow cytometry crossmatch. A positive CDC crossmatch indicates a higher level of donor-specific antibo...
View Discussion
RE: Fibrillary GN 15 hours ago
Thank you Dr. Glassock and Dr. Rodby for a prompt response. Hep C negative. Age appropriate Cancer screening is negative. SPEP/UPEP -unremarkable -...
View Discussion
RE: Adjunctive acetazolamide therapy for the treatment of Bartter syndrome 17 hours ago
Also as I read the pharmacologic concentration of Sando tablet, each tablet contain 600 mg KCl and 400 mg KHCO3 giving a total of 12 mmol K salts s...
View Discussion
RE: Adjunctive acetazolamide therapy for the treatment of Bartter syndrome 17 hours ago
NSAIDs use address the pathophysiology of Bartter syndrome as those patients have high PGE2 resulting from uncoupled tubuloglomerular feedback as C...
View Discussion
RE: Primary hyperaldosteronism 21 hours ago
Thank you ASN forum members for all the responses. So screening for Pheo Latest Reference Range & Units 02/12/24 09:18 03/07/24 1...
View Discussion
RE: Fibrillary GN 21 hours ago
I would seriously consider enrolling this patient in the Obinutuzumab For Fibrillary GN being conducted at the Mayo Clinic (under direction of Lada...
View Discussion
RE: Post TX TMA 21 hours ago
De novo PT-TMA is more common than recurrent PT-TMA so I agree with Dr. Lerman that after rule out CMV infection and ABMR, this TMA may be due to C...
View Discussion
RE: Post TX TMA 22 hours ago
Since you did several changes Plex/ dc Tac/ start rapamune hard to know which is responsible for clinical improvement. -----------------------...
View Discussion
RE: Adjunctive acetazolamide therapy for the treatment of Bartter syndrome 22 hours ago
NSAID therapy will be long life I don not now is it safe? --------------------------------- Mohamed Mahmoud MBBS NEPHROLOGIST MOH Egypt 00965 5...
View Discussion
RE: management of PLA2R negative membranous nephropathy 22 hours ago
Hi, Dr. Aledan, Thank you so much for your suggestions. will try to see if can get the serum antibodies first. I will need to discuss with pathol...
View Discussion
RE: Adjunctive acetazolamide therapy for the treatment of Bartter syndrome 22 hours ago
Isn't NSAID therapy indicated in this patient? SCr (130 micromol/L) is not very high. ------------------------------ K.K. Venkat MD Troy MI (248)...
View Discussion
RE: Primary hyperaldosteronism 22 hours ago
Dr Duch, What a nice analysis and explanations and very important questions. Looking at t his thread however, especially Dr Duch's response, ...
View Discussion
RE: Primary hyperaldosteronism 23 hours ago
Interesting case with some confounding variables that make accurate interpretation somewhat challenging. Adrenal vein sampling (AVS) is designed to...
View Discussion
RE: A Case Of GN In Hepatitis C Positive Patient 1 day ago
PS: Don't forget fibrillary GN associated with hepatitis C! (This case is not fibrillary GN according to the description/diagnosis but fibrillary G...
View Discussion
RE: Fibrillary GN 1 day ago
Was the biopsy confirmed Fib GN with DNSJb9 staining? I will assume it was as done in 2019. Did you check for Hep C, is associated and if positi...
View Discussion
RE: Fibrillary GN 1 day ago
I presume you have confirmed the diagnosis of Fibrillary GN with aDNAJB9 IHC study. Also what are the HCV serology results. With a course of wors...
View Discussion
Transplant Question 1 day ago
In HLA-incompatible transplant why is graft loss higher at 5 years for patient who are cdc +ve but flow cytometry negative compared to cdc -be but ...
View Discussion
RE: Primary hyperaldosteronism 1 day ago
It may make sense to screen such patients for any MEN syndromes, especially with the suggestion of symptomatic hypertension, and the probability of...
View Discussion
RE: Paucimmune GN with Low Complements In Young Patient 1 day ago
Noted endocapillary proliferation and neutrophils segmentally in some glomeruli. Was EM done on biopsy? If electron dense deposits are noted (despi...
View Discussion
RE: Primary hyperaldosteronism 1 day ago
In this case, the adrenal vein samplings do not support the diagnosis of unilateral adrenal disease. The selectivity index was 15 on the left and ...
View Discussion
RE: Primary hyperaldosteronism 1 day ago
Suggest checking catecholamine pheo w/u consider ganglioma /paraganglioma ------------------------------ Conjeevaram Kesavan MD, MBBS, FASN Du...
View Discussion
RE: Primary hyperaldosteronism 1 day ago
Interestingly, even salt-loading (Na 270 mmol in 24hr urine) did not suppress renin concentration in this patient. With non-suppressed renin and el...
View Discussion
Fibrillary GN 1 day ago
66 y/o Caucasian gentleman with HTN, HLD, Gout, OSA-CPAP, CKD stage IIIa [SCr 1.4 -1.6mg/dl]. Noted to have mild proteinuria in 2000 when examined ...
View Discussion
RE: Post TX TMA 1 day ago
"Do you think testing of genetic complement mutation would be of value at the moment" if genetic testing reveals a mutation significantly associa...
View Discussion
RE: Post TX TMA 1 day ago
More details of the pathology may help assess if the biopsy was also performed in the resolving phase of the disease. In that case the thrombi ma...
View Discussion
RE: Post TX TMA 1 day ago
Thank you for your explanation Do you think testing of genetic complement mutation would be of value at the moment ? ---------------------------...
View Discussion
RE: Binder 1 day ago
This is obviously a tough ? and agree with many of the points above. If it is acute feedings, not sure I would worry about it too much. For chronic...
View Discussion
RE: management of PLA2R negative membranous nephropathy 1 day ago
Agree for conservative approach and I advise to send for serum THSD7A antibodies and stain the biopsy for THSD7A Ag as 5-10% of PLA2R Ab negative M...
View Discussion
RE: Post TX TMA 1 day ago
"So for the CNI induced TMA to develop, we should have a another hit" Dr. Emara: Let me clarify regarding the above statement. It has been sugges...
View Discussion
RE: management of PLA2R negative membranous nephropathy 1 day ago
Dear Dr. El-Meanawy, Thanks for the suggestions. I will check anti-PLA2R antibody which I have not done. 24 hour urine protein and UPCR are d...
View Discussion
RE: Post TX TMA 1 day ago
Thank you. For sharing this case let's summarize primary disease unknown LRDKT and was uneventful tacrolimus trough level acceptable fo...
View Discussion
RE: management of PLA2R negative membranous nephropathy 1 day ago
Dear Dr. Glassock, Thank you for much for the suggestions. Yes, there was no LC monotypism seen in the IF. IF stained Glomerular capillary wall...
View Discussion
Primary hyperaldosteronism 1 day ago
Apologies in advance for a lengthy presentation 51 y.o. female. Comes in for follow up after recent hospitalisation 2/6/2024-2/14/2024 for hypokal...
View Discussion
RE: Post TX TMA 1 day ago
TAC trough levels are low for this 6 month posttransplant and this may explain borderline TCMR. I don’t thick there is specific features for CNI in...
View Discussion
RE: Paucimmune GN with Low Complements In Young Patient 1 day ago
Many thanks Dr. Glassock for your nice comments. C3 0.3 g/l (0.9-1.8) and C4 0.06 g/l (0.2-0.4). --------------------------------- Hayder Aledan...
View Discussion
RE: management of PLA2R negative membranous nephropathy 1 day ago
I agree with Dr. Glassock that negative PLA2R staining does not rule out PLA2R-Ab mediated MN. Based on 24 protein and UPCR, she is only producin...
View Discussion
RE: Adjunctive acetazolamide therapy for the treatment of Bartter syndrome 1 day ago
Amiloride not tried yet --------------------------------- Mohamed Mahmoud MBBS NEPHROLOGIST MOH Egypt 00965 51377736 -----------------------...
View Discussion
Apixaban In hd Patient 1 day ago
Hypothetical scenario - HD pt with left sided av fistula. Patient has new arm swelling right side . Found to be new DVT. We decide to use apixaban...
View Discussion
RE: Post TX TMA 1 day ago
I got your point So for the CNI induced TMA to develop, we should have a another hit May be an ischemic event happened during operation and not ...
View Discussion
RE: Post TX TMA 1 day ago
The donor was the mother 55 y Mismatch 3/6 PRA : 0% NO technical problem (ischemia time 50 mins) with 1ry graft function and adequate UOP Creat ...
View Discussion
RE: Hypertension in pregnant patient 2 days ago
The levels of PRA in pregnancy are not so high and in the average around 4-5 and not much higher with pre-eclampsia. For the moment, I would cont...
View Discussion
RE: Post TX TMA 2 days ago
Dr. Amara: What was the degree of HLA-match between donor and recipient? Can you please post a deidentified biopsy report? What was the pretranspla...
View Discussion
RE: Hypertension in pregnant patient 2 days ago
The high PRA could be the result of the two vasodilators given together. The combination of hydralazine and nifedipine makes no sense. I would use ...
View Discussion
RE: Hypertension in pregnant patient 2 days ago
Neither chronic administration of nifedipine or Labetolol would likely explain the elevated Plasma renin activity, so increased progesterone conseq...
View Discussion
RE: Diet and creatine in a personal trainer with single kidney 2 days ago
My opinion. Does the patient have a history of low birth weight? If so, avoidance of a high protein diet is definitely advisable and his BP should ...
View Discussion
RE: Hypertension in pregnant patient 2 days ago
labetalol and nifedipine. ------------------------------ Jennifer Waldmann MD Attending Saint Peters University Hospital howell NJ (732) 996-674...
View Discussion
RE: A Case Of GN In Hepatitis C Positive Patient 2 days ago
Appreciate your input , pt admitted , hope we can approve inpatient start of Anti-HCV treatment --------------------------------- Aymen Al-Duajil...
View Discussion
RE: Post TX TMA 2 days ago
@K.K. Venkat Would you switch to Rapamine in similar conditions early after tx ? (@Mark Lerman)(@Richard Glassock) -----------------------------...
View Discussion
RE: Post TX TMA 2 days ago
Despite the prevalence of buzz words like tubular vacuolization and medial necrosis/hyaline change in the literature on CNI toxicity, I am not sure...
View Discussion
Diet and creatine in a personal trainer with single kidney 2 days ago
A 50 year old muscular sport trainer with nephrolithiasis, recent total Lt nephrectomy due to RCC. Was used to 1.6 gram kilo protein a day and...
View Discussion