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: IgA Vasculitis in an adult 1 hour ago
"Going through the insurance hoops." A period of forced observation may be imposed if insurance approval for rituximab is delayed. It will be reass...
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RE: Significance of Parvus tardus wave form in one interlobar artery 1 hour ago
Since patient has uncontrolled hypertension on 3 drugs, wonder about branch renal artery stenosis in the branch of renal artery supplying the super...
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RE: Significance of Parvus tardus wave form in one interlobar artery 3 hours ago
I would think that the identification of this flow pattern on a Doppler US in a patient with treatment resistant hypertension (in a transplanted ki...
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RE: IgA Vasculitis in an adult 3 hours ago
I understand Dr. Rodby's "saving the nephrons" approach to treatment of this complicated patient. If the eGFR is steadily improving, (off Hydralazi...
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RE: IgA Vasculitis in an adult 4 hours ago
Is this IgAN/IgAV with hydralazine induced benign serologies or hydralazine induced Vasculitis (pauci immune) on top of an IgAN? Yes you can wa...
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Significance of Parvus tardus wave form in one interlobar artery 6 hours ago
Dear members, Good morning. What is the significance of tardus parvus pattern in the superior interlobar artery of a transplant kidney ? RI is lo...
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RE: IgA Vasculitis in an adult 6 hours ago
Urine studies were still pending. This was before Rituximab. Going through the insurance hoops. Should I consider holding off since GFR is improvin...
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RE: isolated. vit d 1,25 elevated 6 hours ago
This is a fascinating problem and both the case and the comments are illuminating. I want to add a minor issue which I think is important to our th...
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RE: Intra-Renal AV Malformation: Observe? Embolize ? Partial Nephrectomy 9 hours ago
In this circumstance, I think that intervention is appropriate, by what ever means are recommended from an experienced Vascular Surgeon or urologis...
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RE: Intra-Renal AV Malformation: Observe? Embolize ? Partial Nephrectomy 10 hours ago
thanks Dr Glassock Only CT contrast was done and it confirmed it is an Aneurysm grown from 1.3cm to 2.4 cm over 5 months. She has not completed h...
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RE: IgA Vasculitis in an adult 11 hours ago
Thanks for posting most recent SCr value. Note that it has come down further to 2.5 mg/dL. Was this before giving first dose of rituximab? Have you...
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RE: Intra-Renal AV Malformation: Observe? Embolize ? Partial Nephrectomy 13 hours ago
Thanks. Difficult case. It is a bit unclear to me from your description if this is an AVM or an intrarenal aneurysm. If it is an AVM premature opac...
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Intra-Renal AV Malformation: Observe? Embolize ? Partial Nephrectomy 14 hours ago
I would appreciate your opinions on the following case: 40yrs old female. fit and well. not on any medications. during routine investigation for ...
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RE: proteinuria and pyuria in Chron's pt on JAKi 16 hours ago
Thank you, Dr Rodby --------------------------------- Asad Riaz Indianapolis IN ---------------------------------
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RE: To biopsy or not to biopsy 17 hours ago
Thank you Dr Glassock, Dr Rodby, Dr Hirsch and Dr Venkat. Patient has never been on Hydralazine. Unlikely to have active urinary sediment with n...
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RE: IgA Vasculitis in an adult 18 hours ago
Sorry for the late reply. Hydralazine was stopped on July 5th. Crt from July 11th came down to 2.5 from 2.98 previously ----------------------...
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RE: Glomerular Proteinuria now? 23 hours ago
I agree with Dr. Mellas that "premium non nocere" does not mean "do nothing ". I would go one step further: it asks one to FIRST do no harm. I inte...
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RE: isolated. vit d 1,25 elevated 1 day ago
yes he is on tapering steroids already since 6/7 and its working Sent from my iPhone
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RE: Glomerular Proteinuria now? 1 day ago
The quote by Hippocrates simply says do no harm. This is a vague statement, subject to individual interpretation, but it does not say do nothing. ...
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RE: Glomerular Proteinuria now? 1 day ago
I'm not saying this applies here, but Primum non nocere does not alway mean Primum do nothing. Sometimes doing nothing can be equally harmful. I...
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RE: isolated. vit d 1,25 elevated 1 day ago
My gut tells me you are going to do testing and still not have a definitive diagnosis and you will be left with empiric treatment I would still giv...
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RE: proteinuria and pyuria in Chron's pt on JAKi 1 day ago
Chrons, I would add Secondary AA amyloid. I should biopsy but also hold on steroids pending results. ------------------------------ Roger Rodb...
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RE: To biopsy or not to biopsy 1 day ago
nice discussion as usual but I would never biopsy this patient with no hematuria. I dint see the answer of whether or not on Hydralazine, might ...
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RE: To biopsy or not to biopsy 1 day ago
> It was a long time ago, a different world, but not only did we not have RAASIs but the benefits of both tight BP and glycemic control were disp...
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RE: To biopsy or not to biopsy 1 day ago
Excellent question. The decision about performing a kidney biopsy of native kidney in patients with advanced CKD (e.g. Stage IV CKD ) is influenced...
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RE: To biopsy or not to biopsy 1 day ago
Did the recent repeat US show further increase in echogenicity/cortical thinning? Regarding GFR cutoff vis-a-vis non-utility of biopsy: rather th...
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RE: To biopsy or not to biopsy 1 day ago
ANCA panel was negative too Dr Glassock ------------------------------ Mohamed Anwar Abdus Samad MD WellSpan Medical Group York PA --------------...
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RE: To biopsy or not to biopsy 1 day ago
Thanks for your input Dr Hirsch. I tried ACEi with thiazides but he ended up having hypovolemia and hyponatremia as well. I haven't attempted oral ...
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RE: To biopsy or not to biopsy 1 day ago
Thank you so much Dr Glassock for your input. I did not know about the differences in antidsDNA specificity with different assays. Good to know. Yo...
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RE: To biopsy or not to biopsy 1 day ago
Also agree, and noting absence of hematuria. Plus, there is a noticeable lack of acuteness or acceleration to this CKD, arguing against a superimpo...
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RE: To biopsy or not to biopsy 1 day ago
Thanks. Though case but I agree with your decision not to biopsy. It is a fairly common issue. Anti-ds -DNA antibodies vary in terms of specificity...
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To biopsy or not to biopsy 1 day ago
Dear community members, I would appreciate your input on this patient of mine on whom I am debating whether or not to do a kidney biopsy. I f...
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RE: proteinuria and pyuria in Chron's pt on JAKi 2 days ago
Thank you Dr Venkat. Yes, I thought of Ig A but for the same reason as you mentioned was not convinced. If it is Ig A , With improved inflammation ...
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RE: proteinuria and pyuria in Chron's pt on JAKi 2 days ago
Two possibilities come to mind: 1. IgA nephropathy because of its known association with IBD. However, lack of hematuria recently is atypical. 2. S...
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RE: isolated. vit d 1,25 elevated 2 days ago
I am curious when your patient last had a colonoscopy and/or if he had diarrhea. Crohn's disease is a reported cause of an elevated 1.25 dihydroxy ...
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RE: proteinuria and pyuria in Chron's pt on JAKi 2 days ago
Thank you for your input , Dr Glassock. --------------------------------- Asad Riaz Indianapolis IN ---------------------------------
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RE: Glomerular Proteinuria now? 2 days ago
"Do no harm" (primum non nocere, or ὠφελέειν ή μὴ βλάπτειν from Hippocrates). I would treat conservatively. ------------------------------ J...
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RE: proteinuria and pyuria in Chron's pt on JAKi 2 days ago
The UACR/UPCR ratio is more suggestive of a glomerular disease. I would do a kidney biopsy and not use empiric steroid therapy. Opinion only. -...
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proteinuria and pyuria in Chron's pt on JAKi 2 days ago
30 YOF with hx of chron's disease, on upadacitinib ( JAK 2 inhibitor) , CKD 2 with biopsy proven AIN/CIN in 2007 ( presumed to be 2/2 mesalamine) w...
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RE: Glomerular Proteinuria now? 2 days ago
Plenty of room on this site for a diversity of opinions on an obviously very difficult, largely philosophical question . I think that those who adv...
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RE: isolated. vit d 1,25 elevated 2 days ago
will order it via mayo with his followup in 9/2024, but renal function cr now 2, vit d active and calcium are now normal on pred 20mg daily this we...
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RE: isolated. vit d 1,25 elevated 2 days ago
Would anyone do a serum 25 hydroxy vitamin D to 24,25 dihydroxy Vitamin D ratio in this case to evaluate the possibility of an acquired auto-immune...
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RE: isolated. vit d 1,25 elevated 2 days ago
damm it, sorry i missed it. as level was 51 but didnt realize ace level 51 post steroids, i had ordered labs on 6/7 but pt pt got started on steroi...
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RE: Glomerular Proteinuria now? 2 days ago
I agree that there is no proven cure for AA amyloidosis once developed. The question is, would you tell the patient that they have incurable diseas...
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RE: Glomerular Proteinuria now? 2 days ago
I think you are being realistic, and I agree with you. ------------------------------ Sadeem Ali MD Bridgeport WV (612) 865-9067 ----------------...
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RE: Glomerular Proteinuria now? 2 days ago
I find it difficult to understand how knowing that one has an untreatable disease will help the patient cope with the disabilities that accompany t...
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RE: isolated. vit d 1,25 elevated 2 days ago
ACE was 2 on and <14 one repeat before steroid use (Normal range 14-82) afterwards, 12 and 10. best, ------------------------------ Jin...
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RE: Glomerular Proteinuria now? 2 days ago
spastic quadriplegic with possible osteo , likely chronic decubuti, Creatinine is 0.8 but this is likely severe CKD given muscle mass, This is...
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RE: isolated. vit d 1,25 elevated 2 days ago
What was the ACE level before starting steroids? ------------------------------ Roger Rodby MD, FASN Professor of Medicine Rush University Med...
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RE: isolated. vit d 1,25 elevated 3 days ago
Hi, Dr. Glassock, I did not exclude 24 hydroxylase deficiency yet since the patient started to have kidney stones in 40s, no family history. Howe...
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