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: Paucimmune GN with Low Complements In Young Patient 2 hours ago
Dr. Venkat, unfortunately no EM was done. --------------------------------- Hayder Aledan MD, FASN Assistant Professor Basra Nephrology and Transp...
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RE: Renal Function in 55 yo male 3 hours ago
Thank you Professor Glassock No history of low endowement. I will check the urine concentrating capacity. Regards Omar Kaisar ---------...
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RE: Renal Function in 55 yo male 3 hours ago
Thank you Dr Rodby. The gentleman is lean and fit. I have attached the urine result below. We had discussed genetic testing. We havent pursued it y...
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RE: Renal Function in 55 yo male 3 hours ago
Dear Dr Venkat Thank you so much. The cystatin C level was done close to the time of the creatinine level. Previous cystatin level was done at...
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RE: Adjunctive acetazolamide therapy for the treatment of Bartter syndrome 3 hours ago
Can someone please explain to me why one would target therapy to correct the elevated plasma bicarbonate in Bartter Syndrome? What are the expected...
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RE: Paucimmune GN with Low Complements In Young Patient 4 hours ago
Dr Venkat But there is no C3 or c1q staining on IF Surprising serum levels very low Any explanation for that Perhaps repeat levels Thanks ----...
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RE: Transplant Question 12 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...
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RE: Fibrillary GN 1 day ago
Thank you Dr. Glassock and Dr. Rodby for a prompt response. Hep C negative. Age appropriate Cancer screening is negative. SPEP/UPEP -unremarkable -...
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RE: Adjunctive acetazolamide therapy for the treatment of Bartter syndrome 1 day 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...
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RE: Adjunctive acetazolamide therapy for the treatment of Bartter syndrome 1 day ago
NSAIDs use address the pathophysiology of Bartter syndrome as those patients have high PGE2 resulting from uncoupled tubuloglomerular feedback as C...
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RE: Primary hyperaldosteronism 1 day 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...
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RE: Fibrillary GN 1 day ago
I would seriously consider enrolling this patient in the Obinutuzumab For Fibrillary GN being conducted at the Mayo Clinic (under direction of Lada...
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RE: Post TX TMA 1 day 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...
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RE: Post TX TMA 1 day ago
Since you did several changes Plex/ dc Tac/ start rapamune hard to know which is responsible for clinical improvement. -----------------------...
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RE: Adjunctive acetazolamide therapy for the treatment of Bartter syndrome 1 day ago
NSAID therapy will be long life I don not now is it safe? --------------------------------- Mohamed Mahmoud MBBS NEPHROLOGIST MOH Egypt 00965 5...
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RE: management of PLA2R negative membranous nephropathy 1 day 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...
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RE: Adjunctive acetazolamide therapy for the treatment of Bartter syndrome 1 day ago
Isn't NSAID therapy indicated in this patient? SCr (130 micromol/L) is not very high. ------------------------------ K.K. Venkat MD Troy MI (248)...
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RE: Primary hyperaldosteronism 1 day ago
Dr Duch, What a nice analysis and explanations and very important questions. Looking at t his thread however, especially Dr Duch's response, ...
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RE: Primary hyperaldosteronism 1 day ago
Interesting case with some confounding variables that make accurate interpretation somewhat challenging. Adrenal vein sampling (AVS) is designed to...
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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...
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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...
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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...
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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 ...
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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...
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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...
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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 ...
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RE: Primary hyperaldosteronism 1 day ago
Suggest checking catecholamine pheo w/u consider ganglioma /paraganglioma ------------------------------ Conjeevaram Kesavan MD, MBBS, FASN Du...
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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...
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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 ...
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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...
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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...
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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 ? ---------------------------...
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RE: Binder 2 days 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...
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RE: management of PLA2R negative membranous nephropathy 2 days 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...
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RE: Post TX TMA 2 days 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...
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RE: management of PLA2R negative membranous nephropathy 2 days 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...
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RE: Post TX TMA 2 days ago
Thank you. For sharing this case let's summarize primary disease unknown LRDKT and was uneventful tacrolimus trough level acceptable fo...
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RE: management of PLA2R negative membranous nephropathy 2 days 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...
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Primary hyperaldosteronism 2 days 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...
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RE: Post TX TMA 2 days 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...
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RE: Paucimmune GN with Low Complements In Young Patient 2 days 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...
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RE: management of PLA2R negative membranous nephropathy 2 days 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...
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RE: Adjunctive acetazolamide therapy for the treatment of Bartter syndrome 2 days ago
Amiloride not tried yet --------------------------------- Mohamed Mahmoud MBBS NEPHROLOGIST MOH Egypt 00965 51377736 -----------------------...
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Apixaban In hd Patient 2 days 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...
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RE: Post TX TMA 2 days 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 ...
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RE: Post TX TMA 2 days 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 ...
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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...
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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...
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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 ...
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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...
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