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 3 (Aug 2024): Acute Kidney Injury and Critical Care Nephrology is now available online.
RE: Tolvaptan for PCKD 17 minutes ago
thank you yes it was the first AM urine will review the predicted gfr decline based on Mayo classification and may consider going up to next d...
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RE: IG A Vasculitis with diffuse profoliferative crecentivrabout 22 minutes ago
No data on safety/efficacy of MMF +RTX. ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-8885 -----------------...
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RE: IG A Vasculitis with diffuse profoliferative crecentivrabout 1 hour ago
I would definitely try RTX, but I recognize rhat it is not a suggestion based on RCT. To my knowledge there are no comparator trials of MMF vs RTX ...
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RE: HBV Viremia 1 hour ago
This is not an outcome based study , and I do not know if the findings were ever independently confirmed. ------------------------------ Richard ...
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RE: HBV Viremia 3 hours ago
Thanks a lot for this paper! I will keep it in mind, especially for the rare cases of slim Western Europeans which may match the slim Asians.
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RE: IG A Vasculitis with diffuse profoliferative crecentivrabout 3 hours ago
Do you see any role for MMF? Currently, I`m treating a 82 year old Caucasian lady diagnosed with IgAV in August. She came to the outpatient clini...
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RE: HBV Viremia 3 hours ago
Will defer to my transplant colleague ,await his reasoning but I did find this https://academic.oup.com/ndt/article-abstract/22/12/3638/19...
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RE: HBV Viremia 4 hours ago
I concur with Dr. Glassock. I would keep the MPA doese at 1440 mg. She`s in the first year of an unrelated kidney transplant, with a probably rathe...
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RE: Tolvaptan for PCKD 4 hours ago
Please see attached a slide that Vicente Torres presented at the 2018 ASN meeting in San Diego. Tolerance (= coping with aquaresis) and effect (def...
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RE: HBV Viremia 5 hours ago
Standard use of MMF or MPA is a fixed dose independent of body weight. Tacrolimus .but not CsA , affects PK of MPA. What is the evidence that using...
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RE: HBV Viremia 8 hours ago
I checked with our transplant neph ( 2 of them ) They both said to reduce MMF based on weight everything else you are doing , they concur ...
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RE: HBV Viremia 9 hours ago
Tough call mycoohenolate PI says caution in HBV ------------------------------ Arvind Madan MBBS, MD Partner Central Florida Kidney ...
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RE: IG A Vasculitis with diffuse profoliferative crecentivrabout 14 hours ago
I agree-PEXIVAS steroid dosing Protocol, but without any PLEX. Interestingly,CYC is without demostrated benefit in IgAV -------------------------...
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RE: Tolvaptan for PCKD 16 hours ago
Tough question- I suspect that there are no good answers. What is subtly included in your question is if any dose dependent off-target effects if T...
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RE: IG A Vasculitis with diffuse profoliferative crecentivrabout 22 hours ago
There is not a lot of data on RItux for IgAN, or IgA vasculitis, BUT, I would want to add something besides steroids And I think Cresentic IgAN...
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RE: IG A Vasculitis with diffuse profoliferative crecentivrabout 23 hours ago
Please post the outcome in a few weeks. I hope that RTX works. Curiously, RTX does not work in IgAN but does seem to work in IgAV. --------------...
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RE: Membranous Nephropathy 23 hours ago
We do not have a KB , but based on a + antiPLA2R this is most likely a primary PLA2R associated MN, not idiopathic MN --------------------------...
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RE: HBV Viremia 23 hours ago
Mycophenolate salts have not been implicated in reactivation or susceptibility to incident HBV infection. Some evidence exists that Mycophenolate s...
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HBV Viremia 23 hours ago
Dear All Would appreciate your inputs on the following patient, A 50 yr female , c/o LRDT recipient ( unrelated donor ) /ATG-TMS/ primary disease...
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RE: Membranous Nephropathy 1 day ago
Since the RVT was L-sided (L already more common than R because of its greater length) & he’s very slim & ‘small’, I assume that’s what you meant b...
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RE: Membranous Nephropathy 1 day ago
Yes very unusual presentation as never saw patient of MN presented with thromboembolism and on work found to have MN ----------------------------...
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RE: Membranous Nephropathy 1 day ago
Thanks for input regarding thrombophilia testing but he never has family history of any thrombotic event ------------------------------ Samee Kha...
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RE: Membranous Nephropathy 1 day ago
Sir his albumin is 3.4g/dl ,very smart and having smoking as risk factor now on anticoagulants , biopsy not performed as hi Anti PLA2R found to be ...
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RE: Membranous Nephropathy 1 day ago
He has smoking as risk factor very slim and smart age in thirtees having serum albumin 3.4g /dl ------------------------------ Samee Khan MBBS...
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RE: IG A Vasculitis with diffuse profoliferative crecentivrabout 1 day ago
thank you Dr Glassock! will do! --------------------------------- Mohammed Ashraf MD, FASN MD Lynchburg Nephrology Physicians Lynchburg VA (43...
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RE: IG A Vasculitis with diffuse profoliferative crecentivrabout 1 day ago
I would add RTX and taper steroids, based on observational studies. With 25% crescents the prognosis is poor. ------------------------------ Ric...
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RE: Membranous Nephropathy 1 day ago
Dear if he is not having any other risk factor for dvt and pulmonary embolism,it's very unusual to have thrombosis with 1002 mg /24hrs protienurea ...
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IG A Vasculitis with diffuse profoliferative crecentivrabout 1 day ago
dear all I would appreciate comment about my patient, regarding manageme of IGA vasculitis and kidney biopsy showing diffuse proliferative glomerul...
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RE: Membranous Nephropathy 1 day ago
Maybe genetic testing for Factor V Leiden mutation would be reasonable. ------------------------------ Richard Glassock MD, FASN Laguna Woods C...
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Tolvaptan for PCKD 1 day ago
wondering about dose titration with Tolvaptan for PKD I have had a patient that I have kept on the lowest dose (45mg am 15mg pm) because her urin...
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RE: Membranous Nephropathy 1 day ago
Good morning, I also agree with treating this patient with Rituximab and, for managing both hypertension and proteinuria, I'd suggest considering A...
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RE: Membranous Nephropathy 1 day ago
Does he have other risk factors for hypercoagulability? Obesity, immobilization, smoking, trauma? Having recent thrombotic event and being on antic...
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RE: TRANSPLANT QUESTION: mycophenolate dosing 1 day ago
Thank you very much for your comments! Charite spent quite a lot of energy in building up a tool for measuring mycophenolate exposure. Attach...
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RE: A middle aged lady with IgA Nephropathy 1 day ago
The rationale of a suggested conversion to Sparsentan is very reasonable, but we lack supportive evidence (RCT or Observational) in patients with a...
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RE: TRANSPLANT QUESTION: mycophenolate dosing 1 day ago
Because of excessive multi-factorial variation of pharmaco- kinetics of MMF and MPA should monitoring of blood MPA levels orAUC become a routine pa...
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RE: TRANSPLANT QUESTION: mycophenolate dosing 1 day ago
Given risk of nephrotoxicity/diabetogenicity/ cosmetic and neurological adverse effects/hyperkalemia/hypomagnesemia/hyperlipid-emia/hypertension, e...
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RE: Choice of therapy - or none - for IgA nephropathy 1 day ago
Anything but oral steroids, Budesonide , MMF, Azathioprine, Cyclophosphamide, Tacrolimus, Cyclosporin, ACTH, Leflunomide, Mizoribine, Tonsillectomy...
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RE: Membranous Nephropathy 1 day ago
I don't think that a kidney biopsy has been done, but MN (PLA2R+ ) is highly likely. (> 95%) I think I would probably treat him with RTX now. ---...
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RE: Membranous Nephropathy 1 day ago
RVT and PE with 1 gram of proteinuria would be very unusual indeed! What are his serum albumin and creatinine? Even if this were resolving MGN, ...
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RE: Choice of therapy - or none - for IgA nephropathy 2 days ago
I will not disagree with anything above, his proteinuria is low but clearly he has progressed. Speaks volumes about what we are learning about the ...
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Membranous Nephropathy 2 days ago
Dear all i want guidance regarding a case of 36 years old male who presented with sudden onset of dry cough and increased blood pressure of 170/100...
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RE: Choice of therapy - or none - for IgA nephropathy 2 days ago
In my opinion, Budesonide (or oral systemic steroids) have a low likelihood of being beneficial in the absence of hematuria and with the biopsy fin...
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RE: Choice of therapy - or none - for IgA nephropathy 2 days ago
Pentoxyphylline is an interesting suggestion. So far as I know the Reno -protective effect of this old drug has never been tested in IgAN. It does ...
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RE: Choice of therapy - or none - for IgA nephropathy 2 days ago
Perhaps another gestalt consideration for this unfortunate young with marked and progressive decline in his renal function, from an inflammatory GN...
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RE: A middle aged lady with IgA Nephropathy 2 days ago
Dear All Thank you for your suggestions . The goal is to have a better BP control and delay the progression to ESKD. Will share and empower the f...
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RE: Choice of therapy - or none - for IgA nephropathy 2 days ago
Insufficient sample is problematic. Especially that we are leaning to dismiss the old diagnosis of IgAN, which is a possibility. What was his bi...
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RE: A middle aged lady with IgA Nephropathy 2 days ago
Two very atypical "IgAN" cases in a row, what are the odds for this. I agree that with a MPGN pattern of injury (very uncommon in IgAN) one must se...
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RE: TRANSPLANT QUESTION: mycophenolate dosing 2 days ago
Agree! With higher dose unless side effects ------------------------------ [Mark] [Lerman] [MD,FASN,FACP,FAST] AST KPCOP EC [Past Medical Directo...
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RE: TRANSPLANT QUESTION: mycophenolate dosing 2 days ago
Hi Christian, The MMF dosing is not universal as the individuals response is not. Some centers tend to start with MMF doses up to 1250 or 1000 mg...
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RE: Tablo dialysis 2 days ago
I am currently a Nephrologist and Division Chief + Medical Director of local program in rural Hospital Based inpatient and outpatient (including ho...
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