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 4 (Oct 2024): Chronic Kidney Disease is now available online.
RE: Need advice on Membranous Nephropathy with Ext-2 39 minutes ago
ubject: Treatment Rationale for PLA2R-Induced Membranous Nephropathy Dear Sir , Thank you for your query regarding the patient with PLA2R-posit...
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RE: Starting SLT2 inhibitor with asymptomatic UTI/colonization? 42 minutes ago
Dr. Ali- will thus study help to tteassure you that starting SGLT2i in patients with asymptomatic bacteruria is safe? No harms noted when SGLT2i st...
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RE: IgA Nephropathy 1 hour ago
I hope many other Open Forum members will join this discussion and express their opinions. It is an important issue with lots of room for variation...
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RE: Need advice on Membranous Nephropathy with Ext-2 5 hours ago
MN and SLE are both auto-immune diseases. Both may respond to MMF or RTX. Obinutuzumab is very good therapy for both diseases. -----------------...
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RE: Diagnosis of ADPKD 5 hours ago
In patients with ADPKD, age 56-65, select group would benefit based on posthoc analysis (manuscript under revision): CKD G3-4, GFR rate of decline ...
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RE: Diagnosis of ADPKD 6 hours ago
For patients with Type 2 PKD Tolvaptan is never indicated, regardless of age. ------------------------------ Richard Glassock MD, FASN Laguna Woo...
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RE: Is this inherited glomerulonephritis, and, if so, which? 6 hours ago
The early age onset , strong FH , lack of Father-Daughter transmission suggests an X-linked disorder. (Alport Syndrome.. due to age dependent delet...
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RE: Diagnosis of ADPKD 6 hours ago
Thanks everyone in the tempo trial there was an age cut off to use tolvaptan. I think 55 years old . In clinical practice can we use it if patient ...
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RE: IgA Nephropathy 7 hours ago
Thanks- the issue of whether TRF-Budesonide is superior in efficacy or safety compared to once daily, oral moderate dose systemically acting steroi...
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RE: IgA Nephropathy 9 hours ago
Dr glassock you are right about that and I also want to mention that I met a 25 year old female pt ( height 4feet 10 in ) recently at Igan workshop...
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RE: Need advice on Membranous Nephropathy with Ext-2 10 hours ago
I will treat with RAASI plus glucose transport inhibitors for 3 months if proteinuria worsens then mmf or rituximab can be considered. Just an opin...
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RE: Need advice on Membranous Nephropathy with Ext-2 10 hours ago
Here is more details: -No TRI, IF shows granular capillary wall staining IgG (3+), C3 (1+), kappa (3+), and lambda (3+). Other stains are negativ...
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RE: IgA Nephropathy 10 hours ago
Thank you Dr Glassock and everyone for all the wonderful remarks. I will discuss with the patient and probably suggest TRF Budenoside as a reasonab...
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Is this inherited glomerulonephritis, and, if so, which? 10 hours ago
Dear experts, may I please have your oppinion on this case: 56 year, female English teacher from Syria - microhematuria since childhood; now conf...
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RE: Need advice on Membranous Nephropathy with Ext-2 10 hours ago
Just curious why did you do Exotin staining in absence clinical evidence of autoimmune disease What did IF show? Non lupus full house picture has b...
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RE: Diagnosis of ADPKD 11 hours ago
Indeed, it's not Mayo class 1, but 2. So, the Mayo ADPKD Calculator (one of the best achievments in medicine!) is not applicable for prognosis pred...
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RE: Need advice on Membranous Nephropathy with Ext-2 11 hours ago
Dr. Solanki- just curious, On what basis did you select a regimen of high dose methyl prednisolone (MP, ?IV) combined with such a low dose of RTX f...
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RE: Starting SLT2 inhibitor with asymptomatic UTI/colonization? 11 hours ago
Difficult to provide an evidence based answer. The data, so far, indicate a very low risk of harm in such patients with asymptomatic bacteruria. Ho...
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RE: IgA Nephropathy 11 hours ago
Understood, but you nay be biased in your experience because of the use of HIGH rather than MODERATE dose oral steroids. If you or the patient are ...
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RE: Starting SLT2 inhibitor with asymptomatic UTI/colonization? 11 hours ago
Yes, it's a difficult question to answer. Therefore, I am placing on this international forum of experts. On one hand, SGLT2 inhibitors are benefic...
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RE: post kidney transplant TMA 11 hours ago
You are stuck between a Rock and a Hard Place- A old proverb indicating a dilemma. I would restart PLEX and give IVIgG and hope for the best, but e...
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RE: Starting SLT2 inhibitor with asymptomatic UTI/colonization? 11 hours ago
Does asymptomatic bacteruria increase the risk if symptomatic UTI after starting SGLT2i in a diabetic with 'incipient" Nephropathy. I do not know t...
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RE: post kidney transplant TMA 11 hours ago
Prednisolone and MMF Iptacopan is not available over here ------------------------------ Bee Boon Cheak; MD Ministry of Health, Malaysia -------...
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RE: post kidney transplant TMA 12 hours ago
What immunosupreive therapy did you switch to ? I would avoid Cyclosporine or Mtor as both could also trigger endothelial damage and induce TMA . C...
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Starting SLT2 inhibitor with asymptomatic UTI/colonization? 12 hours ago
Gentleman age 68 with Diabetes type II insulin requiring and last A1c rising to 7.5 in July, 2024. GFR stable at 77. Potassium 3.9. Magnesium 1.5...
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RE: IgA Nephropathy 13 hours ago
You are correct about prednisone but over time I have developed aversion to systemic steroids ( esp if I have other options ) because of adverse ev...
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RE: IgA Nephropathy 14 hours ago
Thank you all for the insights! I’m definitely leaning towards treatment. --------------------------------- Eithan Orlev-Shitrit MD MONTGOMERY ...
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RE: post kidney transplant TMA 14 hours ago
Eculizumab is very likely the best therapy for de novo TMA developing post living unrelated ABO incompatible donor transplant . If it is available ...
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RE: Need advice on Membranous Nephropathy with Ext-2 15 hours ago
We have a similar patient Pt 56 year /M , with strong H/O DM /Retinopathy presented with heavy proteinuria and severe hypoalbunemia ,and S.Cr in th...
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RE: IgA Nephropathy 15 hours ago
Why not oral systemic steroids in a moderate dose as an option as well, if TBMB is excluded by EM analysis? No direct comparator studies for TRF -B...
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RE: Need advice on Membranous Nephropathy with Ext-2 15 hours ago
Interesting anecdote. It would be if interest to have Dr. Ismail share additional data concerning the IF and EM of his patient with EXTI/II + MN. A...
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RE: Need advice on Membranous Nephropathy with Ext-2 15 hours ago
I have a similar pt was treated with ritux twice in 3 years in PR , moved to FL SLE w/u eventually became positive after so many years . -------...
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RE: IgA Nephropathy 15 hours ago
Hematturia is not benign finding any longer . There is a thought process that suppressing proteinuria with arb and sglt2 etc does not treat igA (...
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post kidney transplant TMA 17 hours ago
I have a patient with unknown primary disease who underwent living related kidney transplant, with donor being the spouse. ABOi and as per standard...
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RE: EuroLupus Protocol in patient with eGFR 20 21 hours ago
Hi Dr Glassock, I have not seen the NIH IV CYC being prescribed before. But I did note KDIGO guideline mentioned IV CYC 0.5-1mg/m2 monthly und...
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RE: EuroLupus Protocol in patient with eGFR 20 21 hours ago
Thank you Dr Prajapati for your input / advice. ------------------------------ Siev Hong Lor PharmD Pharmacist Liverpool Hospital, NSW E: hong...
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RE: IgA Nephropathy 22 hours ago
In our observational study of IgAN only about 14% of those with hematuria at BL did not have an M1 lesion by KB.See Bobart S, et al, NDT, 2019. -...
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RE: IgA Nephropathy 23 hours ago
Thank you very much Dr Glassock. TBMN is an interesting option I did not think of. --------------------------------- Eithan Orlev-Shitrit MD MON...
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RE: Diagnosis of ADPKD 1 day ago
Since this patient very likely does not have ADPKD, then the Mayo Classification system is NOT applicable. Tolvaptan is not indicated. See Dr. Cheb...
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RE: Diagnosis of ADPKD 1 day ago
Thanks . Would mayo apply here ? Its seems atypical isn’t ? Not diffuse cystic nature in kidneys --------------------------------- Muhammad Soob...
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RE: IgA Nephropathy 1 day ago
I agree! - no good evidence to support use if TRF Budesonide in this case, . But if prescribed it would be 'on label" as the FDA does not specify a...
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RE: IgA Nephropathy 1 day ago
Thank you very much Dr Rodby ! Given the lack of improvement in hematuria / proteinuria and her age I was considering Budenoside with the main con...
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RE: IgA Nephropathy 1 day ago
Hematuria is now considered by some to be a predictor of poor outcome bc it is the sign of inflammation something not really dont see in this bi...
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RE: Need advice on Membranous Nephropathy with Ext-2 1 day ago
Thank you for prompt response. he doesn't have any autoimmune features, and extended antibody panels were negative. Biopsy didn't show diabetic f...
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IgA Nephropathy 1 day ago
I’m treating for the past 9 month a 33 y/F that presented to me with 2 years of Hematuria. K biopsy revealed: Diagnosis: IgA nephropathy LM: On...
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RE: MCGN 1 day ago
very odd that he is so steroid responsive yet did not respond to rituximab. Obi is a good idea as suggested by Dr Glassock, but if you cannot...
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RE: Case of Interstitial Nephritis 1 day ago
If it wasn’t for the hypotension (& negative serologies), I would have honed in on the pre-glomerular vasculopathy (rather than the interstitial ne...
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RE: Need advice on Membranous Nephropathy with Ext-2 1 day ago
not really nephrotic Exostocin MGN is supposed to have a better prognosis I generally think most MGNs regardless of the antibody should be tre...
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RE: Need advice on Membranous Nephropathy with Ext-2 1 day ago
EXTI/II MN is usually associated with lupus like auto.immune features, but this might be an exceptional case. The prognosis is usually favorable , ...
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RE: Case of Interstitial Nephritis 1 day ago
The striking features in this case are hypokalemia, intermittent hypercalcemia, low BP and vascular lesions (resembling " hypertensive" microangiop...
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