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: Low urine creatinne 1 hour ago
Thanks Dr. Mellas for your comments - the original post stated that the patient appeared "well nourished" . This would seem to make sarcopenia an u...
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RE: Low urine creatinne 2 hours ago
Having studied daily creatinine excretion for a research paper I have found daily urine creatinine levels as low as 10 mg/kg. This has been in pati...
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RE: Low urine creatinne 3 hours ago
Dr. Asplin- thanks for your very helpful comments. If there eGFR Cystatin C and the the serum creatinine value is correct, the urine creatinine con...
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RE: Low urine creatinne 3 hours ago
If we go back to the original issue, which was getting a urine that would qualify as adequate for a drug test, we need to know the goal. Here are t...
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RE: Low urine creatinne 18 hours ago
Thank you all. Will repeat and see ------------------------------ Arani Nanavati MD West Des Moines IA ------------------------------
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RE: Low urine creatinne 18 hours ago
so her 24 hour urine creatinine is low, either low muscle mass or under collection. that would have to be a real low muscle mass for this number ...
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RE: Low urine creatinne 21 hours ago
What was the rationale for giving cetrizine? Just curious ------------------------------ Richard Glassock MD, FASN Laguna Woods CA (949) 388-888...
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RE: TRANSPLANT QUESTION: mycophenolate dosing 23 hours ago
Thank You Dr Rosenberger for sharing this study. It would be wonderful if Erythrocyte IMPDH activity becomes more widely available as MPA drug leve...
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RE: Low urine creatinne 23 hours ago
The eGFR-Cystatin C of 113 ml/min;and a Scr of 0.7 translates to a urine creatinine excretion rate of about 1.5 gms / d so the accuracy of a 24 hr ...
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RE: Low urine creatinne 1 day ago
The "normal" 24 hour creatinine excretion in a 38 year old woman is about 20.4 mg/kg/d (+ or - 3.9) or about 1.4 gms/d in this subject. With urine ...
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RE: Low urine creatinne 1 day ago
you must mean 670 mg/day, if it were 670 mg/dl X 14 dl = her 24 hr urine Cr excretion would be 9.3 grams. Assuming it is 670 mg/day she either ha...
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Low urine creatinne 1 day ago
Hello all, I have a patient who was referred to me for low urine creatinine. She is a 38 yo Caucasian lady who used to abuse drugs. She lost t...
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2nd Annual UME Educator Kidney Week Meetup 1 day ago
Do you teach medical students? Would you like to meet renal block leaders, to share the joys and challenges of teaching nephron physiology? Com...
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RE: HBV Viremia 1 day ago
Thanks. Let us know what you decided to do and what was the outcome in this patient. A n=1 experiment. ------------------------------ Richard Gla...
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RE: HBV Viremia 1 day ago
Dear All, Thank you very much for your reviews and suggestions. In a way I am happy that it generated lots of discussion and as Prof Glassock sum...
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RE: Hypokalemia without an obvious cause and Urine potassium appropriately low 1 day ago
you cannot evaluate K wasting when the K is normal Disregard that K/Cr ration of 78 ------------------------------ Roger Rodby MD, FASN P...
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RE: Hypokalemia without an obvious cause and Urine potassium appropriately low 1 day ago
Spot urine K value not much help since K deficit largely replaced. Everything is quite compatible with extra-renal K depletion, but the posts all p...
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RE: Hypokalemia without an obvious cause and Urine potassium appropriately low 1 day ago
Today as outpatient, Spot urine potassium 73.1 million mole per litter and spot urine Creatinine 93.9 mg/dL so looks like potassium to creatinine r...
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RE: HBV Viremia 1 day ago
You are right sir Original post had 2 questions hbv issue we all agreed dosing issue was independent of hbv viremia -----------...
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RE: HBV Viremia 1 day ago
Great discussion- very divided opinions- mainly on MMF/MPA dosing, not so much on the HBV issues. No real consensus emerged (so far). -----------...
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RE: HBV Viremia 1 day ago
I think I would agree with Dr Singh in terms of reducing mycophenolate dose but not for the HBV infection. There was a study from Vellore where the...
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RE: HBV Viremia 1 day ago
Cyclosporine reduces mycophenolic acid exposure by 40% while other calcineurin inhibitors such as Tacrolimus and Voclosporin don't. There is ...
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RE: HBV Viremia 1 day ago
Hi all, this is only based on my limited experience in renal transplant medicines. Looking through the 'Viral hepatitis: guidelines by the Ame...
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RE: Membranous Nephropathy 2 days ago
@Richard Glassock Dear Dr. Glassock, why do you prefer RTX now over observation of PLA2R trend over few months? ------------------------------ M....
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RE: Membranous Nephropathy 2 days ago
Nothing mention to show that this was provoked PE ? Was hypercoagulability workup done? Not sure if we a have a clear picture or one disease t...
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RE: IG A Vasculitis with diffuse profoliferative crecentivrabout 2 days ago
Thanks a lot! Such gut feeling is very valuable!
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RE: Tolvaptan for PCKD 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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 2 days 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 3 days 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 3 days 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 3 days 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 3 days 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 3 days 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 3 days 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 3 days 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 3 days 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 3 days 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 3 days 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 3 days 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 3 days 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 3 days 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 3 days 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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