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 1 (May 2024): Pediatric Kidney Disease is now available online.
RE: Nephrotic range proteinuria, steroid resistant FSGS ? Genetic, steroid treatment cessation 3 hours ago
In my opinion, the answer to Question #1 is yes, but urine protein excretion very uncommonly exceeds 8 gms/d. With a lesion of "thin Basement mem...
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RE: Primary FSGS 3 hours ago
I fully concur with your hypothesis. Genetic testing is I definitely indicated . How the results will influence your approach to management is the ...
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RE: Primary FSGS 4 hours ago
Indeed Dr Glassock it's uncommon but perhaps more common than we think since these cases are usually not tested for genetic causes. Since this part...
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Nephrotic range proteinuria, steroid resistant FSGS ? Genetic, steroid treatment cessation 6 hours ago
I have a 24 yr old Bosnian male with diagnosis of biopsy proven secondary perihilar FSGS of unclear etiology at 18 yrs with initial sub-nephrotic r...
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RE: IV Calcium for Hypocalcemia in Hemodialysis patients 8 hours ago
In my "experience " the most common causes of persistent hypocalcemia in HD patients are Denosumab (or bisphosphonate ) exposure , Cinacalcet , and...
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RE: IV Calcium for Hypocalcemia in Hemodialysis patients 11 hours ago
This remains suggestive of poor calcium absorption in the gut. I would try changing the vitamin D from alphacalcidol to calcitriol as a first mea...
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RE: Primary FSGS 11 hours ago
What denominator should be applied to these case reports. For every 100 cases of proven genetic FSGS, how many can be expected to have a spontaneou...
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RE: THSD7A Membranous Nephropathy 13 hours ago
Indeed, it would be nice to have an anti-THSD7A titer before and after Rituximab treatment. This can be done semi-quantatively using the commercial...
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RE: Primary FSGS 13 hours ago
While uncommon there are reported cases of patients with genetic forms of MCD/FSGS that can have relapsing course giving an apparent impression of ...
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RE: IV Calcium for Hypocalcemia in Hemodialysis patients 13 hours ago
I find this to be very unusual, especially if it is in several patients. have they all had parathyroidectomies?. In the absence of cinacalcet and d...
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RE: Initiation of hemodialysis 16 hours ago
Thank youThis is what I thought too Sent from my iPhone
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RE: Initiation of hemodialysis 16 hours ago
It takes a bit more planning, but I see NO reason to admit that patient. If you are really worried about disequilibrium, ( I am rarely, but...) ...
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Initiation of hemodialysis 17 hours ago
Hi , I have noticed that some nephrologist admits CKD patients who reached end stage to initiate hemodialysis in house even though they have a ma...
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RE: IV Calcium for Hypocalcemia in Hemodialysis patients 20 hours ago
No exposure to denosumab or Cinacalcet. Everyone is o highest Dialysis calcium bath (1.75) Everyone one is on highest tolerated IV alfacalcidol...
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RE: IV Calcium for Hypocalcemia in Hemodialysis patients 21 hours ago
I find this scenario most unusual as in the presence of elevated PTH and absence of vitamin D deficiency serum calcium should be normal or slightly...
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RE: IV Calcium for Hypocalcemia in Hemodialysis patients 21 hours ago
Agree with po Ca supplements, po calcitriol, and higher dialysate Ca. In my experience I look for the Ca level that is not symptomatic but do not...
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RE: THSD7A Membranous Nephropathy 21 hours ago
Some people think that PET/CT scanning is useful. I do not have any experience with this strategy so I cant estimate the yield rate. ------------...
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RE: THSD7A Membranous Nephropathy 21 hours ago
No - not too late. Always nice to know that CD19 B cells are suppressed. At 4 months they should be. ------------------------------ Richard Glass...
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RE: THSD7A Membranous Nephropathy 22 hours ago
we checked CT chest, abdomen, pelvis, mammogram, EGD, and colonoscopy and all were negative. I did not check CD19. Would it be too late at this ...
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RE: Primary FSGS 23 hours ago
I agree that in Medicine there are no hard and fast rules, but it is extremely uncommon for a genetic forms of FSGS to pursue a remitting and relap...
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RE: Primary FSGS 1 day ago
Dear Dr. Glassock, I had a patient with familial FSGS who once had the protein to creatinine ratio improved to 0.7 (from nephrotic range) with BP c...
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RE: Primary FSGS 1 day ago
How well documented are the complete remissions and relapses in this case.? If confirmed this would be highly unusual for a genetic MCD/FSGS. ---...
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RE: Primary FSGS 1 day ago
Yes I ordered but will take time her brother was Nephrotic ended in dialysis and death ------------------------------ Sara Amr MS The capital...
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RE: Primary FSGS 1 day ago
so I will stop steroid and tacrolimus and give Rituximab and if so shall I start with 375 weekly or 1000 every 2 weeks taking Into considerati...
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RE: Primary FSGS 1 day ago
I think hereditary FSGS is on the differential. I would consider genetic testing if you have access to it. ------------------------------ M.N. A...
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RE: p-ANCA positive in sitting of recent MI 1 day ago
If a fresh urine sediment examined microscopically shows RBC casts and acanthocytes , I would treat with RTX and no steroids . Could be AKI plus AN...
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IV Conivaptan use and practical indications 1 day ago
Dear experts, I recently had a post surgical patient after GI surgery developing hyponatremia with urine osm of ~550 mosm/L. I thought IV conivap...
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RE: p-ANCA positive in sitting of recent MI 1 day ago
This is the urine analysis before the day of admission 4/13/24: UA 4/9/24 11/20/23 Color clear clear SG 1.01...
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RE: Genetic testing in hypertension 1 day ago
Natera has a very complete genetic renal panel and in my experience the patient rarely if ever has to pay anything. I dont know about the others. ...
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RE: p-ANCA positive in sitting of recent MI 1 day ago
This feels like AKI from her multiple significant medical problems, not RPGN since it is getting better in its own. Im not impressed with the MPO a...
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p-ANCA positive in sitting of recent MI 1 day ago
80-year-old female with a medical history of type 2 diabetes mellitus, hypertension, CKD-3a, NASH)/NAFLD) liver cirrhosis (compensated with normal ...
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RE: Genetic testing in hypertension 1 day ago
Thanks so much ------------------------------ Hamza Shahran MD, MS Aurora BayCare Medical Center ------------------------------
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RE: Genetic testing in hypertension 1 day ago
Numerous companies in the USA offer genetic testing , including (to name a few - Invitae , Natera, Quest, LabCorp, Mayo Clinic, Ambry. Have a look ...
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Genetic testing in hypertension 1 day ago
I have a patient who is suspected of having genetic causes of hypertension. Which lab or facility should I send the genetic test to for an accurate...
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RE: IV Calcium for Hypocalcemia in Hemodialysis patients 1 day ago
Are you avoiding active vitamin-D analogs for any particular reason in these patients? Calcitriol can be given orally or IV at the end of each dial...
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RE: IV Calcium for Hypocalcemia in Hemodialysis patients 1 day ago
Have any of your patients on HD with persistent hypocalcemia received Denosumab for "presumed" osteoporosis (based on a DEXA scan).? How are you ma...
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RE: KDIGO 2024 CLINICAL PRACTICE GUIDELINE FOR THE MANAGEMENT OF AAV 1 day ago
I would use dialysis requirement AND 100% crescents (zero normal glomeruli) AND oliguria AND absence of diffuse alveolar hemorrhage - not the way t...
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RE: THSD7A Membranous Nephropathy 1 day ago
I agree with Dr. Rodby, it is too early to give up on RTX, although the failure ofxSalb to increase is not a good sign. You might check with Mayo C...
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RE: Primary FSGS 1 day ago
Agree with RTX if compliance is an issue. If this is late steroid/CsA resistance RTX likely will not work. Late steroid resistance is really bad ne...
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RE: Primary FSGS 1 day ago
agree, in fact if steroid compliance is the real issue you could use rituximab without steroids, as primary induction. It has been shown to work qu...
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RE: hyperaldosteronism without symptoms 1 day ago
Glad this is still going on; interesting paper in Surgery by Sato et al. I DO have another case of hyperaldo, but this one with hyperreninemia. The...
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RE: THSD7A Membranous Nephropathy 1 day ago
What did your malignancy work-up consist of? I might add a PET scan if you can get it approved? 4 months is a little early to panic, I might ...
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RE: KDIGO 2024 CLINICAL PRACTICE GUIDELINE FOR THE MANAGEMENT OF AAV 1 day ago
".... plus PLEX in all patients with anti-GBM GN except those who are treated with dialysis at presentation, have 100% crescents" Is an "and"...
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THSD7A Membranous Nephropathy 1 day ago
Good afternoon, would appreciate recommendations on this case. I have a 62 year old female, hx of DM and HTN who was initially sent to me in ...
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RE: KDIGO 2024 CLINICAL PRACTICE GUIDELINE FOR THE MANAGEMENT OF AAV 1 day ago
For anti-GBM disease (Goodpasture's Syndrome) the studies are mainly observational as well mentioned by Dr Glassock. The following is the summary...
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RE: Primary FSGS 1 day ago
Rituximab is a good option given her noncompliance. Hopefully, you can give 2 initial 1 gram doses now and she will show up at least if and when ne...
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Primary FSGS 1 day ago
20 ys old female was diagnosed as minimal change at 10 years old Non compliance Remission and relapses till 19 years Presented with Anasarca 7 mo...
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IV Calcium for Hypocalcemia in Hemodialysis patients 1 day ago
Hi everyone, I have a small cohort of Hemodialysis pts with chronic hypocalcemia with mean 1.85 (normal 2.1-2.6 mmolL). Some were following parat...
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RE: hyperaldosteronism without symptoms 1 day ago
Thank you, Dr. Glassock for posting this article demonstrating elevated aldosterone levels post colectomy. ------------------------------ Manooc...
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RE: hypocomplementenemic urticarial vasulitis syndrome 2 days ago
forgot to tell you that the patient had persistent low c3, negative anca, DNA, and ana ------------------------------ Abdulrahman Buali MD hamad ...
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