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 22: Issue 4 (Feb 2024): Pregnancy and Kidney Disease is now available online.
DUE MAY 8TH: Opportunity for Fellows. Encourage fellows to volunteer as case report reviewers for Kidney Week 2024! 12 hours ago
ASN invites ASN Fellows-in-Training members to serve as reviewers for case reports submitted by trainees for Kidney Week 2024. The reviewing/gradin...
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RE: Progressive renal failure with High ANA, low Complement (C4) and positive cryoglobulins 14 hours ago
Type II or Type III? Type II is "mixed" IgG/IgM CryoIg .Thanks. Let us know the EM findings when available. ------------------------------ Richar...
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RE: Progressive renal failure with High ANA, low Complement (C4) and positive cryoglobulins 15 hours ago
further discussion today with Immunologist, confirming type III mixed cryoglobulinemia (trace amount). planning to start her on Rituximab soon ...
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RE: Young patient with Lupus-like pattern on IF in kidney biopsy 16 hours ago
I agree that infection (including Bartonella, Borellua , Q fever, leptospirosis, etc needs to be excluded by appropriate culture and serology. Do y...
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RE: Young patient with Lupus-like pattern on IF in kidney biopsy 22 hours ago
Kidney and liver are injured . With splenomegaly .Infection should be excluded ..bartonella can cause this full house pattern Leptospirosis can ca...
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RE: Progressive renal failure with High ANA, low Complement (C4) and positive cryoglobulins 22 hours ago
If this is a "polyclonal " CryoIg why is the RF elevated. Thus suggests a mixed IgG=IgM Type II CryoIg. Could this be old burnt out HCV and a late ...
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RE: Progressive renal failure with High ANA, low Complement (C4) and positive cryoglobulins 1 day ago
quantitative cryoglobulin report not available. surprisingly, patient has no features of any vasculitis, neuropathy or arthropathy. she was even ...
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RE: Progressive renal failure with High ANA, low Complement (C4) and positive cryoglobulins 1 day ago
Thanks for your response Rheumatoid factor (RF) Latex 48 IU/ml ( normal range < 30) Cyclic citrullinated peptide (CCP) antibodies <1 no prev...
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RE: Progressive renal failure with High ANA, low Complement (C4) and positive cryoglobulins 1 day ago
that is a VERy low C4 and this has been described in cryoglobulinemia. Do you have a quantitative amount of the cryoglobulin? ----------...
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RE: Progressive renal failure with High ANA, low Complement (C4) and positive cryoglobulins 1 day ago
Thanks for your response Albumin Creatinine ratio is in mg/mmol normal range (0.0 -3.6) Complement C4 level 0.072 (range 0.150 - 0.450 g/L) N...
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RE: Nephrotic syndrome treatment 1 day ago
Equivocal staining for IgG and IgM. Nothing remarkable ------------------------------ M Kaisar Nephrologist Brisbane ---------------------------...
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RE: Appears to be posting issues here 1 day ago
Seems to be fixed. ------------------------------ Roger Rodby MD, FASN Professor of Medicine Rush University Medical Center Chicago IL (773) 505...
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RE: Young patient with Lupus-like pattern on IF in kidney biopsy 1 day ago
seems to be working again ------------------------------ Roger Rodby MD, FASN Professor of Medicine Rush University Medical Center Chicago IL ...
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RE: Nephrotic syndrome treatment 1 day ago
HelloWe don't have EM yet. There is a a long delay in getting EM at the moment due to technician issues as all done in a single centre. Sent from ...
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RE: Progressive renal failure with High ANA, low Complement (C4) and positive cryoglobulins 1 day ago
What is the Rheumatoid Factor level? How sure are you that the Cryo is polyclonal? Have you tested for HCV viral RNA.? --------------------------...
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RE: Nephrotic syndrome treatment 1 day ago
He might be a candidate for RTX. Any "dusting " of IgG in the glomeruli by frozen IF? ------------------------------ Richard Glassock MD, FASN La...
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RE: Young patient with Lupus-like pattern on IF in kidney biopsy 1 day ago
this is a test of the software, there have been problems posting. ignore ------------------------------ Roger Rodby MD, FASN Professor of Medici...
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Appears to be posting issues here 1 day ago
I think there is a glitch in the software, and posts are not posting. I doubt it is just me, you can try to respond to this But i have been ge...
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RE: Nephrotic syndrome treatment 1 day ago
how effaced were the foot processes on EM? ------------------------------ Roger Rodby MD, FASN Professor of Medicine Rush University Medical Cent...
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RE: Progressive renal failure with High ANA, low Complement (C4) and positive cryoglobulins 1 day ago
I do not see an explanation for the eGFR of 12, except the ATN. what are the units of albumin creatinine ratio and what are normals for those un...
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RE: SGLT2i And eGFR Reduction 1 day ago
GREAT ------------------------------ George Bakris MD, MA, FASN Professor of Medicine, Director, Am.Heart Assoc. Comprehensive Hypertension Cente...
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Progressive renal failure with High ANA, low Complement (C4) and positive cryoglobulins 1 day ago
Dear Esteemed members, I would like to discuss an interesting case and would appreciate your thoughts :) A 72 year old Caucasian female (weighs...
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Nephrotic syndrome treatment 1 day ago
Good evening I would be grateful for feedback and advise in regards to a 40 year old male with nephrotic syndrome. Presented acutely nephrotic...
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RE: Young patient with Lupus-like pattern on IF in kidney biopsy 1 day ago
If a. Infectious cause is excluded , I would give MMF+ low dose steroids. Have you considered C1q nephropathy? Could you post the results of a peri...
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RE: Young patient with Lupus-like pattern on IF in kidney biopsy 1 day ago
Antiphosphlipid antibodies were negative. No history of recurrent UTI. ID is involved and suggests to screen for strongyloides, but I will definite...
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RE: SGLT2i And eGFR Reduction 2 days ago
In our group we have more stringent HbA1c before we start SGLT2i because we have seen AKID in patient with uncontrolled DM. ---------------------...
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RE: SGLT2i And eGFR Reduction 2 days ago
Sheldon thanks for this and as you saw I responded and quoted and updated review in AJN 2022-but agree with what you said obviously in people with ...
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RE: ANCA vasculitits 2 days ago
Agree with you and that's why I thought she may actually developed hydra induce vasculitis ------------------------------ Narjes Alamri MD Nephr...
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RE: ANCA vasculitits 2 days ago
Yes, but the trajectory of GFR loss, pre-2021, would not predict the findings in 2023, unless something happened to increase the rate of loss of CC...
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RE: ANCA vasculitits 2 days ago
There was no labs between 9/21 and 3/2023 ! ------------------------------ Narjes Alamri MD Nephrology Attending SFMC Cape Girardeau MO --------...
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RE: SGLT2i And eGFR Reduction 2 days ago
The endocrine strategy of withholding SGLT2Is for A1C > "low 8s" does not seem evidence-based: CREDENCE allowed A1C up to 12 and did not describe g...
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RE: ANCA vasculitits 2 days ago
Out of curiosity, I plotted 1/ Scr values vs time 2017-2024. The plot does not show steady relentless progression of CKD and something happened bet...
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RE: Measuring individual kidney creatinine clearance 2 days ago
At the present time I think the Gates test using Tc99 DTPA is the preferred method of assessing differential kidney function . It is at least as ac...
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RE: Measuring individual kidney creatinine clearance 2 days ago
It is my understanding that in normal healthy individuals with approximate equal contribution of each kidney to total kidney function immediately a...
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RE: Measuring individual kidney creatinine clearance 2 days ago
If right kidney has significantly more function than left kidney, and we use same Cr of 0.7 as in this case to calculate individual or split Cr Cl,...
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RE: Young patient with Lupus-like pattern on IF in kidney biopsy 2 days ago
interested case, I would emphasize more about any infectious process, tropical infectious sources like leishmaniasis, malaria, syphilis, and IV dru...
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RE: Young patient with Lupus-like pattern on IF in kidney biopsy 2 days ago
Auto-immune inflammatory myositis has been repeatedly associated with an immune complex GN. This may be such a case. She has a chronic progressive,...
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RE: Young patient with Lupus-like pattern on IF in kidney biopsy 3 days ago
Immunofluorescence and EM findings show a predominantly mesangial immune complex process. Lack of endocapillary proliferation, normal complements a...
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RE: SGLT2i And eGFR Reduction 3 days ago
It hasn't -no interest ------------------------------ George Bakris MD, MA, FASN Professor of Medicine, Director, Am.Heart Assoc. Comprehensive H...
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RE: Young patient with Lupus-like pattern on IF in kidney biopsy 3 days ago
Infections are common cause of GN among children in developing countries. In addition to Malaria would suggest to look for other chronic infections...
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Young patient with Lupus-like pattern on IF in kidney biopsy 3 days ago
A 17 yo patient was referred to us by his GP due to hypertension, nausea and fatigue. The patient is of sub-Saharan descent and only 3 months ago c...
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RE: ANCA vasculitits 3 days ago
I think the creatinine history 3.2 mg/dl 1 year ago, at 79 that is quite advanced CKD and no hematuria and only abnormal serology being a low g...
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RE: ANCA vasculitits 3 days ago
I am an outlier here, but we do not know if stopping Hydralazine alone will be sufficient to arrest her progression to ESKD. I agree that the lack ...
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RE: ANCA vasculitits 3 days ago
I concur with all above, But, I am itching to prescribe Rx Prednisone 10 mg every other day for only 6 months No refill BTW, h...
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RE: ANCA vasculitits 3 days ago
How strongly does the patient want to know? Physician wanting to know the nature of renal disease with no expectation of treatment being influenced...
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RE: ANCA vasculitits 3 days ago
Do you all think kidney biopsy even if it only show sclerosis will help me and the patient know for sure ? That's nothing can be salvageable ---...
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RE: ANCA vasculitits 3 days ago
Dr. Glassock: I agree with stopping hydralazine. However, i am not sure I would subject this 79 -year-old patient who has been inexorably losing re...
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RE: ANCA vasculitits 3 days ago
@Richard Glassock this patient has a steadily worsening creatinine since 2017 and no evidence of a recent jump. She has proteinuria with no 'active...
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RE: SGLT2i And eGFR Reduction 3 days ago
Dr.Bakris. Good tip. Worth remembering. Has the link between HBA1c and the magnitude of the post SGLT21 dip in eFFR been formally studied? If not, ...
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RE: SGLT2i And eGFR Reduction 3 days ago
Fully agree with Roger to stop it in this setting. Many times thats caused by HBa1c 9 or more and gfr at >50 you get an osmotic diuresis and volume...
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