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 2 (Jun 2024): Electrolytes and Acid-Base Disorders is now available online.
RE: defibrotide in TMA 4 hours ago
No personal experience with defibrotide in kidney transplant recipients. Has been used in PLEX/FFP and eculizumab-refractory TMA in hematopoietic s...
View Discussion
RE: CMV in renal transplant 4 hours ago
In the 1970s-80s, four-fold increase in CMV IgG antibody level in serial blood samples over a few weeks was suggested as diagnostic of active/recen...
View Discussion
Potential donor with family history of PKD 4 hours ago
I would love the community input on the following potential kidney donor: 38-year-old Caucasian female without significant past medical history wh...
View Discussion
RE: CMV in renal transplant 5 hours ago
Typically the IgG+ , IgM - anti-CMV pattern means prior exposure and cannot define active infection. A CMV -PCR is needed to define active infectio...
View Discussion
RE: CMV in renal transplant 6 hours ago
Needs blood CMV quantitative PCR and colonoscopy. Must also keep in mind that CMV colitis causing diarrhea can occur (especially cases occurring > ...
View Discussion
CMV in renal transplant 6 hours ago
41 years old female patient post kindness transplant ( 6 years ago ) on tacrolimus , cellcept and steroid known case of DM and hypertension P...
View Discussion
RE: defibrotide in TMA 8 hours ago
This looks like a haplotype associated with MCP genetic variants associated with Familial aHUS. What do the genetic counselors advise?See Bu F, et ...
View Discussion
RE: defibrotide in TMA 9 hours ago
This is genetic analysis Analysis of point variants Presence of variant c.1343-3dupC in 1 allele gene ADAMTS13. presence of variants included in...
View Discussion
RE: defibrotide in TMA 10 hours ago
What specific gene variants have been detected in this patient ? Deletions and reduplications can be difficult to detect in WES. This patient has a...
View Discussion
RE: Intra-Renal AV Malformation: Observe? Embolize ? Partial Nephrectomy 11 hours ago
Thanking all for all your very useful feedbacks. ------------------------------ Dr Mohamed Buhary MBBS, FRCP, FASN Consultant Nephrologist Jedda...
View Discussion
defibrotide in TMA 11 hours ago
30-yeard old female after 3rd Ktx (esrd at the age of 7 due to unknown cause, biopsy tool late, first kidney from father lost due to TMA in , confi...
View Discussion
RE: Significance of Parvus tardus wave form in one interlobar artery 12 hours ago
What antihypertensive and doses ? Bruit? Is patient adhering to meds? Does color flow Doppler showed evidence decreased perfusion to the upper lobe...
View Discussion
RE: hypocomplementemia in C3GN 14 hours ago
As you haven't mentioned the age of the patient, I would split Dr Rodby's recommendation into two. Genetic studies for [More]
View Discussion
RE: Dietary Protein in CKD 1 day ago
Dear contributors, in fairness sake I want to post what may be the definitive statement (opinion) on the use of Plant-based , low protein diets (PL...
View Discussion
RE: Is it atypical HUS? 1 day ago
Dr. El-Meanawy: Why do you prefer albumin to FFP in treating aHUS? All the literature I have reviewed mentions PLEX + FFP replacement or FFP infusi...
View Discussion
RE: Dietary Protein in CKD 1 day ago
As noted by several contributors, in this day and age of far more effective and tolerable and not so hard to follow CKD strategies, severe protein ...
View Discussion
RE: Dietary Protein in CKD 1 day ago
THe recidivism rate for diet adherence is about 99% at 8 months according to the USPHTF. All I can say is that thank G-d for statins as it allow...
View Discussion
RE: RRT in a critically ill Jehovah's witness 1 day ago
is he making urine? If so, you may be able to reduce HD to 1-2x per week, controlling acidosis, hyperkalemia with usual drugs. Rising creatinine wo...
View Discussion
RE: Is it atypical HUS? 1 day ago
Presentation BP not super high unless baseline is low which is not expected based on chronic changes in the kidney. I agree that eculizumab is not ...
View Discussion
RE: RRT in a critically ill Jehovah's witness 1 day ago
Going to show my age on this possible drug recommendation. Was a dialysis tech pre-med 1976 ( long before my fellowship at UAB 1986-88) when we wer...
View Discussion
RE: Intra-Renal AV Malformation: Observe? Embolize ? Partial Nephrectomy 1 day ago
I have one patient's who AVM burst the night before she was supposed to get embolization. If she wasn't here in Rochester, I don't think she would ...
View Discussion
RE: RRT in a critically ill Jehovah's witness 1 day ago
I had a somewhat similar case 4 years ago; hemoglobin was 4.6 but he was CKD stage 5 with BUN/creatinine 52/10 and no indication to initiate dialys...
View Discussion
RE: Significance of Parvus tardus wave form in one interlobar artery 1 day ago
Dr. Sriperumbuduri: very interested in finding out the results of additional imaging studies you might order and results of angioplasty/stenting, i...
View Discussion
RE: RRT in a critically ill Jehovah's witness 1 day ago
I'm not sure why shorter more frequent would help, unless clotting occurs later in a treatment? I would try to avoid a higher BUN as uremic plat...
View Discussion
RE: hypocomplementemia in C3GN 1 day ago
What a complicated disease: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6876298/ The proteinuric response to MMF is i-impressive, I woul...
View Discussion
hypocomplementemia in C3GN 1 day ago
I have a patient who presented initially with 3 gram proteinuria/ day and low C3 complement fraction( it was 60 with normal range above 90). Kidn...
View Discussion
RE: Dietary Protein in CKD 1 day ago
I agree with Drs. Glassock and Rodby. While I know some of our colleagues still push the notion of protein restriction in CKD, the evidence that it...
View Discussion
RE: RRT in a critically ill Jehovah's witness 1 day ago
Have you considered a switch to PD? What is his level of residual renal function. I always tried to avoid HD in Jehova's Witness patients. Just a t...
View Discussion
RRT in a critically ill Jehovah's witness 2 days ago
I would appreciate some advice with a difficult situation A 70 yr old ESRD patient presented to our hospital with what was likely a diverticular...
View Discussion
RE: Significance of Parvus tardus wave form in one interlobar artery 2 days ago
Thank you Dr Glassock, Dr Venkat and Dr Balan serum creatinine is between 1.3- 1.5. ------------------------------ [Sriram] [Sriperumbuduri] [...
View Discussion
RE: Is it atypical HUS? 2 days ago
This ex-vivo test is not approved by the FDA nor it available in the USA on a patient care basis. Too bad- it is very good at defining a role for C...
View Discussion
RE: Is it atypical HUS? 2 days ago
Ex vivo C5B-9 test is not commercially available In US or Canada If you want this test done talk to your Alexion drug company to arrange in a lab i...
View Discussion
RE: Is it atypical HUS? 2 days ago
"See Timmermans S, et al KI Reports 2021; 6: 1099-1209 for suggestions as to how to proceed to define a background for Complement mediated TMA to j...
View Discussion
RE: Dietary Protein in CKD 2 days ago
the days of protein restriction to avoid uremia are long over, patients should not be starved to avoid dialysis. Few things are harder for patien...
View Discussion
RE: Dietary Protein in CKD 2 days ago
The spectrum of opinions on this subject is quite broad. Most agree that fruit and vegetable sources of calories and protein are better than meat a...
View Discussion
Dietary Protein in CKD 2 days ago
I'm curious about opinions and practices regarding advising patients with CKD about dietary protein. I get that with advanced CKD protein restricti...
View Discussion
RE: Significance of Parvus tardus wave form in one interlobar artery 2 days ago
I don't usually do MRA in these cases because the resolution of the MRA is not great and I find that they confuse more than they help. As Dr Venkat...
View Discussion
RE: Intra-Renal AV Malformation: Observe? Embolize ? Partial Nephrectomy 2 days ago
I agree. Endovascular intervention by an interventional radiologist or vascular surgeon would be preferred in most cases. It's possible they will a...
View Discussion
RE: Intra-Renal AV Malformation: Observe? Embolize ? Partial Nephrectomy 2 days ago
I would think coil embolization would be a relatively easy case for an experienced interventional radiologist. ------------------------------ Ro...
View Discussion
RE: isolated. vit d 1,25 elevated 3 days ago
I had my patient tested at genedx, spoke to genetic counselor they said he was neg on nephrolithiasis panel which does include cyp24a1. natara was ...
View Discussion
RE: IgA Vasculitis in an adult 3 days ago
"Going through the insurance hoops." A period of forced observation may be imposed if insurance approval for rituximab is delayed. It will be reass...
View Discussion
RE: Significance of Parvus tardus wave form in one interlobar artery 3 days ago
Since patient has uncontrolled hypertension on 3 drugs, wonder about branch renal artery stenosis in the branch of renal artery supplying the super...
View Discussion
RE: Significance of Parvus tardus wave form in one interlobar artery 3 days ago
I would think that the identification of this flow pattern on a Doppler US in a patient with treatment resistant hypertension (in a transplanted ki...
View Discussion
RE: IgA Vasculitis in an adult 3 days ago
I understand Dr. Rodby's "saving the nephrons" approach to treatment of this complicated patient. If the eGFR is steadily improving, (off Hydralazi...
View Discussion
RE: IgA Vasculitis in an adult 3 days ago
Is this IgAN/IgAV with hydralazine induced benign serologies or hydralazine induced Vasculitis (pauci immune) on top of an IgAN? Yes you can wa...
View Discussion
Significance of Parvus tardus wave form in one interlobar artery 3 days ago
Dear members, Good morning. What is the significance of tardus parvus pattern in the superior interlobar artery of a transplant kidney ? RI is lo...
View Discussion
RE: IgA Vasculitis in an adult 3 days ago
Urine studies were still pending. This was before Rituximab. Going through the insurance hoops. Should I consider holding off since GFR is improvin...
View Discussion
RE: isolated. vit d 1,25 elevated 3 days ago
This is a fascinating problem and both the case and the comments are illuminating. I want to add a minor issue which I think is important to our th...
View Discussion
RE: Intra-Renal AV Malformation: Observe? Embolize ? Partial Nephrectomy 3 days ago
In this circumstance, I think that intervention is appropriate, by what ever means are recommended from an experienced Vascular Surgeon or urologis...
View Discussion
RE: Intra-Renal AV Malformation: Observe? Embolize ? Partial Nephrectomy 3 days ago
thanks Dr Glassock Only CT contrast was done and it confirmed it is an Aneurysm grown from 1.3cm to 2.4 cm over 5 months. She has not completed h...
View Discussion