Blogs

Hello every one I wonder if anyone here has an idea about guidlines or evidence based algorithm to manage CKD patients (especially advanced stages 4-5) perioperatively ..factors affecting decision of dialysis ? Volume state ? K , urea level, blood gases ? type of surgery ? Thanks in advance
Five Reasons You Should Join an ASN Community-led Poster Tour 1) Relax- Let the community leaders do all of the work. Let’s face it. Who wants to sift through hundreds of posters when someone is volunteering to do all of the work for you. 2) Surprise- Learn something new. If you rely on your own planning you will likely go to the same types of research/posters that you go to every year. Spread your wings are learn something new. Who knows it could change your career. 3) New Friends- Each year your Kidney Week punch card grows and grows. While meeting up with old friends is an essential part of any large society gathering, sometimes meeting new people ...
Kidney Week offers numerous sessions across a variety of Learning Pathways ranging from Acute Kidney Injury, to Dialysis to " Other ." The Other category covers a wide variety of topics including The Best of ASN Journals: JASN & CJASN, High-Impact Clincial Trials and Shaping the Future of Nephrology Education. Also included is a session on Navigating Your Career Path that will focus on everything from burnout and identifying workforce needs to the role of mentors/mentees. Here are the top reasons why you should attend this innovative session: This special session is the only Kidney Week session that focuses on nephrology career paths. You ...
1) Attend the ASN Plenary sessions Plenary sessions are excellent. They start early, and there is a different plenary session every day. Pick what you like, but the ASN president’s talk is a must. Thursday, October 25 : Opening Plenary Session: President's Address, Kidney Week Planning Committees Recognition, State-of-the-Art Lecture "Imaging Cellular Structure and Dynamics from Molecules to Organisms" Friday, October 26 : ASN Foundation for Kidney Research Presentation, Kidney Health Initiative Recognition, Homer W. Smith Award Address and Presentation, State-of-the-Art Lecture "Cell Atlases as Roadmaps to Human Disease" ...
ASN released the latest nephrology workforce analysis, entitled Early Career Nephrologists: Results of a 2017 Survey . George Washington University researchers found practice setting was a key factor influencing income and job satisfaction. “The survey revealed significant differences between nephrologists working in group practices compared to those in academic positions,” said GW-HWI principal investigator Edward Salsberg, MPA. “After reviewing other factors—including gender, location/type of education (US medical graduate [USMG] vs. international medical graduate [IMG]), and length of time since graduation—practice setting is a major factor influencing educational ...
By Ryan Murray; ASN Research Advocacy Specialist The Congressional Kidney Caucus hosted a briefing titled The Vital Public-Private Partnership in Kidney Care: Advancing Care, Research & Innovation for Individuals with Kidney Diseases, Kidney Failure and Transplants o n Friday, September 28, 2018. Organized in cooperation with the American Association of Kidney Patients , the American Society of Nephrology , Kidney Care Partners , and the Renal Physicians Association , the briefing highlighted the public health crisis that kidney diseases pose for our society and the work that is being done across the government — from Congress, to regulatory agencies, ...
ASN Kidney week is full of exciting opportunities to learn, network, and present your basic science research. Kidney Week is a social media friendly event, and we encourage you to live Tweet, Instagram post, Facebook post, ASN Community post, etc. If you use the #ASNBasicSci and #Kidneywk you will be able to archive your posts and have other users follow your updates. It’s also a great way to keep up with other attendees and see what our colleagues deem as exciting findings from the meeting. Don’t forget to follow the ASN on Twitter @ASNKidney, on Facebook at American Society of Nephrology, and on Instagram at asnkidney. This year there is a new, Basic ...
Every year, ASN’s Kidney Week is a packed conference with countless oral presentations, plenary sessions, poster sessions, exhibitions, social events, and more – and can be daunting for first-time attendees and trainees. So…where should you go and what should you do to get the most out of your trip to sunny San Diego? Here are 5 tips to getting the most out of Kidney Week as a trainee: 1) Review the schedule in advance. If you don’t glance at the program for the week before hand, the meeting will be over before you have a chance to flip through it. Kidney Week can be broken down into two parts: “Early Programs” (Oct 23 – 24) and “Annual Meeting” ...
Once again, an exciting Kidney Week is fast approaching! As always, this meeting offers many opportunities to catch up on the latest developments in basic science and its translational applications. This year, the excitement starts early, with the Advances in Research Conference on “-Omics, Organoids, and Organs-on-Chips ” that will take place during the Early Program, preceding the main meeting. Organoids and engineered organs offer many possibilities for studying renal development and testing disease-mediating mechanisms and potential therapies. This pre-meeting, led by the two leaders in the field, Melissa Little, PhD and Jonathan Himmelfarb, MD, FASN ...
Size: Did you know that San Diego is the 8th largest city in the U.S. with a population of 1.5 million? And that eight percent of its population is made up of military members and their families? But, if you combine the population with its border city of Tijuana, Mexico, the population jumps to five million. Incorporation: The area was first claimed by Spain in 1542. In 1834 when Mexico won its independence from Spain, San Diego became part of Mexico. In 1848, under the Treaty of Guadalupe Hidalgo, the land was ceded to the U.S. Weather: The average temperature in October is 74 degrees which is only four degrees higher than the annual average temperature ...
By Roger Rodby MD, FACP, FASN Introduction and Background A 46 y/o male with history antiphospholipid Abs on apixoban for DVT in 2012 was referred for renal failure and proteinuria. The patient was seen 9/17 with creatinine 1.6 mg/dl (1.1 in 1/16, 1.4 in 1/17), U/A 2+ protein, no blood, urine P/C ratio 146 mg/g. Serologic w/u normal including serum and urine immunofixation and serum free light chains (FLC): kappa FLC 45.6, lambda FLC 51.9 with a K/L FLC ratio of 0.9 (nl 0.37-3.1 in pts with renal insufficiency) https://tinyurl.com/yakoqt9d . A renal biopsy showed a mesangial proliferative GN with only IgG1 lambda by immunofluorescence ...
By Mark Lerman , MD, FASN Introduction A patient is scheduled for an ABO incompatible kidney transplant. He is blood type A and donor blood type B. Anti-B IgG titers were only <1:2, but IgM titers were 1:32. Query Is it safe to proceed with this transplant without lowering the anti-B IgM titers? Is this risking early post-transplant antibody mediated rejection? Discussion Most studies show anti-ABO IgG titers to be the most important and recommend them being <1:8 using the indirect anti-globulin test (IAT) in an ABO incompatible kidney transplant. The data on anti-ABO IgM antibodies is limited, but there have been ...
By Beatrice Concepcion, MD, FASN Burnout. This topic evokes such a varied range of emotions and opinions from doctors in many fields. It is a condition that is inherently understood though it presents in multiple ways. At its core it signifies loss. It could be a loss of energy, of compassion, of hope or any number of things we hold valuable and important in our lives, both personal and professional. It is a topic that has stirred a spirited discussion within our Open Forum Community with over fifty comments posted. @kenarjhaveri opened the discussion with a link to a post on his blog nephronpower.com found here . The subsequent thread ...
By Scherly Leon , M.D., M.S Introduction and Background A 58-year-old female presented with sudden sharp right sided flank pain, associated with vomiting. The symptoms improved with analgesics. She had a similar episode the next day with acute left sided flank pain. She had no other associated symptoms. Her medical history was significant only for migraines and palpitations for which she takes Zomig and Propranolol respectively. CT Scan imaging was suggestive of bilateral renal infarcts with some narrowing and irregularity along the anterior branch of right renal artery and the distal aspect of posterior branch after bifurcation of the ...
Sri Lekha Tummalapalli, MD, MBA, Nephrology Fellow, UCSF On March 27, 2018, members of American Society of Nephrology (ASN) and the American Association of Kidney Patients (AAKP) joined together in Washington, D.C. for Kidney Health Advocacy Day. Patients and physicians joined together to meet with Senate and House Congressional Offices in Capitol Hill to support innovation in kidney health. Months of efforts by ASN staff culminated on April 26, 2018, when ASN signed a Memorandum of Understanding with the Department of Health and Human Services to establish the Kidney Innovation Accelerator, KidneyX We had a lively discussion on ASN Communities on the ...
Introduction and Background A 59-year-old with long-standing diabetes and end-stage liver disease secondary to NASH is being evaluated for a liver transplant. The patient’s baseline serum creatinine was 1.4-1.8 mg/dl but developed an acute increase in creatinine to 2.7 with worsening ascites and a decrease in urine output. After paracentesis, withholding diuretics, and the administration of IV albumin with octreotide, the urine output increased and creatinine decreased to 2.4 mg/dl. The urine sodium was low and both a renal ultrasound and urinalysis were unremarkable for obvious parenchymal renal disease. Query Should this patient receive a liver transplant ...
By Hayder Aledan, MD, FASN Introduction and background This Communities discussion compared the results of two randomized clinical trials (SMART and SALT-ed) reported on in the New England Journal of Medicine that compared the effects of normal saline and a “balanced solution” in preventing AKI. Isotonic saline (0.9% NS) is the main crystalloid solution used for resuscitation of hypovolemic critically or non-critically ill patients. The SMART trial in which 7,942 critical care patients were randomized to either 0.9% NS or a more balanced electrolyte fluid preparation (Lactated Ringers or Plasma-Lyte A) showed a higher rate of composite of death from ...
by Roger Rodby, MD Query and Hypothesis Is the risk of ODS the same at all levels of starting PNa levels? And if not, perhaps we do not need to re-lower the PNa if starting in the mid-120s? Discussion The discussion focused on several points: The relative change in serum osmolality (and therefore shifting of brain water) is not the same with a 12 meq/L PNa change when you consider, for example, starting at a PNa of 110 vs. 125. Thus, you would not expect the risk of ODS to be the same in those two patients. This is confirmed by the fact that most cases of ODS have been reported at lower starting PNa levels. Other ODS risk factors should be considered ...
By Rebecca Rojas, MD Introduction and Background Acceptance of Hepatitis C donor kidneys is a big topic of conversation today. Are we underutilizing these donor organs for kidney transplantation? With our ever-expanding wait list, more advanced testing (nucleic acid testing (NAT)) and newer hepatitis C medications able to be used now in our kidney population, we should be reconsidering how best to utilize these donor organs. Risk of transmission and current treatment options need to be weighed against the risk of waiting on the wait list. Primary Query Can we safely utilize hepatitis C Virus seropositive non viremic donor ...
Thin Basement Membrane Disease ASN Communities Weekly Rewind Beatrice Concepcion, MD, FASN Introduction and Background A 45 year old white male wishes to donate a kidney. He has a history of persistent hematuria with no proteinuria and a normal blood pressure. Kidney biopsy revealed thin basement membrane nephropathy (TBMN). He has no family history of kidney disease, hearing loss or lenticonus. Query Would you allow this man to donate a kidney? Discussion The discussion focused on two issues: How does one definitively exclude Alport syndrome (including carrier states) in this potential donor? There was an enlightening discussion regarding ...