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General Internal Medicine

Nephrology   

Questions discussed in this category

How would you treat ESRD patients on hemodialysis with recurrent AV fistula thrombosis found with low protein C activity?
For ESRD patients with decreased Protein C activity level, the purported etiology may be a dialyzable substance in uremic plasma that interferes with ...
1 Answer available
What is the maximum diuretic regimen recommended in patients with end-stage kidney disease who have residual renal function and volume overload?
4 Answers available
How would you approach management of retroperitoneal fibrosis causing ureteral compression that has already caused irreversible loss of kidney function?
Renal perfusion scan shows 14 % perfusion on affected side. 
3 Answers available
How would you manage persistent Norovirus diarrheal infections in a kidney transplant patient that are not responding to a decrease in the patient’s maintenance immunosuppressive regimen?
3 Answers available
Do you recommend holding ACE inhibitors, ARBs, and SGLT2 inhibitors for patients with chronic kidney disease and malignancy who are about to start high-dose intravenous methotrexate?
1 Answer available
Do you make any dose adjustments for patients with ESKD who are on apixaban and do not otherwise meet criteria for reduced dosing?
2 Answers available
What is your treatment approach when managing patients with relapsing lupus nephritis who previously achieved remission with mycophenolate and steroids?
6 Answers available
Under what circumstances would you hold an ACE inhibitor or ARB prior to surgery in a patient with CKD?
2 Answers available
Do you recommend any specific testing for patients with recurrent nephrolithiasis and suspected absorptive hypercalciuria?
2 Answers available
How do you approach consults regarding clearance of patients with chronic kidney disease for surgery?
4 Answers available
What treatment options would you consider for a young patient with limited mobility, low bone mass and multiple vertebral compression fractures who is on dialysis for advanced kidney disease?
1 Answer available
For which patients with calciphylaxis would you recommend a parathyroidectomy?
4 Answers available
How would you manage an ESKD patient who complains of severe fatigue after hemodialysis, but does not experience intradialytic or post-dialysis hypotension and has not responded to dry weight adjustments?
2 Answers available
Do you use delayed-release budesonide over prednisone or methylprednisolone for the treatment of IgA nephropathy, considering the available safety and efficacy data?
2 Answers available
Is there a BMI cutoff for which you would refer a patient needing a native kidney biopsy to interventional radiology?
1 Answer available
What is your approach for patients with a history of nephrolithiasis who are being evaluated for living kidney donation?
1 Answer available
Would you recommend initiation of cinacalcet in a patient with hypercalcemia and recurrent nephrolithiasis attributed to an atypical presentation of familial hypocalciuric hypercalcemia?
1 Answer available
Would you stop an ACE inhibitor/ARB or instead initiate a potassium binder to manage hyperkalemia in a patient with proteinuric CKD stage 5 who is on an ACEi/ARB?
5 Answers available
Is there a role for cinacalcet suppression testing when evaluating patients for suspected primary hyperparathyroidism who also have recurrent calcium containing kidney stone disease?
1 Answer available
Do you recommend initiating immunosuppression and plasmapheresis in patients with dialysis dependent AKI in the setting of anti-GBM disease who do not have pulmonary involvement?
1 Answer available
How do you approach hematuria in a patient with diabetic nephropathy?
3 Answers available
What is your approach to management of intradialytic hypotension and autonomic dysfunction in a patient with ESKD?
3 Answers available
What is your preferred iron loading strategy for patients with anemia of chronic kidney disease?
4 Answers available
Are there any varying treatment considerations to make when managing patients with carbonate apatite versus hydroxyapatite kidney stones?
1 Answer available
How do you approach a patient with biochemical evidence of primary hyperparathyroidism, but normal parathyroid scan?
5 Answers available
What is your approach to management of tremors in a kidney transplant recipient who is taking a CNI for immunosuppression?
1 Answer available
Do you try to treat the acidosis resulting from acetazolamide in patients with IIH?
1 Answer available
Should CT coronary calcium score be avoided in dialysis patients in light of presumed high prevalence of CAC in this population?
3 Answers available
What is your approach to patients with chronic kidney disease who are found to have pelviectasis without hydronephrosis on renal ultrasound imaging?
1 Answer available
Do you stop ACEi or ARB medications in patients with ESKD who are on hemodialysis and have issues with chronic hyperkalemia?
2 Answers available
What is your approach for patients with recurrent nephrolithiasis who you have a strong suspicion for primary hyperoxaluria though genetic testing returns without any abnormalities?
1 Answer available
Do you take any different approaches for patients with end stage kidney disease who are about to be initiated on intermittent hemodialysis and have residual renal function?
1 Answer available
Do you recommend checking 1,25-hydroxy vitamin D levels in patients with recurrent nephrolithiasis who have hypercalciuria of unknown etiology?
3 Answers available
Would you treat an ESKD patient with renal artery stenosis in an attempt to improve blood pressure control and preserve residual renal function?
2 Answers available
How would you approach the treatment for patients with renal-limited ANCA vasculitis who have persistent proteinuria, hematuria, and ANCA titers and have completed a steroid taper and received three doses of rituximab?
1 Answer available
Would you recommend transition to hemodialysis for a patient with calciphylaxis, hyperphosphatemia, and ESKD on peritoneal dialysis?
2 Answers available
How many days prior to surgery do you recommend stopping SGLT2 inhibitors and when is it safe to resume therapy?
1 Answer available
How do you determine which patients with ANCA associated vasculitis may be good candidates for reduced dose glucocorticoid tapering?
This question is part of our collaboration with ACR Convergence 2024 to Continue the Conversation from the meeeting. This question was inspi...
1 Answer available
Do you interpret failure to develop hypernatremia with prolonged water deprivation (such as for 12 hours) as evidence against diabetes insipidus even if the urine osmolality is just below normal?
For a patient whose sodium remains 142 despite water deprivation from 8 pm to 8 am, with urine osm of about 500, is further testing needed?
2 Answers available
Do you recommend immediate catheter removal or anticoagulating for a certain amount of time before removing the tunneled dialysis catheter of a patient with an incidentally found, asymptomatic thrombus at the end of the catheter that does not interfere with hemodialysis?
2 Answers available
Do you recommend obtaining both a parathyroid ultrasound and a parathyroid nuclear medicine scan when evaluating a patient with recurrent calcium based nephrolithiasis who is found to have an elevated PTH level, hypercalcemia, and hypercalciuria?
2 Answers available
What are some indications that might lead you to pursue a kidney biopsy in a patient with presumed diabetic kidney disease?
3 Answers available
Do you find adding fludrocortisone helpful in treating persistent hypotension in HD patients already on midodrine and without evidence of adrenal insufficiency?
5 Answers available
Do you use any urinary staining techniques when performing urine microscopy for patients with acute kidney injury?
1 Answer available
How do you approach the management of patients with suspected membranous lupus nephritis who are found to have positive PLA2R antibodies?
1 Answer available
How do you counsel patients on peritoneal dialysis regarding the safety of engaging in aerobic and resistance exercises, considering the risk of developing abdominal wall complications?
1 Answer available
How do you approach palliative conversations about what patients can expect when deciding to stop maintenance dialysis?
1 Answer available
Do you recommend avoiding radial artery access for cardiac catheterization to preserve potential future dialysis access sites in patients with advanced CKD?
7 Answers available
Are there instances when you dose sodium zirconium cyclosilicate more than once daily for long term therapy for patients with end stage kidney disease and hyperkalemia?
1 Answer available
What is the role for iothalamate clearance testing for glomerular filtration estimation in patients with chronic kidney disease?
4 Answers available
How do you counsel patients who experience diarrhea from mycophenolate mofetil (Cellcept)?
Do you generally recommend anti-diarrheals, dietary modifications, or consider this an unacceptable side effect and move to other therapies? 
2 Answers available
Do you avoid sodium zirconium cyclosilicate use in your patients with ESKD and hyperkalemia who also have peripheral edema?
1 Answer available
What is your approach for steroid dosing for patients with ANCA vasculitis on induction treatment with rituximab, avacopan, and glucocorticoid therapy?
1 Answer available
Do you recommend parathyroid adenoma resection or ablation for patients with primary hyperparathyroidism and recurrent nephrolithiasis who are found to have a single gland adenoma on parathyroid ultrasound and nuclear medicine imaging?
1 Answer available
Do you prefer starting a SGLT2i before steroids in patients with IgA nephropathy and proteinuria > 1.0 gram/day who are unable to tolerate ACEi/ARB due to hypotension?
1 Answer available
How would you approach a patient with end stage kidney disease on peritoneal dialysis who has an adequate Kt/V but persistent azotemia?
1 Answer available
For patient with polycystic kidney disease and proteinuria who are on maximum dose of ACEi/ARB, what are other anti-proteinuric medications that should be considered?
1 Answer available
How do you approach long-term blood pressure parameters in ischemic stroke patients with severe symptomatic intracranial stenosis?
How do you balance between having a higher long-term blood pressure to prevent flow failure and leading to worsening of stenosis or occlusion from the...
2 Answers available
What is your approach to immunosuppression in patients with preserved kidney function who are found to have nephrotic syndrome of unknown etiology and cannot safely undergo a kidney biopsy?
1 Answer available
How would you approach post-operative VTE prophylaxis for renal transplant in patients with a prior history of provoked VTE?
Are there specific guidelines for managing this patient population?
1 Answer available
What is your approach to initiating spironolactone in patients with end stage kidney disease and heart failure?
4 Answers available
How do you dose gabapentin in patients with renal failure?
3 Answers available
Are there instances when you would recommend obtaining a 24 hour urine protein measurement in place of spot urine protein studies in patients with acute kidney injury and proteinuria?
2 Answers available
Do you recommend daily topical exit site antibiotic use for patients with a peritoneal dialysis catheter that is only currently being accessed for once weekly flushes?
2 Answers available
Do you still consider hepatorenal syndrome in patients with renal impairment and liver disease who are found to have rare muddy brown casts on urine microscopy?
1 Answer available
How would you approach pursuing a kidney biopsy in a patient with suspected lupus nephritis who is on warfarin for antiphospholipid antibody syndrome? 
2 Answers available
What is your threshold to repeat a kidney biopsy in a patient with a history of lupus nephritis who is on maintenance therapy and develops subtle changes in urinary protein excretion or microscopic hematuria?
3 Answers available
What is your approach to managing hypokalemia in patients with Bartter syndrome who are on high doses of potassium chloride but cannot tolerate amiloride or ACEi/ARBs due to low blood pressures?
1 Answer available
Do you prefer cinacalcet or etelcalcetide for patients with hyperparathyroidism in the setting of kidney disease?
3 Answers available
Do you recommend parathyroid imaging testing for patients with recurrent nephrolithiasis who are incidentally found to have an elevated PTH but who do not have hypercalciuria, hypercalcemia, hypovitaminosis D, or chronic kidney disease?
2 Answers available
Are there instances when you recommend performing a kidney biopsy in patients with presumed acute interstitial nephritis who are already on steroids and have improving renal function?
2 Answers available
Do you prefer monitoring creatinine over cystatin C levels in patients with lymphoma and chronic kidney disease given the potential for cystatin C levels to be increased with certain malignancies?
Hammouda et al., PMID 28282874
1 Answer available
Do you prefer assessing cystatin C or creatinine when monitoring a patient’s eGFR who is receiving chemotherapy for malignancy?
1 Answer available
Would you recommend genetic testing to determine if there is a potential underlying primary process in a patient with congenital solitary kidney who is presumed to have secondary FSGS?
1 Answer available
How long do you recommend patients hold aspirin for prior to and after undergoing a native kidney biopsy?
1 Answer available
Given the risk of hypocalcemia in dialysis dependent patients treated with denosumab, what is the best method of treatment for osteoporosis for these patients, and should we be transitioning to a different agent?
2 Answers available
How do you time 24 hour urine collections when calculating creatinine clearance for patients receiving thrice weekly hemodialysis?
2 Answers available
Should GLP1 R agonists be used as first line glucose lowering agents in patients with ESKD and DM2?
1 Answer available
Are there instances when you recommend against a kidney biopsy in a patient with a single kidney who otherwise has indications for a biopsy, consents, and has no medical contraindications for the procedure?
1 Answer available
Do you rule out active urinary tract infections prior to performing a kidney biopsy?
2 Answers available
Do you check EPO levels in patients with anemia of chronic kidney disease?
2 Answers available
Are there instances when you recommend femoral vein dialysis catheter placement in patients newly started on hemodialysis in an effort to preserve upper extremity future fistula options?
1 Answer available
What instances will you start outpatient steroids in patients with nephrotic syndrome of unknown etiology prior to obtaining a kidney biopsy?
2 Answers available
What is your approach to managing intradialytic cramping that recurs despite multiple dry weight adjustments in a patient with ESKD?
2 Answers available
What is your preferred initial imaging choice for a patient suspected of having renal artery stenosis who does not have any contraindications to imaging contrast media?
1 Answer available
What further work up do you recommend for patients with a chronic high anion gap metabolic acidosis with normal eGFR who have been ruled out for lactic acidosis, ketosis, toxic alcohols, and other usual culprits of high anion gap metabolic acidosis?
3 Answers available
Do you recommend sending an autoimmune work up for patients with recurrent nephrolithiasis and 24 hour urine chemistries consistent with distal renal tubular acidosis?
1 Answer available
How do you choose between spironolactone and finerenone for patients with proteinuric diabetic kidney disease and heart failure?
2 Answers available
How long after surgical repair of a pleuroperitoneal leak do you resume peritoneal dialysis?
1 Answer available
What is the management strategy for patients who develop AKI and nephrotic range proteinuria secondary to biopsy proven FSGS during immune checkpoint inhibitor therapy?
1 Answer available
Would you recommend delaying left heart catheterization until development of ESKD in a patient with CKD Stage 5 and stable coronary artery disease given concern for contrast-induced nephropathy?
5 Answers available
Do you avoid ESAs in patients with anemia and chronic kidney disease who also have Factor V Leiden?
1 Answer available
When do you recommend testing for APOL1 variants in patients with proteinuric chronic kidney disease?
2 Answers available
How do you manage patients with end stage kidney disease and recurrent ascites who do not have any evidence of cardiac or liver disease?
3 Answers available
What is your approach to differentiating primary from secondary hyperparathyroidism in recurrent kidney stone formers who also have chronic kidney disease, an elevated PTH, and hypercalcemia?
1 Answer available
Are there patients with granulomatosis with polyangiitis on maintenance rituximab therapy for whom you do not co-administer glucocorticoid therapy?
1 Answer available
Do you routinely check a TSH level in patients with recurrent kidney stones who have hypercalciuria of unknown cause?
1 Answer available
How often do you check carnitine levels in your patients with end stage kidney disease on hemodialysis?
2 Answers available
What is your approach to managing osteoporosis in patients with end stage kidney disease?
1 Answer available
Do you extend the duration of maintenance therapy past 24 months for patients with ANCA glomerulonephritis who have multiple organ involvement?
2 Answers available
For patients with suspected complement-mediated TMA, are there specific clinical or laboratory parameters that can help guide the decision for starting empirical treatment (e.g., eculizumab) while awaiting the results of complement testing?
1 Answer available
What are your next steps when managing patients with suspected Gitelman syndrome for whom genetic testing reveals variants of uncertain significance or novel mutations not well characterized?
2 Answers available
Do you avoid ESAs in patients with end stage kidney disease who also have heart failure due to increased risk of stroke?
2 Answers available
Do you recommend a kidney biopsy for patients who develop acute kidney injury after starting sacituzumab?
1 Answer available
What are your management strategies for patients with nephrolithiasis and hypercalciuria who have a severe sulfa drug allergy and are unable to tolerate thiazide diuretics?
1 Answer available
Do you pursue a skin biopsy or kidney biopsy in patients whom you suspect have X-linked Alport syndrome?
2 Answers available
What are your management strategies for patients with end stage kidney disease on hemodialysis who develop hypercalcemia of immobility?
1 Answer available
Is there a role for SGLT-2 inhibitors in the treatment of chronic hypomagnesemia?
1 Answer available
Do you use serum or urine biomarkers other than creatinine when evaluating patients with acute kidney injury?
3 Answers available
Do you recommend placement of a backup AV fistula in an advanced CKD patient who is planning to do peritoneal dialysis?
Prior retrospective studies have suggested a lower rate of future catheter use with a backup AVF in place (Haralabopoulos et al., PMID 32852703).
4 Answers available
Do you recommend patients temporarily hold cilostazol prior to and after a kidney biopsy?
1 Answer available
How do you distinguish between primary and tertiary hyperparathyroidism in a patient with ESRD?
1 Answer available
What is your approach to a patient with IgG4RD with past pulmonary involvement (biopsy proven) managed with steroids alone, now with new hematuria/proteinuria, but stable renal function?
Would you obtain renal biopsy first or treat with additional immunosuppression for suspected renal involvement related to IgG4?
4 Answers available
What is the approach to use of ACE inhibitors for suspected scleroderma renal crisis in patients with only mildly elevated BP and renal artery stenosis?
2 Answers available
In which patients with suspected IgA nephropathy and microalbuminuria would you recommend a kidney biopsy?
1 Answer available
What are the important aspects that you mention when consenting patients for hemodialysis?
1 Answer available
How do you manage severe intra-dialytic hypertension that is not responsive to dry weight challenge in an asymptomatic patient with ESKD?
1 Answer available
Are there instances when you prefer serum creatinine over cystatin C when estimating GFR in a patient with CKD?
1 Answer available
In which patients with nephrocalcinosis and an incomplete distal RTA would you consider further testing for medullary sponge kidney?
1 Answer available
What else do you consider in the differential diagnosis for pulmonary-renal syndromes if there is low clinical and serologic evidence of AAV, Goodpasture's or other rheumatologic disease (SLE, RA, APS, Scleroderma)?
2 Answers available
Do you recommend obtaining a spot urine or 24-hour urine magnesium measurement when evaluating patients with persistent hypomagnesemia of unknown etiology?
3 Answers available
What are your management strategies for patients with recurrent uric acid nephrolithiasis and chronic kidney disease who have persistent hypocitraturia and acidic urine pH?
2 Answers available
Would you treat a patient aggressively for lupus nephritis if they have persistent proteinuria over 1 gram but cannot get a timely kidney biopsy?
3 Answers available
What are your management strategies for patients with chronic kidney disease attributed to deferasirox use who require frequent blood products for a hematologic disorder?
1 Answer available
What is your approach to establishing a dry weight in a pregnant patient with ESKD on hemodialysis given the expectation of weight increase and pregnancy-related edema?
2 Answers available
What is your approach to determining the need for continued isolation in the dialysis unit for an ESKD patient who had a positive hepatitis B surface antigen one year ago but who now has a negative HbsAg in the absence of treatment?
1 Answer available
Do you avoid ESA use in patients with anemia and chronic kidney disease who also have APLS and risk for thrombosis?
2 Answers available
Would you add voclosporin to mycophenolate for refractory proteinuria in a patient with low EF?
Low EF in the range of 30%
1 Answer available
For patients with microscopic hematuria, do you prefer a lab submitted urinalysis sample undergoes automated urine analysis or microscopic analysis by laboratory staff for quantification of red blood cells?
1 Answer available
What is your approach to managing patients with labile blood pressures secondary to baroreflex failure?
1 Answer available
What considerations do you take when evaluating a patient for kidney transplantation who has a history of kidney disease and an abdominal aortic aneurysm treated with past stenting?
1 Answer available
What would be the clinical role of SGLT-2 inhibitors for lupus nephritis given it has an indication for proteinuria related to CKD?
5 Answers available
Is there a role for monitoring serum ANCAs to assess ANCA associated vasculitis disease activity?
This question is part of a collaboration with RheumMadness and is in reference to Pathogenic ANCA (RAVE Trial).
2 Answers available
When would you consider a kidney biopsy in a patient with longstanding diabetes and hypertension (baseline creatinine 4-5, 4+ proteinuria) who was recently found to have dsDNA positivity?
1 Answer available
For patients with kidney stone disease and chronic kidney disease, is there an eGFR threshold at which you no longer recommend pursing 24 hour urine stone risk studies?
2 Answers available
How do you dose apixaban in patients with CrCl <30 mL/minute?
1 Answer available
Would you check ANCA titers in a patient with a history of PR-3-ANCA glomerulonephritis in remission and a stable creatinine but with recurrent microscopic hematuria?
6 Answers available
Are there instances when you would pursue a kidney biopsy in a pregnant patient instead of waiting to perform the procedure post-delivery?
2 Answers available
Which patients do you recommend referral to interventional radiology to perform a kidney biopsy?
1 Answer available
In which patients awaiting a kidney transplant do you evaluate for primary hyperoxaluria given the high risk of allograft dysfunction following transplantation?
1 Answer available
What is your strategy for managing immunosuppression in patients with a kidney transplant who develop metastatic cancer?
3 Answers available
What is your approach to using bisphosphonates in those with severe hypercalcemia and chronic kidney disease?
1 Answer available
Do you recommend continuing SGLT2 inhibitors in patients with diabetic kidney disease and congestive heart failure who have been taking the medication for several years and later develop end stage kidney disease?
3 Answers available
What is your mmHg threshold to cancel a kidney biopsy for patients with pre-procedural elevated blood pressures?
1 Answer available
What is your preferred method for diagnosing adenine phosphoribosyltransferase (APRT) deficiency in a patient with recurrent kidney stones and abnormal crystalluria?
2 Answers available
Are there instances when you perform a repeat kidney biopsy in patients whom tolerated the first procedure but are still without a definitive diagnosis?
1 Answer available
Do you consider hyperuricemia as a potential etiology of an anion gap metabolic acidosis in patients with elevated uric acid levels and no other readily explainable causes of acidosis?
1 Answer available
Are there instances when you would recommend against pursuing adrenal vein sampling in a patient with primary hyperaldosteronism and normal adrenal imaging?
1 Answer available
Would you recommend mycophenolate mofetil for patients with progressive IgA nephropathy who do not tolerate corticosteroids?
Based on the results of the MAIN trial; Hou et al., PMID: 36745456
2 Answers available
What additional studies would you obtain for a patient with end stage kidney disease on hemodialysis who has persistent hypercalcemia and low PTH?
1 Answer available
Is there a kidney length for which you would no longer recommend attempting a kidney biopsy due to safety concerns and lack of diagnostic yield?
1 Answer available
Do you reduce the steroid regimen for patients with acute interstitial nephritis who have a high risk for developing side effects from glucocorticoid therapy?
1 Answer available
Are there instances when you do not perform urine microscopy and rely solely on laboratory performed urinalysis when evaluating a patient for acute kidney injury?
1 Answer available
Do you recommend noninvasive testing or coronary angiography as the initial test for pre-kidney transplant evaluation of an asymptomatic patient older than 50 years of age with ESKD secondary to diabetic nephropathy and no known history of CAD?
1 Answer available
Which medications do you deem necessary to stop prior to measuring plasma renin and plasma aldosterone when evaluating a patient for possible primary aldosteronism?
1 Answer available
Are there preventative measures that you take in your cancer patients with chronic kidney disease who require periodic iodinated contrast CT studies for monitoring of their malignancy?
2 Answers available
When do you avoid or stop erythropoietin-stimulating agents in patients with anemia and end stage kidney disease?
1 Answer available
Is there a role for vascular intervention in patients with renal artery stenosis found during work up of resistant hypertension?
1 Answer available
What is your preferred method for confirming the diagnosis of primary aldosteronism in a patient with an elevated plasma aldosterone to renin ratio?
1 Answer available
When do you avoid or stop iron agents in patients with anemia and end stage kidney disease?
1 Answer available
Do you recommend a kidney biopsy in a patient with myelodysplastic syndrome diagnosed two years prior who develops new onset proteinuria?
1 Answer available
What factors should prompt a kidney biopsy to evaluate for monoclonal gammopathy of renal significance in a patient with MGUS and suspected chronic diabetic nephropathy?
1 Answer available
Can an acid loading test be used to assist with the diagnosis of RTAs other than an incomplete distal RTA?
1 Answer available
How do you manage patients with systemic sclerosis and chronic thrombotic microangiopathy on renal biopsy, but no other evidence of scleroderma renal crisis?
Patient with nephrotic range proteinuria, but there is no evidence of active TMA on renal biopsy.
1 Answer available
Would you recommend avoiding PICC line placement in a kidney transplant patient with an estimated GFR of more than 45 ml/min/1.73m2 and no functional AV access?
2 Answers available
What is your approach to patients with membranous glomerulonephritis who have persistently elevated PLA2R titers but largely improved proteinuria and creatinine?
1 Answer available
Does your goal rate of correction in patients with chronic hypoosmolar hyponatremia differ based on the degree of hypoosmolarity?
4 Answers available
Do you recommend continuing peritoneal dialysis in an ESKD patient on peritoneal dialysis who is diagnosed with encapsulating peritoneal sclerosis since abdominal symptoms may worsen when peritoneal dialysis is stopped?
1 Answer available
How long would you wait before performing a kidney biopsy in a patient with possible AIN whose creatinine has plateaued, but not improved, after discontinuing the suspected offending agent?
1 Answer available
How do you manage recurrent hemodialysis filter clotting in an in-center ESKD patient with heparin-induced thrombocytopenia?
1 Answer available
Do you recommend targeting a higher Kt/V in an ESKD patient on hemodialysis with pruritis and a Kt/V of 1.4?
1 Answer available
Would you recommend giving N-acetylcysteine in addition to holding diuretics in a patient with chronic kidney disease and mild hypervolemia who is planned to have a contrast study?
1 Answer available
Below what platelet count would you avoid using an AV fistula in a patient with ESKD and thrombocytopenia?
1 Answer available
Do you recommend obtaining a vasculitis work up for all patients seen for chronic kidney disease who are without a kidney biopsy?
1 Answer available
Do you use 24 hour urine stone risk profiles for purposes other than managing nephrolithiasis?
2 Answers available
How long would you continue prednisone in an ESKD patient with a failed kidney transplant who develops mild graft pain when steroids are tapered?
1 Answer available
Do you stop tolvaptan below a certain eGFR in a patient with autosomal dominant polycystic kidney disease?
1 Answer available
How do you manage hyponatremia in patients with renal cell carcinoma on cabozantinib and nivolumab?
2 Answers available
How soon after an end stage kidney disease patient receives a MRI study with gadolinium contrast do you perform their next hemodialysis session?
1 Answer available
How do you treat sarcoidosis associated hypercalcemia in a patient with adenopathy and no other signs of systemic involvement?
1 Answer available
When do you perform a kidney biopsy in a patient with AKI that is thought to be related to an immune checkpoint inhibitor?
Do you wait to monitor response to empiric corticosteroids before pursuing a kidney biopsy?
2 Answers available
Are there cases of glomerulonephritis where you do not perform a kidney biopsy in a patient deemed safe to undergo the procedure?
1 Answer available
What is your PTH threshold for referring an ESKD patient with secondary hyperparathyroidism on maximum medical therapy for parathyroidectomy?
1 Answer available
When is a kidney biopsy warranted in a patient with possible scleroderma renal crisis?
1 Answer available
What changes to immunosuppressant medications do you adopt for kidney transplant patients who contract COVID-19?
1 Answer available
What is your approach to the medical management of struvite kidney stones?
1 Answer available
What is the preferred timing for removal of a peritoneal dialysis catheter in a patient who has transitioned to hemodialysis?
1 Answer available
Do you prefer transtubular potassium gradient (TTKG) or urine potassium to urine creatinine ratio when evaluating patients with abnormal potassium levels?
1 Answer available
What is the antifungal prophylaxis regimen that you use in patients on peritoneal dialysis who are receiving antibiotics?
1 Answer available
In which clinical scenarios is relying on the urine protein-to-creatinine ratio as a measure of proteinuria unreliable, and interpretations should be made looking at urine protein and urine creatinine separately?
1 Answer available
Would you consider clearing a patient with essential thrombocytosis for a kidney donation?
1 Answer available
What is your treatment algorithm for management of retroperitoneal fibrosis that does not respond to high-dose glucocorticoids?
1 Answer available
Do you hold IV iron in the setting of active infection?
1 Answer available
How would you manage an incidental catheter-related thrombosis in a functioning dialysis catheter?
- Dialysis catheter used for hemodialysis- RIJ thrombus in dialysis catheter was incidentally found- Patient asymptomatic with no prior history of VTE...
2 Answers available
How do you approach relapsing ANCA-associated vasculitis in a patient who has already undergone kidney transplant?
1 Answer available
How do you approach the management of immunosuppression in patients with lupus nephritis that go on to dialysis?
3 Answers available
Is there any role for iron chelation in a patient with iatrogenic transfusion-induced iron overload such as in patients with end-stage kidney or liver disease?
Does transplant eligibility make a difference for management?
1 Answer available
How do steroids and/or DMARDs affect biopsy results if a renal biopsy for suspected lupus nephritis is delayed?
1 Answer available
Would you consider giving ESA for anemia secondary to chronic kidney disease in a patient with follicular lymphoma in remission and on rituximab maintenance?
1 Answer available


Papers discussed in this category

Ann. Rheum. Dis., 2018 Apr 25
Comparison of individually tailored versus fixed-schedule rituximab regimen to maintain ANCA-associated vasculitis remission: results of a multicentre, randomised controlled, phase III trial (MAINRITSAN2).
PLoS One, 2021 Apr 08
Effectiveness and safety of rivaroxaban versus warfarin in Taiwanese patients with end-stage renal disease and nonvalvular atrial fibrillation: A real-world nationwide cohort study.
Kidney international, 2009-12
A prospective study of protein excretion using short-interval timed urine collections in patients with lupus nephritis.
Clinical journal of the American Society of Nephrology : CJASN, 2010-07
Comparison of urinary albumin-creatinine ratio and albumin excretion rate in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications study.
Journal of the American Society of Nephrology : JASN, 2010-08
Comparison of different measures of urinary protein excretion for prediction of renal events.
Am J Kidney Dis, 2016 Sep 16
Timed Urine Collections for Albumin and Protein: "The King Is Dead, Long Live the King!".
J Rheumatol, 2004 Aug
Urine protein-to-creatinine ratio is a reliable measure of proteinuria in lupus nephritis.
Circulation, 2022 Nov 06
A Randomized Controlled Trial Comparing Apixaban With the Vitamin K Antagonist Phenprocoumon in Patients on Chronic Hemodialysis: The AXADIA-AFNET 8 Study.
Circulation, 2022 Nov 06
Apixaban for Patients With Atrial Fibrillation on Hemodialysis: A Multicenter Randomized Controlled Trial.
Perit Dial Int, 2022 Mar
ISPD peritonitis guideline recommendations: 2022 update on prevention and treatment.
The Journal of clinical endocrinology and metabolism, 2016-05
The Management of Primary Aldosteronism: Case Detection, Diagnosis, and Treatment: An Endocrine Society Clinical Practice Guideline.
Clin Chim Acta, 2020 Oct 20
Diagnostic value of parameters from a spot urine sample for renal potassium loss in hypokalemia.
Am J Kidney Dis, 2019 Jun 19
Physiology and Pathophysiology of Potassium Homeostasis: Core Curriculum 2019.
Curr Opin Nephrol Hypertens, 2011 Sep
Intrarenal urea recycling leads to a higher rate of renal excretion of potassium: an hypothesis with clinical implications.
Journal of vascular and interventional radiology : JVIR, 2015-02
Risk of bleeding after native renal biopsy as a function of preprocedural systolic and diastolic blood pressure.
AACE Clin Case Rep, 2020 Aug 06
METHOTREXATE TREATMENT FOR SARCOIDOSIS-INDUCED HYPERCALCEMIA.
Am J Med, 1987 Jun
Hydroxychloroquine treatment of hypercalcemia in a patient with sarcoidosis undergoing hemodialysis.
Sarcoidosis Vasc Diffuse Lung Dis, 2012 Mar
Hypercalcemia from sarcoidosis successfully treated with infliximab.
Arch Osteoporos, 2017 Jul 19
Glucocorticoid sparing effect of zoledronic acid in sarcoid hypercalcemia.
BMJ Case Rep, 2022 Jul 08
Hungry bone syndrome like presentation following single-dose denosumab for hypercalcaemia secondary to sarcoidosis with IgA nephropathy.
Arthritis Res Ther, 2014 Mar 24
Bone fragility in sarcoidosis and relationships with calcium metabolism disorders: a cross sectional study on 142 patients.
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