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Chronic kidney disease   

Questions discussed in this category

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?
3 Answers available
Would you recommend oral or intravenous iron in a chronic kidney disease stage 4 patient who is not on an ESA and has a hemoglobin of 12.7 g/dl and an iron saturation of less than 20%?
3 Answers available
Would you consider restarting a SGLT2i at a reduced dose in a patient who you previously discontinued the medication because of an associated significant decline in eGFR?
1 Answer available
How do you approach managing patients with diabetic kidney disease and proteinuria who develop hypoglycemia after initiation of a SGLT2 inhibitor?
1 Answer 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
What is your approach to managing hyperkalemia in pregnant patients with chronic kidney disease?
1 Answer available
When would you repeat a kidney ultrasound with post void residual measurement for a patient with chronic kidney disease from bladder outlet obstruction who is started on tamsulosin?
1 Answer available
Would you avoid SGLT2 inhibitors in patients with nephrostomy tubes?
1 Answer available
Would you avoid SGLT2 inhibitors in patients with urinary incontinence requiring incontinence briefs due to concern with genitourinary hygiene and risk for infections?
4 Answers available
What are your top takeaways from ASN 2024?
1 Answer available
For outpatients undergoing a kidney biopsy, do you routinely recommend an overnight admission for continued hemoglobin monitoring?
6 Answers available
What is the role for iothalamate clearance testing for glomerular filtration estimation in patients with chronic kidney disease?
4 Answers available
At what serum bicarbonate level do you initiate alkali therapy for patients with chronic kidney disease?
3 Answers available
Do you recommend patients with chronic kidney disease avoid supplements containing creatine?
1 Answer available
What are your criteria for starting tolvaptan in adult patients diagnosed with autosomal dominant polycystic kidney disease?
1 Answer available
Would you stop denosumab in a patient with chronic kidney disease if they develop asymptomatic hypocalcemia after the injection?
4 Answers available
Is your decision to prescribe empagliflozin for CKD patients without albuminuria influenced by a recent cost-utility analysis showing that empagliflozin was not cost-effective for this group?
Odawara et al., Clinical Journal of the American Society of Nephrology 2024
2 Answers available
What is your approach to weaning dialysis in a patient with AKI on CKD and CHF who now has resolved AKI but a history of recurrent episodes of decompensated heart failure?
1 Answer available
Do you recommend SGLT2i use for patients with chronic kidney disease, diabetes mellitus, and polycystic kidney disease? 
See dapagliflozin drug insert form which states Farxiga is not recommended for patients with PKD.
3 Answers available
Do you recommend uric acid lowering therapies for asymptomatic hyperuricemia in chronic kidney disease?
1 Answer available
What is your approach to patients with advanced chronic kidney disease who are taking aluminum containing medications?
Aluminum hydroxide/magnesium hydroxide (i.e. Maalox).
2 Answers available
Are recurrent UTIs a contraindication to SGLT2i use?
4 Answers 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
Would you start an SGLT2 inhibitor in patients with diabetic kidney disease who also have a history of prior toe amputation?
3 Answers available
How do you counsel patients with CKD who are on a PPI given a prior observational study showing an association between PPI use and incident CKD?
Lazarus et al., PMID 26752337
2 Answers available
Do you recommend using vitamin D analogs for patients with CKD and a high PTH but a normal 25-hydroxy vitamin D level?
3 Answers available
What is your approach to genetic counseling prior to obtaining genetic testing in young asymptomatic patients suspected of having autosomal dominant polycystic kidney disease?
1 Answer available
If a patient who has tolerated allopurinol for a prolonged period of time is subsequently found to be positive for the HLA-B*58:01 gene, how would you manage urate-lowering therapy thereafter?
1 Answer available
Do you prefer allopurinol or febuxostat for patients with chronic kidney disease who are receiving treatment for asymptomatic hyperuricemia?
4 Answers available
Do you recommend a ketogenic diet for patients with autosomal dominant polycystic kidney disease?
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 approaches do you take to prevent worsening kidney function for patients with chronic kidney disease who have an upcoming outpatient CT scan with iodinated contrast?
5 Answers available
Do you prefer performing a kidney biopsy on the left or right kidney if both kidneys appear similar on pre-biopsy imaging?
2 Answers available
Would you recommend starting an SGLT2 inhibitor in a proteinuric CKD patient with chronic asymptomatic bacteriuria?
2 Answers available
Do you prefer cinacalcet or etelcalcetide for patients with hyperparathyroidism in the setting of kidney disease?
3 Answers available
Given the cardioprotective and renoprotective effects of SGLT2 inhibitors, should we consider administering to patients with well controlled type 1 diabetes despite the risk of DKA?
3 Answers available
Do you recommend stopping a SGLT2i indefinitely if a patient with chronic kidney disease and diabetes develops euglycemic diabetic ketoacidosis?
1 Answer available
What is your approach to lab and imaging monitoring in a patient with an elevated creatinine following a unilateral nephrectomy?
3 Answers available
Do you recommend dietary protein restriction in your patients with chronic kidney disease?
1 Answer available
Do you prefer sodium bicarbonate or sodium citrate in your chronic kidney disease patients with metabolic acidosis?
1 Answer available
Do you perform a kidney ultrasound in patients following a kidney biopsy to evaluate for post-procedural complications?
2 Answers available
Would you consider adding an SGLT2i for a patient with proteinuric kidney disease who is already on maximal dose ACEi/ARB and has a UACR < 300 mg/g?
3 Answers 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
Are there instances when you recommend initiation of dialysis in patients with advanced chronic kidney disease who are scheduled for a major surgery but do not currently have any indications for renal replacement therapy?
2 Answers available
Do you check EPO levels in patients with anemia of chronic kidney disease?
2 Answers available
Are you offering GLP-1 agonists to patients with CKD and diabetes mellitus?
4 Answers available
Is the phosphorus-lowering benefit of patiromer compelling enough to switch a patient with chronic hyperkalemia and hyperphosphatemia from sodium zirconium cyclosilicate to patiromer?
2 Answers available
Do you recommend decreasing the loop diuretic dose when starting an SGLT2 inhibitor in a CKD patient given its natriuretic and osmotic diuretic effects?
2 Answers available
Do you have a higher threshold regarding when to hold bevacizumab for proteinuria in patients who had known baseline proteinuria from diabetic nephropathy?
2 Answers available
Will you use vadadustat in place of an ESA in treating anemia of chronic kidney disease?
2 Answers available
How do you choose between spironolactone and finerenone for patients with proteinuric diabetic kidney disease and heart failure?
2 Answers available
Do you prefer celecoxib over a nonselective NSAID in patients with chronic kidney disease?
4 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
In which patients with non-proteinuric chronic kidney disease would you initiate a SGLT2i?
3 Answers 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
Do you pursue any additional testing in your patients with chronic kidney disease who are found to have "small hypodensities too small to characterize" on renal ultrasound?
2 Answers available
Do you restrict topical diclofenac use in your patients with chronic kidney disease?
3 Answers available
How do you approach consults regarding clearance of patients with chronic kidney disease for surgery?
3 Answers available
How do you choose between the different vitamin D analogs for patients with CKD, an elevated PTH, and a normal 25-hydroxy vitamin D level?
4 Answers available
Do you recommend giving IV albumin with furosemide to augment diuresis in a patient with hypoalbuminemia and volume overload?
1 Answer available
Would you consider using finerenone for proteinuric CKD associated with type 1 diabetes mellitus?
3 Answers available
Do you add a separate dose of losartan for patients with heart disease and proteinuric kidney disease who are on maximal doses of sacubitril/valsartan but continue to experience proteinuria?
6 Answers available
How often do you screen for cerebral aneurysms in patients with autosomal dominant polycystic kidney disease who do not have a family history of intracranial aneurysms or for whom the family history is unknown?
1 Answer available
Do you recommend starting SGLT2 inhibitors for patients with a normal creatinine but who have microalbuminuria and are unable to tolerate ACEi or ARBs?
1 Answer available
Do you recommend patients temporarily hold cilostazol prior to and after a kidney biopsy?
1 Answer available
Do you obtain periodic kidney ultrasounds in patients with stable chronic kidney disease to evaluate for changes in kidney size that might reflect progression of kidney disease not detected with serum studies?
2 Answers available
Are there instances when you prefer serum creatinine over cystatin C when estimating GFR in a patient with CKD?
1 Answer available
Would you recommend switching a diabetic CKD patient on oral semaglutide to the subcutaneous form since the benefits in CKD have primarily been reported in studies using subcutaneous GLP-1 receptor agonists?
1 Answer available
How early do you involve palliative care in the management of a CKD Stage 5 patient who does not wish to pursue renal replacement therapy?
1 Answer 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
Do you avoid ESA use in patients with anemia and chronic kidney disease who also have APLS and risk for thrombosis?
2 Answers 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
Which medications do you recommend for lactating mothers with kidney disease and proteinuria that persists post-delivery?
1 Answer available
What are some measures to prevent flares of loin pain-hematuria syndrome?
1 Answer available
How do you dose apixaban in patients with CrCl <30 mL/minute?
1 Answer available
How do you manage proteinuria in a patient with type 1 diabetes mellitus who has orthostatic hypotension and is unable to tolerate ACEi/ARBs? 
3 Answers available
Is reduction in proteinuria with SGLT2i dose dependent?
2 Answers available
What are your top takeaways from ASN 2023?
2 Answers available
What is the minimum eGFR at which we should avoid initiating SGLT2i therapy?
1 Answer available
Do you recommend holding metformin in a patient with chronic kidney disease who has an upcoming CT contrast study?
3 Answers 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
What criteria do you use, if any, to recommend statin therapy for patients with polycystic kidney disease?
1 Answer available
How do you approach urate-lowering therapy in patients with advanced chronic kidney disease?
What doses of allopurinol do you use, and how frequently do you titrate the dose?
1 Answer available
Do you recommend genetic testing for patients with a family history of polycystic kidney disease and who meet the imaging criteria, but the specific genetic variant in the family is unknown?
1 Answer available
Would you recommend use of ESA for anemia of kidney disease in the setting of metastatic solid tumor malignancy?
1 Answer available
Do you recommend using a risk equation or eGFR alone in deciding when to refer a patient with advanced CKD for vascular access placement?
3 Answers available
How much decrease in eGFR do you tolerate before discontinuing finerenone started in patients with diabetic kidney disease?
2 Answers available
How much decrease in eGFR do you tolerate before discontinuing a SGLT2i started in patients with diabetic kidney disease?
1 Answer available
Do you use alkali therapy in those with stable chronic kidney disease and a normal serum bicarbonate level who have a low urine pH?
1 Answer available
Would you recommend AV fistula placement in a CKD Stage 5 patient who is over the age of 80?
2 Answers available
Below what eGFR would you consider discontinuing lithium in a bipolar disorder patient with chronic kidney disease?
1 Answer available
Do you stop tolvaptan below a certain eGFR in a patient with autosomal dominant polycystic kidney disease?
1 Answer available
Do you recommend initiating an ACE inhibitor or ARB in a patient with proteinuric CKD Stage 5?
1 Answer available
In which patients with chronic kidney disease and low 25-OH vitamin D levels do you prefer weekly ergocalciferol to daily cholecalciferol supplementation?
1 Answer available
How do you approach treatment of osteoporosis in patients with CKD who develop a fragility fracture while on denosumab?
1 Answer available
How do you approach prophylaxis against glucocorticoid-induced osteoporosis in patients with end-stage renal disease on dialysis?
1 Answer available
How would you approach immunosuppression for patients with severe aplastic anemia who are not transplant or ATG candidates?
Such as patients who are frail, elderly, renally impaired? Would you consider sirolimus over cyclosporine or tacrolimus for safer nephrotoxicity prof...
1 Answer available
Do you use leflunomide in rheumatoid arthritis patients on hemodialysis?
If so, would you adjust the dose?
1 Answer available


Papers discussed in this category

Clin Rheumatol, 2012 Nov 22
Leflunomide in dialysis patients with rheumatoid arthritis--a pharmacokinetic study.
Ann Pharmacother,
Effect of hemodialysis on leflunomide plasma concentrations.
Am J Kidney Dis, 2019 Aug 05
The Use of Erythropoiesis-Stimulating Agents in Patients With CKD and Cancer: A Clinical Approach.
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.
The New England journal of medicine, 2019-06-13
Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy.
Clin J Am Soc Nephrol, 2021 Apr 20
Clinical Implications of an Acute Dip in eGFR after SGLT2 Inhibitor Initiation.
FASEB J, 2023 Apr
Acute kidney injury in diabetes mellitus: Epidemiology, diagnostic, and therapeutic concepts.
Kidney Int Rep, 2022 May 05
Prescribing SGLT2 Inhibitors in Patients With CKD: Expanding Indications and Practical Considerations.
N Engl J Med, 2020 Oct 23
Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes.
Circulation, 2020 Aug 29
Renal and Cardiovascular Effects of SGLT2 Inhibition in Combination With Loop Diuretics in Patients With Type 2 Diabetes and Chronic Heart Failure: The RECEDE-CHF Trial.
Kidney360, 2021 Feb 01
Real-Life Prescribing of SGLT2 Inhibitors: How to Handle the Other Medications, Including Glucose-Lowering Drugs and Diuretics.
Ann Intern Med, 2019 Jul 30
Sodium-Glucose Cotransporter-2 Inhibitors and the Risk for Severe Urinary Tract Infections: A Population-Based Cohort Study.
Am J Kidney Dis, 2021 Mar 08
Assessing Risk of Rapid Progression in Autosomal Dominant Polycystic Kidney Disease and Special Considerations for Disease-Modifying Therapy.
Kidney Int, 2019 Jan
Hemodialysis vascular access in the elderly-getting it right.
Gastroenterology, 2019-09
Safety of Proton Pump Inhibitors Based on a Large, Multi-Year, Randomized Trial of Patients Receiving Rivaroxaban or Aspirin.
Kidney360, 2022 Jan 04
Do Proton-Pump Inhibitors Cause CKD and Progression of CKD?: COMMENTARY.
Diabetes Metab, 2021 Dec 13
Acute renal injury events in diabetic patients treated with SGLT2 inhibitors: A comprehensive review with a special reference to RAAS blockers.
The New England journal of medicine, 2013 Jul 10
Case records of the Massachusetts General Hospital. Case 23-2013. A 54-year-old woman with abdominal pain, vomiting, and confusion.
Clin J Am Soc Nephrol, 2021 Feb 18
Patients with Protein-Truncating Mutations and Mild ADPKD.
Hypertension (Dallas, Tex. : 1979), 2020 Jan 27
Orthostatic Hypotension, Cardiovascular Outcomes, and Adverse Events: Results From SPRINT.
Circulation, 2021 Dec 14
Effect of the Glucagon-Like Peptide-1 Receptor Agonists Semaglutide and Liraglutide on Kidney Outcomes in Patients With Type 2 Diabetes: Pooled Analysis of SUSTAIN 6 and LEADER.
JAMA neurology, 2022 Apr 01
Association of Intensive vs Standard Blood Pressure Control With Cerebral Blood Flow: Secondary Analysis of the SPRINT MIND Randomized Clinical Trial.
Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie, 2022 Oct 31
Empagliflozin reduces kidney fibrosis and improves kidney function by alternative macrophage activation in rats with 5/6-nephrectomy.
Kidney international, 2022 Nov
Executive summary of the KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease: an update based on rapidly emerging new evidence.
Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2023 Jan 18
The rationale, design and baseline data of FLOW, a kidney outcomes trial with once-weekly semaglutide in people with type 2 diabetes and chronic kidney disease.
Cardiovascular diabetology, 2024 Feb 08
Cardiorenal effectiveness of empagliflozin vs. glucagon-like peptide-1 receptor agonists: final-year results from the EMPRISE study.
The New England journal of medicine, 2024 May 24
Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes.
Kidney international, 2001 Mar
Role of diuretics in the preservation of residual renal function in patients on continuous ambulatory peritoneal dialysis.
American journal of nephrology, 1992
Acute and long-term effects of therapy with high-dose furosemide in chronic hemodialysis patients.
Kidney research and clinical practice, 2019 Mar 31
Efficacy of triple diuretic treatment in continuous ambulatory peritoneal dialysis patients: A randomized controlled trial.
The New England journal of medicine, 2022 Nov 04
Empagliflozin in Patients with Chronic Kidney Disease.
Journal of the American Society of Nephrology : JASN, 2004-01
Timing of complications in percutaneous renal biopsy.
AJR. American journal of roentgenology, 2015-08
Management of Anticoagulant and Antiplatelet Medications in Adults Undergoing Percutaneous Interventions.
Journal of vascular and interventional radiology : JVIR, 2019 Jun 20
Society of Interventional Radiology Consensus Guidelines for the Periprocedural Management of Thrombotic and Bleeding Risk in Patients Undergoing Percutaneous Image-Guided Interventions-Part II: Recommendations: Endorsed by the Canadian Association for Interventional Radiology and the Cardiovascular and Interventional Radiological Society of Europe.
Kidney360, 2023 Nov 22
All Patients with ADPKD Should Undergo Screening for Intracranial Aneurysms: PRO.
Clinical journal of the American Society of Nephrology : CJASN, 2019 Nov 18
Genetic Testing for Genetic Variants in Clinical Practice: Finally Starting to Arrive.
Diabetes, obesity & metabolism, 2024 Apr 28
Real-world effectiveness of sodium-glucose cotransporter-2 inhibitors on the progression of chronic kidney disease in patients without diabetes, with and without albuminuria.
Kidney international, 1978-07
Use of computerized tomography to diagnose complications of percutaneous renal biopsy.
Annals of clinical and laboratory science, 1982
Perinephric abscess: an unusual late infectious complication of renal biopsy.
American journal of kidney diseases : the official journal of the National Kidney Foundation, 2019 Jan 17
Update on the Native Kidney Biopsy: Core Curriculum 2019.
The Journal of urology, 1964 Apr
DEATH DUE TO SEPTICEMIA FOLLOWING PERCUTANEOUS NEEDLE BIOPSY OF THE KIDNEY.
Transplantation direct, 2021 Sep 07
Significance of Asymptomatic Pyelonephritis Found on Kidney Transplant Biopsy.
Mayo Clinic proceedings, 1995 Mar
Renal biopsy.
The New England journal of medicine, 2018-03-29
Cardiovascular Safety of Febuxostat or Allopurinol in Patients with Gout.
Lancet, 2020 Nov 09
Long-term cardiovascular safety of febuxostat compared with allopurinol in patients with gout (FAST): a multicentre, prospective, randomised, open-label, non-inferiority trial.
Nephrology (Carlton, Vic.), 2019 Oct 23
KHA-CARI Guideline recommendations for renal biopsy.
Arthritis care & research, 2012-10
2012 American College of Rheumatology guidelines for management of gout. Part 1: systematic nonpharmacologic and pharmacologic therapeutic approaches to hyperuricemia.
Proceedings of the National Academy of Sciences of the United States of America, 2005 Mar 02
HLA-B*5801 allele as a genetic marker for severe cutaneous adverse reactions caused by allopurinol.
The New England journal of medicine, 2024 Oct 26
Bi- and Monoallelic Variants and Chronic Kidney Disease in West Africans.
Atencion primaria, 1997 Sep 30
[The existing differences between adolescent girls served on a first visit in a family planning center in 2 time periods].
The New England journal of medicine, 2024 Oct 25
Long-Term Effects of Empagliflozin in Patients with Chronic Kidney Disease.

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