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Nephrology   

Questions discussed in this category

Do you recommend a patient with recurrent nephrolithiasis who is performing a 24 hour urine collection add a urine preservative or keep the specimen refrigerated?
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?
1 Answer 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
How would you treat a kidney transplant patient with both biopsy-proven BK nephropathy and recurrent membranous glomerulonephritis with nephrotic range proteinuria?
1 Answer 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
Would you recommend administering IV amino acids prior to cardiac surgery with cardiopulmonary bypass, given recent trial findings of improved AKI rates but no significant difference in kidney-replacement therapy with IV amino acids?
Landoni et al., PMID 38865168
1 Answer available
What is your approach to using calcium containing medications for patients with recurrent nephrolithiasis and hyperoxaluria?
1 Answer available
Would you order a repeat DEXA scan 1 year later for a kidney transplant patient who had an initial DEXA scan within the first 6 months post-transplant showing osteopenia but no history of fractures, and who has been stable on glucocorticoid-free immunosuppressive therapy?
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
Do you try to treat the acidosis resulting from acetazolamide in patients with IIH?
1 Answer 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
How often do you check renal function panels for patients with recurrent nephrolithiasis?
1 Answer available
In a patient with severe hyponatremia and acute kidney injury in the setting of hypovolemic shock, would fluid resuscitation take precedence over the rate at which sodium is corrected?
3 Answers available
Would you start potassium citrate in a patient with recurrent nephrolithiasis of unknown stone composition who has hypocitraturia and alkaline urine pH?
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
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
Would you recommend desmopressin for a patient with ESKD receiving thrice weekly hemodialysis who is hospitalized for a persistent gastrointestinal bleed not amenable to usual interventional treatment strategies?
1 Answer available
Is there a maximum dose of potassium citrate you would use for patients with recurrent calcium oxalate nephrolithiasis and hypocitraturia?
1 Answer available
What is your approach to managing patients with recurrent calcium oxalate nephrolithiasis since childhood who are found to be gene carriers for mutations in genes associated with primary hyperoxaluria?
1 Answer available
Do you use any urinary staining techniques when performing urine microscopy for patients with acute kidney injury?
1 Answer available
Have you considered priming CRRT machines with renal replacement solutions during the current crystalloid solution shortage?
2 Answers available
Do you ever combine voclosporin and belimumab in the treatment of lupus nephritis?
Do you use them sequentially or together?
3 Answers available
What are some important considerations for use of ACE inhibition in scleroderma renal crisis patients who require dialysis?
For example, is captopril dialyzable? 
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
Is there a serum potassium level for when you would recommend discontinuing potassium citrate in a patient with recurrent nephrolithiasis, hypocitraturia, and hyperkalemia?
1 Answer available
Are there instances where you may transiently transition a perioperative ESKD on PD inpatient from peritoneal dialysis to hemodialysis if they are likely to receive a large volume of fluid?
Invited Professor Series Video: Volume Management and Access Troubleshooting in Peritoneal Dialysis - Claretha Lyas, MD
2 Answers available
Do you recommend CT or ultrasound imaging testing when monitoring a patient with nephrocalcinosis?
1 Answer available
What is your approach to preventing exercise-associated hyponatremia?
2 Answers available
What are your top takeaways from ASN 2024?
1 Answer available
How do you determine the optimal time to restart a diuretic in a patient with cirrhosis, ascites, and lower extremity edema who presented with acute kidney injury that resolved with IV albumin and holding diuretics?
1 Answer available
Do you recommend checking a serum phosphorus level in patients with recurrent nephrolithiasis?
1 Answer available
How would you manage a patient with CKD4 due to lupus nephritis of unknown class who develops AKI requiring hemodialysis and nephrotic range proteinuria and is found to have atrophic kidneys on imaging?
3 Answers 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
What is your blood pressure or mean arterial pressure goal in a critically ill patient with acute kidney injury?
1 Answer available
What strategies do you use to prevent overcorrection of serum sodium in patients with severe hyponatremia and adrenal insufficiency when initiating glucocorticoid therapy?
1 Answer available
Do you avoid performing urine microscopy in patients with AKI who have COVID-19 given concern for potential aerosolization?
2 Answers available
At what serum bicarbonate level do you initiate alkali therapy for patients with chronic kidney disease?
3 Answers available
How do you approach treatment for patients with proliferative glomerulonephritis with monoclonal IgG deposits (PGNMID) with end-stage renal disease who are considering kidney transplant?
Most patients with PGNMID have no detectable disease in their marrow or blood and urine protein cannot adequately be monitored.
1 Answer 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
Are there instances when you use letermovir without the addition of acyclovir when managing a kidney transplant recipient for CMV prophylaxis?
2 Answers available
Do you recommend switching from tacrolimus to cyclosporine in a kidney transplant patient diagnosed with PTLD?
Bustami et al., PMID 14678038
4 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
Are there any instances when you would not perform 3 consecutive daily dialysis sessions when initiating a patient on hemodialysis?
2 Answers available
How often do you recommend basic metabolic panel checks in a hospitalized ESKD patient on thrice weekly hemodialysis and for whom hyperkalemia is not of major concern?
2 Answers available
Do you recommend a daily B complex multivitamin for patients with end stage kidney disease who are receiving peritoneal dialysis?
1 Answer available
Do you recommend non-bypass bariatric surgeries over intestinal bypass procedures for kidney transplant-eligible candidates to prevent oxalate nephropathy, given the higher risk of kidney oxalate deposition with intestinal bypass?
2 Answers available
How do you approach increasing urinary citrate levels in a patient with recurrent calcium nephrolithiasis who has hypocitraturia, non-acidic urine, and normal serum bicarbonate levels?
How do you approach increasing urinary citrate levels in a patient with recurrent calcium nephrolithiasis who has hypocitraturia non-acidic urine?
1 Answer available
Should all kidney transplant patients be started on statin therapy post operatively given their increased risk of CVD?
At what doses do you start? and how do you titrate therapy?
1 Answer available
Would you recommend adding a daytime dwell over an additional nighttime exchange to achieve volume and clearance targets for an ESKD patient who recently stopped making urine and has been receiving only nighttime automated peritoneal dialysis?
3 Answers available
Do you recommend Moonstone supplements for patients with recurrent calcium oxalate nephrolithiasis who have hypocitraturia and mild hyperkalemia for which potassium citrate is contraindicated?
2 Answers available
Do you prefer using losartan in your patients with hypertension and gout due to its uricosuric effects?
2 Answers available
Would you stop denosumab in a patient with chronic kidney disease if they develop asymptomatic hypocalcemia after the injection?
4 Answers available
Do you avoid sodium zirconium cyclosilicate use in your patients with ESKD and hyperkalemia who also have peripheral edema?
1 Answer available
Are there instances when you recommend initiation of hemodialysis for patients with severe symptomatic hypercalcemia?
1 Answer available
Do you taper steroids more aggressively to decrease the risk of developing new-onset diabetes after transplantation in kidney transplant recipients who had pretransplant impaired fasting glucose?
2 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
Do you recommend starting pyridoxine in a patient with ESKD secondary to primary hyperoxaluria type 1 who is also on lumasiran for plasma oxalate reduction?
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
How do you recommend discussing family member genetic testing with a patient recently diagnosed with ADPKD?
1 Answer available
Does vitamin D supplementation in primary hyperparathyroidism increase the risk of kidney stones?
Is this seen more with high dose vitamin D supplementation?
1 Answer available
How would you approach management of a patient with ESRD on the transplant list who is found to have high titer APS labs (ACL, B2GP1, LAC)?
1 Answer 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
Should HCQ be continued in an asymptomatic SLE patient who has received renal transplant?
If a patient has received a kidney transplant for SLE-LN and is stable and doing well. Managed by their transplant team and on chronic immunosuppressi...
2 Answers 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
Is there a serum phosphorus level you would consider too low to safely perform hemodialysis?
2 Answers available
How do the results of the ESPRIT trial, which evaluated the impact of an SBP target of <120 mmHg on preventing major cardiovascular events, influence your blood pressure management goals for hypertensive patients with diabetes or a history of stroke?
ESPRIT Trial
1 Answer available
Do you recommend adding Moonstone supplements for patients with recurrent calcium oxalate nephrolithiasis who are on potassium citrate but continue to have hypocitraturia?
3 Answers available
What is your daily correction goal for those patients being treated for hyponatremia?
1 Answer available
What factors influence your decision between guidewire exchange versus removal and replacement through a new tunnel tract for patients with tunneled hemodialysis catheter mechanical failure?
Lazarus, et al., PMID: 38913437
1 Answer available
In which clinical scenarios do you use prolonged intermittent renal replacement therapy (PIRRT)?
2 Answers available
What is your approach to managing insomnia in an ESKD patient?
2 Answers available
Do you recommend avoiding ESAs in pregnant patients with anemia of chronic kidney disease who also have preeclampsia?
1 Answer available
Do you recommend uric acid lowering therapies for asymptomatic hyperuricemia in chronic kidney disease?
1 Answer available
Do you recommend plasmapheresis for treatment of patients with osmotic demyelination?
1 Answer available
Do you recommend dosing potassium citrate three times or two times daily for patients with recurrent calcium oxalate nephrolithiasis and hypocitraturia?
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
Do you recommend prophylactic post-operative use of an intravenous calcium infusion for patients with ESKD who undergo subtotal parathyroidectomy for secondary hyperparathyroidism?
1 Answer available
What is your treatment approach when managing patients with relapsing lupus nephritis who previously achieved remission with mycophenolate and steroids?
5 Answers available
What are your management strategies for patients with biopsy proven IgA nephropathy with rapidly progressive glomerulonephritis?
2 Answers 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 administer calcium to patients with K > 6.5 without EKG changes?
3 Answers available
How do you approach the management of persistent hyperphosphatemia in ESKD patients who are non-adherent to phosphate binders?
1 Answer available
How do you approach a patient request to decrease hemodialysis time when Kt/V values are above target but serum phosphorus remains poorly controlled?
2 Answers available
What is your approach to interpreting urine studies in patients hospitalized for hyponatremia who have recently received intravenous fluids containing sodium chloride?
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
Do you routinely obtain serum anti-THSD7A and anti-NELL1 tests in your patients with nephrotic syndrome suspected secondary to membraneous nephropathy?
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
Do you routinely use markers or tests other than serum creatinine when estimating GFR to determine if patients with liver failure, not on dialysis, meet criteria for a simultaneous liver-kidney transplant?
3 Answers 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
What recommendations do you offer for patients who have a peritoneal dialysis catheter and who wish to swim?
2 Answers available
Do you assess for podocyte detachment in addition to effacement when considering the degree of glomerular injury and potential treatment options following a native kidney biopsy in a patient with proteinuria?
1 Answer 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
What are your management strategies for patients with recurrent nephrolithiasis and hypercalciuria who develop hypercalcemia after thiazide initiation?
1 Answer available
What is your approach to managing acidic urine in patients with recurrent uric acid nephrolithiasis who have normal urinary citrate levels?
2 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
Below what ejection fraction would you avoid referral for AV access creation in a patient with advanced CKD and heart failure with reduced ejection fraction?
1 Answer available
Do you recommend genetic testing for patients incidentally found to have nephrocalcinosis on imaging?
1 Answer available
How do you manage a pregnant patient with lupus who develops renal disease during pregnancy that is not due to pre-eclampsia?
2 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
Do you have patients with recurrent nephrolithiasis target a certain urine volume or rather consume fluids as needed for goal of having consistent clear urine?
1 Answer available
Do you transition patients with recurrent nephrolithiasis and hypercalciuria off of hydrochlorothiazide in favor of an alternative thiazide diuretic?
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
Do you recommend fluid restriction in addition to other management strategies for patients with hyponatremia due to SIADH?
5 Answers available
Do you have a preferred oral magnesium formulation for patients with hypomagnesemia secondary to Gitleman syndrome and who also have chronic diarrhea?
1 Answer available
Do you alternate CT stone scans and renal ultrasounds for stone monitoring in your patients with recurrent nephrolithiasis with the goal of limiting radiation exposure?
1 Answer available
What is your approach to initiating spironolactone in patients with end stage kidney disease and heart failure?
4 Answers 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
How do you dose gabapentin in patients with renal failure?
3 Answers available
How do you monitor multiple myeloma in patients receiving dialysis?
Since free light chains are removed by dialysis and SPEP can also be impacted, is there a reliable way to monitor patients with ESRD and MM?
1 Answer available
How does contralateral suppression of more than 50% with cosyntropin during adrenal venous sampling influence your decision to recommend adrenalectomy in patients with primary aldosteronism?
Okubo et al., PMID 38442744
1 Answer available
Do you preferentially avoid use of piperacillin-tazobactam for empiric anti-pseudomonal coverage in hospitalized patients due to risk of nephrotoxicity?
ACORN Randomized Clinical Trial 
1 Answer available
Do you avoid terlipressin for patients with hepatorenal syndrome who have a serum sodium level less than 125 mEq/L?
2 Answers available
Do you prefer allopurinol or febuxostat for patients with chronic kidney disease who are receiving treatment for asymptomatic hyperuricemia?
4 Answers available
Can a dihydropyridine calcium channel blocker (CCB) like amlodipine be prescribed in addition to a non-dihydropyridine CCB such as diltiazem or verapamil for treating hypertension?
2 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 use potassium phosphate for patients with recurrent nephrolithiasis to acidify the urine and prevent certain types of stones?
1 Answer available
How frequently do you recommend flushing a peritoneal dialysis catheter for patients with ESKD who are hospitalized and are not currently undergoing peritoneal dialysis?
6 Answers available
Would you recommend normal saline for pre- and post-LHC hydration in patients with CKD stage III to IV with reduced LV systolic function, and if so, what is a reasonable amount of volume?
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 recommend starting anti-fungal prophylaxis for patients on systemic antibiotics who have a peritoneal dialysis catheter that is only currently being accessed for once weekly flushes?
1 Answer available
Do you prefer still over carbonated water for your patients with recurrent nephrolithiasis who have chronically low urine volumes?
1 Answer available
Would you use voclosporin or belimumab as adjunctive therapy for treatment of lupus nephritis?
How does the presence of extra-renal manifestations influence this decision?
8 Answers available
Would you recommend cinacalcet for patients with recurrent nephrolithiasis who have hypercalciuria despite thiazide diuretic use and who also have an elevated PTH level without localizing parathyroid adenoma on imaging?
1 Answer 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
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
Do you recommend using methionine to acidify the urine in patients with alkaline urine and recurrent calcium phosphate nephrolithiasis?
1 Answer 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
Are there instances when you recommend using sevelamer for patients with recurrent calcium phosphate nephrolithiasis?
1 Answer 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
Do you use terlipressin for patients with hepatorenal syndrome who also have elevated blood pressures?
1 Answer available
How do you adjust your management strategy to address the unique needs of anuric end-stage kidney disease patients when treating diabetic ketoacidosis?
1 Answer 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
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?
2 Answers available
Would you recommend starting an SGLT2 inhibitor in a proteinuric CKD patient with chronic asymptomatic bacteriuria?
2 Answers available
How do you adjust the loading and maintenance doses for Keppra when treating status epilepticus in patients with ESRD, patients on HD, or patients on CVVH?
2 Answers available
What drives you to choose voclospsorin over tacrolimus given the substantially higher cost?
2 Answers available
Would you recommend against starting SGLT2 inhibitors in patients with a history of struvite nephrolithiasis who also have proteinuria and chronic kidney disease?
1 Answer 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 reduce the potassium citrate dose for patients with recurrent calcium oxalate nephrolithiasis who are started on the medication but experience persistently elevated urinary pH levels above 7.0?
1 Answer available
What is your approach to ESA use in patients with ESKD and active malignancy on treatment?
2 Answers available
Do you prefer cinacalcet or etelcalcetide for patients with hyperparathyroidism in the setting of kidney disease?
3 Answers available
Do you avoid potassium citrate due to concerns with increasing the urine pH in patients with recurrent struvite nephrolithiasis who also have hypocitraturia?
1 Answer available
In a patient with acute stroke/ICH/SDH/hyperammonemia at risk for rebound edema with new onset renal failure, do you prefer CRRT versus low and slow HD? How frequently do you monitor osmolarity?
1 Answer available
Do you have patients with recurrent calcium oxalate kidney stones stop taking supplements containing vitamin C if their 24 hour urine oxalate excretion is normal?
2 Answers available
Would you recommend initially starting twice-weekly outpatient hemodialysis with close lab monitoring for nonoliguric AKI patients?
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 hospitalize patients with newly diagnosed lupus nephritis and nephrotic syndrome if you are able to provide pulse steroids outpatient and follow them closely?
 When do you decide to hospitalize?
1 Answer available
Do you require lupus patients with ESKD or advanced CKD to be on minimal immunosuppression around the time of kidney transplantation?
1 Answer available
Do you recommend stopping a SGLT2i indefinitely if a patient with chronic kidney disease and diabetes develops euglycemic diabetic ketoacidosis?
1 Answer 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
What is your approach to managing patients with recurrent nephrolithiasis and nephrocalcinosis in the setting of hypoparathyroidism?
1 Answer 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
For a patient with idiopathic hypercalciuria and a history of calcium kidney stones who has not normalized 24-hr urine calcium level on thiazide diuretic, is there evidence for targeting a certain urine calcium level for decreased future risk of nephrolithiasis and osteoporosis?
2 Answers available
Do you prefer telmisartan over other ARBs given its longer half life elimination?
2 Answers available
What is your approach to lab and imaging monitoring in a patient with an elevated creatinine following a unilateral nephrectomy?
3 Answers available
What is your preferred fill volume, dialysis solution, and dwell time for patients with suspected peritoneal dialysis associated peritonitis who arrive to the hospital with a dry abdomen?
2 Answers available
Do you prefer assessing cystatin C or creatinine when monitoring a patient’s eGFR who is receiving chemotherapy for malignancy?
1 Answer available
Do you recommend initiating a potassium sparing diuretic in patients with recurrent nephrolithiasis who have hypercalciuria but do not tolerate thiazide diuretics?
1 Answer available
Do you recommend dietary protein restriction in your patients with chronic kidney disease?
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
Do you prefer sodium bicarbonate or sodium citrate in your chronic kidney disease patients with metabolic acidosis?
1 Answer available
Should GLP1 R agonists be used as first line glucose lowering agents in patients with ESKD and DM2?
1 Answer available
Is there a BMI cutoff for which you no longer recommend kidney transplantation in a patient with end stage kidney disease and obesity?
3 Answers available
How would you approach the management of a new SLE patient presenting with lupus podocytopathy with FSGS and severe proteinuria (Pr/Cr 18) without immune complex deposition?
2 Answers 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 reducing the dialysate sodium concentration to 135 meq/L as a strategy to decrease interdialytic weight gain in a hypervolemic ESKD patient?
Miskulin, et al., PMID 38349776
1 Answer available
Do you recommend stopping triamterene in patients with recurrent kidney stones who have stone composition results consistent with calcium based stone disease?
1 Answer 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
What sort of telehealth approaches do you pursue for a newly diagnosed end stage kidney disease patient starting peritoneal dialysis or home hemodialysis?
1 Answer available
What is your approach for patients with recurrent nephrolithiasis who require daily use of acetazolamide for management of an unrelated chronic condition?
1 Answer available
Do you rule out active urinary tract infections prior to performing a kidney biopsy?
2 Answers available
Do you use a phosphate binder to manage inpatient hyperphosphatemia in patients with AKI who have no history of CKD?
5 Answers 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
Would you recommend a TIPS procedure in the management of hepatorenal syndrome for a patient with no history of hepatic encephalopathy?
1 Answer available
Is there any way to safely treat patients with mCRPC with 177-Lu PSMA who are on hemodialysis?
2 Answers available
How long do you wait to repeat a 24 hour urine stone risk study after stopping topiramate in patient with recurrent calcium based kidney stones attributed to the medication?
1 Answer 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
Is there a role for 24 hour urine stone risk profiles in your patients with known recurrent struvite kidney stones?
1 Answer available
Do you obtain spot urine protein or 24 hour urine protein quantification studies in pregnant patients who are found to have proteinuria on a standard urinalysis test?
1 Answer available
What is your blood pressure threshold to hold an ESA for patients with ESKD, anemia, and hypertension?
2 Answers available
Are you offering GLP-1 agonists to patients with CKD and diabetes mellitus?
4 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
How do you determine duration of therapy for patients who have responded well to voclosporin therapy?
How do you monitor response and what do you consider a satisfactory response? Do you aim for a certain threshold of proteinuria?
3 Answers available
How often do you monitor plasma oxalate levels for patients with ESKD secondary to primary hyperoxaluria who are on hemodialysis and receiving lumasiran?
1 Answer available
When would you administer the next maintenance dose of rituximab in a patient with ANCA glomerulonephritis who last received an infusion six months ago and has low immunoglobulin levels and an undetectable CD-19 cell count?
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 PTH target for patients with ESKD and brown tumor?
2 Answers available
Do you recommend careful correction of serum sodium to avoid osmotic demyelination syndrome in patients who are found to have isoosmolar hyponatremia in the setting of an elevated BUN level?
2 Answers available
What advice do you offer to patients with recurrent nephrolithiasis who are on a tube feeding diet and seeking stone prevention guidance?
2 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
How do you approach discussing the pill burden of voclosporin with patients who already have to take a regimen such as MMF+HCQ+ACEi and possibly more?
2 Answers available
What is your approach to patients with recurrent nephrolithiasis and hypercalciuria who take daily calcium supplements?
1 Answer available
What is your approach to managing intradialytic cramping that recurs despite multiple dry weight adjustments in a patient with ESKD?
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 consider Randall's plaque as a form of nephrocalcinosis necessitating genetic testing for monogenic kidney stone disorders?
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
Do you take any special approaches with patients with recurrent nephrolithiasis who first developed stones prior to adulthood but have negative kidney stone disorder genetic test findings?
1 Answer available
What is your approach to prednisone use in a kidney transplant recipient with allograft failure, residual allograft function, and an ongoing dialysis requirement for more than one year?
2 Answers available
Will you use vadadustat in place of an ESA in treating anemia of chronic kidney disease?
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 is your approach to patients with recurrent nephrolithiasis and hypercalciuria who are unable to tolerate thiazide diuretics due to hyperglycemia?
1 Answer available
Would you recommend initiating a SGLT2i for proteinuria secondary to bevacizumab in a patient who has a sub-optimal response to an ACEi or ARB?
2 Answers 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 decide between CT and ultrasound imaging tests for surveillance imaging for patients with recurrent nephrolithiasis?
1 Answer available
Do you periodically check a urine culture for patients without dysuria but who have a history of struvite kidney stones and urinary tract infections with urease producing organisms?
1 Answer available
What is your approach to anticoagulation in a patient with AKI and cirrhosis who has frequent filter clotting on CRRT?
2 Answers available
Do you start patients on a B complex multivitamin if they are on CRRT and have not previous been on renal replacement therapy?
1 Answer available
Do you recommend automatically starting CRRT anticoagulation when initiating CRRT if there are no medical contraindications to anticoagulation?
1 Answer available
How do you choose between spironolactone and finerenone for patients with proteinuric diabetic kidney disease and heart failure?
2 Answers available
Do you routinely perform in-office urine microscopy for your patients with recurrent nephrolithiasis?
1 Answer available
What are some considerations to make when managing patients with recurrent nephrolithiasis who are found to have nephrocalcinosis on imaging?
2 Answers available
Do you prefer celecoxib over a nonselective NSAID in patients with chronic kidney disease?
4 Answers available
Do you recommend antibiotic prophylaxis for an ESKD patient with a tunneled dialysis catheter who is planned for a dental procedure?
2 Answers available
How do you choose between eculizumab and ravulizumab for patients with acute kidney injury from complement mediated thrombotic microangiopathy?
1 Answer available
How frequently do you recommend skin cancer screens in your patients with kidney transplants who are on immunosuppression?
3 Answers available
Is there a subset of ANCA vasculitis patients for which you would try plasma exchange?
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
What is your approach to safely performing hemodialysis in a patient with a fistula who is hospitalized for altered mental status and unable to remain still?
1 Answer available
How frequently do you monitor anti-PLA2R antibody titers in patients with stable renal function/proteinuria and a past diagnosis of PLA2R-associated membranous nephropathy?
1 Answer 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
Do you recommend obtaining a DEXA scan for patients with recurrent nephrolithiasis and hypercalciuria of unknown etiology?
2 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
What is the role of APOL1 genotyping in the evaluation of a living kidney donor?
1 Answer available
Do you routinely prescribe acetazolamide for patients with cystinuria who do not have significant urinary alkalinization or are intolerant to citrate therapy?
1 Answer available
In which patients with non-proteinuric chronic kidney disease would you initiate a SGLT2i?
3 Answers available
Do you initiate peritoneal dialysis with an incremental strategy to ease patients into their treatment, even though it might lead to frequent lab monitoring and the risk of underdialysis?
Auguste & Bargman, PMID 36208963
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
What is your plasma oxalate target when treating patients with lumasiran for end stage kidney disease secondary to primary hyperoxaluria type 1?
1 Answer available
What is your approach to differentiating diabetes insipidus from primary polydipsia in the outpatient setting?
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
In patients with hypertension and suspected primary aldosteronism who have undergone negative confirmatory testing, what follow-up and monitoring strategies would you recommend to ensure early detection of potential aldosteronism?
1 Answer available
What is your approach to determining which patients with ESKD and pruritis should be started on difelikefalin?
2 Answers available
Do you routinely check a TSH level in patients with recurrent kidney stones who have hypercalciuria of unknown cause?
1 Answer 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
Would you offer adjuvant immunotherapy in a patient with high risk RCC with new/worsening post-op renal dysfunction and CrCl<30?
KEYNOTE-564 required CrCl 30 or above. Not having a baseline/stable CrCl may make it difficult to diagnose or treat IO nephritis. 
1 Answer available
What are your strategies for safely prescribing peritoneal dialysis for patients who have pets at home?
4 Answers available
Would you consider a BRCA carrier patient for kidney transplantation?
5 Answers available
What is your approach to recurrent uric acid stone formers who have a persistently acidic urine pH and are unable to tolerate potassium citrate?
1 Answer available
Do you have your patients with recurrent nephrolithiasis stop supplements such as turmeric?
1 Answer available
Has your management of severe hyponatremia changed after a recent observational study described higher in-hospital mortality for sodium correction of <6 mEq/L compared to 6-10 mEq/L in the first 24 hours?
Seethapathy et al., NEJM
5 Answers available
How often do you check carnitine levels in your patients with end stage kidney disease on hemodialysis?
2 Answers available
How long do you continue PJP prophylaxis in a patient with GPA who is able to wean steroids and remains only on rituximab for maintenance therapy?
1 Answer available
What is your approach to managing osteoporosis in patients with end stage kidney disease?
1 Answer available
Do you recommend taking any unique approaches to managing patients with persistent hypertension following bilateral renal artery stenting?
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
What is your approach to management of recurrent nephrolithiasis in patients with mixed composition uric acid and calcium phosphate stones?
3 Answers available
Would you prescribe a thiazide diuretic for patients with recurrent nephrolithiasis attributed to hypercalciuria in the setting of excess dietary sodium or animal protein intake who fail or are unwilling to adhere to recommended dietary changes?
1 Answer 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
Do you make adjustments to the immunosuppressive regimen for kidney transplant recipients on tacrolimus who develop posterior reversible encephalopathy syndrome (PRES)?
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 prefer a mycophenolate or tacrolimus based glucocorticoid-sparing regimen for patients with minimal change disease?
2 Answers available
Under what circumstances do you recommend targeting a systolic blood pressure of less than 120 mmHg in a patient with CKD?
2 Answers available
How do you approach the decision to use terlipressin in a patient with hepatorenal syndrome type 1, AKI, and a history of heart failure given its potential cardiovascular effects?
1 Answer available
How has the introduction of lumasiran affected the need for combined liver and kidney transplantation in patients with ESKD related to primary hyperoxaluria type 1?
2 Answers available
Do you recommend a kidney biopsy for patients who develop acute kidney injury after starting sacituzumab?
1 Answer 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 bedtime administration of antihypertensives in patients who exhibit nondipping on ambulatory blood pressure monitoring?
3 Answers 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
How do you manage patients blood pressures while on anti-angiogenic TKIs?
Do you insist on ambulatory/home blood pressures to rule in/out white coat hypertension? Does your practice have a system to log patients' BPs to supp...
1 Answer available
What is the optimal approach to treat isolated diastolic hypertension?
1 Answer available
Do you recommend increasing dietary potassium intake for blood pressure management in non-CKD patients with hypertension?
1 Answer available
Are there other therapies such as SGLT2 inhibitors or alpha lipoic acid that you are offering your patients with cystinuria who continue to have active stone disease despite conservative therapy and thiol-based agents?
1 Answer available
Do you use acetazolamide to aid diuresis in patients with acute on chronic respiratory acidosis with significantly elevated serum bicarbonate levels?
3 Answers available
Do you recommend giving IV albumin with furosemide to augment diuresis in a patient with hypoalbuminemia and volume overload?
1 Answer available
What are your management strategies for acute kidney injury attributed to pembrolizumab in patients with a kidney biopsy showing predominately acute tubular injury?
2 Answers available
What are your next steps for managing biopsy-proven interstitial nephritis from checkpoint inhibitors in patients who do not have a response to prednisone?
3 Answers available
Do you increase the frequency of hemodialysis for patients with calciphylaxis?
3 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
Would you consider using finerenone for proteinuric CKD associated with type 1 diabetes mellitus?
3 Answers available
What is your approach to nephrology referral for patients with lupus nephritis?
Do you refer all patients with suspected LN, patients with confirmed LN, or patients with specific features (not responding to usual therapy, certain ...
3 Answers available
Do you pursue a skin biopsy or kidney biopsy in patients whom you suspect have X-linked Alport syndrome?
2 Answers available
Do you routinely use 3% sodium chloride and desmopressin to correct hypovolemic hyponatremia in an asymptomatic patient with serum sodium of less than 120 mEq/L?
3 Answers available
What considerations do you take when managing a patient with end stage kidney disease on peritoneal dialysis who is planning on undergoing PEG tube placement?
1 Answer available
What are your management strategies for patients with end stage kidney disease on hemodialysis who develop hypercalcemia of immobility?
1 Answer available
Would you recommend starting an SGLT2i in a patient with a kidney transplant and moderately increased albuminuria?
2 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
What approaches do you take for your patients with nephrolithiasis who undergo intermittent fasting for cultural, religious, or personal reasons?
1 Answer 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
Is there a role for SGLT-2 inhibitors in the treatment of chronic hypomagnesemia?
1 Answer available
What is the current recommendation for using thiazide diuretics in patients with calcium oxalate stone disease, given the negative results of the NOSTONE trial?
4 Answers available
For patients on CRRT with worsening hyperkalemia despite high replacement fluid rate using a 0 mEq/L potassium bath, do recommend using an additional CRRT machine with separate dialysis access for improved clearance?
3 Answers available
In which patients with MGUS do you recommend a kidney biopsy to evaluate for MGRS?
2 Answers 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 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 assess the kidney tissue under a microscope following a kidney biopsy to determine the quality of the specimen obtained and if additional tissue is needed?
3 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 monitoring for recovery in a patient with non-oliguric AKI requiring dialysis?
4 Answers 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
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
In which patients with suspected IgA nephropathy and microalbuminuria would you recommend a kidney biopsy?
1 Answer available
What is your daily correction goal for those patients being treated for hypernatremia?
2 Answers available
Between mean arterial pressure (MAP) and blood pressure (BP), which do you use when prescribing hemodialysis to instruct a hold on additional ultrafiltration should the value become too low?
1 Answer available
How do you advise an ESKD patient who wants to drink pickle juice to reduce intradialytic muscle cramps?
3 Answers 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
Does your treatment strategy differ when managing patients with recurrent calcium oxalate monohydrate versus calcium oxalate dihydrate stones?
2 Answers available
Would you feel comfortable adding benlysta to patient already taking both mycophenolate and tacrolimus (and hydroxychloroquine) who still has some evidence of active lupus nephritis?
3 Answers available
How do you advise patients with recurrent nephrolithiasis who also have chronic mild hyponatremia for which they limit daily fluid intake?
1 Answer available
Do you intensify the dialysis prescription for patients with end stage kidney disease who develop uremic pericarditis despite regular dialysis sessions?
3 Answers 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
Are there patients with recurrent nephrolithiasis for who you recommend magnesium supplementation to reduce stone risk?
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
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 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
How long do you wait before reassessing a 24 hour urine calcium level in patients with recurrent nephrolithiasis, hypercalciuria, and osteoporosis who are initiated on bisphosphonate therapy?
3 Answers available
Is there benefit to performing CVVH instead of intermittent hemodialysis for a patient with AKI secondary to rhabdomyolysis who requires renal replacement therapy?
1 Answer available
Are there any special considerations when treating patients with recurrent nephrolithiasis who also have medullary sponge kidney?
1 Answer 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
Do you recommend preloading with IV magnesium to decrease the risk of cisplatin nephrotoxicity?
3 Answers available
For which patients with calciphylaxis would you recommend a parathyroidectomy?
3 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
How often do you check urine osmolality and urine electrolytes when treating hospitalized patients with hyponatremia?
2 Answers available
How do you manage unintended hypercalciuria that results from an increase in dietary calcium intake as recommended to patients with recurrent calcium oxalate nephrolithiasis attributed to enteric hyperoxaluria?
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
What is your approach to managing patients with recurrent nephrolithiasis who have 24 hour urine chemistry results that demonstrate low risk for stone formation but continue to experience stone events?
1 Answer available
How do you manage hemodialysis for an ESKD patient presenting with severe hyponatremia and a serum sodium more than 10 mEq/L below the lowest available dialysate sodium concentration?
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
Are there any instances when you use vitamin B6 to prevent kidney stones in patients with recurrent calcium oxalate nephrolithiasis who do not have primary hyperoxaluria?
1 Answer 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
What is your approach to managing patients with recurrent ammonium urate kidney stones?
1 Answer 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
How do you approach a patient with biochemical evidence of primary hyperparathyroidism, but normal parathyroid scan?
4 Answers available
Which medications do you recommend for lactating mothers with kidney disease and proteinuria that persists post-delivery?
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 is your approach for a kidney transplant patient who develops proteinuria after everolimus initiation?
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
What are some measures to prevent flares of loin pain-hematuria syndrome?
1 Answer available
In patients with intrinsic acute kidney injury of unknown etiology and with pending kidney biopsy results, are there instances when you would recommend a trial of glucocorticoids?
1 Answer 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
Do you stop activated vitamin D (ie paricalcitol) in your dialysis patients who have hyperphosphatemia despite low phosphate diet and phosphorus binder adherence?
1 Answer available
How soon after an intervention is done for peritoneal catheter inflow or outflow obstruction is it advisable to repeat the Kt/V?
Invited Professor Series Video: Volume Management and Access Troubleshooting in Peritoneal Dialysis - Claretha Lyas, MD
1 Answer available
How long would you wait for outflow to improve before consulting surgery in a peritoneal dialysis patient with an outflow obstruction who is prescribed laxatives for catheter migration?
Invited Professor Series Video: Volume Management and Access Troubleshooting in Peritoneal Dialysis - Claretha Lyas, MD
1 Answer available
How do you determine the fill volume of icodextrin for a volume-overloaded ESKD on PD patient considering that the dwell may last throughout the day?
Invited Professor Series Video: Volume Management and Access Troubleshooting in Peritoneal Dialysis - Claretha Lyas, MD
1 Answer 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
Is there a role for eculizumab in the management of refractory lupus nephritis?
3 Answers available
Which patients do you recommend referral to interventional radiology to perform a kidney biopsy?
1 Answer available
Do you think there would be benefit in using sparsentan over irbesartan for FSGS given a higher percentage of patients with partial remission of proteinuria on sparsentan despite no significant difference in eGFR slope in the DUPLEX Trial?
PMID 37921461
2 Answers available
What are the factors that you would consider for the use of ESA in patients with anemia of CKD with a history of stroke or TIA?
1 Answer available
Do you consider starting hydroxyurea in a patient with hemoglobin S-beta thalassemia with chronic kidney disease secondary to FSGS?
No transfusion dependence but has hemoglobin in the 8-9 g/dl range.
1 Answer available
For patients with nephrolithiasis and hypercalciuria attributed to a parathyroid adenoma, how long after a partial parathyroidectomy do you assess for improvement in 24-hour urine calcium levels?
2 Answers 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
How do you manage vitamin D dosing in patients with nephrolithiasis and hypercalciuria who require supplemental vitamin D for treating other medical conditions?
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
How is monoclonal gammopathy of renal significance (MGRS) different from myeloma kidney?
If there are light chain deposits on the kidney, is that conclusive of MGRS?
1 Answer available
What are some considerations to make when managing a patient on peritoneal dialysis who develops acute pancreatitis?
1 Answer available
What are your top takeaways from ASN 2023?
2 Answers 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 the minimum eGFR at which we should avoid initiating SGLT2i therapy?
1 Answer available
What is your approach between choosing lumasiran or nedosiran for patients with primary hyperoxaluria type 1?
2 Answers available
What is your approach to achieving hypernatremia in a patient on CRRT for whom increasing the rate of a post-filter 3% sodium chloride infusion is insufficient?
2 Answers available
Are there instances when you do not recommend tunneled dialysis catheter exchange in patients on hemodialysis who are found to have bacteremia?
2 Answers available
How do you approach prevention of kidney stones in patients with an ileal diversion and recurrent nephrolithiasis?
1 Answer available
Do you recommend checking urine sodium 2 hours after loop diuretic administration to determine the need for dose adjustment in a patient with acute decompensated heart failure?
1 Answer available
What strategies have you used to help patients with advanced kidney disease who are asymptomatic understand the severity of their condition?
3 Answers available
Do you recommend performing cognitive testing in the clinic to determine the blood pressure target in patients 80 years or older?
1 Answer available
Would you recommend complement testing in a kidney transplant recipient with chronic antibody-mediated rejection and biopsy-proven thrombotic microangiopathy to determine the need for eculizumab?
1 Answer available
What is your mmHg threshold to cancel a kidney biopsy for patients with pre-procedural elevated blood pressures?
1 Answer available
Are there instances when you recommend obtaining more than 2 kidney cores when performing a native kidney biopsy?
2 Answers available
Would you wait a period of time before collecting a 24 hour urine stone risk study in a patient with nephrolithiasis who recently underwent a urologic stone removal procedure?
1 Answer available
Do you recommend performing surveillance kidney allograft biopsies in your asymptomatic kidney transplant recipients?
3 Answers available
For a patient interested in home dialysis modalities, what are some key points that you discuss with them to help them make a decision on peritoneal dialysis versus home hemodialysis?
1 Answer available
Do you avoid losartan in patients with hypertension and uric acid nephrolithiasis due to the drugs uricosuric effects?
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
Is there a platelet count threshold when you would avoid performing a kidney biopsy in patients with thrombocytopenia?
1 Answer 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 recommend ligation of a functional arteriovenous fistula after kidney transplantation?
2 Answers 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
Is there a role for a kidney biopsy in patients diagnosed with Fabry disease through genetic testing?
2 Answers available
Do you recommend holding metformin in a patient with chronic kidney disease who has an upcoming CT contrast study?
3 Answers 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 is your approach to a living kidney donor evaluation for a patient with normal kidney function who wishes to donate to their monozygotic twin who has ESKD due to an autoimmune disorder?
1 Answer available
What is your preferred intravenous fluid type for matching volume loss in a patient with persistent surgical drain output and pre-renal acute kidney injury?
1 Answer 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
How do you approach “clearing” a patient with SLE and ESRD for renal transplant?
A specific example would be a clinically quiescent but serologically active patient.
1 Answer available
Do you use mannitol when initiating patients on intermittent hemodialysis?
1 Answer available
Do you recommend obtaining 24 hour urine ammonium levels in patients with recurrent uric acid nephrolithiasis?
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
Are there instances when you use erythropoietin stimulating agents in patients with acute kidney injury requiring dialysis?
2 Answers available
What is your approach to thiazide diuretic use in those with uncontrolled hypertension and advanced chronic kidney disease?
2 Answers available
Would you recommend proceeding with a kidney biopsy for patients' with Waldenström's macroglobulinemia who have hematuria and normal kidney function?
2 Answers available
Would you consider a patient with spina bifida and end stage kidney disease secondary to reflux nephritis with an ileal conduit for a kidney transplant?
2 Answers 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
What is a reasonable blood pressure goal for refractory HTN in the geriatric population?
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
What criteria do you use, if any, to recommend statin therapy for patients with polycystic kidney disease?
1 Answer available
Would you perform dialysis on a patient with altered mental status in the setting of an elevated blood urea nitrogen level attributed to a tube feeding diet?
1 Answer available
Do you hold CRRT for a period of time before performing a diuretic challenge in a patient with whom you are assessing for the ability to wean off of continuous dialysis?
2 Answers available
Do you recommend dietary changes to your patients with recurrent kidney stone disease who consume coffee and low oxalate teas daily?
3 Answers 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
What is the next best anti-hypertensive medication to start after mineralocorticoid receptor antagonists in patients with primary aldosteronism?
1 Answer available
Would you consider adding an SGLT2 inhibitor to augment diuresis in patients with worsening renal function presenting with acute decompensated heart failure and AKI on CKD?
1 Answer 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
Do you recommend using doses of ACEi or ARBs that is above the usual dosing with the goal of reducing a patient's proteinuria further?
1 Answer available
What adjustments do you make to a hemodialysis prescription for a patient with a recent stroke?
3 Answers 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
Do you recommend switching to a non-dihydropyridine calcium channel blocker with the goal of decreasing proteinuria in a proteinuric, hypertensive CKD patient already on a dihydropyridine calcium channel blocker?
1 Answer available
Do you recommend using dextrose based solutions to induce osmotic diuresis for euvolemic patients with acute kidney injury in the setting of a hemolytic condition?
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
How would you manage a patient with recurrent calcium phosphate nephrolithiasis who has hypercalciuria, hypocitraturia, and a urine pH greater than 6.3?
1 Answer available
For which patients do you prioritize ambulatory blood pressure monitoring over self-measured blood pressure?
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 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 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
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
What is your approach to patients with membranous glomerulonephritis who have persistently elevated PLA2R titers but largely improved proteinuria and creatinine?
1 Answer available
Would you perform plasmapheresis for an ABO-incompatible kidney transplant recipient who has titers of 1:16 and a stable creatinine 3 months post-transplant?
2 Answers available
Does your goal rate of correction in patients with chronic hypoosmolar hyponatremia differ based on the degree of hypoosmolarity?
4 Answers available
How long do you continue a thiazide diuretic in a patient with nephrolithiasis and hypercalciuria who achieves normalization of urinary calcium excretion following therapy initiation?
2 Answers available
How frequently do you monitor urine protein levels in a patient receiving bevacizumab who develops proteinuria of less than 2 grams per day?
2 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
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 targeting a higher Kt/V in an ESKD patient on hemodialysis with pruritis and a Kt/V of 1.4?
1 Answer available
What is your approach to inpatient immunosuppression for a kidney transplant patient on home tacrolimus, prednisone, and mycophenolic acid who cannot tolerate anything by mouth?
2 Answers 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
How often do you monitor labs such as complete blood count, liver function panel, and urine protein in a patient with cystinuria receiving tiopronin?
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
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
What is your preferred therapy to raise urinary citrate in a patient with recurrent calcium based stone disease and hypocitraturia?
1 Answer available
How much decrease in eGFR do you tolerate before discontinuing finerenone started in patients with diabetic kidney disease?
2 Answers 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 performing a kidney biopsy in patients with suspected ifosfamide nephrotoxicity?
1 Answer available
Do you recommend holding cinacalcet after kidney transplantation and monitoring PTH levels before restarting it?
If so, how long would you monitor PTH levels?
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
When do you deem it reasonable to transition outpatient management of a kidney transplant patient to general nephrology?
1 Answer available
What is your approach to elevated urine uric acid levels in a recurrent calcium based stone former?
2 Answers available
How do you approach treating mild hypercalcemia in patients with sarcoidosis?
1 Answer available
Do you use 24 hour urine stone risk profiles for purposes other than managing nephrolithiasis?
2 Answers available
Do you recommend obtaining one or two 24-hour urine stone risk profile(s) when evaluating patients with nephrolithiasis?
Parks et al., PMID 11912373
3 Answers available
Do you recommend starting aspirin for a patient with ESKD secondary to lupus nephritis with detected antiphospholipid antibodies on pretransplant workup but no history of a thrombotic event?
3 Answers available
In what instances might you recommend twice daily 7.5% icodextrin to patients on peritoneal dialysis?
1 Answer available
How would you manage tubulointerstitial nephritis and renal tubular acidosis (RTA) in a patient with Sjogren's who is pregnant?
2 Answers available
Have you encountered acute kidney injury after starting eltrombopag for aplastic anemia as part of triple immunosuppressive regimen with ATG and cyclosporine?
1 Answer available
How do you approach COVID-19 vaccination in those with a prior history of glomerular 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
When would you recommend adding peritoneal dialysis to a patient with oxalosis who is already receiving hemodialysis?
1 Answer available
Would you recommend initiating RRT in a patient with tumor lysis syndrome and a phosphorus of 9 mg/dl or more who does not have symptomatic hypocalcemia or other indications for dialysis?
1 Answer available
Would you recommend transition to hemodialysis for a patient with calciphylaxis, hyperphosphatemia, and ESKD on peritoneal dialysis?
2 Answers available
Do you recommend stopping Vitamin D supplementation in a patient with hypercalcemia and a low 25(OH)D level?
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
What considerations do you make to the dialysis prescription for a pregnant patient on peritoneal dialysis?
1 Answer available
Would you add an SGLT2 inhibitor to augment diuresis during a hospitalization in a patient with nephrotic syndrome, an eGFR above 30 mL/min/1.73m2, and refractory hypervolemia on an intravenous loop diuretic?
1 Answer 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
Should CAR-T therapy be considered for a kidney transplant patient with refractory PTLD?
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 use tolvaptan for management of hyponatremia related to heart failure given the side effect profile and lack of mortality benefit seen in a previous trial?
The EVEREST Outcome trial (Konstam et al., PMID 17384437)
1 Answer available
What is your blood pressure goal for a pregnant patient on hemodialysis?
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
Do you recommend initiating an ACE inhibitor or ARB in a patient with proteinuric CKD Stage 5?
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
What changes in AV access flows measured during hemodialysis would prompt you to refer for an angiogram?
1 Answer available
What is your approach to the use of desmopressin prior to performing a kidney biopsy to potentially prevent procedural associated bleeding?
1 Answer available
What is your approach to the use of intravenous sodium thiosulfate for the management of calciphylaxis in a patient with end stage kidney disease and on hemodialysis?
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
How would you manage a patient with osteoporosis on denosumab who develops significant renal insufficiency where it is difficult to continue denosumab due to increased risk of hypocalcemia (i.e. eGFR in the low 20’s)?
1 Answer available
Do you recommend testing for G6PD deficiency in those with whom rasburicase for tumor lysis syndrome is indicated?
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
How would you manage hemodialysis for an ESKD patient who presents with a phosphorus of 1.6 mg/dl and potassium of 6.5 mEq/L without ECG changes?
1 Answer available
Do you proceed with outpatient hemodialysis for an asymptomatic ESKD patient who has missed the last three hemodialysis sessions?
1 Answer available
What is your blood pressure goal for the first three months after kidney transplantation?
2 Answers available
Do you prefer that hospitalized peritoneal dialysis patients use their own home dialysis equipment during the admission?
2 Answers available
Do you recommend retreatment with an immune checkpoint inhibitor in a patient with a history of immune checkpoint inhibitor-related AKI that resolved with holding the immune checkpoint inhibitor and a glucocorticoid taper?
3 Answers 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
Do you give a short-acting antihypertensive before starting outpatient hemodialysis on an asymptomatic ESKD patient with a predialysis blood pressure of more than 200/100?
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
What do you use to treat a kidney transplant patient with progressive BK nephropathy despite a maximal decrease in immunosuppression for months?
1 Answer available
Do you treat low 25-OH vitamin D levels in those with end stage kidney disease?
1 Answer available
How do you manage anticoagulation bridging for outpatient ESKD patients given concerns for bleeding risk with enoxaparin in this population?
Would you bridge with enoxaparin 0.7 mg/kg/day in an ESKD patient, as described in a previous retrospective study (Pon et al., PMID: 24718051)?
1 Answer available
How would you manage a patient with stable axial spondyloarthritis who develops newly active IgA nephropathy?
Is there a role for immunosuppressive medications such as TNF inhibitors in the management of IgA nephropathy in this setting?
2 Answers available
How do you approach COVID-19 vaccination in those who underwent kidney transplantation for native kidney glomerular disease?
1 Answer available
When is a kidney biopsy warranted in a patient with possible scleroderma renal crisis?
1 Answer available
Do you routinely advise patients waiting for a kidney transplant to seek referrals at multiple institutions to decrease waiting time?
1 Answer available
Do you use both rituximab and plasmapheresis in patients with recurrent primary FSGS within three months of kidney transplantation?
1 Answer available
Under what conditions do you perform a post-procedural kidney ultrasound in patients who recently underwent a kidney biopsy?
1 Answer available
Do you require patients who undergo a kidney biopsy to be admitted to the hospital for observation?
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
How do you advise your kidney stone patients about optimal daily fluid intake?
1 Answer available
Do you advise patients to limit physical exertion including lifting heavy objects following a kidney biopsy?
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
What degree of hyperkalemia do you tolerate for those with proteinuric chronic kidney disease and persistently elevated serum potassium levels?
1 Answer available
What is your approach to managing hypocalcemia following a parathyroidectomy in patients with end stage kidney disease?
1 Answer available
When do you restart ACEi/ARB medications for patients whom these medications were previously discontinued due to acute kidney injury?
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
How frequently do you obtain 24 hour urine stone risk profiles in your patients with kidney stone disease who pass less than one stone per year?
1 Answer available
How do you estimate daily dietary sodium intake in your patients with hypertension?
1 Answer available
In which patients do you obtain genetic testing for further evaluation of kidney stone disease?
1 Answer available
What dietary advice do you provide your patients with calcium oxalate nephrolithiasis?
1 Answer available
What do you use for treatment induction in pure class V lupus nephritis with nephrotic-range proteinuria when MMF is contraindicated?
2 Answers 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
How would you manage immune check point inhibitor induced capillary leak syndrome refractory to IVIG monotherapy?
1 Answer available
How do you use colchicine for gout in patients with chronic kidney disease or end-stage renal disease on hemodialysis?
2 Answers available
Would you consider clearing a patient with essential thrombocytosis for a kidney donation?
1 Answer available
Is peritoneal dialysis a contraindication to pelvic radiotherapy?
What are the expected outcomes if you were to irradiate the pelvis in someone on peritoneal dialysis? 
2 Answers 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 monitor a patient with scleroderma during pregnancy?
1 Answer available
What is your treatment algorithm for management of retroperitoneal fibrosis that does not respond to high-dose glucocorticoids?
1 Answer available
What is your approach to using NIH activity and chronicity indices from renal biopsy in tailoring immunosuppression to a patient with new lupus nephritis?
3 Answers 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
What is your preferred first line regimen for myeloma with severe renal impairment, either on or off dialysis?
1 Answer 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 use of endothelin receptor antagonists in patients with scleroderma renal crisis and hypertension refractory to maximum ACE inhibition and calcium channel blockers?
1 Answer available
How do you approach the management of immunosuppression in patients with lupus nephritis that go on to dialysis?
3 Answers available
How do you approach prophylaxis against glucocorticoid-induced osteoporosis in patients with end-stage renal disease on dialysis?
1 Answer 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
Do you eventually stop urate-lowering therapy in gout patients with CKD who start hemodialysis?
1 Answer available
How do you manage calcium and vitamin D supplementation in patients with sarcoidosis on chronic steroids?
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

N Engl J Med, 2020 Feb 13
Plasma Exchange and Glucocorticoids in Severe ANCA-Associated Vasculitis.
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).
Kidney international, 2019-01
A randomized, controlled double-blind study comparing the efficacy and safety of dose-ranging voclosporin with placebo in achieving remission in patients with active lupus nephritis.
N Engl J Med,
Two-Year, Randomized, Controlled Trial of Belimumab in Lupus Nephritis.
Clinical journal of the American Society of Nephrology : CJASN, 2008-01
Value of a complete or partial remission in severe lupus nephritis.
Lancet, 2021 May 07
Efficacy and safety of voclosporin versus placebo for lupus nephritis (AURORA 1): a double-blind, randomised, multicentre, placebo-controlled, phase 3 trial.
Lancet (London, England), 2011 Feb 04
Efficacy and safety of belimumab in patients with active systemic lupus erythematosus: a randomised, placebo-controlled, phase 3 trial.
Arthritis & rheumatology (Hoboken, N.J.), 2023 Jul 19
Safety and Efficacy of Long-Term Voclosporin Treatment for Lupus Nephritis in the Phase 3 AURORA 2 Clinical Trial.
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.
Am J Kidney Dis, 2019 Aug 05
The Use of Erythropoiesis-Stimulating Agents in Patients With CKD and Cancer: A Clinical Approach.
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.
QJM, 2013 May 21
Targeting the endothelin axis in scleroderma renal crisis: rationale and feasibility.
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.
JAMA, 2016-06-28
Intensive vs Standard Blood Pressure Control and Cardiovascular Disease Outcomes in Adults Aged ≥75 Years: A Randomized Clinical Trial.
JAMA, 2019-02-12
Effect of Intensive vs Standard Blood Pressure Control on Probable Dementia: A Randomized Clinical Trial.
The American journal of medicine, 1983-09
Prognostic factors in lupus nephritis. Contribution of renal histologic data.
Arthritis care & research, 2011-06
Predicting outcomes of lupus nephritis with tubulointerstitial inflammation and scarring.
Kidney international, 2018-04
Revision of the International Society of Nephrology/Renal Pathology Society classification for lupus nephritis: clarification of definitions, and modified National Institutes of Health activity and chronicity indices.
Kidney Int, 2010 Feb 24
Tubulointerstitial lesions of patients with lupus nephritis classified by the 2003 International Society of Nephrology and Renal Pathology Society system.
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.
Semin Dial, 2010 May 10
Why dialysis patients need combination therapy with both cholecalciferol and a calcitriol analogs.
Perit Dial Int, 2022 Mar
ISPD peritonitis guideline recommendations: 2022 update on prevention and treatment.
Kidney Int Rep, 2021 Oct 06
COVID-19 Vaccination and Glomerulonephritis.
Kidney360, 2023 Mar 01
COVID-19 Vaccination and New Onset Glomerular Disease: Results from the IRocGN2 International Registry.
Kidney Int, 2022 Sep 10
Incidence of new onset glomerulonephritis after SARS-CoV-2 mRNA vaccination is not increased.
Kidney360, 2021 Dec 03
COVID-19 in Patients with Glomerular Disease: Follow-Up Results from the IRoc-GN International Registry.
Nephrol Dial Transplant, 2022 Jul 26
Perspective on COVID-19 vaccination in patients with immune-mediated kidney diseases: consensus statements from the ERA-IWG and EUVAS.
Clin Kidney J, 2021 Dec 21
Clinical spectrum of gross haematuria following SARS-CoV-2 vaccination with mRNA vaccines.
Clin Exp Nephrol, 2021 Nov 13
Gross hematuria after SARS-CoV-2 vaccination: questionnaire survey in Japan.
Kidney Int, 2021 Sep 14
COVID-19 vaccination followed by activation of glomerular diseases: does association equal causation?
J Am Soc Nephrol, 2022 Nov 04
A Population-Based Analysis of the Risk of Glomerular Disease Relapse after COVID-19 Vaccination.
J Am Soc Nephrol, 2020 Jul 17
Kidney Biopsy Findings in Patients with COVID-19.
Clinical transplantation, 2017-05
Kidney allograft surveillance biopsy practices across US transplant centers: A UNOS survey.
Transplantation proceedings, 2020 Jun 21
Kidney Graft Surveillance Biopsy Utilization and Trends: Results From a Survey of High-Volume Transplant Centers.
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.
Hypertension (Dallas, Tex. : 1979), 2017 Nov 13
2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.
The New England journal of medicine, 2021 Nov 05
Chlorthalidone for Hypertension in Advanced Chronic Kidney Disease.
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.
Kidney Int, 2002 Jul
Hyperkalemia: An adaptive response in chronic renal insufficiency.
Clinical journal of the American Society of Nephrology : CJASN, 2019-05-07
Rate of Correction of Hypernatremia and Health Outcomes in Critically Ill Patients.
Curr Opin Cell Biol, 1995 Aug
Cell volume regulated transporters of compatible osmolytes.
Journal of vascular and interventional radiology : JVIR, 2012 Apr 17
Consensus guidelines for periprocedural management of coagulation status and hemostasis risk in percutaneous image-guided interventions.
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.
Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2009-08
The value of post-biopsy ultrasound in predicting complications after percutaneous renal biopsy of native kidneys.
POCUS J, 2022 Feb 01
Point of Care Ultrasound in Monitoring of Post-Renal Biopsy Bleeding.
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.
Am J Transplant, 2021 Feb 23
Rituximab for recurrence of primary focal segmental glomerulosclerosis after kidney transplantation: Results of a nationwide study.
Transplantation, 2009 Aug 15
Use of rituximab in focal glomerulosclerosis relapses after renal transplantation.
N Engl J Med, 2023 Mar 02
Hydrochlorothiazide and Prevention of Kidney-Stone Recurrence.
Kidney Int Rep, 2020 Mar 16
Spondyloarthritis-Associated IgA Nephropathy.
Rheumatology international, 2017 Mar 03
Expanding the therapeutic options for renal involvement in lupus: eculizumab, available evidence.
Rheumatology (Oxford, England), 2015 Aug 27
Eculizumab as rescue therapy in severe resistant lupus nephritis.
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.
Am J Transplant, 2019 Jul 01
Two-year outcomes in de novo renal transplant recipients receiving everolimus-facilitated calcineurin inhibitor reduction regimen from the TRANSFORM study.
Transpl Infect Dis, 2020 Jul 14
T-cell adoptive immunotherapy for BK nephropathy in renal transplantation.
Journal of the American Society of Nephrology : JASN, 2014-07
BP, cardiovascular disease, and death in the Folic Acid for Vascular Outcome Reduction in Transplantation trial.
Kidney Int, 2021 Mar
KDIGO 2021 Clinical Practice Guideline for the Management of Blood Pressure in Chronic Kidney Disease.
Pediatr Transplant, 2018 Dec 09
Effects of the strict control of blood pressure in pediatric renal transplant recipients-ESCORT trial.
N Engl J Med, 2015 Nov 09
A Randomized Trial of Intensive versus Standard Blood-Pressure Control.
Kidney Int, 1998 Jan
Association of chronic kidney graft failure with recipient blood pressure. Collaborative Transplant Study.
Sci Rep, 2019 Jul 19
Intensive blood pressure control is associated with improved patient and graft survival after renal transplantation.
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.
Radiology, 2021 Jan
Use of Intravenous Gadolinium-based Contrast Media in Patients with Kidney Disease: Consensus Statements from the American College of Radiology and the National Kidney Foundation.
JAMA, 2019-08-13
Association of Intensive vs Standard Blood Pressure Control With Cerebral White Matter Lesions.
Kidney Int, 2019 Jan
Hemodialysis vascular access in the elderly-getting it right.
Nat Rev Nephrol, 2015 Nov 16
Renal involvement in primary Sjögren syndrome.
J Rheumatol, 2017 May 15
Longterm Hydroxychloroquine Therapy and Low-dose Aspirin May Have an Additive Effectiveness in the Primary Prevention of Cardiovascular Events in Patients with Systemic Lupus Erythematosus.
Renal failure, 2006
Intraperitoneal sodium thiosulfate for the treatment of calciphylaxis.
American journal of nephrology, 2014
Oxalate quantification in hemodialysate to assess dialysis adequacy for primary hyperoxaluria.
Clinical journal of the American Society of Nephrology : CJASN, 2015-11-06
Peritoneal Equilibration Test and Patient Outcomes.
Perit Dial Int, 2020 Jan 21
International Society for Peritoneal Dialysis practice recommendations: Prescribing high-quality goal-directed peritoneal dialysis.
Am J Kidney Dis, 2009 Apr 25
The importance of residual kidney function for patients on dialysis: a critical review.
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.
American journal of kidney diseases : the official journal of the National Kidney Foundation, 2013-01
Thrombocytopenia associated with one type of polysulfone hemodialysis membrane: a report of 5 cases.
Seminars in dialysis, 2014
Thrombocytopenia in ESRD patients: epidemiology, mechanisms and interventional nephrology perspective.
Kidney Int, 2012 May 16
Hemodialysis effect on platelet count and function and hemodialysis-associated thrombocytopenia.
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, 2018-02-15
Outcomes after Angiography with Sodium Bicarbonate and Acetylcysteine.
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.
Perit Dial Int, 2017 Jul-Aug
Length of Time on Peritoneal Dialysis and Encapsulating Peritoneal Sclerosis - Position Paper for ISPD: 2017 Update.
Semin Nephrol, 2017 Jan
Encapsulating Peritoneal Sclerosis.
Annals of clinical and laboratory science, 2008
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