Podcasts about glomerular

Send us a textCan one AI system learn from every organ — and teach us something new about all of them?In this edition of DigiPath Digest #31, I explore how artificial intelligence is transforming pathology across multiple organ systems, revealing connections that help us diagnose faster, more consistently, and more accurately than ever before.From glomerulonephritis to hepatocellular carcinoma, AI is no longer confined to a single specialty — it's becoming the connective tissue between them.What's Inside:1️⃣ AI for Bladder Cancer Classification We begin with a multicenter study validating AI models for urothelial neoplasm classification using over 12,000 whole-slide images. Both CNNs and transformer models achieved high accuracy (AUC 0.983, F1 score 0.9). I discuss why the F1 score matters — and what it tells us about model balance between sensitivity and specificity.2️⃣ AI in Colorectal Cancer Care Next, we explore multimodal AI — integrating histopathology, radiology, genomics, and blood markers to modernize colorectal cancer workflows. AI now helps detect adenomas, infer microsatellite instability (MSI) from H&E slides, and predict treatment outcomes. I highlight the critical need for external validation, interpretability, and governance as AI enters clinical use.3️⃣ AI for Glomerular Nephritis Diagnosis A deep learning model trained on over 100,000 kidney biopsy images identified four nephritis types — FSGS, IgA, MN, and MCD — with over 85% accuracy. This technology could ease workloads and improve turnaround time in renal pathology. Still, I share why AI support may feel both empowering and unsettling for many pathologists.4️⃣ AI in Liver Disease (MASLD & HCC) AI is advancing noninvasive fibrosis staging and risk prediction in liver pathology. From large consortia like NIMBLE and LITMUS to predictive models for HCC therapy response, AI is moving us closer to precision hepatology. I also discuss the challenge of translating these tools from research to regulatory approval.5️⃣ Lightweight AI for Domain Generalization Finally, we look at one of pathology AI's biggest challenges: domain shift — when a model trained on one scanner or staining style performs poorly elsewhere. The new Histolite framework shows how lightweight, self-supervised models can generalize across data sources — trading some accuracy for reliability in real-world use.My TakeawayAcross every study, a single message stands out: AI isn't replacing pathologists — it's amplifying our vision. By connecting kidney, colon, liver, and bladder insights, AI is teaching us that medicine works best when it learns across boundaries.Episode HighlightsBladder cancer AI validation (06:41)Multimodal colorectal AI (12:38)Glomerular nephritis deep learning (19:29)AI in liver pathology (29:55)Domain shift & Histolite framework (38:17)Halloween wrap-up + SITC preview (46:18)Join me next time for updates from the SITC 2025 Conference, where I'll be live at Booth 415 with Hamamatsu and Biocare, discussing how AI and spatial biology are converging to drive clinical utility.#DigitalPathology #AIinHealthcare #ComputationalPathology #CancerDiagnostics #LiverPathology #RenalPathology #FutureOfMedicine #DigiPathDigestSupport the showGet the "Digital Pathology 101" FREE E-book and join us!

Suxia Wang, MD - Expert Perspective on the Diagnostic Pathways for Glomerular Diseases

Suxia Wang, MD - Expert Perspective on the Diagnostic Pathways for Glomerular Diseases

Drs. Shipra Agrawal and Monoj K. Das discuss the results of their study, "RNA Alternative Splicing and Polyadenylation and Regulation of the Glomerular Filtration Barrier," with JASN Deputy Editor Alan S.L. Yu and Junior Associate Editor Jason O. Wu.

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Estimated Glomerular Filtration Rate Variability and Incident Heart Failure in Adults With Type 2 Diabetes.

In this episode, we review the high-yield topic of⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠Glomerular Filtration Rate (GFR) ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠from the Renal section.Follow⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Medbullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets

In this podcast, Dr. Tracy Anderson-Haag, Dr. Sandra Kane-Gill, and Dr. Andrew Webb discuss the AJHP Descriptive Report, “Moving forward from Cockcroft-Gault creatinine clearance to race-free estimated glomerular filtration rate to improve medication-related decision-making in adults across healthcare settings: A consensus of the National Kidney Foundation Workgroup for Implementation of Race-Free eGFR-Based Medication-Related Decisions,” with host and AJHP Editor in Chief Dr. Daniel Cobaugh. The information presented during the podcast reflects solely the opinions of the presenter. The information and materials are not, and are not intended as, a comprehensive source of drug information on this topic. The contents of the podcast have not been reviewed by ASHP, and should neither be interpreted as the official policies of ASHP, nor an endorsement of any product(s), nor should they be considered as a substitute for the professional judgment of the pharmacist or physician.

Podcast Overview The podcast, hosted by Valentin Fuster on January 21, 2025, provides an in-depth review of the FINEARTS-HF trial, which evaluated the efficacy of the non-steroidal mineralocorticoid receptor antagonist finerenone in patients with heart failure and mildly reduced or preserved ejection fraction (HFmrEF/HFpEF). The episode highlights findings published in the Journal of the American College of Cardiology (JACC). Introduction to the FINEARTS-HF Trial (00:03:19 – 00:05:56) The FINEARTS-HF trial demonstrated that finerenone reduced heart failure events by 16% compared to placebo in patients with HFmrEF/HFpEF. However, cardiovascular death rates were similar between groups, making the overall clinical impact moderate. Finerenone's Impact on Quality of Life (00:05:59 – 00:12:46) The trial assessed quality of life using the Kansas City Cardiomyopathy Questionnaire (KCCQ), revealing only a slight improvement (1.62 points) with finerenone. Critics, including the FDA, questioned the clinical relevance of these results and suggested the need for simpler, more meaningful patient-reported outcome measures. Finerenone in Patients with Recent Worsening Heart Failure (00:12:58 – 00:20:30) Patients with recent worsening heart failure showed a greater absolute benefit from finerenone, as they were at higher risk of recurrent events and cardiovascular death. However, further studies are needed to confirm these findings. Finerenone's Role in Obese Patients with HFmrEF/HFpEF (00:20:31 – 00:25:20) In obese patients, the benefits of finerenone were consistent across body mass index (BMI) categories, with a possible greater effect in those with higher BMI. Nevertheless, the reliance on BMI as a metric for obesity was criticized, and alternative measures were recommended. Finerenone and Kidney Outcomes (00:25:23 – 00:40:52) Finerenone showed a modest reduction in albuminuria but did not significantly alter kidney disease progression. Initial declines in glomerular filtration rate (GFR) were noted but should not automatically lead to discontinuation of therapy. Mixed findings highlight the need for more research to understand its renal effects. Conclusion (00:40:54 – 00:44:05) The FINEARTS-HF trial was recognized as a landmark study, showcasing modest benefits of finerenone in a challenging patient population. The podcast calls for continued research to refine quality of life metrics, better understand obesity's role in HFmrEF/HFpEF, and explore finerenone's long-term renal and cardiovascular impacts.

Jennifer Moore discusses how plant-based solutions can prevent the progression of kidney disease. Learn about dietary changes that support kidney health and overall wellness. #KidneyHealth #PlantBasedSolutions #Wellness

Ian SD Roberts, MBChB, FRCPath / Joris Roelofs, MD, PhD - Best Practices in Renal Pathology: Avoiding Common Pitfalls in the Diagnostic Pathways for Glomerular Diseases

Ian SD Roberts, MBChB, FRCPath / Joris Roelofs, MD, PhD - Best Practices in Renal Pathology: Avoiding Common Pitfalls in the Diagnostic Pathways for Glomerular Diseases

Ian SD Roberts, MBChB, FRCPath / Joris Roelofs, MD, PhD - Best Practices in Renal Pathology: Avoiding Common Pitfalls in the Diagnostic Pathways for Glomerular Diseases

Ian SD Roberts, MBChB, FRCPath / Joris Roelofs, MD, PhD - Best Practices in Renal Pathology: Avoiding Common Pitfalls in the Diagnostic Pathways for Glomerular Diseases

Jonathan Barratt, PhD, FRCP / Joris Roelofs, MD, PhD - The Central Role of Renal Pathology in the Differential Diagnosis of Glomerular Diseases: Sharing Expertise, Experience, and Essential Next Steps

Jonathan Barratt, PhD, FRCP / Joris Roelofs, MD, PhD - The Central Role of Renal Pathology in the Differential Diagnosis of Glomerular Diseases: Sharing Expertise, Experience, and Essential Next Steps

Jonathan Barratt, PhD, FRCP / Joris Roelofs, MD, PhD - The Central Role of Renal Pathology in the Differential Diagnosis of Glomerular Diseases: Sharing Expertise, Experience, and Essential Next Steps

Jonathan Barratt, PhD, FRCP / Joris Roelofs, MD, PhD - The Central Role of Renal Pathology in the Differential Diagnosis of Glomerular Diseases: Sharing Expertise, Experience, and Essential Next Steps

Kidney Week 2024 on the go. Gentzon Hall, MD, PhD, FASN, Matthias Kretzler, MD, and Heather Reich, MD, PhD, discuss progress in glomerular disease research, emerging trends, and clinical challenges.

Kidney Week 2024 on the go. Gentzon Hall, MD, PhD, FASN, Matthias Kretzler, MD, and Heather Reich, MD, PhD, discuss progress in glomerular disease research, emerging trends, and clinical challenges.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/XWR865. CME credit will be available until June 4, 2025.Aligning Clinical Practice With Emerging Evidence: Navigating the Rapidly Evolving Landscape of Glomerular Kidney Disease ManagementThe University of Cincinnati is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.This activity is developed in collaboration with our educational partner, PVI, PeerView Institute for Medical Education.SupportThis activity is supported by an educational grant from Novartis Pharmaceuticals Corporation.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/XWR865. CME credit will be available until June 4, 2025.Aligning Clinical Practice With Emerging Evidence: Navigating the Rapidly Evolving Landscape of Glomerular Kidney Disease ManagementThe University of Cincinnati is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.This activity is developed in collaboration with our educational partner, PVI, PeerView Institute for Medical Education.SupportThis activity is supported by an educational grant from Novartis Pharmaceuticals Corporation.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/XWR865. CME credit will be available until June 4, 2025.Aligning Clinical Practice With Emerging Evidence: Navigating the Rapidly Evolving Landscape of Glomerular Kidney Disease ManagementThe University of Cincinnati is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.This activity is developed in collaboration with our educational partner, PVI, PeerView Institute for Medical Education.SupportThis activity is supported by an educational grant from Novartis Pharmaceuticals Corporation.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/XWR865. CME credit will be available until June 4, 2025.Aligning Clinical Practice With Emerging Evidence: Navigating the Rapidly Evolving Landscape of Glomerular Kidney Disease ManagementThe University of Cincinnati is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.This activity is developed in collaboration with our educational partner, PVI, PeerView Institute for Medical Education.SupportThis activity is supported by an educational grant from Novartis Pharmaceuticals Corporation.Disclosure information is available at the beginning of the video presentation.

Assam El-Osta discusses the findings from his study, "Set7 Methyltransferase and Phenotypic Switch in Diabetic Glomerular Endothelial Cells," with JASN Deputy Editor David H. Ellison.

In this episode, we review the high-yield topic of ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Glomerular Filtration Rate (GFR)⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠from the Renal section. Follow ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Medbullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets Linkedin: https://www.linkedin.com/company/medbullets

Jai Radhakrishnan, MD, MS / Ladan Zand, MD - Investigating Novel Approaches and Unmet Needs in the Management of Glomerular Diseases

Jai Radhakrishnan, MD, MS / Ladan Zand, MD - Investigating Novel Approaches and Unmet Needs in the Management of Glomerular Diseases

Jai Radhakrishnan, MD, MS / Ladan Zand, MD - Investigating Novel Approaches and Unmet Needs in the Management of Glomerular Diseases

Jai Radhakrishnan, MD, MS / Ladan Zand, MD - Investigating Novel Approaches and Unmet Needs in the Management of Glomerular Diseases

Overview Urinalysis Color & Clarity Protein RBC WBC Glucose Specific gravity Ketones pH Bilirubin/Urobilinogen Nursing Points General Normal value range Color & Clarity Normal – Yellow Other colors Drug interactions Propofol  – green Methylene blue – blue/green Trauma Red/Brown Liver failure Brown/tea colored Clear – Normal Cloudy Cell or contaminant related Turbid Severe presence of cells (WBC, RBC) pH ~6 Changes in body condition can change pH Metabolic acidosis/alkalosis Protein 0-trace Glomerular permeability/infection RBC 0-2 Bleeding Trauma/injury  below kidneys WBC Negative Sepsis/Infection/UTI Glucose Negative Diabetes Ketones Negative Presence of ketones can indicate endocrine disease like Diabetes Urine Specific Gravity 1.010-1.030 Facilities vary Ability to concentrate urine Hydration Overhydration Decreased USG Dehydration Increased USG Diabetes insipidus Causes increased diuresis SIADH (Syndrome of Inappropriate Antidiuretic Hormone) Causes decreased diuresis Bilirubin/Urobilinogen Negative Presence indicates potential liver problems Nursing Concepts Lab Values Elimination

The important question is when to suspect vasculitis based on clinical presentation? We discuss differentials and workup (with emphasis on ANCA positivity or negativity or markers of Glomerular involvement) as well as management options and complications (including Mono-neuritis multiplex) for most common classes of vasculitides including Medium-size & Small - vessel Vasculitides including Polyarteritis Nodosa (including updated 3/10 Diagnostic criteria of American College of Rheumatology), Buerger's Disease (Thromboangiitis Oblisterans) Wegener's Granulomatosis, Microscopic Polyangiitis, Churg-Strauss.

Get a free nursing lab values cheat sheet at NURSING.com/63labs   Overview Urinalysis Color & Clarity Protein RBC WBC Glucose Specific gravity Ketones pH Bilirubin/Urobilinogen Nursing Points General Normal value range Color & Clarity Normal – Yellow Other colors Drug interactions Propofol  – green Methylene blue – blue/green Trauma Red/Brown Liver failure Brown/tea colored Clear – Normal Cloudy Cell or contaminant related Turbid Severe presence of cells (WBC, RBC) pH ~6 Changes in body condition can change pH Metabolic acidosis/alkalosis Protein 0-trace Glomerular permeability/infection RBC 0-2 Bleeding Trauma/injury  below kidneys WBC Negative Sepsis/Infection/UTI Glucose Negative Diabetes Ketones Negative Presence of ketones can indicate endocrine disease like Diabetes Urine Specific Gravity 1.010-1.030 Facilities vary Ability to concentrate urine Hydration Overhydration Decreased USG Dehydration Increased USG Diabetes insipidus Causes increased diuresis SIADH (Syndrome of Inappropriate Antidiuretic Hormone) Causes decreased diuresis Bilirubin/Urobilinogen Negative Presence indicates potential liver problems Nursing Concepts Lab Values Elimination

To receive up to 1.0 CME/CE credit please complete the evaluation and request form here:  https://www.ceconcepts.com/igan-ee-podcastThis activity will take learners on a deep dive into the pathophysiology of proteinuric glomerular disease, with an incisive focus on IgA nephropathy (IgAN). Expert faculty will review the totality of emerging evidence for novel therapeutics in IgAN, including an appraisal of consensus guidelines and regulatory updates. Finally, the session will conclude with a case-based segment wherein attendees will get to apply the principles they've learned to real-world clinical scenarios.Supported through an independent educational grant from Travere.

Host: Frank Cortazar, MD There are several challenges associated with the management of glomerular diseases like IgA nephropathy and C3 glomerulopathy. But in order to overcome those challenges, we must first have a firm understanding of them. That's why Dr. Frank Cortazar from the New York Nephrology Vasculitis and Glomerular Center is here to break down those common challenges so we can work to better manage IgA nephropathy and C3 glomerulopathy.

In this episode, we review the high-yield topic of Glomerular Filtration Barrier from the Renal section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets --- Send in a voice message: https://anchor.fm/medbulletsstep1/message

Looking for more information on this topic? Check out the Regulation of Renal Blood Flow and Glomerular Filtration brick. If you enjoyed this episode, we'd love for you to leave a review on Apple Podcasts.  It helps with our visibility, and the more med students (or future med students) listen to the podcast, the more we can provide to the future physicians of the world. Follow USMLE-Rx at: Facebook: www.facebook.com/usmlerx Blog: www.firstaidteam.com Twitter: https://twitter.com/firstaidteam Twitter: https://twitter.com/mesage_hub Instagram: https://www.instagram.com/firstaidteam/ YouTube: www.youtube.com/USMLERX Learn more about Rx Bricks by signing up for a free USMLE-Rx account: www.usmle-rx.com You will get 5 days of full access to our Rx360+ program, including over 800 Rx Bricks.  After the 5-day period, you will still be able to access over 150 free bricks, including the entire collections for General Microbiology and Cellular and Molecular Biology.

Reversing chronic kidney disease (CKD) with a ketogenic lifestyle. Dr. Nally's Ketogenic Dietary Information: https://www.docmuscles.com/dietpage/ Show References: 1. Siperstein MS, Unger RH, Madison LL. “Further Electron Microscopic Studies of Diabetic Microagniopathy.” Early Diabetes: Advances in Metabolic Disorders, sup 1. New York: Academic Press, 1972, p261-271. 2. Nasr SH, D'Agati VD. “Nodular glomerulosclerosis in the nondiabetic smoker.” J Am Soc Nephrol. 2007;18(7):2032. 3. Poplawski MM, Mastaitis JW, Isoda F, Grosjean F, Zheng F, Mobbs CV (2011) Reversal of Diabetic Nephropathy by a Ketogenic Diet. PLoS ONE 6(4): e18604. doi:10.1371/journal.pone.0018604 4. Kundu S, Hossain KS, Moni A, Zahan MS, Rahman MM, Uddin MJ. Potentials of ketogenic diet against chronic kidney diseases: pharmacological insights and therapeutic prospects. Mol Biol Rep. 2022 Oct;49(10):9749-9758. doi: 10.1007/s11033-022-07460-8. Epub 2022 Apr 20. PMID: 35441940. 5. Rojas-Morales P, León-Contreras JC, Sánchez-Tapia M, Silva-Palacios A, Cano-Martínez A, González-Reyes S, Jiménez-Osorio AS, Hernández-Pando R, Osorio-Alonso H, Sánchez-Lozada LG, Tovar AR, Pedraza-Chaverri J, Tapia E. A ketogenic diet attenuates acute and chronic ischemic kidney injury and reduces markers of oxidative stress and inflammation. Life Sci. 2022 Jan 15;289:120227. doi: 10.1016/j.lfs.2021.120227. Epub 2021 Dec 16. PMID: 34921866. 6. Jolliffe N, Smith HW. The excretion of urine in the dog. I. The urea and creatinine clearances on a mixed diet. Am J Physiol 98: 572–577, 1931. 7. Parving HH, Noer J, Kehlet H, Mogensen CE, Svendsen PA, Heding L. The effect of short-term glucagon infusion on kidney function in normal man. Diabetologia 13: 323–325, 1977pmid:334617. 8. Fioretto P, Trevisan R, Velussi M, Cernigoi A, De Riva C, Bressan M, Doria A, Pauletto N, Angeli P, De Donà C, et al. Glomerular filtration rate is increased in man by the infusion of both D,L-3-hydroxybutyric acid and sodium D,L-3-hydroxybutyrate. J Clin Endocrinol Metab. 1987 Aug;65(2):331-8. doi: 10.1210/jcem-65-2-331. PMID: 3298305. #CKD #ChronicKidneyDisease #Kidney #diabeticNephropathy #Diabetes #LeadFolloworGetOutOrMyWay #JustKeepEsterifying #Ketogenic #Keto #KetogenicLifestyle #Carnivore #DrAdamNally #DocMuscles #DocMusclesLive #DocTalk #DocsWhoLift #LiftRunShoot #DocMusclesLife YouTube.com/drnally/.

The Journal RETINA is devoted exclusively to diseases of the retina and vitreous. These podcasts are intended to bring to its listeners summaries of selected articles published in the current issue of this internationally acclaimed journal.

Looking for more information on this topic? Check out the Glomerular Diseases: Foundations and Frameworks brick. If you enjoyed this episode, we'd love for you to leave a review on Apple Podcasts.  It helps with our visibility, and the more med students (or future med students) listen to the podcast, the more we can provide to the future physicians of the world. Follow USMLE-Rx at: Facebook: www.facebook.com/usmlerx Blog: www.firstaidteam.com Twitter: https://twitter.com/firstaidteam Twitter: https://twitter.com/mesage_hub Instagram: https://www.instagram.com/firstaidteam/ YouTube: www.youtube.com/USMLERX Learn more about Rx Bricks by signing up for a free USMLE-Rx account: www.usmle-rx.com You will get 5 days of full access to our Rx360+ program, including over 800 Rx Bricks.  After the 5-day period, you will still be able to access over 150 free bricks, including the entire collections for General Microbiology and Cellular and Molecular Biology.

Dr. Centor discusses the quantification of inaccuracy in estimation of glomerular filtration rate with Dr. Tariq Shafi.

Host: Javed Butler, MD, MBA, MPH Guest: Tariq Shafi, MD Although population-level differences between estimated glomerular filtration rate (eGFR) and measured glomerular filtration rate are well-known, the individual-level differences are not. So what clinical implication can this have for our patients? Learn about these fresh findings with Dr. Javed Butler and Dr. Tariq Shafi, the John D. Bower Director of the Division of Nephrology and Professor of Medicine at the University of Mississippi Medical Center. Together, they discuss a recent study from the Annals of Internal Medicine that explored this topic.

References Dr Guerra lecture notes Front. Endocrinol., 14 October 2014. Sci Rep. 2020; 10: 21628. --- Send in a voice message: https://anchor.fm/dr-daniel-j-guerra/message Support this podcast: https://anchor.fm/dr-daniel-j-guerra/support

Looking for more information on this topic? Check out the Physiology of Glomerular Filtration brick. If you enjoyed this episode, we'd love for you to leave a review on Apple Podcasts.  It helps with our visibility, and the more med students (or future med students) listen to the podcast, the more we can provide to the future physicians of the world. Follow USMLE-Rx at: Facebook: www.facebook.com/usmlerx Blog: www.firstaidteam.com Twitter: https://twitter.com/firstaidteam Instagram: https://www.instagram.com/firstaidteam/ YouTube: www.youtube.com/USMLERX Learn how you can access over 150 of our bricks for FREE: https://usmlerx.wpengine.com/free-bricks/ from our Musculoskeletal, Skin, and Connective Tissue collection, which is available for free. Learn more about Rx Bricks by signing up for a free USMLE-Rx account: www.usmle-rx.com You will get 5 days of full access to our Rx360+ program, including nearly 800 Rx Bricks.  After the 5-day period, you will still be able to access over 150 free bricks, including the entire collections for General Microbiology and Cellular and Molecular Biology.

In this podcast, Dr. Kim Thielen, a nephrologist/kidney specialist with Minnesota Kidney Specialists joins us today to continue part 2 of our discussion on acute kidney injury, as we wade further "into the weeds"  discuss intrinsic renal disease. This episode will break down hallmark urinary findings and further subdivide intrinsic concerns into bland, nephrotic and nephritic, various causes, and treatment. Enjoy the podcast! Objectives:   Upon completion of this podcast, participants should be able to: State the 3 types of urinary analysis findings related to instrinic acute kidney injury. Describe etiology of presentation of each type of intrinsic acute kidney injury. CME credit is only offered to Ridgeview Providers & Allied Health Staff for this podcast activity. Complete and submit the online evaluation form, after viewing the activity.  Upon successful completion of the evaluation, you will be e-mailed a certificate of completion within approximately 2 weeks. You may contact the accredited provider with questions regarding this program at  rmccredentialing@ridgeviewmedical.org. To receive continuing education credit for this activity - click the link below, to complete the activity's evaluation. CME Evaluation (**If you are listening to the podcasts through iTunes on your laptop or desktop, it is not possible to link directly with the CME Evaluation for unclear reasons. We are trying to remedy this. You can, however, link to the survey through the Podcasts app on your Apple and other smart devices, as well as through Spotify, Stitcher and other podcast directory apps and on your computer browser at these websites. We apologize for the inconvenience.)  DISCLOSURE ANNOUNCEMENT  The information provided through this and all Ridgeview podcasts as well as any and all accompanying files, images, videos and documents is/are for CME/CE and other institutional learning and communication purposes only and is/are not meant to substitute for the independent medical judgment of a physician, healthcare provider or other healthcare personnel relative to diagnostic and treatment options of a specific patient's medical condition; and are property/rights of Ridgeview Medical Center & Clinics.  Any re-reproduction of any of the materials presented would be infringement of copyright laws.  It is Ridgeview's intent that any potential conflict should be identified openly so that the listeners may form their own judgments about the presentation with the full disclosure of the facts. It is not assumed any potential conflicts will have an adverse impact on these presentations. It remains for the audience to determine whether the speaker's outside interest may reflect a possible bias, either the exposition or the conclusions presented. Ridgeview's CME planning committee members and presenter(s) have disclosed they have no significant financial relationship with a pharmaceutical company and have disclosed that no conflict of interest exists with the presentation/educational event. Thank-you for listening to the podcast. SHOW NOTES: *See the attachment for additional show information.  Intrinsic Kidney Injuries: Urinary analysis findings- Bland Urine: no protein - Nephrotic: protein - Nephritic: protein and blood Hallmark Urinary Findings: Casts - Tamm Horsfall Protein : Mucoprotein made by tubular epithelial cells that precipitate out and congeal    to form casts on whatever is in the cells at the time.  (i.e. RBCs, WBCs, tubular debris) Bland Urine States- Crystalline Induced Renal Injury: obstruction and infllamatory response       - Uric Acid Neuropathy (Most common)              - Cancers, lymphomas, etc.              - Drugs: acyclovir, methotrexate, protease inhibitors, etc.              - Toxins: Ethylene glycol - Bland Urine Disease states: results from injury to tubules, instertim or pre glomerular blodd vessels, not    the filters of the kidney       - Interstital Nephritis              - Hallmark: pyuria and WBC casts                      - Biopsy: inflammatory infiltrate              - Causes:  viral, PPIs, Adenover, mizalamin, etc., Checkpoint inhibitors       - Acute Tubular Necrosis              - Hallmark: tubular epithelial cell cast                      - Granular: (course or fine) diagnostic of ATN              - Biopsy: denuded dilated tubular cells              - Causes: #1: Ischemia;  toxins, drugs, contrast dye;  pigment injury. myoglobin              - What about contrast dye?                      - Categorized under ATN                      - Per Dr. Thielen, plays a role, but injury is not solely dependent on dye alone.       - Hepatorenal Syndrome: ischemic injury to the kidney due to unopposed vasocontstriction               - Ace inhibitors cause unopposed efferent vasoconstriction + nonsteroidals cause                 unposed afferent vasoconstriction = no glomerular perfusion pressure       - Multiple Myeloma              - Hallmark: Light chain cast nephropathy or myeloma kidney                      - Light chains precipitate  out causing obstruction, inflammatory response and causes                        tubular damage              - Presentation: older possibly with anemia, bone pain and elevated creatinine with a bland urine.              - Protein to creatinine ratio: + for protein (non albumin)              - Dipstick: (which measures for albumin and not light chains) will be negative for protein aka                 bland urine       - Hypertensive Nephrosclerosis              - Small vessel vascular disease                     - Blood vessels prematurely atherosclerosis causing glomerular drop out and scarring of the                        interstim       - Scleroderma                - Limited cutaneous systemic sclerosis                - Diffuse cutaneous systemic sclerosis: 60-80% have renal injury from disease state itself                           - FANA positive                           - Concern for Scleroderma Renal Crisis = medical emergency                                   - AKI, moderate to severe HTN and bland urine                                   - Uncontrolled accumulation of collage, thickens vascular walls, narrowing and renal                                       ischemia                          - Occurs in 10-15% of those with Diffuse Cutaneous Systemic sclerosis and happens early                              in disease                                     - Left untreated: renal failure in 1-2 months and death in 1 year                          - Treatment: ACE Inhibitor Nephrotic Urine States - Urine protein: albumin excretion greater than 3.5g in 24 hours - Nephrotic Syndrome:      - Present with 3 things (nephrotic range protein, hypoalbuminemia, peripheral edema)       - Hyperlipidemia: due to increased hepatic lipogenesis                - Increased risk of renal disease and arthroscleratic       - Venous thrombotic disease:                 - Loose proteins other than albumin and develop a hypercoagulale state                 - Renal and peripheral venous thrombosis      - Lipiduria (forms fatty casts,  looks like a latese cross under microscope)  -Pathophysiology or nephrotic syndrome    - Glomerular capillary wall           - 3 layers that work as a glomerular filtration and responsible in the filtration between blood and             urine                  - Fenestrated Capillary Enothelial cells (fenestrations allow plasma through to the basement                     membrane)                 - Glomerular Basement Membrane (maintains glomerular filtration barrier; negatively charged,                     repels albumin)                 - Epithelium: Podocytes (Have highly specialized foot processes that connect and form slit                     diaphragms; Slit diaphragm important for the efficient flow of small solute and water)          - Anything that messes with any of these layers: nephrotic proteinuria - Nephrotic Disease States:     - Biopsy: anyone with nephrotic proteinuria (besides diabetics)          1) Light microscopy: high overview          2) Immunofluorescens: looks for nephritic component and identif immunce complexes          3) Electron microscopy: (EM) helps look at the ultrastructure and better identify immune deposits    - Diabetic nephropathy           - Leading cause of kidney disease in U.S. and western society           - Responsible for 30-40% of all ESRD causes           - Hyperglycemia: produces inflammatory responses, oxidative stress, and injures the podocytes and             deposits that charge and affect the ability of the kidney to filter.     - Amyoidosis            - Organize into betapleted sheets and produce spikes of the capillary uniion and poke through the               GF membrane            - Easily identified by apple green birefringence on congo red            - Terminal illness            - Present with HTN, cardiac effects and elevated creatine  - Nephrotic Disease states based of histologic appearance      - Diagnosed by histologic appearance but does not determine the etiology      - Minimal Change Disease              - Fairly common              - Minimal change under light microscope              - EM: podocytes are abnormal, fused, no unique cell-cell junction              - Primary: Immune generated circulating facture;  alters the cytoskeleton of the podocytes       - Secondary               - Nonsteriodal - most common cause of secondary minimal change disease               - Gama interferon               - Hodgkin's lymphoma               - Allergy: 30% of minimal change have associate allergy (mechanism unknown)       - Presentation               - Sudden onset (days to weeks)               - Marked edema and hypoablbuminemia               - 60% have normal blood pressure,    82% have normal creatinine - Focal Segmental Glomerulosclerosis (FSGS) - primary and secondary         - Most common cause idopathic nephrotic syndrome in adults        - Primary glomerulonephritis in the US that causes ESRD        - Widespread podocyte injury     - Primary: circulating factor that messes with regulation of foot process and adhesion to the         glomerular basement membrane (afffect all podocytes)          - Present with nephrotic syndrome and rapid progression          - HTN and elevated creatinine    - Secondary: the visceral epithelial cells don't replicate          - Nephron loss or obesity or direct foot process injury          - Cannot replicate (podocytes), leads to decreased to podo denisty at specific areas (focal injury)          - 2/3 of all cases FSGS          - Present: with slowly increasing proteinuria and kidney impairment over time          - Causes: interferon, bisphosphonates, talc, anabolic steroids    - Genetics: gene mutations that encode for the slit diaphragms of the podocytes (affect all podocytes)            - Present in Childhood: full blown nephrotic and progress rapidly to ESRD Membranous Nephropathy - Most common cause of nephrotic syndrome in caucasion adults - 80% present with nephrotic but develops more slowly to ESRD - Primary: Major antigen identified      - antibody to trans-membrane receptor that is highly expressed on the glomerular podocyte - Secondary: Cancers (lung, breast, GI), Lupus, Thyroiditis, Hep B, Syphilis, Nonsteroidals, Monoclonal    Antibodies Nephritic Syndrome - Hematuria and proteinuria    - Hematuria: blood from kidney or outside the kidney             - Outside the kidney: look the same             - Inside the kidney: dysmorphic red cells    - Present:             - Renal impairment for days to weeks             - Edmatous, HTN and look critically ill              - Vasculitis, sinusitis, oral ulcers             - Pulmonary renal syndrome: short of breath or hemoptysis             - Skin changes: bruising , bleeding, purpura             - Myalgias and arthritis     - Urine:             - Hallmark: red blood cell casts (polymorphic red cells)             - dipstick + for blood             - elevated proteinuria    - Biopsy: nephritic and + urine Nephritic Disease States (based on immunofluorescence staining) - Pauci Immune Disease         - Ankle vasculitis, common         - A paucity (little amount) of immune complexes         - See black on imaging         - Lab work: check on ANCA and peripheral eosinophils - Anti-GBM Disease         - Renal limited, or classic pulmonary renal: Good Pasture's          - linear staining of the glomerular basement with anti IGG (looks like a ribbon on a package)          - Treat with cytotoxic agents - Immune Complex          - Starry sky pattern          - Glomerulus looks dotted with stars                - Stars = immune complex definition          - Diseases:  Lupus (FANA), Post Infectious GN, Membranous Proliferative GN  - IGA Nephropathy           - Most common cause of glomerulonephritis in the world          - Presentation:                 - Peak incidence is the 2nd and 3rd decades of life                - 40-50% gross hematuria with upper respiratory and GI illness          - Risk Factors for Progression:                - younger age or hypertension at time of presentation                - > 1g proteinuria                - Elevated creatinine at time of presentation Thanks for listening.

In this episode, we review the high-yield topic of Glomerular Filtration Rate (GFR) from the Renal section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbulletsIn this episode --- Send in a voice message: https://anchor.fm/medbulletsstep1/message

Show notes at pharmacyjoe.com/episode631. In this episode, I’ll discuss whether kinetic GFR equations can be used in patients with shock. The post 631: Can Kinetic Glomerular Filtration Rate Equations Be Used in Patients With Shock? appeared first on Pharmacy Joe.

Having trouble knowing what to do with those hard to classify patterns of glomerular disease? Worry not. Dr. Silva is here to help!