ISN Education

This is the official handle of the ISN Social Media Committee • Follow the International Society of Nephrology ➡️ @ISNkidneycare

[ISN Education @ISNeducation]

Thankyou for wonderful discussion.Pleasure having @edgarvlermamd @DrGeetikaSingh1 #ECNeph
Huge thanks @dakidneydoc for discussing case.
Signing off @myadla @Dilushiwijay

[Dilushi Wijayaratne @Dilushiwijay]

#ECneph

[Dilushi Wijayaratne @Dilushiwijay]

#ECneph

[Dilushi Wijayaratne @Dilushiwijay]

#ECneph

[Edgar V. Lerma 🇵🇭 @edgarvlermamd]

Holistic approach for improving outcomes in patients with diabetes and chronic kidney disease (CKD) ca. 2022 from @goKDIGO
#Nephpearls #ECNeph

https://t.co/ka7hU7mBp8

[Edgar V. Lerma 🇵🇭 @edgarvlermamd]

Holistic approach for improving outcomes in patients with diabetes and chronic kidney disease (CKD) ca. 2022 from @goKDIGO
#Nephpearls #ECNeph

https://t.co/ka7hU7mBp8

[ISN Education @ISNeducation]

@Dilushiwijay @onlinetrolley96 @dakidneydoc @myadla @edgarvlermamd @DrGeetikaSingh1 Case report of lupus podocytopathy over DKD #ECneph
unlikely in our case
Liu L, Murray B, Tomaszewski JE. Lupus podocytopathy superimposed on diabetic glomerulosclerosis: A case report. Medicine (Baltimore). 2021 Sep 17;100(37):e27077.

[ISN Education @ISNeducation]

5/n #ECNeph @dakidneydoc @myadla @Dilushiwijay @edgarvlermamd @DrGeetikaSingh1
Will go with serology investigations ?
ANA pos in 50 YO woman with nephrotic -Nephritic picture :
Should we consider lupus ?
EULAR -ACR criteria ?

[Srikanth Bathini @dakidneydoc]

Multiple Mechanisms of podocyte injury at play in diabetes:

1. Lipotoxicity
2. Vascular Injury,Inflammation
3. Reactive Oxygen Species mediated injury
4. Mitochondrial toxicity

https://t.co/xL0oFt0R7W

#ECNeph @ISNkidneycare @Dilushiwijay @myadla @edgarvlermamd @DrGeetikaSingh1 @ECNeph

[ISN Education @ISNeducation]

Thanks to our wonderful discussant @dakidneydoc for sharing his case and to our amazing faculty @edgarvlermamd @DrGeetikaSingh1 for their expertise!

And thanks to the #ECNeph community for joining in

We will see you next time!

Signing off, your hosts . @myadla @Dilushiwijay

[ISN Education @ISNeducation]

Could you share follow up of patient ? #ECneph
What treatment strategies are given ?

[Srikanth Bathini @dakidneydoc]

Here's a general outlook on Podocytopathy and the mechanisms underlying

#ECNeph @ISNkidneycare @Dilushiwijay @myadla @edgarvlermamd @DrGeetikaSingh1 @ECNeph

[Edgar V. Lerma 🇵🇭 @edgarvlermamd]

AKI = Hemodynamic + tubular injury + glomerular disease
#Nephpearls #ECNeph

AKI is NOT just GN

Likely contributors:
☑️ Severe nephrotic syndrome: ↓ effective arterial volume

☑️ Acute tubular injury: Supported by biopsy (denuded tubules)

☑️ Renal venous congestion: From volume overload

☑️ Underlying DN

[Srikanth Bathini @dakidneydoc]

Learning points 2/2

Diabetes does not exclude a second Glomerular disease!

Serologies should always be interpreted in the clinical context

⚡️A podocytopathy may co-exist with diabetic nephropathy

#ECNeph @ISNkidneycare @Dilushiwijay @myadla @edgarvlermamd @DrGeetikaSingh1 @ECNeph

[Edgar V. Lerma 🇵🇭 @edgarvlermamd]

Management of Podocytopathies from @smirioglu @IMBajema @AnnetteBruchfe1 @KateIsabelle24 @AKronbichler
#Nephpearls #ECNeph

https://t.co/NFDDTw51Sa

[ISN Education @ISNeducation]

@dakidneydoc @ISNkidneycare @Dilushiwijay @myadla @edgarvlermamd @DrGeetikaSingh1 @ECNeph in this case , whats the cause of AKI ? pathological correlate if any #ECNeph

[ISN Education @ISNeducation]

@dakidneydoc @DrAkshayaJ @ISNkidneycare @Dilushiwijay @myadla @edgarvlermamd PET-CT ? #ECneph or any specific screening modalities

[ISN Education @ISNeducation]

@dakidneydoc @Sandyrvsdav @ISNkidneycare @Dilushiwijay @myadla @edgarvlermamd How does the prognosis vary ? #ECneph

[ISN Education @ISNeducation]

@dakidneydoc @Sandyrvsdav @ISNkidneycare @Dilushiwijay @myadla @edgarvlermamd Do they have early progression to ESRD?
Lin HY, Niu SW, Kuo IC, Lim LM, Hwang DY, Lee JJ, Hwang SJ, Chen HC, Hung CC. Hematuria and Renal Outcomes in Patients With Diabetic Chronic KidneyDisease. Am J Med Sci. 2018 Sep;356(3):268-276. #ECneph

[ISN Education @ISNeducation]

@dakidneydoc @ISNkidneycare @Dilushiwijay @myadla @edgarvlermamd @DrGeetikaSingh1 @ECNeph How to explain active urine sediment ?#ECneph
ANA positivity ...

[ISN Education @ISNeducation]

@Sandyrvsdav @dakidneydoc @ISNkidneycare @Dilushiwijay @myadla @edgarvlermamd good differential ..ANA being positive , active urine sediment .is there a possibility of proliferative lupus too ? #ECNeph

[ISN Education @ISNeducation]

@dakidneydoc What are the indications for EM in DN ?#ECNeph @DrGeetikaSingh1