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3/n the exposure to vitC raised concerned about oxalate nephropathy, so we proceeded to perform 🔬#UrineMicroscopy: no crystals, but massive “muddy” brown granular casts. Unexpected! Kinda #UrinarySediment we often encounter in the ICU, not in clinic

5/n 2 wks later, off ARB, off vitC: Cr 3.9, unchanged. UPCR 0.9. And #UrinarySediment still shows MBGC, scattered CaOx crystals in casts. So strong suspicion to AKI over CKD remains (versus brushing off the Cr rise as CKD progression)

8/n so, we are left with an unexplained ATI with massive presence of MBGCs. Time to regroup and reconsider culprits. Med list: Tessalon? Nope, not reported. What about Crestor? Can it cause ATI without causing rhabdo? Back to Pubmed “rosuvastatin acute tubular”:

9/n found this AJKD paper reporting biopsy-proven ATI 2/2 rosuvastatin without rhabdo pubmed.ncbi.nlm.nih.gov/27856086/

11/n the next step was obvious: stopping Crestor and reassessing, but before doing so, we triple checked urine🔬: unchanged, massive MBGC

15/n there is evidence of ⬇️of receptor-mediated endocytosis in renal tubules by HMG-CoA reductase inhibitors. But we still lack full understanding of the ATI pathogenesis. Maybe pharmacogenetic factors play a role. For now, be vigilant of Crestor. pubmed.ncbi.nlm.nih.gov/15339974/ Fin

Connect with nearly 22,000 kidney professionals and enjoy discounted registration to leading nephrology educational events such as #KidneyWk and BRCU. With ASN membership, you will take your career to new heights and help advance kidney care. Join today: asn.kdny.info/sfxt50STn9k

Now online at NDT Sandra Herrmann MD, FASN Immune checkpoint inhibitor-associated nephritis - treatment standard 🧐A subset of patients will require additional steroid-sparing therapies for corticosteroid-dependent or refractory ICI-AKI. ▶️academic.oup.com/ndt/article-ab…

Recent review on the diagnosis & management of ICI associated acute tubulointerstitial nephritis, integrating the Mayo Clinic approach to patients with ICI-ATIN, including when & how to re-challenge. Elena-Bianca Barbir, MD Abhijat Kitchlu | Onconephrology NDT @HerrmannMD academic.oup.com/ndt/advance-ar…

Great review on onco nephrology by Sandra Herrmann MD, FASN and coworkers academic.oup.com/ndt/advance-ar…

Another stimulating renal physiology discussion with the great Channel Your Enthusiasm: The Burton Rose BookClub crew, recording another episode of the Channel Your Enthusiasm Podcast 🎙️🎧🔥

Delighted to share our article on “Immobilization-associated hypercalcemia in patients with malignancy in the hospital setting” published in CKJ American Society of Onconephrology Acanthabella Juan Carlos Q Velez Ochsner Nephrology doi.org/10.1093/ckj/sf…

Immobilization-associated hypercalcemia in patients with malignancy in the hospital setting | Clinical Kidney Journal | Oxford Academic oup2-idp.sams-sigma.com/authorize?auth…

Vacuolar cast in a #UrinarySediment from a pt with endocarditis-associated glomerulonephritis and nephrotic-range proteinuria. Dark field illumination, SM stain. #UrineMicroscopy Ochsner Nephrology pdfs.journals.lww.com/kidney360/2024…

1) A pre course in American Society of Onconephrology American Society of Nephrology #kidneywk 2024 this year in San Diego-- join us and learn from the very best and diverse faculty. This course is co-directed by myself and Shruti Gupta asn-online.org/education/kidn…

#OncoNephrology pre-course American Society of Nephrology #ASNKidneyWk2024 Amazing crew 🌟🌟 Great topics line up Shruti Gupta Kenar Jhaveri

Report of our working group on the aHUS/TMA nomenclature is out!! Supported by National Kidney Foundation, this is an initial effort to standardize terminology to align with advancements in our understanding of the underlying pathophysiology of the various TMAs. kidney-international.org/article/S0085-…

Hepatorenal Syndrome, latest nephSAP issue nephsap.org/downloadpdf/vi… the new definition and more. Also in this issue, many other great articles on AKI / Critical Care topics American Society of Nephrology

📣Editor's Choice in #AmJNephrol ➡️Association of Proton Pump Inhibitor Use & Immune Checkpoint Inhibitor-Mediated #AKI: A Meta-Analysis and a Review of Related Outcomes ✍️ @Arjunn_Mohan1 @HermannMd et al. Mayo Clinic Nephrology 🔗#FreeAccess at karger.com/ajn/article-ab… #NephTwitter

🌟Onco-Nephrology symposium round the corner ! 🌟Great opportunity to connect with the experts in the field 📚Join us on Sep 13-14 In person and virtual options available MSK CME Memorial Sloan Kettering Nephrology Sheron Latcha Aisha Shaikh