Kidney Week 2025 Annual Meeting-Nephrology Quiz and Questionnaire 2025

Video Transcription

Video Summary

The session is a live “Quiz and Questionnaire” format where attendees answer case-based nephrology questions via phone polling and compare their responses with prior votes from program directors and fellows. Moderators Roger Rodby and Dia Wagesbeck introduce four topic areas: electrolytes, glomerulonephritis (GN), CKD, and transplant.<br /><br />In the electrolyte segment, Juan Carlos Velez presents: (1) refractory hypokalemia with hypertension and high urinary potassium losses in a man on abiraterone for prostate cancer. The teaching point is estimating large total-body potassium deficits at very low serum potassium and recognizing abiraterone’s blockade of steroid synthesis leading to ACTH-driven accumulation of mineralocorticoid-active steroids (notably corticosterone), causing hypokalemia despite prednisone; stopping abiraterone resolves it. (2) hyponatremia in a woman on oxcarbazepine with concentrated urine and high urine sodium consistent with SIAD physiology, but due to “inappropriate aquaporin-2 activation” rather than elevated vasopressin; copeptin may not be high. Management emphasizes increasing solute excretion—oral urea being most effective—and recognizing multifactorial hyponatremia.<br /><br />Tim Yao’s GN cases highlight diagnostic pitfalls: IgA-dominant infection-related GN due to occult Bartonella (culture-negative endocarditis) initially treated with steroids until serologies clarified the infection; antibiotics led to renal recovery. A second case initially looked like minimal change disease, but steroid resistance and subtle findings prompted Congo red staining, revealing renal amyloidosis (MGRS/AL), requiring hematologic therapy.<br /><br />Mary Ann Lim discusses transplant cases: recurrent “atypical anti-GBM” pattern with linear IgG/lambda staining suggesting monoclonal gammopathy despite negative SPEP/UPEP—bone marrow biopsy is key and targeted therapy stabilizes function. Another case shows EBV-mismatched recipient with an allograft mass diagnosed as EBV+ PTLD, stressing EBV viral-load monitoring and immunosuppression reduction plus rituximab.<br /><br />Laura Morsetter reviews CKD topics: acquired cystic kidney disease as a cause of flank pain/hematuria in long-term dialysis and considerations for selective cancer screening. She also reviews CKD-MBD/osteoporosis management in dialysis, emphasizing treating secondary hyperparathyroidism (e.g., cinacalcet) and considering parathyroidectomy when fractures persist, while being cautious with bisphosphonates and recognizing emerging roles for denosumab.

Asset Subtitle

Moderator(s): Jennifer Flythe, Bharvi Oza-Gajera

Presentation(s):

Clinical Approach to Patients with Recurrent Dialysis Access Thrombosis - Theodore Saad
Selection and Management of Dialysis Access in Patients with Chronic Hypotension - Adina Voiculescu
Selection and Management of Dialysis Access in Patients with Central Venous Stenosis - Gerald Beathard
Strategies to Create Functional Dialysis Access in Patients with Obesity - Rick Mishler

Meta Tag

Date 11/8/2025

Pathway 1 Other

Session ID 507650

Keywords

nephrology quiz

case-based learning

electrolyte disorders

refractory hypokalemia

abiraterone mineralocorticoid excess

hyponatremia

oxcarbazepine-induced SIAD

aquaporin-2 activation

oral urea therapy

infection-related glomerulonephritis

Bartonella endocarditis

renal amyloidosis (AL/MGRS)

atypical anti-GBM disease

EBV-positive PTLD