Medicine is a science built on evidence, training, and skill, but it’s practiced in the realm of uncertainty. Even the most experienced clinicians, armed with years of education and the best diagnostic tools, encounter moments when the next step is not a clear path. Subtle variations, rare conditions, or unexpected results can leave room for doubt.
When Dr. Matthew Perez, a family physician in Edmonds, Washington, reviewed the labs for one of his patients—a man in his mid-60s with chronically uncontrolled type 2 diabetes—he hesitated. The patient’s rash across both lower legs looked unmistakably like IgA vasculitis (Henoch–Schönlein Purpura), a condition far more common in children than adults.
The labs confirmed elevated inflammatory markers and protein in the urine, suggesting possible kidney involvement.
“This was a case of an uncommon condition in adults that has a characteristic rash and some abnormal lab findings,” Dr. Perez said. “I could have confirmed the diagnosis with a skin biopsy or additional testing, but I wasn’t sure if it was necessary and the patient was uninsured.”
With specialty referrals often taking months and limited access to nephrology care, Dr. Perez submitted a consult through MAVEN Project, a national nonprofit that connects clinicians in community and safety-net clinics with volunteer specialist physicians. Within hours, the case was reviewed by Dr. Lucius Wright, a nephrologist in Jackson, Tennessee, with more than four decades of clinical experience.
“He had a rash, GI distress, kidney disease,” Wright said. “The vasculitis is usually self-limited so the focus on diabetes management is exactly right.”
Wright recommended adding an SGLT2 inhibitor to help reduce protein in the urine, continued use of specific medications, and monitoring—noting at the specific point in the future where a referral would be appropriate.
For Perez, the consult provided clarity and confidence.
“Getting my patients to specialists is never quick or easy. Even for a suburban area within 20 minutes of Seattle, there are fewer specialists in the county. And many don’t see our Medicaid or uninsured clients,” Perez said. “I haven’t seen IgA vasculitis in adults more than a handful of times in over ten years. The MAVEN specialist was familiar with this disease process and helped confirm and improve my plan.”
The patient’s rash resolved with continued monitoring and Dr. Perez was able to manage follow-up care without a lengthy or stressful referral process.
This case underscores the growing collaboration between MAVEN Project and the American Kidney Fund (AKF), which launched in March 2025 to strengthen kidney care in underserved communities. Together, the organizations are expanding access to expert nephrology guidance, supporting earlier identification of kidney disease, and helping clinicians make informed, cost-conscious decisions for patients with limited resources.
For AKF, this work is central to its mission of fighting kidney disease and helping people live healthier lives. Kidney disease is a top 10 leading cause of death in the United States, yet it often develops without warning and remains widely misunderstood. Through education, early intervention, and efforts to advance equitable access to care, AKF aims to ensure more patients receive timely, appropriate treatment before kidney disease progresses.
For both physicians in this case—one in the earlier stretch of his career, the other in a thoughtful second act—the encounter illustrates how expert guidance can transform uncertainty into clarity. It also highlights the power of partnership. Together, MAVEN and AKF are not just connecting physicians—they’re building a bridge to better outcomes for patients.
About MAVEN Project
MAVEN Project (Medical Alumni Volunteer Expert Network) is a national telehealth nonprofit that strengthens frontline care by connecting primary care providers with volunteer physicians across 70 specialties. Partnering with more than 625 individual clinic sites — including FQHCs and free and charitable clinics— in 37 states, MAVEN equips clinicians with provider-to-provider support through medical consults, medical education, and mentoring.
About the American Kidney Fund
The American Kidney Fund (AKF) fights kidney disease on all fronts as the nonprofit with the greatest direct impact on people with kidney disease. AKF works on behalf of the 1 in 7 American adults living with kidney disease, and the millions more at risk, with an unmatched scope of programs that support people wherever they are in their fight against kidney disease—from prevention through post-transplant living. AKF fights for kidney health for all through programs that address early detection, disease management, financial assistance, clinical research, innovation and advocacy.
