Discover and read the best of Twitter Threads about #NephMadness
Most recents (24)
1/
Oh no! This patient is coming with heart failure exacerbation again. He is taking his diuretics but it seems they do not work. What can we do?
#DiureticResistanceMechanisms
#NephMadness #NephTwitter #MedTwitter
Oh no! This patient is coming with heart failure exacerbation again. He is taking his diuretics but it seems they do not work. What can we do?
#DiureticResistanceMechanisms
#NephMadness #NephTwitter #MedTwitter
2/
#DiureticResistance
Diuretic resistance is the failure to achieve euvolemia despite increasing doses or maximal tolerated diuretic therapy
#DiureticResistance
Diuretic resistance is the failure to achieve euvolemia despite increasing doses or maximal tolerated diuretic therapy
3/
What will be your first line to use to diurese a patient?
What will be your first line to use to diurese a patient?
We don’t talk about Bruno 🤫, but we can talk about pregnancy and lupus nephritis (LN)!
Time for a tweetorial! 🚨
#Nephmadness2022 Lupus Region: Tweetorial 🧵
@jkidd03 @Dr_KeishaGibson @anna_burgner @maximal_change
ajkdblog.org/2022/03/11/nep…
1/19
Time for a tweetorial! 🚨
#Nephmadness2022 Lupus Region: Tweetorial 🧵
@jkidd03 @Dr_KeishaGibson @anna_burgner @maximal_change
ajkdblog.org/2022/03/11/nep…
1/19
Disclaimer‼️
The information presented in this tweetorial is for informational purposes only and does NOT constitute or substitute medical advice.Medical decisions should be made according to the latest guidelines and medical literature and after consulting with your doctor. 2/19
The information presented in this tweetorial is for informational purposes only and does NOT constitute or substitute medical advice.Medical decisions should be made according to the latest guidelines and medical literature and after consulting with your doctor. 2/19
⦿ SLEs disproportionately affects 👩🏻🦰 of child-bearing age
⦿ Patients are at risk of unplanned pregnancies
pubmed.ncbi.nlm.nih.gov/18512717/
⦿ Family planning is 🔑 to prevent poor maternal and fetal outcomes due to lupus flares 🔥 3/19
⦿ Patients are at risk of unplanned pregnancies
pubmed.ncbi.nlm.nih.gov/18512717/
⦿ Family planning is 🔑 to prevent poor maternal and fetal outcomes due to lupus flares 🔥 3/19
1/16 Inspired by #NephMadness, let’s briefly touch on:
💢Role of kidney biomarkers in patients with CHF
💢‘Worsening kidney function’ in heart failure
💢Permissive hypercreatininemia
💢Handling RAASi and SGLT2i in heart failure
#NephTwitter #MedTwitter
ajkdblog.org/2022/03/01/nep…
💢Role of kidney biomarkers in patients with CHF
💢‘Worsening kidney function’ in heart failure
💢Permissive hypercreatininemia
💢Handling RAASi and SGLT2i in heart failure
#NephTwitter #MedTwitter
ajkdblog.org/2022/03/01/nep…
2/16 Let’s have a poll.
Forward failure, characterized by decreased kidney perfusion, is the main determinant of kidney dysfunction in acute decompensated heart failure. Is this true or false?
Forward failure, characterized by decreased kidney perfusion, is the main determinant of kidney dysfunction in acute decompensated heart failure. Is this true or false?
3/16 That’s false!
◀️“Backward failure” (Kidney congestion, interstitial edema and tubular dysfunction) is believed to play a more vital role compared to “Forward failure”▶️ (decreased kidney perfusion)
Neurohumoral and inflammatory mechanisms also operate
PMID:34970606
◀️“Backward failure” (Kidney congestion, interstitial edema and tubular dysfunction) is believed to play a more vital role compared to “Forward failure”▶️ (decreased kidney perfusion)
Neurohumoral and inflammatory mechanisms also operate
PMID:34970606
1/ 🧵Hello #medtwitter Ready for some NephMadness? 🤯
Not just any madness, but beware your mosquito bites 🦟, because today’s topic is #Malaria and kidney involvement.
#NephTwitter #NephMadness
@NephMadness
Not just any madness, but beware your mosquito bites 🦟, because today’s topic is #Malaria and kidney involvement.
#NephTwitter #NephMadness
@NephMadness
2/ 🧵 Where does the word malaria originate from?
PMID: 11053494
PMID: 11053494
3/🧵 Malaria is an Italian word composed of “mala” and “aria,” meaning bad (malus) air (aeris). It was first used to describe a fever (miasma) mistakenly attributed to exposure to poisonous air.
PMID: 11053494, 9641206
PMID: 11053494, 9641206
1/
Let's be honest...
💥💥“THE TISSUE IS THE ISSUE” 💥💥
#Nephropath #NephMadness
This region features:
🔎PLA2R 🆚Other Membranous Antigens
🔎DNAJB9 🆚IgG4 Disease
READY???👇👇
ajkdblog.org/2022/03/01/nep…
Let's be honest...
💥💥“THE TISSUE IS THE ISSUE” 💥💥
#Nephropath #NephMadness
This region features:
🔎PLA2R 🆚Other Membranous Antigens
🔎DNAJB9 🆚IgG4 Disease
READY???👇👇
ajkdblog.org/2022/03/01/nep…
2/
Matchup 1⃣: PLA2R 🆚Other MN Antigens
PLA2R facts
✅Present in healthy human podocytes
✅70-80% 👥with 1ry MN & ~ 60% of ALL MN
✅Serum Ab are measured via ELISA & IF
💡💡DX:
🧪ELISA > 14 RU/mL or
🧪ELISA 2 - 14 RU/mL WITH a positive IFA
pubmed.ncbi.nlm.nih.gov/34556256/
Matchup 1⃣: PLA2R 🆚Other MN Antigens
PLA2R facts
✅Present in healthy human podocytes
✅70-80% 👥with 1ry MN & ~ 60% of ALL MN
✅Serum Ab are measured via ELISA & IF
💡💡DX:
🧪ELISA > 14 RU/mL or
🧪ELISA 2 - 14 RU/mL WITH a positive IFA
pubmed.ncbi.nlm.nih.gov/34556256/
3/
Check this beautiful Visual Abstract by @Vernisartan on the serology based approach to MN
A few more words on Anti-PLA2R titers:
✅>150 RU/mL- ⏫ risk of progression
✅> 45 RU/mL- ⏫risk of recurrence post transplant
💡 Titers are part of the risk stratification algorithm💡
Check this beautiful Visual Abstract by @Vernisartan on the serology based approach to MN
A few more words on Anti-PLA2R titers:
✅>150 RU/mL- ⏫ risk of progression
✅> 45 RU/mL- ⏫risk of recurrence post transplant
💡 Titers are part of the risk stratification algorithm💡
1/ Nephrologists & cardiologists might agree on 1 #NephMadness region: #CardioRenal
Matchup 1:
Diuretic resistance mechanisms vs treatment
ajkdblog.org/2022/03/01/nep…
So many diuresis roadblocks, summarized below by @hellokidneyMD
@DrFlashHeart @NishaKidneyDoc @HeartDocSadiya
Matchup 1:
Diuretic resistance mechanisms vs treatment
ajkdblog.org/2022/03/01/nep…
So many diuresis roadblocks, summarized below by @hellokidneyMD
@DrFlashHeart @NishaKidneyDoc @HeartDocSadiya
2/
Loop diuretics have an S-shaped dose-response curve
ajkdblog.org/2022/03/01/nep…
#NephMadness #CardioRenal @kidney_boy
Loop diuretics have an S-shaped dose-response curve
ajkdblog.org/2022/03/01/nep…
#NephMadness #CardioRenal @kidney_boy
3/
#CardioRenal Matchup 2:
♥️ biomarkers in #CKD vs 🥔 biomarkers in ♥️ disease
NT-proBNP, BNP, & troponin degradation products are filtered through the glomerulus
ajkdblog.org/2022/03/01/nep…
#NephMadness @DrFlashHeart
#CardioRenal Matchup 2:
♥️ biomarkers in #CKD vs 🥔 biomarkers in ♥️ disease
NT-proBNP, BNP, & troponin degradation products are filtered through the glomerulus
ajkdblog.org/2022/03/01/nep…
#NephMadness @DrFlashHeart
1/14
🎤“Don’t make a change too complicated, just begin.”
🔊 We have a chance to make a ‘change for good’ in anemia Rx in CKD.
👥Let’s discuss hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHIs), the probable champions🏆 of NephMadness 2021. #AnemiaRegion
🎤“Don’t make a change too complicated, just begin.”
🔊 We have a chance to make a ‘change for good’ in anemia Rx in CKD.
👥Let’s discuss hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHIs), the probable champions🏆 of NephMadness 2021. #AnemiaRegion
2/ 📖Hypoxia Inducible Factor (HIF) - Physiology
- Present in all tissues.
- Has O2 regulated 𝞪 (3 isoforms) and constitutively expressed 𝛃 subunits.
- HIF-2𝞪 is expressed in the peritubular fibroblasts, mainly involved in the upregulation of EPO gene.
- Present in all tissues.
- Has O2 regulated 𝞪 (3 isoforms) and constitutively expressed 𝛃 subunits.
- HIF-2𝞪 is expressed in the peritubular fibroblasts, mainly involved in the upregulation of EPO gene.
3/
🗝️↓ Hypoxia, HIF 𝞪 heterodimerizes with 𝛃 subunit in the nucleus → the complex binds with DNA sequences called hypoxia response elements → Gene activation → ↑ RBC production by ↑ essential protein synthesis linked with iron and EPO pathways. mdpi.com/1422-0067/19/2…
🗝️↓ Hypoxia, HIF 𝞪 heterodimerizes with 𝛃 subunit in the nucleus → the complex binds with DNA sequences called hypoxia response elements → Gene activation → ↑ RBC production by ↑ essential protein synthesis linked with iron and EPO pathways. mdpi.com/1422-0067/19/2…
1/ When bubbles settle on the surface of the urine it indicates disease of the kidneys-Hippocrates
In the day, urinary exam was so crucial, the urine flask was as much a symbol of a physician as today's white🥼!
🧵Is proteinuria a worthy rival to GFR?
#Nephmadness #primarycare
In the day, urinary exam was so crucial, the urine flask was as much a symbol of a physician as today's white🥼!
🧵Is proteinuria a worthy rival to GFR?
#Nephmadness #primarycare
2/
*⃣Normal urinary protein excretion is <150mg/d and comprises mainly Tamm-Horsfall proteins, with very little albumin (5-10mg/d)
*⃣ We don't understand what happens to albumin in the kidney 💯
*⃣ But overall the degree of albuminuria is a ⚖️of filtration + reabsorption 👇
*⃣Normal urinary protein excretion is <150mg/d and comprises mainly Tamm-Horsfall proteins, with very little albumin (5-10mg/d)
*⃣ We don't understand what happens to albumin in the kidney 💯
*⃣ But overall the degree of albuminuria is a ⚖️of filtration + reabsorption 👇
3/Albuminuria is common in injury to the GBM (GLOMERULAR proteinuria)
But non-albumin proteins sometimes dominate the filtrate.
The classic case is OVERFLOW proteinuria in paraproteinemia
CLUE: Neg dipstick, with⬆️Urine PCR
💡Urine dip +=Albuminuria #renalrules
But non-albumin proteins sometimes dominate the filtrate.
The classic case is OVERFLOW proteinuria in paraproteinemia
CLUE: Neg dipstick, with⬆️Urine PCR
💡Urine dip +=Albuminuria #renalrules
1/ I often get asked about the presence of granular casts on the automated UA reported by the lab whether it is equivalent to seeing muddy brown casts.
❓Do you think granular casts can be used to diagnose ATN?
More to see in #NephMadness on #liquidbiopsy
@NSMCInternship
❓Do you think granular casts can be used to diagnose ATN?
More to see in #NephMadness on #liquidbiopsy
@NSMCInternship
2/ Spin the urine! This is one of the maneuvers that I enjoy doing with residents the most as there is a lot to uncover.
I totally underestimated the power of this test. How many times have you spun the urine yourself before nephrology training?
I totally underestimated the power of this test. How many times have you spun the urine yourself before nephrology training?
3/ The clinical properties of urine have long been described by the medical community.
‘Diabetic’ (polyuric) disorders were classified as ‘mellitus’ (honey-sweet) or ‘insipidus (flavorless) based on the urine’s taste!
#NephMadness #liquidbiopsy
‘Diabetic’ (polyuric) disorders were classified as ‘mellitus’ (honey-sweet) or ‘insipidus (flavorless) based on the urine’s taste!
#NephMadness #liquidbiopsy
1/ Monitoring eGFR in CKD is almost a reflex🦵!
But how did we get here?
What are we trying to assess?
And how does eGFR help?
#NephMadness #primarycare pits GFR vs proteinuria in CKD
In this tweetorial let's take a closer look at GFR
But first, who has your vote?#NephTwitter
But how did we get here?
What are we trying to assess?
And how does eGFR help?
#NephMadness #primarycare pits GFR vs proteinuria in CKD
In this tweetorial let's take a closer look at GFR
But first, who has your vote?#NephTwitter
2/ The concept of GFR as a marker of kidney function dates way back to the 1950s. (Apologies to the tubules, we do❤️you!)
But how could we measure GFR??
It was suggested that if a solute had certain characteristics its plasma clearance would = GFR
Let's briefly recap🤓
But how could we measure GFR??
It was suggested that if a solute had certain characteristics its plasma clearance would = GFR
Let's briefly recap🤓
3/ The solution, INULIN, a non-toxic exogenous molecule, came through studies on aglomerular fish! #AnimalHouse
INULIN renal clearance= measured GFR
It is considered the GOLD standard🏆
But it comes with baggage
🧳It's expensive
🧳It's tedious
🧳It's hardly available anymore
INULIN renal clearance= measured GFR
It is considered the GOLD standard🏆
But it comes with baggage
🧳It's expensive
🧳It's tedious
🧳It's hardly available anymore
1/12
It has been more than a century tackling Anemia in CKD since its first description by Richard Bright in 1835.
👉 #NephMadness 2021 is featuring strong contenders from the #AnemiaRegion.
🤔 Let's find out why Anemia in CKD is an important consideration. #NSMCInternship
It has been more than a century tackling Anemia in CKD since its first description by Richard Bright in 1835.
👉 #NephMadness 2021 is featuring strong contenders from the #AnemiaRegion.
🤔 Let's find out why Anemia in CKD is an important consideration. #NSMCInternship
2/📊 What % of patients with CKD stage 4 have anemia based on KDOQI (Hb <13.5 g/dL for men and <12.0 g/dL for women) and WHO (<13.0 g/dL for men & <12.0 g/dL for women)?
3/
😳 Around 60% of the patients with stage 4 CKD not on dialysis have anemia based on KDOQI/WHO.
😟 Anemia contributes to significant morbidity in patients with CKD.
pubmed.ncbi.nlm.nih.gov/18359408/
😳 Around 60% of the patients with stage 4 CKD not on dialysis have anemia based on KDOQI/WHO.
😟 Anemia contributes to significant morbidity in patients with CKD.
pubmed.ncbi.nlm.nih.gov/18359408/
1/🧵
🔥PART 2/2 on #PD catheter complications
#NephTwitter #NSMC #medtweetorials #medtwitter #Nephmadness
You see a patient w/ a past history of C-section for poor inflow/outflow 1️⃣ week post laparoscopic PD catheter insertion
📊What are the possible causes of flow problems?
🔥PART 2/2 on #PD catheter complications
#NephTwitter #NSMC #medtweetorials #medtwitter #Nephmadness
You see a patient w/ a past history of C-section for poor inflow/outflow 1️⃣ week post laparoscopic PD catheter insertion
📊What are the possible causes of flow problems?
2/
What’s your approach to flow?
1️⃣ Catheter irrigation → 1L of solution (dialysate/saline)
2️⃣ If slow fill → Flush/aspirate with syringe (aseptic technique! 🧤 😷)
3️⃣ If resistance both ways → Likely two-way obstruction
👇 Use an approach to catheter flow problems:
What’s your approach to flow?
1️⃣ Catheter irrigation → 1L of solution (dialysate/saline)
2️⃣ If slow fill → Flush/aspirate with syringe (aseptic technique! 🧤 😷)
3️⃣ If resistance both ways → Likely two-way obstruction
👇 Use an approach to catheter flow problems:
3/
➡️⬅️obstructions due to intraluminal/extraluminal process
👉Fibrin → most common cause of intraluminal obstruction
👉Fibrin → arises with inflammation (e.g. peritonitis)/embedded catheters too!
👉 Diagnose by clinical suspicion (🔎 for fibrin traces in drain bag)
➡️⬅️obstructions due to intraluminal/extraluminal process
👉Fibrin → most common cause of intraluminal obstruction
👉Fibrin → arises with inflammation (e.g. peritonitis)/embedded catheters too!
👉 Diagnose by clinical suspicion (🔎 for fibrin traces in drain bag)
1/ What causes #AKI with extracorporeal membrane oxygenation (ECMO)?
🗣️🗣️Let’s explore this 🔥topic from #NephMadness 2021
🧵#tweetorial #CriticalCare #NephTwitter @NSMCinternship @ASPNeph
Poll: How common is AKI in patients receiving ECMO?
🗣️🗣️Let’s explore this 🔥topic from #NephMadness 2021
🧵#tweetorial #CriticalCare #NephTwitter @NSMCinternship @ASPNeph
Poll: How common is AKI in patients receiving ECMO?
2/ Basics first:
⚡️ECMO: temporary mechanical assistance device that provides prolonged cardiopulmonary support
⚡️Venovenous (VV) ECMO→ full respiratory support
⚡️Venoarterial (VA) ECMO→ both respiratory and hemodynamic support
ajkd.org/article/S0272-…
⚡️ECMO: temporary mechanical assistance device that provides prolonged cardiopulmonary support
⚡️Venovenous (VV) ECMO→ full respiratory support
⚡️Venoarterial (VA) ECMO→ both respiratory and hemodynamic support
ajkd.org/article/S0272-…
⚡ Protocol Biopsies in Lupus Nephritis (LN)⚡
1/ Let's take another stab at (pun intended?) protocol biopsies in LN!
💡 The idea is certainly not new - it has been successfully implemented in kidney transplant recipients #NephTwitter #Tweetorial #FOAMed @NSMCInternship
1/ Let's take another stab at (pun intended?) protocol biopsies in LN!
💡 The idea is certainly not new - it has been successfully implemented in kidney transplant recipients #NephTwitter #Tweetorial #FOAMed @NSMCInternship
2/ Out of curiosity - have you asked for repeat biopsies in these patients? When & why? Does your hospital have a protocol for it? Share your experience in the comments too! 👇
3/ I mean, you nailed the diagnosis the first time around, right? So why would you ask for a repeat kidney biopsy in a patient with LN? 🤔
Did you check out the latest SKG case? Read all about it in this awesome and fun thread by @nepherson
👇
⚡️Taking inspiration, here’s a 🧵on the complications of hyponatremia
#NSMC #Tweetorial @TheSkeletonKG
👇
👇
⚡️Taking inspiration, here’s a 🧵on the complications of hyponatremia
#NSMC #Tweetorial @TheSkeletonKG
👇
1/22
But before we start - I have two words for you!
☝️OSMOLALITY and
✌️TONICITY
Are they the same or are they not?
🤔
But before we start - I have two words for you!
☝️OSMOLALITY and
✌️TONICITY
Are they the same or are they not?
🤔
Are OSMOLALITY and TONICITY the same thing?
Association of Opioids and NSAIDs With Outcomes in CKD: Findings From the @CRICStudy ca. 2020 from @AJKDonline #Nephpearls #NephJC
#VisualAbstract by @AliMehdiMD
👉🏼 ajkd.org/article/S0272-…
#VisualAbstract by @AliMehdiMD
👉🏼 ajkd.org/article/S0272-…
Pharmacological management of pain in patients with CKD ca. 2019 from @CJASN #Nephpearls #NephJC
👉🏼 cjasn.asnjournals.org/content/clinja…
👉🏼 cjasn.asnjournals.org/content/clinja…
Association of NSAID Prescriptions
With Kidney Disease Among Active Young and Middle-aged Adults ca. 2019 from @JAMA_current @JAMAInternalMed #Nephpearls #NephJC
#VisualAbstract by @Stones__
👉🏼 jamanetwork.com/journals/jaman…
With Kidney Disease Among Active Young and Middle-aged Adults ca. 2019 from @JAMA_current @JAMAInternalMed #Nephpearls #NephJC
#VisualAbstract by @Stones__
👉🏼 jamanetwork.com/journals/jaman…
🌍Earth's temp🌡️ has ⬆️ 0.8°C in the past decades🤨
Is this changing pattern of climate threatening 👀 kidney health❓
Let's find out why this global rise in temp concerns nephrologists so much❓
🌍🔥🌍🔥🌍🔥
💥Tweetorial alert 💥
#NephMadness #NephTweetorial #NSMC
Is this changing pattern of climate threatening 👀 kidney health❓
Let's find out why this global rise in temp concerns nephrologists so much❓
🌍🔥🌍🔥🌍🔥
💥Tweetorial alert 💥
#NephMadness #NephTweetorial #NSMC
What makes the kidneys more susceptible to acute injury from climate change?
Kidney is an amazing organ🙃🙂
⚡️It excretes concentrated waste ( To minimize fluid loss)
⚡️It is highly metabolic work🥵🥶
⚡️It excretes concentrated waste ( To minimize fluid loss)
⚡️It is highly metabolic work🥵🥶
Ready for a short @thecurbsiders recap #tweetorial on #SGLT2Inhibitors Ep 204 #NephMadness Hat tip to the Shownotes @BrighamSK @PaulNWilliamz @DoctorWatto @kidney_boy @HannahRAbrams
SGLT2i Pearls:
1. SGLT2 inhibitors have significant long-term protection of GFR. However, because they cause afferent arteriolar vasoconstriction, expect to see an acute drop in GFR after initiating.
1. SGLT2 inhibitors have significant long-term protection of GFR. However, because they cause afferent arteriolar vasoconstriction, expect to see an acute drop in GFR after initiating.
2. SGLT2 inhibitors work w/ ACEi/ARBs & can still provide improvement in renal outcomes for pts w/ diabetic kidney disease on max dose ACEi/ARB.
3. Patients already on thiazide can experience significant volume loss with SGLT2i initiation. Consider reducing or stopping thiazides
3. Patients already on thiazide can experience significant volume loss with SGLT2i initiation. Consider reducing or stopping thiazides
1/
Speaking of staying at home 🏠... let’s not forget that #AdvancingAmericanKidneyHealth (AAKH) aims to have 80% of people with kidney failure use a home dialysis modality or obtain a transplant by 2025. Do you know how close we are to that goal?
#NephMadness #EthicsRegion
Speaking of staying at home 🏠... let’s not forget that #AdvancingAmericanKidneyHealth (AAKH) aims to have 80% of people with kidney failure use a home dialysis modality or obtain a transplant by 2025. Do you know how close we are to that goal?
#NephMadness #EthicsRegion
2/
As of December 2017, the USRDS reported 38% of people with kidney failure (or end stage renal disease/ESRD) in the United States were either on peritoneal dialysis (PD), home hemodialysis (HD), or had a functioning kidney transplant. What’s the breakdown of each modality?
As of December 2017, the USRDS reported 38% of people with kidney failure (or end stage renal disease/ESRD) in the United States were either on peritoneal dialysis (PD), home hemodialysis (HD), or had a functioning kidney transplant. What’s the breakdown of each modality?
3/
By and large, that 38% is made up of transplant - 30% of all ESRD patients have a functioning kidney transplant. Only 7% are on PD, and 1.3% are on home HD. The rest of our patients (~ 61%) receive in-center HD.
By and large, that 38% is made up of transplant - 30% of all ESRD patients have a functioning kidney transplant. Only 7% are on PD, and 1.3% are on home HD. The rest of our patients (~ 61%) receive in-center HD.
Have you ever wondered when we should pursue genetic testing in paediatric patients with cystic kidneys?#nephtwitter #medtwitter #NephMadness #Genetics. But first a quick primer on paediatric genetic kidney cystic diseases😃😃
Paediatric genetic cystic kidneys are heterogenous group of disorders. The age of presentation, clinical features and family history are often useful for coming to a diagnosis. linkinghub.elsevier.com/retrieve/pii/S…
But first let's talk about 4 common genetic causes of cystic kidney disease in children:
🌟ADPKD
🌟 ARPKD
🌟Nephronophthisis
🌟 HNF-Beta related disease
🌟ADPKD
🌟 ARPKD
🌟Nephronophthisis
🌟 HNF-Beta related disease
SGLT2i 💊 are emerging as a promising agent to prevent and ⤵️the progression of DKD
Ever wondered
What do they do to electrolytes❓
Why r these diuretics not associated with electrolyte depletion❓
Let's dive deeper🔓
#medtwitter #NephMadness #SGLT2iRegion
Ever wondered
What do they do to electrolytes❓
Why r these diuretics not associated with electrolyte depletion❓
Let's dive deeper🔓
#medtwitter #NephMadness #SGLT2iRegion
What is the impact of SGLT2i on Na and water hemostasis?
First, let’s revisit, how Na and glucose are handled in the nephron 📜
💥100% of the filtered glucose is reabsorbed along the nephron (90%, via SGLT2 in PCT)
💥1 Na+ ion for every glucose molecule gets absorbed from the lumen
💥In PCT 60 - 80% of sodium is reabsorbed
💥100% of the filtered glucose is reabsorbed along the nephron (90%, via SGLT2 in PCT)
💥1 Na+ ion for every glucose molecule gets absorbed from the lumen
💥In PCT 60 - 80% of sodium is reabsorbed
1/
I’ve been working on my #medtwitter elevator pitch. Mostly because lately I seem to have lots of fleeting conversations about it.
And I know I’m not alone.
Here's what I find:
Some are sold but nervous.
Some are intrigued but don’t get it.
And a lot are precontemplative.
I’ve been working on my #medtwitter elevator pitch. Mostly because lately I seem to have lots of fleeting conversations about it.
And I know I’m not alone.
Here's what I find:
Some are sold but nervous.
Some are intrigued but don’t get it.
And a lot are precontemplative.
2/
I think it’s because it can seem like all #medtwitter users look the same.
Them: “I would get on Twitter but I’m not a social media person.”
Me: “Twitter is different! Even if you don’t do social media!”
Them: 😐“Nah. Can’t see it.”
*ping*
Them: ✌️🏾
Elevator ride over.
I think it’s because it can seem like all #medtwitter users look the same.
Them: “I would get on Twitter but I’m not a social media person.”
Me: “Twitter is different! Even if you don’t do social media!”
Them: 😐“Nah. Can’t see it.”
*ping*
Them: ✌️🏾
Elevator ride over.
3/
But I’ve been thinking about the many different #medtwitter identities there are. Most can find a fit nestled somewhere in 1 or a few of them.
What works for each person depends on a few things:
Who you are
What you hope to get from it
What’s going on in your life
Yup.
But I’ve been thinking about the many different #medtwitter identities there are. Most can find a fit nestled somewhere in 1 or a few of them.
What works for each person depends on a few things:
Who you are
What you hope to get from it
What’s going on in your life
Yup.
PRESERVE Trial: NaHCO3 ➕ Acetylcysteine ~ NO significant difference across groups in death, need for dialysis or >/= 50% increase in creatinine at 90 days
#KidneyWk #Nephpearls
👉🏼 nejm.org/doi/pdf/10.105…
#KidneyWk #Nephpearls
👉🏼 nejm.org/doi/pdf/10.105…
Renalism: Coronary angiography and mortality in patients with CKD ca. 2004 from @gchertow @JASN_News
#KidneyWk #Nephpearls
👉🏼 jasn.asnjournals.org/content/jnephr…
#KidneyWk #Nephpearls
👉🏼 jasn.asnjournals.org/content/jnephr…
