Hariharasudan Natarajan

T3d
Benefits may vary, and results in the general population on CV risk and mortality are still
controversial.
Overall, the results of recent studies have been mixed results. Different study populations,
end points and dosing may account for the lack of clarity. #NephJC

Fish Oil in Dialysis: A Big Catch or an Empty Net — NephJC Holy Mackerel! This week we will discuss fish oil use in maintenance hemodialysis patients. Could this be the one thing that bends the curve on CV mortality, or is it just a red herring?

Check out the insightful summary by
Dr. Akshaya, AKA- @nephromommy-akshu.bsky.social #NephJC

PISCES: The Visual Abstract — NephJC Curious how n-3 PUFAs may cut serious cardiovascular events in dialysis? 🐟 A big signal, a big dose, and a big discussion ahead — don’t miss this #NephJC! Check out the VA made by our master Brian Rifkin

🎨Beautiful visual abstract by Dr Brian Rifkin @brianrifkin.bsky.social #NephJC

Although, you admired the very beautiful visual abstract made by @brianrifkin.bsky.social, #NephJC team (ha, @nephroseeker.medsky.social ) loved fish oil so much that made another one, right after #KidneyWk simultaneous publication 🎣

www.nephjc.com/news/...

Thank you very much, Dr. Hiremath! I’m currently a fellow at Mount Sinai Hospital in NYC 😃

Hello everyone. I am Hari, a renal fellow here to learn about 🐟 trial. No COI. #NephJC

Hello everyone. I am Hari, a second-year fellow, lurking while pre-charting for tomorrow's clinic to learn the most recent updates on managing hypertension! #NephJC

Finally, the concurrent results of the ALCHEMIST trial (www.sciencedirect.co...) also showed that spironolactone did not reduce major cardiovascular events in older, high-risk hemodialysis patients. #NephJC
Infographic by @nephroseeker.medsky.socia

Spironolactone is effective in treating hypokalemia among peritoneal dialysis patients - PubMed Spironolactone is safe and effective in treating hypokalemia in PD patients. It is also an effective antihypertensive agent and merits further study in the PD population.

Agree

We do try it very cautiously for hypertension

And we do use it a bunch in PD for managing hypOkalemia pubmed.ncbi.nlm.nih.gov/29125879/

#NephJC

T3b:
But… theoretical reasons do not matter anymore since in this well done, large trial with absolutely no benefit of spironolactone in ESRD. Coupled with the risk of serious hyperkalemia, spironolactone should no longer be used for CV protection in ESRD. #NephJC

T0c:
💔 CV morbidity & mortality in ESRD is driven by:
🔹 Cardiac remodeling, ischemia and myocardial fibrosis
All fueled by chronic pressure–volume overload + inadequate salt/water excretion → relative hyperaldosteronism 🧂 #NephJC

www.imrpress.com/jou...

Hari, a Nephro fellow, No COI. I’m just lurking and learning ☺️ #NephJC

I’m back from hibernation, hehe. Thank you, Cristina!! 😁 #nephJC

Hari, Nephro fellow. No COI. Just lurking! ☺️ #NephJC