Ashish Sharma

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NephJC Shorts: Should we Screen for Kidney Disease? — NephJC Should we screen for CKD?

should we screen for CKD in the general population?

Finally, flozins, finerenone and GLP1s allow a good cost-effectiveness case

www.nephjc.com/news/2025/7/... for #NephJC shorts

Time to stop just being dialysis-ologists and flozinate, glipinate!

#NephSky

Algorithmic approach to Peritoneal Dialysis (PD) Catheter OUTFLOW FAILURE
#Nephpearls #NephSky

👉🏼 pubmed.ncbi.nlm.nih.gov/20630641/

CKD-MBD still undefeated in its ability to generate negative trials!

This study sounds like a three-foot putt. How can sevelamer not be better at reducing propensity toward calcification? I don't know but P=0.8.

HELLO I HAVE A ROUTINE CONSULT THEY CAN BE SEEN IN THE MORNING JUST WANNA LET YOU KNOW ABOUT IT NOW AT MIDNIGHT OKAY THANKS GOODNIGHT

consulted for a potassium of 5.5 on a patient who recently started both entresto and aldactone. i am a salieri in a world with no mozarts.

Work smarter, not harder!

A low renin with concurrent use of ACEi/ARB is almost certainly some shade of Primary Aldosteronism.

Either way, aldosterone-directed therapy is very likely to provide major clinical benefits

www.ahajournals.org/eprint/TUS6C...

FRESH-UP Trial #ACC25 #medsky

RCT comparing liberal vs restricted fluid intake (≤1500 ml/d) in 504 pts with stable chronic HF

🌊No difference in status health quantified by Kansas City Cardiomyopathy Questionnaire at 3 mths
🌊 More thirst distress with restriction

www.nature.com/articles/s41...

People look at this and scream about getting an AV accesses because of the dramatically lower infection rate, but 1.2 infections per 100 patient-years is 1.2 blood stream infections per patient per 8.8 years

We have bigger fish to fry in dialysis than one BSI per decade.

Survival analysis

Tables with actual event rates

The oral sema results are interesting

Difficult to comment indirectly, but seems less impressive than injectable sema?

Lot of kidney and HF events and favourable point estimates but not a huge effect

#ACC25

Although I suppose that the newly published meta-analysis is the counterpoint.

Starter packs may be passé - but we have had an influx, and we now have a 1/3rd full 6th nephrology pack

5th pack go.bsky.app/JJ4h8su
4th pack: go.bsky.app/YeuH82
3rd pack: go.bsky.app/2yLiYN4
2nd pack go.bsky.app/N27Kzri
1st pack: go.bsky.app/H4td28C
6th go.bsky.app/Gsm6BeJ

#NephSky

Also note two large RCTs ongoing - or about to start - in France: bsky.app/profile/dgue...

INCH-HD - Australasian Kidney Trials Network (AKTN) The INCremental dialysis to improve Health outcomes in people starting Haemodialysis (INCH-HD) study: a randomised controlled trial

We also recently transitioned a pt to both - incremental HDF 💧💦 Some are very CONVINCEd in our dept but we may INCH closer to finding an answer #AKTN aktn.org.au/inch-hd/ pubmed.ncbi.nlm.nih.gov/36938090/ @sarahkmels.bsky.social @nephmadness.bsky.social

#Quiz: A man in his 40s with untreated hypertension presented with right-sided neurologic deficits and slurred speech. His hypertension & age prompted investigation for a secondary etiology of his hypertension. What is the differential diagnosis?

bit.ly/3gyO2ie (FREE)

Ugh
This is a nephrologist
(And an NSMC internship grad)

#NephSky #MedSky

>50% of Nephrologists in the US are foreign graduates, likely many not US citizens. It's one of most cognitively complicated specialties in medicine, and not paid well enough for amount of work involved for many US grads. Good luck caring for aging US population when deporting >50% of your doctors

#NephSky #MedSky
We support our Nephrology colleagues everywhere!
This is not acceptable, free Dr. Alawieh.

4-year-old Wisconsin boy calls 911 after mom ate his ice cream | CNN A 4-year-old boy in Wisconsin called 911 last week to report a very serious offence: his mother ate his ice cream.

There are some things in life you just don’t do - like steal someone’s ice cream.

Obinutuzumab in lupus nephritis: The REGENCY Trial Visual Abstract — NephJC Is Obinutuzumab Effective and Safe in Active Lupus Nephritis?  Check out the beautiful VA by NSMC Faculty Dr Divya Bajpai on the REGENCY Trial, answering the same.

It's March, 2 days before #WorldKidneyDay, so tonight there is the perfect opportunity to celebrate ( 9 pm Eastern, on 🦋)🌺🌻 #NephJC

🎨Until then, take a look at this beautiful and colorful #visualabstract made by Divya Bajpai

www.nephjc.com/news/2025/3/...

Incremental should be about about personalizing the prescription. From psychological factor, biological needs, to establishing realistic goals for every patient (transplant in the next 12-28 months/ balancing their wishes for personal or professional life with time spent in HD)

Hypertensive nephropathy: revisiting the causal link between hypertension and kidney disease Rajiv Agarwal; Hypertensive nephropathy: revisiting the causal link between hypertension and kidney disease, Nephrology Dialysis Transplantation, , gfaf014

Contrary to popular- (ahem, cardiology bias)- opinion, it is unlikely that hypertension is causal of chronic kidney disease: academic.oup.com/ndt/advance-... #openaccess
Classic editorial this week from the #NephSky expert, Dr. Agarwal!!, 👀🤓🙏💛

1/10
Last #NephJC we continued our Aldo streak as we discussed mineralocorticoid antagonist (MRA) withdrawal before ✅aldosterone renin ratio (ARR) & adrenal vein sampling (AVS) #NephSky #MedSky
#TenPostNephJC makes this #Endosky oriented topic easy.
pubmed.ncbi.nlm.nih.gov/39660429/

On the occasion of the #InternationalWomensDay
@pd-perls.bsky.social and I chat with three extraordinary women in #peritonealdialysis on a new special episode of the #PDExchange #podcast
Podcast Link
Spotify - spoti.fi/3DxBOli
Apple - apple.co/3pboqwa

@ispd.org @pdi-journal.bsky.social

Thank you @hswapnil.medsky.social for your incredible efforts in building and connecting the nephrology community on SoMe and dedication to #FOAMed. Excited to be part of #NephSky and looking forward to engaging with fellow colleagues!

Harmonizing Definitions for Diagnostic Criteria and Prognostic Assessment of Transplantation-Associated Thrombotic Microangiopathy: A Report on Behalf of the European Society for Blood and Marrow Tran... Transplantation-associated thrombotic microangiopathy (TA-TMA) is an increasingly recognized complication of hematopoietic cell transplantation (HCT) associated with significant morbidity and mortalit...

Happy new year Swapnil!! Hoping to see you at WCN?
Agree that t/t TMA is a broad topic and depends on the underlying etiology. HSCT-TMA diagnosis & t/t is probably still a bit controversial.
I like this article personally:

pmc.ncbi.nlm.nih.gov/articles/PMC...

Maybe. It all depends on what you 'get' out of the RKF. Dialysis addresses two needs, solute clearance and UF. I think that each patient presents a unique relative mix of those two needs. I'd be willing to take out what's left of RKF in some patients whose greater need is maintaining euvolemia.

This #InternationalWomensDay, let’s highlight the impact of kidney disease on women.
Women with CKD face challenges in fertility, pregnancy, and postpartum care. With rising cases & limited guidance, building obstetric nephrology expertise is critical.
#AccelerateAction #IWD2025 @unwomen.bsky.social

Yes that’s true - our home HD all do Alt day or more. Less time is bad. Phosphate is a good example. Longer hours removes phosphate such that those patients don’t need binders. In our 6 days 6-8hrs patients on long hours we actually added phosphate to the dialysis fluid as we removed too much.