𝐑𝐚𝐥𝐩𝐡 𝐌𝐨𝐡𝐭𝐲 𝐌𝐃 𝐌𝐏𝐇

Figure 1 The Complement System in the Pathophysiology of IgA Nephropathy. Complement involvement in the four-hit pathogenic model for IgA nephropathy. The glomerulus shows mesangial deposition of galactose-deficient IgA1-containing immune complexes, mesangial cell proliferation, a membrane attack complex in the capillary wall, complement activation and early crescent formation.

excellent review of complement based therapies in ...IgA Nephropathy in @ajkd.bsky.social from @sstoneman.bsky.social et al

www.ajkd.org/article/S027...

Fig 1 with the 4-hit theory 1/

Interesting, LC restricted? Pronase?

3/n although the lobulated nuclei made it clear that the cells were leukocytes, we still confirmed it with Prescott-Brodie stain

a man wearing a shirt that says sticker giant on it ALT: a man wearing a shirt that says sticker giant on it

1/n young adult gets transferred to our hospital for higher level of care. Had presented to a rural institution with weakness; found to have Hgb 7.5, serum Cr 2.6 mg/dL, hematuria. Prompted a positive p-ANCA. Nephrology is consulted on arrival

BigPAK or a bundle of balderdash? — NephJC We break down the latest salvo from Zarbock et al on a supposedly wonderful ‘bundle’

We really don’t think BigPAK makes sense

From our journal club at @uottawa.ca into a #NephJC shorts

www.nephjc.com/news/2025/12...

7. Personal level. Beyond his talent and expertise, I met an extraordinary man. Humble, altruistic, wise, friendly, and with a great sense of humor. I brought him a vacuolar cast tie as a present and he wore it proudly right away 🤩

1/n Recently attended an international congress about Urinalysis in Santiago, Chile 🇨🇱. I was expecting a small meeting. I was wrong. Pleasantly surprised with the size of the meeting and the energy and interest from the participants. Let me share the highlights of my experience:

Hospital Hemodialysis Unit Flexibility and Hospital Length of Stay This quality improvement study evaluates the association of hospital length of stay with a first-in-state model in which an inpatient hemodialysis unit received regulatory approval to provide temporar...

A study that could only happen in the US

jamanetwork.com/journals/jam... in @jamanetworkopen.com

Offering outpatient dialysis to uninsured peeps with kidney failure might help save $$ by reducing LoS

#NephSky

Dual-Antigen Membranous Nephropathy

doi.org/10.1016/j.kint.2025.10.006

#NephSky #MedSky #membranousnephropathy @mayoclinicpath.bsky.social @arkanalabs.bsky.social @lynncornell.bsky.social @aaronstorey.bsky.social

🔬for the diagnosis of glowmrulonephritis, searching for urinary acanthocytes only using bright field illumination is clearly suboptimal compared to utilizing dark field illumination or phase contrast microscopy. #UrinarySediment #UrineMicroscopy karger.com/gdz/article/...

The urine in glomerulonephritis really glows ✨
#urinarySediment

Thanks @amyaimei.bsky.social for giving an excuse to share some #UrinarySediment pics. See below for context 👇🏼

a baby is crying while being held by a woman in a crowd . ALT: a baby is crying while being held by a woman in a crowd .

Not hugely practice-changing, as many folks are already using bicarb to reduce dialysis risk based on BICAR-ICU-1

Lack of mortality impact is unsurprising given how difficult it is to prove in ICU (discussed: emcrit.org/pulmcrit/mor...)

Reduced dialysis & bacteremia are important pt-centered wins

Renal tubular epithelial cell cast (Sternheimer-Malbin stain) under 1000x bright field. Pt with nephrotic range proteinuria, suspected GN. Note small lipid droplets on most inferior cell in the cast.

This is great! Renal biopsy by the nephrologists!

Skeleton Key Group Case #40: Cosmetic Calcium Author: Nikitha (Niki) Cherayil, MD A. The Stem A middle-aged woman with chronic kidney disease stage 3 in the setting of hypertension and recurrent kidney st

Interesting case from the Skeleton Key Group which just keeps pumping out the #FOAMed

www.renalfellow.org/2025/09/28/s...

Largest ever study of peripheral 23.4% NaCl with 863 administrations 😀

Some extravasation did occur, but it *didn't* lead to any major problems (tissue necrosis etc)

If someone is having an ICP crisis, you should worry about their BRAIN and not their ARM - their arm will be fine #EMIMCC

Mixed cellular containing RBCs, WBCs (blue) and RTECs (fuchsia) in the #UrinarySediment from a patient with suspected IgA nephropathy 🔬bright field (500x) and oblique illumination (1000x) #UrineMicroscopy #OchsnerNephrology

I was just reminded that I once made an autoportrait of my distal LAD flow in 3D (and got it published!) #echosky #cardiosky pubmed.ncbi.nlm.nih.gov/29993929/

Following #KidneyWk I’ll be flying to Santiago, Chile, for a #UrinarySediment Microscopy conference 🔬 citem.cl/congreso-int...

Key point from my invasive CO talk the other day #CHEST2025

Tox and Hound - Fellow Friday - Whence the Protons of Lactic Acidosis? The Scream, by Edvard Munch, 1893. Public Domain from wikimedia.org Whence the Protons of Lactic Acidosis? The case of impaired mitochondrial electron

I wish we would switch from saying "we produce lactic acid" to "we produce lactate, and by the way also some protons" toxandhound.com/toxhound/ff-...

A famous nephrologist getting ready to go see the most famous guy who plays a nephrologist @glaucomflecken.bsky.social @stanforddeptmed.bsky.social Grand Rounds!

great name they chose, will be a pleasure watching the pronunciation happen real-time

We are thrilled to announce that we have generously received funding for a one-year hypertension fellowship, and we are recruiting now for a candidate to start fellowship July 1, 2026 .
med.stanford.edu/hypertension/e…

-Jehan Zahid Bahrainwala
HTN Fellowship Program Director

Go to Stanford and learn from the best for hypertension!

#NephSky

Very key point for learners regarding stressed vs unstressed volumes and how our Rx/pressors change that balance

Direct Vascular Effects of Furosemide in Humans | Circulation Background In humans, hemodynamic changes observed within minutes after systemic administration of furosemide are often referred to as direct vasoactivity. However, these immediate changes do not per ...

Secondly, loop diuretics act as venodilators, which means if you look at vena cava shortly after a diuretic dose, vena cava (and RAP/CVP for that matter) may suggest normovolemia even if the patient is still volume overloaded. www.ahajournals.org/doi/10.1161/...

Estimation of Central Venous Pressure Using the Ratio of Short to Long Diameter from Cross-Sectional Images of the Inferior Vena Cava - PubMed S/L of an IVC cross-section measured using three-dimensional echocardiography may be a reliable parameter to estimate CVP compared with standard grading by 2DE.

First of all, I think it’s well overdue that we abandon the use of vena cava size (or at least downgrade it). It’s the poorest parameter! Vena cava circularity/sphericity is much better! pubmed.ncbi.nlm.nih.gov/28065586/

Some thoughts on this study on using vena cava to guide in-patient treatment of deconpensated heart failure and why it will not change the way I diurese (I use vena cava wisely). #emimcc #cardiosky