@hardik4u24.bsky.social
Consultant Nephrologist 🫘 | Manipal Goa 🩺 Founder @BuddingNephrologist 🌱IND | Internist | Cricket 🏏 & Sachin Fan | RF 🎾 Fan | Lifelong Learner 📚
🔍Proteinuria in monoclonal gammopathy? Don’t miss the diagnostic clues!
🚰uAPR < 40%? Think tubular
🧪uAPR > 40%? Glomerular path ahead
From cast nephropathy to MGRS, biopsy is 🔑
📉LC ≤10%= cast nephropathy
📊LC >10%= #LCPT
🧬 #MGRS = Biopsy it
🔗 doi.org/10.1016/j.lp...
#NephSky #MGRS #MM #Medsky
📉 Why are infections so common—and deadly—in people with chronic kidney disease?
🧠 SIDKD (Secondary Immune Deficiency of Kidney Disease) affects gut health, immune cells, metabolism & more.
This visual breaks it down beautifully 👇
🔗 doi.org/10.1097/IMNA... 🆕
🧬 Nephrologists, time to zoom in!
🚨NEW Weapons vs #MDR bugs!
💉Explore 3️⃣ hot β-lactam/β-lactamase inhibitor combos:
🦠 Cefepime/enmetazobactam
🦠 Aztreonam/avibactam
🦠 Sulbactam/durlobactam
⚖️💧Renal dose adjustments? Covered👇
🔗 doi.org/10.3390/path... 🆕
#Nephrology #MedTwitter #ICU #ID #Antibiotics #IM
Reducing CKD burden in Europe: first make the elephant apparent!
doi.org/10.1093/ckj/...
Chronic Kidney Disease in Older Adults: Trends in Prevalence and Healthcare Service Quality from 2012 to 2018
doi.org/10.1093/ckj/...
💊💓HFrEF management is evolving!
Why wait months to optimize therapy?
👇Compare ESC 2021 vs McMurray/Packer 2021 strategies
💥 SGLT2i | GLP-1RA | Finerenone
Game-changers in 🫀, 🫘 & 🧠
🔗 doi.org/10.3390/jcm1...
#Nephrology #Cardiology #MedEd #SGLT2i #HeartFailure #CKD #IM #MedSky
🥩🫘#HRS-AKI is more pre-renal than pre-renal AKI!🤯
Check out this mind-bending FENa table in cirrhosis-related AKI from a must-read #ICU review
🔑note: FENa is helpful—but don’t overtrust it alone!
🔗 doi.org/10.1177/0885... 🆕
#Nephrology #MedEd #AKI #Hepatology #Cirrhosis #NephSky #Hepatorenal
🚨#SGLT2 inhibitors in cirrhosis? Where #Nephrology meets #Hepatology
🧪11/11:↓ ascites (💧less taps)
📉7/9: slowed progression (fewer decompensations)
⚠️AKI/hypotension in refractory cases—balance matters!
Dual win:Natriuresis + anti-inflammatory
🔗 doi.org/10.3390/ijms...
🎛️Hemoadsorption in septic shock? Not so fast ❌
🚫 Immune meddling, 🎯 non‑selective action, 📉no survival edge &⚠️ potential harm
🔥 Massimo et al. editorial a must‑read for ICU & nephro teams
🔗 doi.org/10.1007/s001... 🆕
#Nephrology #ICU #Sepsis #AKI #CriticalCare #NephSky
🚨Peripheral Artery Disease🦵 is up to 6x more common in CKD 🫘
❤️🔥Vascular calcification, inflammation & CKD-MBD🦴 fuel the fire 🔥
📉Don’t miss early signs—ankle-brachial index can help!
🔗https://doi.org/10.1093/ckj/sfaf089 @ckj-era.bsky.social review
#MedSky #MedEd #CKD #PAD #Nephrology #NephSky
🦸♂️🦸♀️ Meet the Dynamic Duo in HFpEF/HFrEF!
SGLT2 inhibitors🟰Robin
Finerenone🟰Batman
Together they battle heart failure💔 with preserved/mid-range EF!
🔗 doi.org/10.36660/abc...
#NephSky #CardioRenal #HFpEF #SGLT2i #Finerenone #HeartFailure #MedSky #InternalMedicine
🧬🔬Renal biopsy says amyloidosis… what next?
This brilliant IHC-based algorithm 🔁 guides you through AL, AA, & rare amyloid types—don’t miss that dual diagnosis!
🔗 doi.org/10.1159/0005... 🆕
#RenalPath #Amyloidosis #Nephrology #MedSky #BlueSky
🫀Heart Failure in CKD🫘 isn’t just about fluid overload — and its Rampant in CKD 🔥-it’s a perfect storm of:
🧬Neurohormones
🦠Inflammation
🧪Uremic toxins
🧱Fibrosis
💣Metabolic chaos
🔗 doi.org/10.1161/CIRC...
#Nephrology #CRS #HF #HeartFailure #CKD #FOAMed #MedEd #IM #NephSky #MedSky
🤔Ever seen IgG3 act this wild in the kidney?🫘
🔬PGNMID = mysterious monoclonal Ig with renal-limited fury
🧩Pathophys still unclear but beautifully illustrated here👇
📖Bridoux et al @ndt-era.bsky.social
🔗 doi.org/10.1093/ndt/...
#Nephrology #MGRS #PGNMID #MedTwitter #RenalPath #NephTwitter
🚀Adrenal Incidentalomas Demystified
🥴Stumbled upon an adrenal mass ? Here’s your roadmap🚏
👉🏻Workup algorithm—from benign to suspicious 🦀what’s next?
⭐️A must-know for #Nephrology #Endocrinology #Urology 👩⚕️
🔗 doi.org/10.1097/JU.0...
#Incidentaloma #FOAMed #MedSky
#NephSky
💉Immune checkpoint inhibitors: 🦸♂️heroes in cancer🦀, 🦹♂️villains for kidneys 🫘?
#ICI-AKI can hit both
Glomeruli (C3GN, MCD, vasculitis)
&
Tubulointerstitium (ATIN, ATN, tubulitis)
📖 doi.org/10.34067/KID... 🆕
@asnpublications.bsky.social K360
#Onconephrology #Nephrology #AKI #NephSky #NephPearls
🧰New tools for early ICI-AKI detection!
💧Urine, 🩸 serum, and 📸 imaging markers are changing the game.
Protect kidneys 🫘 , save lives!🌱
🔗 doi.org/10.34067/KID...
@asnpublications.bsky.social K360
@sabinekaram.bsky.social et al
#Nephrology #OncoNephrology #AKI #NephSky #MedSky
#NephPearls
🦀🦴Treatment of Cancer-Associated Hypercalcemia
➡️Start with IV fluids
➡️Then hit osteoclasts with #Bisphosphonates or #Denosumab
But remember, real control = treating the malignancy
🔗 www.nejm.org/doi/full/10....
#Hypercalcemia #Malignancy #OncoNephrology #Nephrology #IM #Oncology #MedSky #NephSky
The CKD-Gut-Immune Axis: A Vicious Cycle 🫘
Uremic toxins → Gut dysbiosis → Inflammation → Immune dysregulation → CKD progression.
Can probiotics break the cycle?
📖 dx.doi.org/10.5527/wjn.... 2025 🆕
#Probiotics #Nephrology #CKD #GutHealth #Uremia #MedSky #NephSky
#Leptospirosis & the #Kidney: A Deadly Duo🦠🫘
Lepto= non-oliguric #AKI→ ATN→ #CKD by blocking Na-K ATPase & inducing vasopressin resistance! Persistent inflammation= fibrosis & kidney failure.
🔗 doi.org/10.1007/s150... 🆕 2025
#Nephrology #InfectiousDiseases #InternalMedicine #MedSky #NephSky
💡Pregnancy after transplant? 🤰🫘🫁🫀
What you need to know!
🔹Pre-pregnancy guidance
🔹Organ-specific outcomes
🔹Risks & expert recommendations
📖 doi.org/10.1097/TP.0... 🆕
@gonikatz.bsky.social @ttsorg.bsky.social (2025)
#TransplantNephrology #Pregnancy #Nephrology #MedTwitter #Transplantation
⚠️Sterile Peritonitis in PD: Think Beyond Infection 🦠
🔍Not always infection!
A broad differential—drugs, malignancy, retrograde menstruation & more! 🏥💡
Freitas et al
🔗https://doi.org/10.1177/089686080502500207
#Nephrology #PeritonealDialysis #PD #MedEd #FOAMed #Dialysis #NephSky #MedSky
🚨Endocrine Hypertension: More Than Just BP🚨
From resistant HTN to adrenal tumors—when should you suspect & how do you approach? 📊🔎
📖Borozan et al., Current Hypertension Reports (2025)
🔗 doi.org/10.1007/s119... 🆕
#Hypertension #Endocrinology #Nephrology #NephSky #MedSky
🚰🔄Vesicoureteral Reflux (VUR): A Silent Threat to Kidneys🫘
From mild reflux to severe tortuosity—grading VUR is key📊
Know when & how to investigate🔍
@diseaseprimers.bsky.social
📖 doi.org/10.1038/s415... (2024-Primer)
#Nephrology #PedsNephro #VUR #UTI #MedEd #FOAMed #NephSky #MedSky
💊🫘Drugs to prevent CKD Progression
doi.org/10.1093/ndt/...
@hjanders.bsky.social
🫘Renal Amyloidosis
academic.oup.com/ndt/article-...
@hjanders.bsky.social
🫘Non invasive biomarkers of Rejection
pubmed.ncbi.nlm.nih.gov/39419272/
@ajkd.bsky.social
Antiphospholipid Syndrome (APS): The Silent Thrombophilia
From molecular pathogenesis to devastating thrombotic complications—#APS is a ticking time bomb! ⏳🧬
📖 APS review: doi.org/10.3390/jcm1... (2025)
#Nephrology #Thrombosis #Lupus #MedTwitter #Rheumatology #Autoimmune
Struggling with hyperphosphatemia in dialysis patients? 🦴🫘
Meet #Tenapanor!
It inhibits paracellular phosphate absorption by modulating NHE3 & tight junctions.
A novel way to tackle phosphorus! 🔬💊
#Nephrology #Hyperphosphatemia #Dialysis #HD
📖https://doi.org/10.1053/j.jrn.2024.07.003
🚨ECMO & AKI: A Deadly Combo🚨
Non-pulsatile flow & venous congestion—ECMO risks renal hypoperfusion, leading to AKI🫀🫘
Can we prevent it? Dive into this review👇
📖AKI in ECMO: Research Progress
🔗https://doi.org/10.1007/s10157-024-02559-7
#Nephrology #ECMO #AKI #CriticalCare #Cardiology #ICU
