Senthil Kumar's Avatar

Senthil Kumar

@drsenthil.bsky.social

MBBS, DNB (Gen.Med.), MRCP (UK), DrNB (Neph.). Consultant nephrologist, Sree Abirami hospital, Coimbatore, India. Passion for internal medicine and love for nephrology. Always believe in "Live and let live"

658 Followers  |  618 Following  |  55 Posts  |  Joined: 12.11.2024  |  2.2683

Latest posts by drsenthil.bsky.social on Bluesky

Post image

๐Ÿ”ฅHot Debateโ€”"The "KDIGO BP Targets in CKD Are (Un)Achievable and (Un)Realistic with
@hswapnil.medsky.social pro unbiased take #ISNWCN

His job was to convince a full room of unbelievers in low BPs #NephSky

08.02.2025 21:23 โ€” ๐Ÿ‘ 18    ๐Ÿ” 5    ๐Ÿ’ฌ 2    ๐Ÿ“Œ 1
Post image

10/ We shouldn't be afraid of creatinine #ISNWCN #MedSky

@scoca1.bsky.social made it very easy to understand: maybe attach this to every consult?

@glaucomflecken.bsky.social

08.02.2025 21:23 โ€” ๐Ÿ‘ 5    ๐Ÿ” 4    ๐Ÿ’ฌ 1    ๐Ÿ“Œ 0
Video thumbnail

2/ It was so close... but there was a winner. Curious to see who won? #ISNWCN

08.02.2025 22:13 โ€” ๐Ÿ‘ 0    ๐Ÿ” 2    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0
Post image

Happy to receive a prize on IgA quiz by Kidney Kolumns from @isn-india.bsky.social at WCN 2025.
Thank you ๐Ÿ™Dr. Mayuri Trivedi, Dr. Shyam Bansal and Dr. Vineet Behera.
#ISNWCN

08.02.2025 16:02 โ€” ๐Ÿ‘ 5    ๐Ÿ” 1    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0
Post image

Doctors shouldn't measure BP ๐Ÿ˜…

We suck at it. ๐Ÿค

There are quite significant pre-requisites for it.

All trials did automated BP recording.
@hswapnil.medsky.social
#ISNWCN

08.02.2025 11:08 โ€” ๐Ÿ‘ 2    ๐Ÿ” 0    ๐Ÿ’ฌ 1    ๐Ÿ“Œ 0
Post image

@nephjc.bsky.social session is happening now.
@hswapnil.medsky.social @nephromythri.bsky.social
#ISNWCN

08.02.2025 07:56 โ€” ๐Ÿ‘ 3    ๐Ÿ” 1    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0
Screening criteria for PA

Screening criteria for PA

Screening rates for PA

Screening rates for PA

Screening criteria per Endocrine society for PA

Contrast with actual screening rates - summarized here pubmed.ncbi.nlm.nih.gov/36965825/ from @ajkd.bsky.social

#ISNWCN #NephSky

08.02.2025 05:39 โ€” ๐Ÿ‘ 4    ๐Ÿ” 2    ๐Ÿ’ฌ 1    ๐Ÿ“Œ 0
Post image

10-20% variability in eGFR.

40-50% variability in Albuminuria.

Make your clinical judgment accordingly.๐Ÿ‘Œ
#ISNWCN

08.02.2025 05:34 โ€” ๐Ÿ‘ 0    ๐Ÿ” 1    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0
Post image Post image Post image Post image

@argaiz.bsky.social killing with his teaching skills. It was an amazing session on POCUS and VExUS ๐Ÿ‘๐Ÿ”ฅ. Thank you ๐Ÿ™
#ISNWCN

07.02.2025 12:46 โ€” ๐Ÿ‘ 0    ๐Ÿ” 0    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0
Figure 4 Approach to immune checkpoint inhibitor (ICPI) nephrotoxicity.โˆ—Treat the underlying disease. AKI, acute kidney injury; ATI, acute tubular injury; ATIN, acute tubulointerstitial nephritis; GN, glomerulonephritis; IrAE, immune-related adverse event; RBC, red blood cell; RTEC, renal tubular epithelial cell; WBC, white blood cell.

Figure 4 Approach to immune checkpoint inhibitor (ICPI) nephrotoxicity.โˆ—Treat the underlying disease. AKI, acute kidney injury; ATI, acute tubular injury; ATIN, acute tubulointerstitial nephritis; GN, glomerulonephritis; IrAE, immune-related adverse event; RBC, red blood cell; RTEC, renal tubular epithelial cell; WBC, white blood cell.

This is the algorithm he prefers from a 2020 for biopsy and management www.kidney-international.org/article/S008...
2020 @kidneyint.bsky.social - looks #OpenAccess

#ISNWCN #NephSky #Onconeph

Watch this space for biomarkers I say ๐Ÿ˜Ž

07.02.2025 04:59 โ€” ๐Ÿ‘ 5    ๐Ÿ” 2    ๐Ÿ’ฌ 1    ๐Ÿ“Œ 0
Post image Post image Post image Post image

Eisei Sohara talking about importance of genetic testing in CKD.

โžก๏ธ10-15% of so called ADPKD do not have family history yet have PKD1/2 mutation.

โžก๏ธ Other genes involved in PKD (IFT40, CFAP47).

โžก๏ธ10% of dialysis patients with unknown cause actually have genetic cause.
#ISNWCN

07.02.2025 05:25 โ€” ๐Ÿ‘ 1    ๐Ÿ” 3    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0
Preview
a man stands in front of a blackboard with the words it 's paradoxical and yet it works ALT: a man stands in front of a blackboard with the words it 's paradoxical and yet it works

The Aldosterone Paradox: A Skeetutorial:

31.12.2024 03:51 โ€” ๐Ÿ‘ 47    ๐Ÿ” 20    ๐Ÿ’ฌ 1    ๐Ÿ“Œ 1

And we need to play by local rules and those rules say, we need to repost rather than just like. It was okay to be a lurker on #MedTweeter, but here we have to embrace our inner extrovert.

Repost rather than like to help build #MedSky

30.01.2025 02:23 โ€” ๐Ÿ‘ 10    ๐Ÿ” 10    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 1
Updates to the KDIGO Guidelines for the treatment of IgA nephropathy, with Prof Jonathan Barratt
YouTube video by Ottawa Nephrology Updates to the KDIGO Guidelines for the treatment of IgA nephropathy, with Prof Jonathan Barratt

The excellent overview of IgA management and the upcoming @kdigo.org guidelines from Prof IgA himself, Dr Barratt

youtu.be/OChs5BcTEGE?...

#NephGR #NephSky

24.01.2025 11:54 โ€” ๐Ÿ‘ 29    ๐Ÿ” 13    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 1
Post image

1๏ธโƒฃ We are pleased to announce the publication of the KDIGO 2025 ADPKD Guideline!

This first-ever KDIGO guideline focused on a rare kidney disease provides practical tools to improve diagnosis, care, and treatment.

Read the news release: kdigo.co/2025-ADPKD-G...

#ADPKD

21.01.2025 15:23 โ€” ๐Ÿ‘ 23    ๐Ÿ” 9    ๐Ÿ’ฌ 2    ๐Ÿ“Œ 2

Some pivot is probably with ICUs and maybe neurgosurgical teams.

So I also added a good rapport with them is also translational. ๐Ÿ˜œ

Of course governments need to make a stronger push. Unless governmental action brings in with stronger effort, I'm not sure what as we nephrologists could do๐Ÿคท

21.01.2025 12:30 โ€” ๐Ÿ‘ 1    ๐Ÿ” 0    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0

@askrenal.bsky.social #askrenal
One of our DrNB final theory questions.

Role of nephrologists to promote Donation after Brain Death (DBD) programme in the country.๐Ÿ˜•

All I could write was SoMe campaign, talks, posters etc.

What would #NephSky and #MedSky add to it?

21.01.2025 10:58 โ€” ๐Ÿ‘ 1    ๐Ÿ” 0    ๐Ÿ’ฌ 1    ๐Ÿ“Œ 0

Tacrolimus search didn't show any result and only cyclosporin did. (I guess because of no binding to cyclophilin).

Alisporivir binds only to cyclophilin and not to calcineurin, hence I assume doesn't have the immunosuppressive action.

21.01.2025 03:46 โ€” ๐Ÿ‘ 0    ๐Ÿ” 0    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0

On doing literature search, there were few reports mentioning improvements of proteinuria with cyclosporin but most were case reports.

One observational study which studied immunosuppressants (+CysA) didn't show benefit.

It will be interesting to see if it picks up further.

21.01.2025 03:46 โ€” ๐Ÿ‘ 0    ๐Ÿ” 0    ๐Ÿ’ฌ 1    ๐Ÿ“Œ 0
Post image Post image

Alisporivir, an original antiviral (HepC) drug had shown to increase in mutant trimers in Alport's syndrome acc. to this paper.

It's also a cyclosporin derivative binding to cyclophilin and not to calcineurin.

This was a final DrNB theory question ๐Ÿ˜‘

journals.lww.com/kidney360/fu...

21.01.2025 03:46 โ€” ๐Ÿ‘ 1    ๐Ÿ” 1    ๐Ÿ’ฌ 1    ๐Ÿ“Œ 0

@safety.bsky.app @bsky.app

12.01.2025 08:02 โ€” ๐Ÿ‘ 1    ๐Ÿ” 0    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0

This looks quite some time back. But I'm able to see all your posts.

12.01.2025 07:56 โ€” ๐Ÿ‘ 1    ๐Ÿ” 0    ๐Ÿ’ฌ 1    ๐Ÿ“Œ 0

Clearly seen.
Is this some sorta prank?๐Ÿ™„

12.01.2025 07:33 โ€” ๐Ÿ‘ 1    ๐Ÿ” 0    ๐Ÿ’ฌ 2    ๐Ÿ“Œ 0

DIPAK. Lanreotide didn't help.

11.01.2025 05:45 โ€” ๐Ÿ‘ 2    ๐Ÿ” 0    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0
Preview
2024 โ€“ A Year in Review - Indian Journal of Nephrology [article]

Good noon all,

IJN: Year: 2025, Volume: 35, Issue: 1, January-February Issue of Indian Journal of Nephrology is live.

Kindly follow the link: indianjnephrol.org/current-issue/

@arvindcanchi.bsky.social @priti899.bsky.social

04.01.2025 11:37 โ€” ๐Ÿ‘ 12    ๐Ÿ” 6    ๐Ÿ’ฌ 1    ๐Ÿ“Œ 0

Unfortunately research in India is all about quantity and never about quality. Glad it has come out.

11.01.2025 01:51 โ€” ๐Ÿ‘ 1    ๐Ÿ” 0    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0

I'm guessing with Na at high N(141) and K at low N(3.8), definitely Aldosterone action is going high despite ACEi + ARB.

So my strong guess is MRA should stop it's work, decrease proteinuria as well and probably would negate the need for dual AT blockers.

Just a theoretical assumption sir.

03.01.2025 07:02 โ€” ๐Ÿ‘ 1    ๐Ÿ” 0    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0

What's surprising here is that Losartan is at 100 mg BD, Enalapril at 5 mg BD and Dapagliflozin at 5mg OD, yet the patient's K is just 3.8.

So I would assume aldosterone breakthrough happening full blown, sir?

02.01.2025 17:41 โ€” ๐Ÿ‘ 2    ๐Ÿ” 0    ๐Ÿ’ฌ 1    ๐Ÿ“Œ 0

๐Ÿ’ฏ%. I just felt the lag is more here. ๐Ÿ˜…

But anyways point duly noted sir ๐Ÿ‘

30.12.2024 15:00 โ€” ๐Ÿ‘ 0    ๐Ÿ” 0    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0
Post image Post image Post image

My bad. ๐Ÿ˜€

And yes sir. It gives in most of the important points.

30.12.2024 14:35 โ€” ๐Ÿ‘ 1    ๐Ÿ” 0    ๐Ÿ’ฌ 1    ๐Ÿ“Œ 0

@drsenthil is following 20 prominent accounts