๐ฅHot 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
@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"
๐ฅHot 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
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
2/ It was so close... but there was a winner. Curious to see who won? #ISNWCN
08.02.2025 22:13 โ ๐ 0 ๐ 2 ๐ฌ 0 ๐ 0Happy to receive a prize on IgA quiz by Kidney Kolumns from @isn-india.bsky.social at WCN 2025.
Thank you ๐Dr. Mayuri Trivedi, Dr. Shyam Bansal and Dr. Vineet Behera.
#ISNWCN
Doctors shouldn't measure BP ๐
We suck at it. ๐ค
There are quite significant pre-requisites for it.
All trials did automated BP recording.
@hswapnil.medsky.social
#ISNWCN
@nephjc.bsky.social session is happening now.
@hswapnil.medsky.social @nephromythri.bsky.social
#ISNWCN
Screening criteria 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
10-20% variability in eGFR.
40-50% variability in Albuminuria.
Make your clinical judgment accordingly.๐
#ISNWCN
@argaiz.bsky.social killing with his teaching skills. It was an amazing session on POCUS and VExUS ๐๐ฅ. Thank you ๐
#ISNWCN
Figure 4 Approach to immune checkpoint inhibitor (ICPI) nephrotoxicity.โTreat 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 ๐
Eisei Sohara talking about importance of genetic testing in CKD.
โก๏ธ10-15% of so called ADPKD do not have family history yet have PKD1/2 mutation.
โก๏ธ Other genes involved in PKD (IFT40, CFAP47).
โก๏ธ10% of dialysis patients with unknown cause actually have genetic cause.
#ISNWCN
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
The excellent overview of IgA management and the upcoming @kdigo.org guidelines from Prof IgA himself, Dr Barratt
youtu.be/OChs5BcTEGE?...
#NephGR #NephSky
1๏ธโฃ 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
Some pivot is probably with ICUs and maybe neurgosurgical teams.
So I also added a good rapport with them is also translational. ๐
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 do๐คท
@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.๐
All I could write was SoMe campaign, talks, posters etc.
What would #NephSky and #MedSky add to it?
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.
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.
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 ๐
journals.lww.com/kidney360/fu...
@safety.bsky.app @bsky.app
12.01.2025 08:02 โ ๐ 1 ๐ 0 ๐ฌ 0 ๐ 0This looks quite some time back. But I'm able to see all your posts.
12.01.2025 07:56 โ ๐ 1 ๐ 0 ๐ฌ 1 ๐ 0Clearly seen.
Is this some sorta prank?๐
DIPAK. Lanreotide didn't help.
11.01.2025 05:45 โ ๐ 2 ๐ 0 ๐ฌ 0 ๐ 0Good 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
Unfortunately research in India is all about quantity and never about quality. Glad it has come out.
11.01.2025 01:51 โ ๐ 1 ๐ 0 ๐ฌ 0 ๐ 0I'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.
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?
๐ฏ%. I just felt the lag is more here. ๐
But anyways point duly noted sir ๐
My bad. ๐
And yes sir. It gives in most of the important points.