Dr.Sridatta

IgA: a friend in the gut, a foe in the glomerulus.
The story of IgA nephropathy captures the thin line between protection and pathology. #Nephrology#nephjc
When it deposits in the kidney, it turns defense into disease IgA nephropathy, the most common primary glomerulonephritis worldwide.

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Last #NephJC we tried to answer the question whether protein supplementation increases health related QoL 🥩💊#TenPostNephJC .
Read the article 👇
pubmed.ncbi.nlm.nih....

Empa is cheaper here

Empa vs Dapa ?
Wch is better ?
#NephJC

Protein supplementation in CKD: The Visual Abstract — NephJC We like protein, or do we? Low protein, high protein, supplements…what’s a nephrologist to do?

Check at the VA for our discussion of protein diet strategies by @msocomd.bsky.social. Is restricting protein in CKD and pushing protein in ESRD #TWDFNR?

www.nephjc.com/news/2025/10...

The Protein Pendulum in CKD: supplement or restrict? — NephJC This week, we will discuss an old dilemma in nephrology. To restrict or supplement the proteins? Premise: advanced CKD and dialysis.

🗓️Join us 10/14/25 as we discuss:
Are you team PRO protein 💪 or team RESTRICT protein 🥗
The strategies seem to shift somewhat as CKD progresses to ESRD. What's the evidence say 🤔?
🕰️9pm EST only on Bluesky. #NephSky #MedSky
www.nephjc.com/news/proteins-eskd

A Skit we performed for Women In Nephrology (WIN-ICON) India conference at Chennai in Sep 2025.

Up next!

CKD & Protein: Is Your Diet a Solution or a Silent Stressor? 🥩🔍
On October 14, we're discussing protein diets and outcomes in CKD/ESRD which still remains an enigma. ☀️📚 #NephJC

pubmed.ncbi.nlm.nih.gov/40876553/

#Skytorial by @nephromommy-akshu.bsky.social
Akshaya's signing off 👋

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Welcome to #TenPostNephJC
Last #NephJC we discussed tolerance induction in HLA matched 🫘 transplants with donor Hematopoietic stem cells (MDR-101).
Missed the Chimeri-chat? No worries - We’re quite “tolerant” to those who missed their IS(Informative Session)!

pubmed.ncbi.nlm.nih.gov/39922283/

a man in a tuxedo and bow tie is standing in front of a clock and says we have a tie . ALT: a man in a tuxedo and bow tie is standing in front of a clock and says we have a tie .

#NephJC
I think the first point may be true but for how long?

Can infection itself protect against rejection? I have a patient who developed severe mucormycosis so had to stop tac and mmf leaving him only on 5 mg steroid. It’s been over 2 years now and he’s still maintaining a stable creatinine of 1.7 and he is only on 5mg steriod
#NephJC

#NephJC Earlier with just cyclo, azo and CDC crossmatch many had no rejection. Now despite using all newer tech like DSA and newer drugs we still see ABMR.

Achieving immune tolerance by chimerism in kidney transplant — NephJC Is getting immunosuppression-free a chimera in kidney transplant? Check out the visual abstract by Bogdan Agavriloaei

Check out the VA by @thekidneywhisperer.bsky.social for tonite's #NephJC discussion on chimerism 🦁🐐🐍 in transplantation. #NephSky #MedSky
9/30/25 at 9 pm only on Bluesky
www.nephjc.com/news/2025/chimerism-kidney-trx

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Welcome to #TenPostNephJC
Last #NephJC we discussed about AHA/ACC 2025 Hypertension guidelines: PREVENT, Detect, Treat
Didn’t catch the pulse of this one? No worries we’ll help you pressure check the 2025 AHA Hypertension Guidelines. ❤ #AHA2025
www.ahajournals.org/doi/10.1161/...

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➡️Up next – September 30 #NephJC Induction of immune tolerance in living related human leukocyte antigen-matched kidney transplantation: a phase 3 RCT
Join us @nephjc.bsky.social
See you soon! @notjustdialysis.bsky.social

Yes some Indian UG/PG textbooks use the term accelerated hypertension while some describe it as malignant hypertension #NephJC

140/90 ?#Nephjc

HT emergency,yes! Accelerated HT- i think it never existed!

High Bp >180/120 without target organ damage is Severe Hypertension now
#NephJC

there is need for a more individualized and tailored approach to blood pressure management in these patients
& more evidence #NephJC

In most centers here, the average bp of patients on MHDs around 160–170 mmHg. They are usually advised to skip the drug on HD days to avoid hypotension and AVF FAILURE. However, maintaining pressures in the 160–170 range or even highercan significantly increase the risk of stroke. #NephJC

#Nephjc
HTN in MHD patients and post transplant

Do accelerated hypertension and hypertensive emergency still exist?
#NephJC

I used to prescribe it only until eGFR dropped to 15 and never in patients on HD. Recently, I started using it on alternate days, assuming potassium clearance during dialysis. But evidence suggests otherwise. Great discussion. I’ll start my day with a tender coconut from my farmhouse
#Nephjc

a close up of a man 's face with a surprised expression ALT: a close up of a man 's face with a surprised expression

#Nephjc

Yes, this is a fairly common discussion, and only a few of us actually prefer spironolactone , but almost every day there’s at least one senior nephrologist emphasizing how much better finerenone is #NephJC

a person is laying on the ground with the words `` it 's not working ! '' ALT: a person is laying on the ground with the words `` it 's not working ! ''

Yes the negative outcome was simply because the drug didn’t work.

two women are running down a path and one of them is saying let 's goooo ! ALT: two women are running down a path and one of them is saying let 's goooo !

I’m not echoing the company’s pitch; I’m pointing out the same line that nephrologists keep repeating at every conference about finerenone.

a man says the man the myth the legend in front of a truck ALT: a man says the man the myth the legend in front of a truck

And is the claim of “less hyperkalemia with finerenone” actually true, or just a myth?

a man wearing glasses and a hat says " am i right or am i right ? " ALT: a man wearing glasses and a hat says " am i right or am i right ? "

Many previous studies using spiro 25 mg have already shown si hyperkalemia, even in patients with a fair eGFR. I don’t understand why the same drug was tested again in ESRD, where GFR is minimal. It might have been more logical to wait for the newer agents. #NephJC

Yes it is expensive in India but many tend to buy the drug when we tell them the benefits
#Nephjc

a man in a suit and tie says i 'm confused in front of a blue background . ALT: a man in a suit and tie says i 'm confused in front of a blue background .

Isn't it how the drug acts on cardiovascular system and protects the heart??? #Nephjc
In ESRD many are anuric, so natriuresis at this stage?