Small group Peritoneal Dialysis case discussion leaders at the Home Dialysis Academy of Excellence! Drs Ananthakrishnan and Young from UC Davis Division of Nephrology Dr @grahamabra.bsky.social from Stanford Division of Nephrology and Dr Harini Sarathy from UCSF Division of Nephrology

It's that time of year again 🍂🍂🍂 The #NephJC Fall pledge drive. Plese give if you are able to support our decades long mission of #FOAMed for all. #NephSky #MedSky www.nephjc.com/news/2025/9/22/nephjc-fall-pledge-drive

I teach it. I have not seen this studied in a systematic way, but Edelman equation is not just a good idea, it’s the law.

Has anyone studied the use of K supplementation to increase daily solute load and subsequently free water excretion in SIADH? #AskRenal

It’s an exciting time to be taking care of patients with Lupus Nephritis! www.healio.com/news/nephrol...

Calling @hswapnil.medsky.social 🚨 vitamin D alert 🚨

Curious if folks ever use this in setting of rapidly rising creatinine to make med dosing decisions - why or why not? #AskRenal @askrenal.bsky.social www.mdcalc.com/calc/10191/k...

Have hyperglycemia (and other DM badness) been hiding in plain sight in ESKD? Probably. Great study using CGMs in ESKD. Pts with treated DM, mean TIR only 43% while mean HbA1c was 7.0% journals.lww.com/jasn/abstrac...

If you are seeing patients with #CKM (cardiac, kidney, metabolic) syndrome, you should be aiming for (and justifying if you are not) the #ruleof10: 10mg of each of Ramipril, Empagliflozin, Finerenone, Rosuvastatin, Ezetimibe, Tirzepatide for your patients (or equivalent doses of similar drugs).

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

Interesting pilot/feasibility trial in @kireports.bsky.social Decremental dialysis in elderly patients with small inter dialytic weight gains - going from 3 to 2x week HD. Easy to recruit, good adherence. www.kireports.org/article/S246...

The CPC from last @ahascience.bsky.social #HypertensionSessions now published in @ahajournals.bsky.social www.ahajournals.org/doi/10.1161/... thanks to @drjmluther.bsky.social and all the education editors for the invite We hope it makes for an educational read!

I recently posted a question about relapsing MCD on @asnkidney.bsky.social Communities community.asn-online.org/home The discussion by Drs. Glassock, Radhakrishnan, Rodby, Aledan and others was extremely valuable and informative. It also proved that AI will never replace smart nephrologists!

An interim analysis of the phase III VISIONARY trial shows how sibeprenlimab demonstrated a 51.2% reduction in proteinuria in people with IgAN. Read more about this promising biologic getting closer to FDA approval: kidney.pub/KN1708-06 #ASNKidneyNews

New 2025 AHA/ACC Hypertension Guideline dropped! www.jacc.org/doi/10.1016/... #hypertension #medsky #nephsky

How and why we should increase home dialysis: domannualreports.stanford.edu/empowering-p... features @grahamabra.bsky.social work in the Bay Area

Home #dialysis can be life changing, but too few patients know it's an option. #StanDOM's @grahamabra.bsky.social is on a mission to change that. Learn how his work is empowering patients to choose the care that fits their lives. stanford.io/4o846Fv

Possibly a rookie #neph question, but anyway, I am wondering: Does an albumin value consistently below 38, i.e. 34-37 or lower, correlate to an increased risk of mortality?, 🤓🤔 Is there a recommended textbook chapter &/or paper about albumin? cc: @askrenal.bsky.social et al Thank you, 🙏

⚠️ Calciphylaxis is a debilitating and painful condition that is hard to treat. ▶️ Do you use daily dialysis as part of treatment? If so, what criteria do you use? #askrenal pubmed.ncbi.nlm.nih.gov/21872378/ doi.org/10.1093/ndt/...

Awesome infographic on genetic testing in ADPKD by Neera Dahl, @pranavgarimella.bsky.social and Fouad Chebib www.kidneynews.org/view/journal...

6/ Give me something clever to say 🤓 👇@kidneyboy.bsky.social and @grahamabra.bsky.social summarize the utility of eGFRdiff nicely

Start your nephrology career with $50K less in student debt. 💸 The 2025 ASN Loan Mitigation Program supports residents and incoming fellows committed to nephrology. Learn more and apply by Wednesday, August 20, at 2:00 p.m. EDT. 🔗 bit.ly/lmp2025

Classic example of Alport spectrum disease in a patient with X-linked Alport syndrome. Lesions of segmental glomerulosclerosis, numerous interstitial foam cells, and atypical GBMs with lamina densa splitting, subepithelial scalloping, and thinning. #renalpath #pathsky #nephsky

Any good refs for recovery from AKI-D post liver transplant? #AskRenal

👏 Great discussion! 📅 Up Next: 8/5/25 we discuss the 📘HiLo trial- A RCT of phosphate targets for HD patients #NephJC Do we finally have data to end “the great phosphate-bypass” pubmed.ncbi.nlm.nih....#NephJC

T1d 🔍 What drives eGFRdiff? They tested for 3 groups. FYI! Shrunken Pore Syndrome: Reduced filtering of larger molecules (5-30 kDa). Diagnosed when eGFRcys is < 60% of eGFRcr. Risk for mortality, CVD and contrast nephropathy. Associated with ⬆️BMI, T2DM, HTN. What else did they miss? #NephJC

T0f So why does this matter? A more negative eGFRdiff (eGFRcr > eGFRcys) is linked to: 🫀 Cardiovascular disease 🧬 Frailty 💓 Heart failure ⚰️ Mortality #NephJC

Graham Abra, nephrologist, no COI #NephJC

This is a fascinating read for anyone interested in the current state of nephrology practice.

What are the best practices for treating patients receiving peritoneal dialysis while hospitalized? This #ASNCJASN "Kidney Case Conference: How I Treat" shares clinician perspective on protocol and procedure. kidney.pub/CJASN0783

The Double-Icodextrin Dose Randomized Controlled Trial of a Double #Icodextrin Dose for #Older Patients on Incremental Continuous Ambulatory Peritoneal Dialysis #CAPD #VisualAbstract by @md_abdulqader83 www.kireports.org/ar...#Icodextrin#Older#CAPD#VisualAbstractobbedezt.bsky.social @clemencebechade.bsky.social

Very nice practical summary article Amazing how far we have come with understanding the genetics behind Alport Syndrome and much of what we used to call “Thin Basement Membrane Disease”

Join us!

#Flozins in ADPKD. Interesting VA data suggesting that they may be safe and have a role in renal preservation journals.lww.com/cjasn/fullte...

A bold guideline from the beginning! “We suggest that all individuals with hypertension be screened for primary aldosteronism”

Apply for HDAE 2025 today! A few slots available 💨 - Case based learning - Hands on PD and HHD equipment sessions - Patient involvement - Expert panel discussions - Small group sessions - Free! Dates: 9/23-9/25/2025 Location: Milpitas, CA hdexcellence.org

We are nephrologists. Hyperkalemia is what scares endocrinologist and cardiologists. we have the knowledge and the tools to manage this problem in this era when using the combo #NephJC

No denial to GDMT. Patients should be as well treated as possible, and then evaluate new therapies vs placebo on top of that. Mandating everyone is on RASi/SGLT2i/MRA/GLP-1 may reduce generalisability, as not all patients will tolerate or can access all 4 drugs

Only reason to sequence the RASi first is that they are good antihypertensives (but note the BP effect in the combo arm of #confidence) #nephjc But no matter the sequence, the goal should be to have someone on the four pillars in less than 6 months

Now hearing rumours of a spironolactone shortage 😱 Anyone else hearing this? #MedSky #PharmSky

What’s your treatment for idiopathic pericarditis in PD? NSAIDs will cause loss of RRF and risk of UGIB. Colchicine at even low doses=diarrhea (and myopathy/cytopenias). Prednisone or try colchicine 0.3-0.6mg po daily to see if tolerated? Defer to cardiology? @askrenal.bsky.social #askrenal

Look what I found while cleaning the office @kidneyboy.bsky.social @grahamabra.bsky.social Vintage #NephJC merch

Interesting data from Alberta www.kidney-international.org/article/S008... in @kidneyint.bsky.social GFR < 15 is classified as ‘kidney failure’ in most studies - but about a third of them die before starting RRT. Is that glass half full or half empty? 🥃 #NephSky

30M with aggressive crescentic IgAN. M1E0S1T1C2. 4g proteinuria with Cr 160 umol/L but rising. Induction with IV CYC and pred. Now 1g protein but Cr, now 250 umol/L. Not sure what next :( maybe repeat biopsy? @nephrowhitt.bsky.social @hswapnil.medsky.social @askrenal.bsky.social

conveniently for the people who passed this, someone with end stage renal disease who cannot afford their $35 copay per dialysis treatment will be dead within 3-4 weeks by not going to their dialysis sessions (or alternatively rack up far larger bills in tens of thousands to go to ED for sessions)

The so-called ‘Big Beautiful Bill’ that passed the Senate today is a giant leap backward for people living with kidney disease. NKF urges Congress to reject these harmful provisions. www.kidney.org/press-room/b...

My patients live at the margins of society. They don’t have much. Just getting to dialysis three times a week is a big ask. Taking from them to fund tax breaks for the rich is just cruel. I want to be outraged but I just feel like crying.

Nephrologists deported Grants defunded NIDDK folded into National Institute of body parts AHRQ demolished Now this… When are our organizations going to speak up? #NephSky

This is nuts, a $35-per-treatment copay for dialysis and CKD patients above the poverty line could cost dialysis patients over $5,000 annually *Quickly checks show of hands at the unit, anyone got $5K?, No one? Ok cool cool I’ll let them know*