Going to add this to my lecture slides.

Interesting diuretic resistance study. Adunctive thiazides take the lead over loop intensification? Nice discussion on mechanisms of DR, both practical and hypothetical. #nephsky journals.lww.com/jasn/abstrac...

🤔 I happen to know @jordybc.bsky.social is a scotch aficionado www.cnn.com/2025/08/14/h...

Latest episode of @freelyfiltered.bsky.social is live! This one on the two RCTs of DDAVP to prevent renal biopsy bleeding. We had special guest Vandana Niyyar join us. @medpeedskidneys.bsky.social @captainchloride.bsky.social www.nephjc.com/freelyfilter...

Thank you to @asnpublications.bsky.social #JASN for letting us write this. Important topic that's unfortunately devoid of robust data for many of our patients. #nephsky journals.lww.com/jasn/abstrac...

Interesting study in pts w/T1D w/ or w/out flozins and comp. With healthy controls. Less glomerulomegaly on routine biopsies. Flozins impacted metabolic transcripts throughout the nephron - ie the effect wasn’t isolated to the proximal tubule. Showing they are powerful metabolic drugs. #nephsky

If you're applying to a Nephrology fellowship, let @glaucomflecken.bsky.social tell you why you need to come to @pdxkidney.bsky.social. Then let us tell you what makes it such a great and unique training program! #nephsky

Our fellows taste testing tap water vs. RO water! #nephsky

ICYMI @captainchloride.bsky.social on the art of decongestion in heart failure Embracing hypercreatininemia Flozins or Acetazolamide How to use Urine Na+ Do we believe the Italian HTS RCTs? www.youtube.com/watch?v=3m2b... #NephGR

Listening to @captainchloride.bsky.social presenting about decongestion strategies, while escalating all the steps to ultrafiltration 🌊 #NephGR 🌊🌊 Oliguric, overhidrated pt, with an SBP of 270 mmHg, a bit of respiratory alkalosis, and Na 133 @hswapnil.medsky.social

Huge thanks to @hswapnil.medsky.social for the invite and to everyone in Ottawa for the incredible hospitality, I had a great time! As a bonus I got to check out the tulip festival (pics courtesy of swap)

In this Core Curriculum, Nayan Arora and Sarah F. Sanghavi discuss disorders of volume, which are typically identified clinically as changes in the extracellular space, and management strategies through a series of clinical vignettes: bit.ly/Arora24CC (FREE)

Really fascinating talk this morning by Dr. Hiroyuki Nakai regarding AAV vector-mediated gene therapy for Alports disease @pdxkidney.bsky.social

I thought we were past this “Too much protein may also strain the kidneys in those with chronic kidney disease, Dr. Campbell said” www.nytimes.com/2025/04/09/w...

Often consulted after initial correction attempts in hyponatremia.👇called after a 12 mmol/L correction over 8 hrs (primary polydipsia). Previously I would've relowered the Na but with the new data (whether you agree or not) we decided to keep things stable until 24h mark. What would you do? #nephsky

Physiologically it never made sense to fluid restrict HF patients without hyponatremia. No difference in outcomes in 👇study, which was predictable. At the same time - from a study perspective - the actual difference in fluid intake between groups was <300cc/day. pubmed.ncbi.nlm.nih.gov/40159556/

Thanks to Sam Kant for the invite to write this. If you pass your boards because of it then it was worth it! www.sciencedirect.com/science/arti...

Dialysis folks - how accurate is this sat - can I use it to calculate a fick? #nephsky

Who knew? That was sarcastic. @jordybc.bsky.social @hswapnil.medsky.social jamanetwork.com/journals/jam...

So maybe we don’t need to hold flozins before surgery after all? jamanetwork.com/journals/jam...

Announcing the #NephJC internship, @nephjc.bsky.social and @kireports.bsky.social joining forces www.nephjc.com/intern-app for details and to apply! #NephSky

These are not the diuretic trials we need. 2 diuretics will generate more urine then 1 www.sciencedirect.com/science/arti...

You must have heard and read about ‘out of sequence’ organ #transplants from @sumitmohan.bsky.social ‘s work Read this www.nytimes.com/interactive/... in the @nytimes.com with excellent graphics to understand the broken US organ transplant system (free link) #NephSky #MedSky

Giving a talk about heart failure treatment in patients with CKD. 👇 the protocol for our clinic

Not a perfect comparison but interesting nonetheless. Augmented UOP with the intervention vs placebo in CLOROTIC, EMPAG-HF and ADVOR HCTZ: 26% Empagliflozin: 25% Acetazolamide: 12%

Talking about KT/V with KatieOverV @katiekwonmd.bsky.social was most definitely on my nephrology bucket list! Recording @freelyfiltered.bsky.social with @kidneyboy.bsky.social @captainchloride.bsky.social 😎

Comp diuretic studies are rare so worth a look but this observational/retrospective one of chlorthalidone v diamox is not great. Concludes latter is better w/ more wt loss but no sig diff in diuresis or natriuresis. Modest doses of furosemide and no diff in LOS pubmed.ncbi.nlm.nih.gov/36493956/

Finally passed 100,000 learners! 7 modules - 16 hours. No prior training needed. And you'll have all the skills you need to read a medical research article yourself, and make decisions unbiased by what you see on social media. Oh and it's free! https://buff.ly/3ZH8oJN

Saw a new AKI consult, diagnosed malignant obstruction, recommended team consult IR for PCN, signed off #nephsky

If you use diuretics then this is a must read #nephsky www.sciencedirect.com/science/arti...

This would be super impressive if it works out. Wish I had bought the stock yesterday… www.globenewswire.com/news-release...

Anyone using CardioMEMs or other remote hemodynamic monitoring devices in their dialysis patients? #nephsky

Excited to share our core curriculum on volume disorder in @ajkd.bsky.social! Thanks to @sarahsanghavi.bsky.social for writing this with me and @melhoenig.bsky.social for the invitation! www.sciencedirect.com/science/arti...

In pts w/ HF w/out DM what's the risk:benefit of holding SGLT2i (recommended) before a procedure vs not? There is harm in holding flozins for 30 days and the risk of EDKA is low. Main risk being - once held they don't get resumed quickly #cardiosky #nephsky www.ahajournals.org/doi/10.1161/...

Well this should add fuel to the fluid wars...

"Retro" is usually reserved for fashion and music. Typically not something you see in medicine - unless it's acetazolamide I guess.

Case of non-dilated obstructive uropathy (NDOU). #nephsky #medsky Woman with a recent dx of metastatic cervical cancer presented with fatigue and noted to be hypotensive with a creatinine of >9 and anuria. Started on fluids, vasopressors and antibiotics without improvement in either parameter

This makes me happy. Chloride delivery… www.kidneynews.org/view/journal...

Mystery solved. Over 1800 mosm from urea. Interestingly he hadn't received ure-na in over 24 hours and his serum BUN was not elevated. #nephsky

What am I missing #nephsky? Pt with SIAD, Uosm >600, SNa 120 mEq/L. SNa up to 133 mEq/L after 2 days with urea. Urinating >4L now so I assumed his ADH was off (initial etiology was likely trauma/pain) but UOsm still >700. Has been off solute loading for >24h. Liquid diet so unlikely dietary solute

We are thrilled to announce the new group of stellar residents who will be joining our fellowship program this fall! #nephsky #nephmatch

This is NOT what you want to see when imaging kidneys. May be the first case I've actually seen and not just answered board questions about. #nephsky #medsky

If you’re celebrating Thanksgiving in Canada are you really even celebrating Thanksgiving? @hswapnil.bsky.social

To celebrate the growing #medsky / #nephsky community, I will post one silly med/kidney cartoon every day for one month! d15: a few more Erys. Can you name them all?

Clear ⏬ with GLP-1RA by ~15% for all clinical outcomes including: Kidney failure ✅ Major CV events ✅ Heart failure ✅ CV death ✅ All-cause death ✅ Updated systematic review/meta-analysis of 11 trials ~85,000 participants, with & without diabetes Now in Lancet D&E: www.thelancet.com/journals/lan...

I’m Nayan and I have the “you can’t leave before the attending even if you’re done with your work” problem

In STRONG-HF a decrease in eGFR by >15% was associated with a decreased likelihood of GDMT uptitration #renalism #nephsky #cardiosky

The pendulum regarding SGLT2 inhibitors increasing UOP via natriuresis or an osmotic diuresis has gone back and forth with conflicting studies. 👇 Trial shows improvement in natriuresis with dapagliflozin added to furosemide in pts with ADHF pubmed.ncbi.nlm.nih.gov/38569758/ #nephsky #cardiosky

Coming off a week of consults where lots of patients were on nipride drips. It's a great drug with balanced preload/afterload reduction but has use expanded beyond indication? 👇study showed it worked better in patients with LOW SBP. #cardiosky #criticalcare #nephsky