HiLo2 brought to you by Coca Cola -free Coke for hi -free Sprite for lo #nephjc #newnewnephrology

CRRT clotting? The answer is access, access, access--Leo Yessayan

Nephrology bootcamp is off to the races Michael Heung suggests AEIOU as mnemonic to remember indications for dialysis. Learning lots.

Week one done #nephforward

Our first time meeting to our last hangout - from nephron to nephrologists!

In Ann Arbor, at the one and only @uofmichigan.bsky.social medical campus: academics, friends, good times 💪 @vipvargh.bsky.social

If it takes 25-30 years to lose your first half of nephrons, it won’t take another 25-30 years to lose the second half

Full circle being back at #kidneycon First came here as a medical student and now coming back as a nephrology fellow 6 years later!

The “Terli Trio” delivered in this year’s #nkfclinicals NephMadness Fellow’s Debate!

Congrats to team terlipressin for winning the #NephMadness debate at #NKFClinicals

🎉 Congrats to Julie Wright Nunes et al whose paper has been selected for the "AJKD Editors' Choice: NKF Mission Award": Patient Education for CKD and Decision Support in Primary Care: Findings From the EPIK Pilot Study bit.ly/3QFxsf1 (FREE) #NKFClinicals

For those interested in glomerular stuff, you gotta see our line-up for the Glom Dis session at KidneyCon! And they will attack the topics that make all of us scratch our heads. Register ASAP, May 1-3 #KidneyCon 2025 @isgd.bsky.social @glomcon.org @kidneycon.bsky.social kidneycon.org

Just a few more days until the #NephMadness Fellows Debate at #NKFClinicals this Friday in Boston

Spicy! Adding lasix to the management of hepatorenal syndrome might be ok if you bump the MAP with pressors @juancarlosqvelez.bsky.social doi.org/10.1016/j.ek... #nephsky #liversky

Fun spam of the day Not just any journal - it’s the Mega Journal of Case Reports (impact factor 6.705!) #MedSky #NephSky

Channel Your Enthusiasm, Chapter 17 of Burton Rose Clinical Physiology of Acid-Base and Electrolyte Disorders is out! An hour and a half of "Introduction to Simple and Mixed Acid-Base Disorders!" www.rosebook.club/episodes/202...

No BP no pee pee 😊

You know that an awesome discussion just took place, when you walk into a room, and the white board looks like this:

A Primer on Indirect Cost Rates

Excited to say, I’ll be joining Henry Ford Division of Nephrology after completing fellowship this year 😊

The highly anticipated #KidneyCON annual meeting is around the corner: May 1-3, Little Rock, Arkansas, USA. Register now! Amazing line-up of speakers and outstanding one-of-a-kind hands-on workshops

The Aldosterone Paradox: A Skeetutorial:

since I can't upload the animated gif to Bluesky, here is a short youtube clip with sound! youtu.be/R_LrpTEAnBs

These tirzepatide miracles are almost becoming routine Weight down 110 lbs Hgb a1c from 12 to 8 Cr from 3.4 to 2.8 Albumin Cr ratio from 1254 to 280 All at 5 mg a week

🎉 Thrilled to share our commentary in Kidney International Reports ✅Is it time to expand the use of SGLT2 inhibitors in KTRs? ▶️Read on www.kireports.org/article/S246... @theisn.org @kireports.bsky.social @myadla.bsky.social @hswapnil.medsky.social @brianrifkin.bsky.social

“I don’t have diabetes any more!” ≠ “My renal clearance of endogenous insulin had reduced to the point where I no longer require exogenous insulin.”

Confession: I LOVE hyponatremia 🤓 (I know, I know. What can I say, I'm a true internist!) HypoNa is often feared, maligned, and misunderstood - but I promise it doesn't have to be scary! Here are my top 10 hyponatremia tips and tricks - a 🧵 #emimcc

4/n we looked into this phenomenon at Ochsner. Project led by @vipvargh.bsky.social and published as Research Letter in @ajkd.bsky.social www.ajkd.org/action/showP...

1/n consultation for multiple electrolyte and acid-base disturbances. Pt arrives with abdominal pain. Not eating for 5 days. Chemistry shows low Na, K and C02. VBG on the other hand shows a CO2 18 mEq/L higher than that of the BMP. Why the discrepancy?…

1/n One of the things that I find valuable in internal medicine in general is pattern recognition. And nephrology is not the exception. AKIs come in different flavors, we can smell the etiology based on the presentation and the way the serum Cr (sCr) rises.

18/n so maybe the drug crystals cause injury as they travel down the nephron but they don’t end up absorbed into the renal parenchyma. As an example, atazanavir crystals do (PMID 32647771) @vipvargh.bsky.social @kireports.bsky.social

In Ontario we line up starting 2 AM like this in the middle of the winter …..not for 🏒 playoff tickets …nor the latest 📱 …but to snag a chance to get a family doctor www.cbc.ca/news/canada/... #OnPoli #CDNPoli #HealthCare

Coiled RBC cast with fibrinous matrix - brightfield with SM stain - from patient with AKI and chronic Staph. osteomyelitis - #UrinarySediment #UrineMicroscopy

🚨One Week Left: Apply for Kidney TREK 2025🚨 Hands-on nephrology experience + mentorship at your choice of location: 🏞️ MDIBL: Research with model organisms. 🏙️ UChicago: Renal physiology and procedures. Apply by January 22 🔗https://www.asn-online.org/treks 📷 Credits: Arvin Halim

Long thin convoluted erythrocyte cast in the #UrinarySediment of pt w/PR3-ANCA-associated pauci immune crescentic glomerulonephritis. Bright field illumination (Sternheimer-Malbin stain, 1000x) #UrineMicroscopy @isgd.bsky.social @glomcon.org 📹🔬

“Microscopic examination of urinary deposits frequently neglected in general practice” - True in 1904 and 2025

Close up view of dysmorphic RBC's including acanthocytes - under darkfield/oblique illumination - from 2024 case of MPA - #UrineMicroscopy #UrinarySediment

Dysmorphic RBC's including acanthocytes - under darkfield/oblique illumination - from 2024 case of MPA - #UrineMicroscopy #UrinarySediment

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...

Interestingly, no change in urine Na in this study of empagliflozin vs placebo in SIADH journals.lww.com/jasn/abstrac...

Kidney shaped agglomeration of uric acid crystals, polarized - just in time for New Years! #UrineMicroscopy #UrinarySediment

"You'll be visited by three spirits." The three spirits:

1/n HydrANCAzine (hydralazine-induced ANCA-associated vasculitis has turn into an important cause of crescentic glomerulonephritis. Wonder how does hydralazine do it? Here is a tweetorial (BlueSkytorial?). I’ll start with an animation that summarizes and simplifies a proposed mechanism.

Ok Dr. Addis, we get it, medical students need to get out more @jrseltzer.bsky.social @juancarlosqvelez.bsky.social

Snake-like RBC cast with hyaline matrix, #UrinarySediment from a pt with MPO-ANCA crescentic necrotizing GN w/ongoing CYC/RTX-based induction IST (1 month in) #UrineMicroscopy #PisseProphet

Another in-human pig kidney xenotransplantation After Boston, it’s back to @nyunephro.bsky.social www.npr.org/sections/sho... #NephSky

1/n sharing a case: Young adult comes in 4 elective ENT procedure. Receives several doses of ketotolac for 3-4 days + empiric vancomycin. Then, labs are checked: Cr 4.0, up from 1.0. UA: neg blood/protein/cells. High suspicion 4 IV NSAID / IV Vanco hemodynamic/tubular insult. Non-oliguric, lytes OK