Discover and read the best of Twitter Threads about #Nephrology

Most recents (10)

@UCIkidney @kamkalantar hosted dinner discussion last night: #AdvancingAmericanKidneyHealth Executive Order
@MSchreiber_MD and @DrBobPro @DaVita | Mark Shapiro (Balboa Nephrology Medical Group)
Big changes happening and #nephrologists need to step up… #nephtwitter
1/x
Starting Jan 2020 half of #nephrology groups in the US will be assigned to the CMS Kidney Care First (KCF) accountable care model.
If you’re picked you HAVE TO participate, but can opt to switch to one of the other #KCC (Kidney Care Choices) models:
innovation.cms.gov/initiatives/ki…
2/x
The other payment models (Comprehensive Kidney Care Contracting #CKCC options) vary in amount of risk the neph practice is willing to take on for care of the #CKD patient.
This is at the level of the #nephrology practice NOT at the dialysis unit.
3/x
Read 12 tweets
1/ Welcome to the Saturday Poster session at #KidneyWk. On behalf of Hector and Edgar, I’d like to welcome you to our tweet thread on • Gender disparities in #SoMe and #MedEd•. You can view our poster (&🗣w/us) live TODAY from 10-12 PM (#27) or learn more about our work below
2/ #SoMe is exploding in medicine & #Nephrology leads the way in many metrics & most certainly in #SoMe research. Many #SoMe *users* are becoming active #SoMe *educators* & share valuable educational information to the larger online community.
datastudio.google.com/u/0/reporting/…
#KidneyWk
3/ Concurrently, there is a greater push to equalize the way we share knowledge. Gender is an area in need of equalization. More men than women are offered presenting &/or moderating opportunities. This imbalance negatively effects both female *and* male learners. #KidneyWk
Read 19 tweets
“Around 2012 or 2013, researchers identified evidence that gadolinium retention was connected to illness in patients with normal kidney function.” scholar.google.com/scholar_case?c…
“In September 2017, after the FDA voted to add concerns about gadolinium retention on warning labels, [gadolinium-based contrast agent] manufacturers, including Defendants, issued a new joint warning to patients with normal kidney function.” scholar.google.com/scholar_case?c…
“The warning [RE: #gadolinium retention] also directed physicians to advise patients of these concerns.”

Consent: valued in the United States since the Nuremberg trials of 1947 🇺🇸 scholar.google.com/scholar_case?c…

☢️#radiology
🥼#nephrology
🏥#publichealth ⚠️#patientsafety
💉#MRIdye
Read 4 tweets
Did my fellows' curriculum lecture today, "Images in #Nephrology"
Thought of sharing the slides as a tweetorial. Goal is to present some 'classic' images that aid in kidney-related diagnoses. Not exhaustive; plan to make 2nd part as well.
#MedEd #FOAMed Not much POCUS involved!
1st question. Classic image but rarely encountered. Note the super high blood urea nitrogen and serum creatinine.
Here is the answer.....
Read 61 tweets
“[T]he American College of Radiology have categorized the various ligands into different safety classes ... despite being grounded in purely observational data,” physiology.org/doi/full/10.11…
#gadolinium ☠️ #patientsafety #radiology #Nephrology
The “American College of Radiology] Committee on Drugs and Contrast Media considers the risk of [‘nephrogenic’ systemic fibrosis] among patients exposed to standard or lower than standard doses of group II [gadolinium-based contrast agents] is ... possibly nonexistent...”
The American College of Radiology, based on more opinion than evidence, guided Group II agents—such as MultiHance—as having “sufficiently low or possibly nonexistent” risk for gadolinium-induced systemic fibrosis. acr.org/Clinical-Resou…
#gadolinium ☠️ #radiology ☢️ #Nephrology
Read 4 tweets
Time for a #tweetorial/#medthread on:

#CALCIPHYLAXIS!

This is a devastating diagnosis often seen in inpatients, so this goes to all the @DermHospitalist & #hospitalists out there!

#FOAMed #MedEd #dermatology #dermatologia #dermtwitter #medtwitter @SHMlive @DermHospitalist
1/
First of all, what is it? The exact mechanism is unknown. What we do know is that there is calcium in the arterioles of the skin, with arterial thrombosis. This interruption of blood flow causes painful ulcers and retiform purpura. Remember this?



2/
That interruption of blood flow causes the clinical picture of calciphylaxis - retiform purpura with a predilection for fatty areas, violaceous borders, necrosis with ulceration, and TERRIBLE PAIN. Without the pain, I really think one needs to reconsider the diagnosis!

3/
Read 17 tweets
“Gadolinium-based contrast agents: Stimulators of myeloid-induced renal fibrosis and major metabolic disruptors,“ is now in press—sciencedirect.com/science/articl…

#gadolinium
#neurology 🧠
#radiology ☢️
#patientsafety
#publichealth
#toxicology
#dermatology
#nephrology
Gadolinium-based “magnetic resonance imaging contrast agent treatment impaired renal function, induced pathologic damage, and increased kidney fibrosis,” sciencedirect.com/science/articl…

#gadolinium
#nephrology
#radiology ☢️
#patientsafety
#publichealth
#toxicology
Read 11 tweets
“Notably, in recently published rodent studies, complete clearance of the brain took up to 6 months after injection of a large amount of” gadolinium-based contrast agents. journals.lww.com/investigativer… @HrsQuiet
#gadolinium
#neurology 🧠
#radiology ☢️
#patientsafety
#publichealth
“[S]o it can be assumed that the total clearance—if achieved at all—might also take months in humans,” after gadolinium-based contrast administration— journals.lww.com/investigativer… @HrsQuiet
#gadolinium
#neurology 🧠
#radiology ☢️
#patientsafety
#publichealth
#toxicology
Read 4 tweets
“A conspicuous knowledge gap now exists about” the safety of gadolinium-based contrast agents—Dr. Stephen Brown, Harvard Medical School, in
The Need for National Guidance Around Informed Consent About GBCA Safety
tandfonline.com/doi/abs/10.108…
#gadolinium #radiology #patientsafety
“The research protocol under discussion highlights where the [National Institutes of Health] Roadmap around [gadolinium-based contrast agents] falls short,” because informed consent about gadolinium deposition could be left out—Dr. Stephen Brown
tandfonline.com/doi/abs/10.108…
“The [Institutional Review Board] should first clarify that gadolinium deposition is NOT INCIDENTAL in this study,” [emphasis added]—Dr. Stephen Brown, Harvard Medical School, in
The Need for National Guidance Around Informed Consent About GBCA Safety
tandfonline.com/doi/abs/10.108…
Read 7 tweets
“Despite significant differences in the thermodynamic stability between non-ionic Omniscan and ionic Magnevist, the [#gadolinium ☠️] concentrations were about the same in the brain,” nibib.nih.gov/sites/default/…
#radiology ☢️ #patientsafety #publichealth #neurology 🧠 #dermatology
“Chronic symptoms attributed to [gadolinium-based contrast agent] exposure:” paresthesias, dysesthesias, clouded mentation, skin discoloration, skin changes, skin thickening, bone pain, bone/joint pain, muscle spasms, arthralgia, muscular weakness—nibib.nih.gov/sites/default/…
“Chronic symptoms attributed to [gadolinium-based contrast agent] exposure:” fatigue/asthenia, digestive symptoms, nausea, vomiting, diarrhea. nibib.nih.gov/sites/default/…
#gadolinium #radiology ☢️ #patientsafety #publichealth #neurology 🧠 #dermatology #nephrology #rheumatology
Read 14 tweets

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