Discover and read the best of Twitter Threads about #Nephtwitter

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1a) Welcome to a 🆕#accredited #tweetorial on the importance of time in range #TIR in #diabetes . . . with additional emphases on #primarycare and on practice in 🇨🇦.
#FOAMed #endotwitter #MedEd @MedTweetorials #nephtwitter #cardiotwitter
1b) Hence we welcome2⃣ expert faculty from Canada: Ilana Halperin @ilanajhalperin, academic endocrinologist at @Sunnybrook and @uoftmedicine, and Noah Ivers @NoahIvers, #familydoc & researcher at Women's College Hospital @UofT ImageImage
2) Earn 0.75hr 🆓CE/#CME by following this🧵! This program is supported by an unrestricted educational grant from Sanofi Canada and is intended for #HCPs. Statement of accreditation & faculty disclosures at
And so we begin . . .
Read 43 tweets
The conventional diuretic treatment of ascites in patients with cirrhosis is high doses of spironolactone w/furosemide (classic 100/40 ratio). This was also mentioned recently on @thecurbsiders. Where does this come from and is it true? A quick🧵. #MedTwitter #nephtwitter
In 1981 Fogel et al compared 3 diuretic strategies in 90 patients w/cirrhosis

1.spironolactone + lasix prn
2.lasix alone
3.spironolactone + lasix

🔥Furosemide alone appeared to perform worst for weight loss though not statistically sig. Required sig up-titration and massive KCl Image
In 1983 Perez-Ayuso et al: lasix v spiro. in 40 pts w/cirrhosis and nml kidney function

If🚫response (UNa excretion <50mmol/d) alt. tx given

🔥Lasix grp: 50% response
🔥90% of non-responders responded to spiro.
🔥spiro. grp: 95% responded: 1 non-responder🚫response to lasix Image
Read 10 tweets
1) Welcome to a 🆕accredited tweetorial from @cardiomet_CE! We welcome back expert faculty @ChristosArgyrop to discuss screening for #CKD in pts w/ #T2D & the role of routine assessment for #microalbuminuria as an effective diagnostic, risk stratification, & patient ed tool.
2) Christos Argyropoulos MD, PhD @ChristosArgyrop is Division Chief, Nephrology @UNMHSC. #CKD is chronic #kidneydisease, #ESKD is end-stage kidney disease.
#FOAMed #nephtwitter #cardiotwitter @MedTweetorials @NephUCommunity @ISNkidneycare @KidneyDiseaseFm Image
3) This program is intended for #HCPs and is supported by an unrestricted educational grant from Bayer. Statement of accreditation & faculty disclosures at
FOLLOW US for more expert-authored #tweetorials and earn #MedEd
Read 43 tweets
💎 of #ApexPathshala

Dr. Patrick Walker takes a deep dive into the history of ‘MPGN’ as a nebulous entity eluding understanding for decades.

Here’s his meandering tale of MPGN that begins in early 1900s & goes on till the turn of the century.🧵

#historyofmedicine #nephtwitter Image

Dr.Theodor Fahr,the first modern pathologist & Dr.Franz Volhard,an internist from Mannheim🇩🇪,undo many prevailing misconceptions through formative work on Bright’s disease.

Their book👇🏻‘Die Bright’sche Nierenkrankenheit’ becomes a classic in the annals of glomerulology.2/n Image

Dr. Rene Habib,a pioneering pediatric nephrologist,studies a large cohort of children with MPGN &provides first descriptions of the disease.

Clinical & histopathological features of what formally gets named as MPGN l at the CIBA symposium convened at London in 1961. 3/n Image
Read 12 tweets
🔥Tweetorial: Atypical Anti-Glomerular Basement Membrane Disease… @kdjhaveri @purvasharma821 @Yihe28745445 @HofstraKidney #NephTwitter @KIReports
1) Circulating anti-GBM antibodies are directly pathogenic in anti-GBM disease.
However, about 10% of patients with anti-GBM disease do not have circulating anti-
GBM antibodies Image
2)Atypical anti-GBM disease is considered when patients have linear IgG deposition along the glomerular basement membrane without anti-GBM antibodies in the circulation. #nephrology #kidney #kidneydisease
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(1/n) Pain management is far from easy, and having chronic kidney disease only complicates things. Let’s take a quick look at the effects pain has on the kidney population, and what we can do about it!

#tweetorial #NephTwitter #pallcare
(2/n) Pain has a prevalence of 60% in the CKD population, 2-3x that of the general population!
It leads to:
⬆️ Depression and Insomnia
⬆️ Withdrawal From Dialysis
⬆️ Hospital Visits
⬇️ Health Related QOL
⬇️ Social Support
⬇️ Life Satisfaction
(3/n) A H&P qualifies pain and chronicity, but every pain discussion should discuss expectations. To set expectations you need to
🔴 Determine a pain level that would be tolerable
🔴 Come up with a tentative duration of treatment
🔴 Discuss risk and benefits of treatment
Read 19 tweets
1) Welcome to this #accredited #tweetorial on genetic testing in the evaluation of patients with cystic kidney disease. #Kidney #cysts are a frequent finding, ranging from simple cysts to suspected or confirmed #ADPKD.
Expert author @dguerrot of @CHURouen 🇫🇷 leads us!
2) This program is supported by an educational grant from Otsuka Pharmaceuticals & is intended for #HCPs. #Physicians #Physicianassociates #nurses #nursepractioners #pharmacists 🇺🇸🇨🇦🇪🇺🇬🇧 earn CE/#CME credit. Statement of accreditation & faculty disclosures
3a) Fortuitous discovery of non-malignant kidney cysts is increasingly frequent with age, and often leads to #nephrology referral.
Read 52 tweets
🧵Let's talk hypernatremia

So often we discuss the correction rate of hyponatremia, but what about hypernatremia? #medtwitter #nephtwitter #meded

🧐What is your correction rate for chronic hypernatremia?
Older guidelines recommend a correction of no more than 8-10 mEq/dL in 24 hours borrowed from pediatric literature

“Fast” correction is generally considered to be more than 12 mEq/dL per day
There are some cases in which you may tolerate permissive hypernatremia, but the evidence behind its benefits we can discuss another day.

Ahem #neurocriticalcare looking at you….
Read 8 tweets
1) Welcome to our #accredited #tweetorial on clinical trial results and emerging data for treatment of Diabetes and CKD #DM in #CKD. I am Brian Rifkin MD, @brian_rifkin, from the Hattiesburg Clinic. #Nephtwitter #Medtwitter #FOAMed
2) This #accredited #tweetorial series on #kidneydisease #CKD is supported by an independent educational grant from the Boehringer Ingelheim/Lilly Alliance. It is not intended for US- or UK-based HCPs. Accreditation statement & faculty disclosures at
3) This activity is accredited for #physicians #physicianassociates #nurses #NPs #pharmacists. Prior programs in this series, still eligible for CE/#CME, can be accessed at FOLLOW US to learn from expert faculty!
Read 41 tweets
🧵1. Thank you to the partners who have provided financial support to the the Kidney Institute of New Mexico.

#MedTwitter #NephTwitter…
🧵2. Your donations have directly translated into essential discoveries leading to improved human health. We appreciate the genuine relationship with our supporters and research participants.

#gadolinium #patientsafety #NephTwitter
🧵3. Financial support assisted with several publications throughout 2022, benchtop experiments, and the continuation of our clinical trials. Also, in 2022 we discovered that gadolinium-rich nanoparticles form in the human kidney from routine diagnostic care.

Read 7 tweets
1/🛎️#TumorBoardTuesday #OncTwitter #NephTwitter
#RenalCell wk continues🔁

🗓️Thu 12.15 @ 8p ET

⚙️Mnging AEs w TKI/IO combos

#CME ℹ️🔗
Supported by edu grants from Eisai & @Merck
🚨Be ready 4 tmrw!
✅Answer #PreTest polls👇
🔁Retweet & tag colleagues🩺
2/ 🏆Claim 🆓#CME 🔛

Answer Pre Polls Qs 👇today
🟢Where r u in your career?
3/ #TumorBoardTuesday #RenalCell #NephTwitter #MedTwitter #BonumCE


🟢#PreTest Q 1️⃣
📊 Which of the following is a common high-grade toxicity associated with the use of TKIs in the management of metastatic RCC?
Read 6 tweets
1/ #OncTwitter #NephTwitter #TumorBoardTuesday
#RenalCell #MedTweetorial🧵
w @brian_rini @shilpaonc @katy_beckermann

🦺TKI/IO safety data
🥽Tox to look 4
⛑AE mgmt

🆓#CME @BonumCe🔗
Support by edu grants from Eisai & @Merck

🟢What's your specialty?
2/ #TumorBoardTuesday #BonumCE #RenalCell #OncTwitter #NephTwitter
🆓#CME info ➕ full ref list🗒️ 👉

✳️The critical elements👇 Image
3/ #TumorBoardTuesday #BonumCE #RenalCell
#OncTwitter #NephTwitter #MedTwitter

🟢 Which of the following TKI/IO combo regimens is 🚫NOT approved by the FDA for the frontline mgmt of #RenalCell carcinoma?
Read 27 tweets
1/ #OncTwitter #NephTwitter
#RenalCell #TumorBoardTuesday #MedTweetorial 🧵
w @brian_rini @shilpaonc @katy_beckermann

🦺TKI/IO safety data
🥽Tox to look 4
⛑AE mgmt

🆓#CME @BonumCe🔗
Support by edu grants from Eisai & @Merck

🟢What's your specialty?
2/ #TumorBoardTuesday #BonumCE #RenalCell #OncTwitter #NephTwitter
🆓#CME info ➕ full ref list🗒️ 👉

✳️The critical elements👇 Image
3/ #TumorBoardTuesday #BonumCE #RenalCell
#OncTwitter #NephTwitter #MedTwitter

🟢 Which of the following TKI/IO combo regimens is 🚫NOT approved by the FDA for the frontline mgmt of #RenalCell carcinoma?
Read 27 tweets
1/ Want to continue the learning streak of #Kidneywk ?
#MedTwitter #NephTwitter, we bring another #ASPNFOAM group tweetorial based on pathology webinar @ASPNeph on T-cell mediated rejection(TCMR) in kidney transplant (Tx) Image
Let's start with a vignette! 13 yr M with CAKUT s/p DDKT 6mo ago, p/w with doubling of Cr from 0.7 to 1.5 mg/dl, normal vitals and PE. UA normal. A lot of recent stressors and concern for non-adherence.
Sounds like a familiar scenario?
What is the potential cause of graft dysfunction in this patient?
Read 28 tweets
Had the privilege of presenting another case to @rabihmgeha and @DxRxEdu on Friday-VMR and it was just mesmerizing hearing them talk through it step by step.
Here are some reflections on the fascinating topic discussed:

CAVE: spoiler alert ‼️
A 60ish M p/w a week of jaundice after Tx w/ bactrim 2 weeks ago. His PMH was significant for T2DM, HLD and he was on a statin and insulin Tx.
PE was notable for marked jaundice w/o signs of cirrhosis and no encephalopathy.
Labs: CBC wnl, liver tests w/ predominant cholestatic, but also hepatocellular pattern of injury
Na+ 113, SOsm 290, glucose 260, normal kidney function
At that time we found ourselves in the space of
hyponatremia w/ a normal serum osmolarity.
A short 🧵:
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1) Welcome to this new #accredited #tweetorial on “Strategies to Apply Current Clinical Trial Data for SGLT2i to Reduce the Progression of CKD,” authored by our ⭐️tweetorialist Edgar V. Lerma 🇵🇭 @edgarvlermamd Image
2) This program is #accredited for CE/#CME #physicians #physicianassociates #nurses #pharmacists #nursepractitioners & is supported by an educational grant from the Boehringer Ingelheim Pharmaceuticals Inc and Eli Lilly Company. It is intended for healthcare professionals.
3) Faculty disclosures and statement of accreditation are provided at Please FOLLOW @ckd_ce (& @cardiomet_CE!) so you don't miss ANY of our unique serialized #tweetorials, always 🆓, always from expert authors! Prior programs at .
Read 26 tweets
🔥Hello #NephTwitter

💥Every other patient in our OPD comes with fever
⚠️But Beware‼️Every fever is not infective in origin

⚡️After ruling out most infective causes👉Look for non-sepsis causes too

#NephroNotes #NephPearls #FOAMed #MedTwitter #MedEd
🔥Fever in Inflammation

⚡️Fever in malignancy
👉~10%: Tumor is direct cause
👉Tumor necrosis/ Pyrogenic cytokines

⚡️Autoimmune diseases

⚡️Autoinflammatory conditions
👉Periodic fever syndromes

#NephroNotes #NephPearls #FOAMed #MedEd #MedTwitter
🔥Drug induced fever

💥Often missed
💥Beta lactams can be a cause‼️
👉Look at medicines causing Drug fever

⚡️Stimulation of non-shivering thermogenesis

doi 10.1186/s13054-016-1375-5
#NephroNotes #NephPearls #FOAMed #MedEd #MedTwitter
Read 7 tweets
1/This July’s @aspneph pathology webinar was all about pediatric Antineutrophil Cytoplasmic Antibody (ANCA)- associated vasculitis (AAV). Let's kick off this pediatric AAV tweetorial✍️with a quick question #NephTwitter
🤔 What is the role of ANCA antibodies❓
✅Diagnostic marker and Pathogenic in nature
▶️ Proteinase-3 (PR3) and Myeloperoxidase (MPO) antigens are sequestered in neutrophil primary granules
▶️ Antigen exposure triggers immune response leading to endothelial activation…
📌Defective neutrophil apoptosis, leading to NETosis
📌Inefficient clearance of PR3/MPO
📌Antimicrobial antibodies cross reacting with PR3/MPO
📌Medication induced
Read 21 tweets
1/n🚨🔊 Hey #nephtwitter #medtwitter #Onconephrology! Tweetorial alert!

🏥What do nephrologists👩‍⚕️, haem- oncologists 👩‍⚕️,@TheSkeletonKG have in common?

Lysing 🎆tumor cells have a story🔖!

Let's read the🔖:Intricacies of pathogenesis, diagnosis & Rx of tumor lysis syndrome -TLS Image
2/n A 13y 👦presented with

👉1 month of intermittent fever🌡️🤒
👉exertional dyspnea
👉significant weight loss⚖️.

On physical examination: He looked pale & volume-depleted.

🩸Labs were as follows: Image
3/n Further investigations showed
🩸Hb = 6.3 g/dL,
🩸total WBC count = 210,000/ mm3
🩸platelet = 10,000/mm3.
🩻CXR = mediastinal mass.
🦴PS & bone marrow examination = suggestive of B-cell type acute lymphoblastic leukemia (ALL).
Read 21 tweets
🚨Tweetorial Alert
🏁”A primer regarding the basics of Ambulatory Blood Pressure monitoring (ABPM)”
🎯Learning Objectives:
1. When is ABPM indicated
2. How to interpret ABPM data
Blood Pressure Measurement is a fundamental Procedure tagged with multiple confounders
❓Why precise BP measurement is needed ?
★ overestimation of blood pressure by 5 mm Hg = Inappropriate labeling of 30 million as Hypertensives

★ Under estimation of BP by 5 mm of Hg = Mislabeling of 20 million true hypertensives as normotensives

PMID: 12597757 12493255
Read 16 tweets
1) Welcome to our new #accredited #tweetorial which is Part 1 of a 2-part "highlights" program on new #SGLT2i & #DKD data presented at @ERAkidney #ERA22. #Physicians #nurses #pharmacists #PAs and #NPs can all earn 0.5h CE/#CME by following this thread!
2) @ERAkidney #ERA22 is a primary international scientific symposium for interaction and exchange among basic scientists and clinicians working in #Nephrology. It was held in May. Our expert author is Dr. Sheila Bermejo (@shbermejo) from @vallhebron in Barcelona, Spain.
3) This program is #accredited for CE/#CME & is supported by an independent educational grant from the Boehringer Ingelheim/Lilly Alliance. It is not intended for US- or UK-based based HCPs. Accreditation statement & faculty disclosures at
Read 43 tweets
1/ Hi #NephTwitter #Renal #MedTwitter @ASPNeph radiology webinar this month was Vesicoureteral reflux #VUR and its management.

Let's get going with a poll!

What percentage of children with febrile UTI may end up having VUR?
2/ Answer: up to 30%
This may be an underestimate since many children don't get tested.

[PMID: 9743033]
3/ Risk factors for VUR:
⚡️Bowel and bladder dysfunction
⚡️Abnormal urinary tract anatomy
⚡️Younger children and infants
⚡️Girls affected >> boys
⚡️Family history: sibling with VUR ➡️ 25% recurrence risk
Read more 👇
Read 19 tweets
Since there are lots of MBBS students are asking me how to approach Harrison in UG,

Here is my approach -->


Etc etc
The latest Harrison is a giant encyclopedia of molecular data. Clinical medicine has been reduced to a bare minimum. I am talking about the 20th ed.
In fact, the Oxford Textbook of Med 6th ed is relatively better clinically but it comes in 4 giant volumes.
Read 4 tweets

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