Discover and read the best of Twitter Threads about #dialysis

Most recents (22)

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
#POCUS puzzle 🧩of the day. Can you put together the pieces and arrive at an unifying diagnosis? Go through the thread 🧵below.
Context: #dialysis patient, physical examination #FOAMed #Nephrology #MedEd

Image No. 1 👇
Color #POCUS
Transverse #POCUS , IVC trace down
Read 8 tweets
Offering #dialysis to patients with a new diagnosis of #malignancy is always an emotive and complex affair if they present with an #AKI or #renaldysfunction
Sometimes it’s pretty clear - like in the 30 something who presents with a cervical cancer , bilateral hydronephrosis and K of 7- one will usually explain to The patient what’s the issue and buy them time for intervention which buys time for an oncology consult and further mx
Sometimes it’s not -70 plus with metastatic lung cancer and #AKI will likely need dialysis but is that the right thing - often it’s easy saying make the shared decision with the patient - but shock and the acuteness of the situation doesn’t help and true #SDM is seldom easy
Read 10 tweets
Hey Twitter! It's been a while. I used to write here all the time hanging out with #scifichat, #comicschat, #litchat, talking about #science, #tech, #autism and a dozen other topics which broadened my horizons and let me share my diverse interests in almost everything.
Then my life got incredibly busy. My son went to high school and coupled with his #autism, our lives became super-complex. I lost my job and my car gave up the ghost after four years of @Uber. Then the unthinkable, my wife experienced #renalfailure.
4 years ago, she underwent an operation for #peritoneal #dialysis. This form of at-home dialysis would let her take care of her renal needs at home avoiding the need for external #hemodialysis centers. In hindsight, this may have saved her life.…
Read 26 tweets
We are about to start (in 10 min)...
Hope you will join us !!

ISN-@DOPPStudy @ISPD1 Webinar: "Cases and controversies in peritoneal dialysis: PDOPPS, please help!" with Beth Piraino, Simon Davies, Melissa Nataatmadja, Muthana Al Sahlawi, and @PD_Perls
Ready to go!

ISN-@DOPPStudy @ISPD1 Webinar: "Cases and controversies in peritoneal dialysis: PDOPPS, please help!" with Beth Piraino, Simon Davies, Melissa Nataatmadja, Muthana Al Sahlawi, and @PD_Perls
#ISNwebinar @ISNKidneycare
Our case study of the day!

ISN-@DOPPStudy @ISPD1 Webinar: "Cases and controversies in peritoneal dialysis: PDOPPS, please help!" with Beth Piraino, Simon Davies, Melissa Nataatmadja, Muthana Al Sahlawi, and @PD_Perls
#ISNwebinar @ISNKidneycare
Read 24 tweets
A Thread.
The Indian Government has increased the gap btw the two doses of #COVID19 vaccination to 3 to 4 months now, ostensibly to improve protection but actually bcos of vaccine stock deficiency. This should NOT apply to Chronic Kidney Disease pts, #Dialysis & Transplant pts.
CKD pts, #dialysis and Transplant pts run a very high risk of morbidity and mortality (4 fold) with #COVID19 infection, much higher than diabetics and pts with heart disease or asthma (1.2 to 2 fold)…
Data from India has also shown high mortality (38%) in dialysis pts. Study by @MayuriTrivedi80 et al
Read 12 tweets
This is a Thread about the Indian caregiver.
Most #CKD & #Dialysis pts come with their relatives as caregivers when they come for an OP consult. Usually it is the spouse & sometimes, the children. I make it a point to enquire about their health even though they are not my pts 1/n
I will tell you why I do that with a couple of real-life events. My 55 yr old #CKD Pt came without her husband for a consult which was unusual. When I asked her, she started bawling out in distress, saying that he'd died of a heart attack the previous month. 2/n
He was 60 years of age and hypertensive, but it appears that he never bothered to go for his regular BP check or for that matter an annual cardiac check. I didn't know of this & wondered at the time, should I have asked him how he was during his many visits to my OP chambers? 3/n
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Renal #POCUS in a #dialysis patient: Looks fine at first glance (thin parenchyma as expected) but fanning anteriorly reveals a large cyst, which would have been missed otherwise. Labeled images and notes in thread 👇
#Nephrology #MedEd #IMPOCUS
Labeled first image #POCUS
Note: peri-renal fat (usually prominent in ESRD patients) can be confused with free fluid.
Labeled second image #POCUS (obtained with phased array probe)
Note: EKG is not needed 😀
Read 5 tweets
Daily Bookmarks to GAVNet 12/15/2020…

#markets #performance
New gene family of antimicrobial proteins discovered in German cockroaches…

#antimicrobial #proteins #gene
Read 8 tweets
#ToughTxCase I am going to start an educational series for #transplant professionals/trainees on complex cases I have the privilege to see @UWHealth Patients have provided informed consent for us to discuss their condition in order to help other similar cases @uw_nephrology
#ToughTxCase #1 is the story of Tom, a 73 year old man, who received a living unrelated #kidney tx for #ESRD due to an unknown etiology. Low immunological risk, VXM (-), #CMV D+/R-, basiliximab induction, standard TAC/MPA/P maintenance Rx on Valgan prophylaxis x 6M @TxPharmD
At his 3M visit, Tom complains of #diarrhea, weight loss (4 lbs in 1 month) and poor energy. His kidney fxn is at baseline Scr 1.3 mg/dL. What is the most likely diagnosis? Please feel free to discuss! @uw_IMresidency @askrenal @Nephro_Sparks
Read 35 tweets
I listened to (while doing some admin) @ISPD1 webinar on dispelling #myths in #peritoneal #dialysis by the inimitable @PD_perls- really interesting content and I’ve added some of my own myths that I’ve been presented with over the years that I’ve lead the service @HeartlandsUHB
Myth #1- Previous abdominal surgery and PD are not compatible..

This is the commonest reason why patients are not offered PD
Advanced laparoscopic tube placement can do away with most issues as this slide shows:
We have also done some percutaneous blind and fluoroscopy guided procedures in patients with simple scars such as a C-section; appendectomy and laparoscopic cholecystectomy and overall, not had any issues
Read 33 tweets
How many families have a loved one coping/fighting #Cancer #epilepsy, needs #dialysis or insulin for #diabetes? Due to #COVID2019 there’s 2.4m backlog, a 10m waiting list expected through no deal. Shortage/delay of medicines from the EU would be the last straw. #No2DeathByNoDeal
Here is the full list of medications which could be affected by a no-deal Brexit, according to E-Surgery:

Acamprosate (Campral) treats alcohol dependence
Aciclovir (Acyclovir) treats herpes, simplex virus infections, chickenpox,shingles
Read 21 tweets
1/ #Nephrology #POCUS case study:
Dr. X is rounding on an ESRD pt who initially presented with dyspnea after missing a dialysis (HD) session; underwent dialysis in the hospital. Pt asymptomatic at the time of exam and lung #ultrasound revealed 👇 Further story in thread #MedEd
2/ Based on the 2-zone lung #POCUS, Dr. X orders for another session of HD. Notably, pt says he is at his 'dry weight' and HD nurse says they could only get 1.5L off during first session. Dr. X doesn't change his/her mind.
Info on various lung scan zones👇
3/ Patient becomes hypotensive during HD and only ~500cc fluid could be removed.
Why can't we get more fluid out of a hypervolemic patient? Dr. X is perplexed and decides to more #POCUS Here is the IVC
Read 16 tweets
#POCUS teaching case: #Dialysis patient c/o sob, reports weight gain. BP low to begin with (~100-110 mmHg systolic) & drops further during ultrafiltration. Dr. X performs IVC #ultrasound at the bedside and sees this 👇 - probably volume depleted? See #thread
#MedEd #nephrology
2/ Dr. X orders to stop ultrafiltration. BP stabilized a little bit.
All done?
Wait, something doesn't make sense. Why did the patient gain weight? (usually #dialysis patients know their dry weight well). Why sob?
In the meanwhile, radiology tech performs chest #X-ray 👇
3/ That's not good. Diagnosis is apparent but lets get Dr. Y who does more than just IVC #POCUS
Subcostal view 👇
Significant pericardial effusion
Read 12 tweets
Seeing this discussion, thought of doing a short #tweetorial on the lung #POCUS scan zones I've come across. Some of them (like 24-zone method) have been utilized to study lung congestion in #dialysis patients
1st slide: 👇
24-zones: better illustrated. #POCUS
Additional zone (#4) added to the commonly used 8-zone method to include the right middle lobe. #POCUS
Read 6 tweets
@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
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:…
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.
Read 12 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
#BlackoutInfo What might be consequences of a national or even european #Blackout, lasting more than 72 hours in our electricity addicted society? How is our country prepared for? And how much our politicians engage for this catastrophic case?
#BlackoutInfo Within hours after a national #Blackout for 90% of all homes no more drinking water will flow out of the tap. Flushing the WC will work only one last time. Therefore risk of diseases is growing fast. No human can stand more than 3 days without water supply...
#BlackoutInfo As a follow of a national #Blackout production of food isn’t possible anymore. Distributing still available stockpiles is becoming difficult & very quick impossible. Automated warehouses can’t deliver anymore, because all is offline. Supermarkets run out of stocks.
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Today is #WorldKidneyDay, so here is a thread about living on #dialysis & #OrganDonation. My name is Belinda Otas. I’m #African. I’m #Nigerian. I'm #Benin. I’m #British & I’m #Black. Beyond the nationalities or passports with my name, I also believe in our shared humanity.
I was 16, when I was diagnosed with End Stage Renal Failure (ESRF.) I had no idea what was happening to me because at the time, it made no sense. However, I remember the pain of that period like noonday. I lived on dialysis until i was 22. #dialysis #OrganDonation #renalhealth
It took over my teenage years. I don’t remember having much of a life as a teenager because dialysis was 3x a week & every session was 4hrs. Add the time it takes to recover from being exhausted by the process, my day was pretty much over. #dialysis #OrganDonation #renalhealth
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#Venezuela's #NicolasMaduro:
"We had a large shipment of medicines to last the country for a year,a large batch of raw materials for food. The bank account was frozen,the contracts were cancelled & the money is seized. They suffocate us,steal our money & put a show for the world"
Nov. 2017:The transnational Pharmaceutical companies Baster,Abbot & Pfizer refused to issue exportation certificates to #Cancer drugs,making it impossible for #Venezuela to buy them
July 2017: The Citibank bank (#USA) refuses to receive #Venezuelan funds from the Central Bank for the import of 300 thousand doses of insulin, destined to cover the demand of 450 thousand registered patients.
Read 62 tweets
Pilot Intervention Addressing Social Support and Functioning of Low Socioeconomic Status–Older Adults With ESRD: The Seniors Optimizing Community Integration to Advance Better Living With ESRD (SOCIABLE) Study

@DrDeidraCrews @sarah_szanton @tkmcudjoe
This is an innovative pilot tested home based program for older low socioeconomic status adults on hemodialysis aimed at improving physical and social function.

@JanieceLTaylor @lakencroberts @DeanDrexelCNHP @Aging_scholar
Why: Older ESRD patients experience increased morbidity, fatigue and decreased physical function. Multiple studies note improvement in health/functional outcomes with social support however few intervention studies aim at improving this..
Read 8 tweets
This looks to be fun look at renal research around the world. I made my picks the way I make my picks at a horse track - I went by the titles. I expect as with #nephmadness as the results come in I'll learn why my picks were wrong and then more about the research that advances.
@RSNhope @ihatedialysis @KidneyPatients @DialysisAtHome @hdunews this is a new social media "game" that pits various renal research studies from around the world against each other in a World Cup style competition. This is a fun
gateway to the world of renal research
We with CKD should familiarize ourselves with the language of research and what is now being worked on so that as opportunities arise to engage we will be prepared to contribute #kidneyresearch #dialysis #kidney
Read 3 tweets

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