Discover and read the best of Twitter Threads about #kidney

Most recents (24)

#TheyDontKnowAndTheyDoItAnyway. -|- "Conclusions
- Water #fluoridation results in higher plasma #fluoride levels in those with lower #renal function. How routine water #fluoridation may affect the many millions of Americans with Chronic #Kidney Disease, ..."
" ... who are particularly susceptible to heavy metal and mineral accumulation, needs to be further investigated."
Read 8 tweets
1) Welcome to an #accredited #tweetorial on optimizing the use of #SGLT2i in the management of #T2D. This program is accredited for 0.50 🆓credits for #physicians #nurses #physicianassociates #nursepratcitioners #pharmacists by @academiccme! I am @tmodarressi of @HeartDoctorNJ.
2) This program is intended for healthcare professionals and is supported by an educational grant from Boehringer Ingelheim Pharmaceuticals Inc. and Eli Lilly Company. See archived programs, all by expert authors, still available for credit at cardiometabolic-ce.com.
Read 47 tweets
Thread on #Magnesium and why it is fundamental for our #health. #micronutrients
..many people debate the various ratios of #macronutrients like #protein, #fat, and #carbohydrates in their diet to find their optimal health. Which is great as we are #bioindividuals but most miss out on #micronutrients like #vitamins and #minerals.
The way our bodies are able to use the #macronutrients is fully dependent on how our #enzymatic pathways are influenced by various #micronutrients. One of the most important amongst is #magnesium.
Read 19 tweets
1) Welcome to our new #accredited #tweetorial on the Pathophysiology of #DKD in #T2D: Traditional Teaching and New Insights. Our expert author is Hans-Joachim Anders, MD, @hjanders_hans from @LMU_Uniklinikum of @LMU_Muenchen
2) This #accredited #tweetorial series on the foundations of #kidneydisease #DKD through the lens of #T2D is supported by an independent educational grant from the Boehringer Ingelheim/Lilly Alliance and is intended for healthcare providers.
3) This activity is accredited for #physicians #physicianassociates #nurses #NPs #pharmacists 🇺🇸🇪🇺🇬🇧🇨🇦. Past programs still eligible for credit are at ckd-ce.com. Faculty disclosures are at ckd-ce.com/disclosures/. FOLLOW US for regular programs by expert faculty!
Read 48 tweets
@Mktweets0 Going to start a thread on #melatonin & its effects on CKD validated by scientific research. Please correct if you find any medical faults.

#kidneys
@Mktweets0 1/ Melatonin was first purified and characterised from the bovine pineal gland extract by Aron Lerner and co-workers in 1958.

However it has systemic effects. #Kidney cells (proximal tubule) express a melatonin receptor of type MTNR1. pubmed.ncbi.nlm.nih.gov/9034171/
@Mktweets0 2/ Looking at mRNA expression across several human tissues, surprisingly it's rather strongly expressed in colon and #kidney.

genecards.org/cgi-bin/carddi…
Read 12 tweets
Study from @salkinstitute found that partial reprogramming using the #Yamanaka transcription factors (#Oct4, #Sox2, #Klf4 & #cMyc) for short periods of time:

-restored a youthful #epigenetic signature to #aging cells & extends the life span of a #premature #aging mouse model.
-long-term partial reprogramming led to rejuvenating effects in different tissues, such as the #kidney & #skin, and at the #organismal level; duration of the treatment determined the extent of the beneficial effects.
-The rejuvenating effects were associated with a reversion of the #epigenetic clock and metabolic and #transcriptomic changes, including reduced expression of genes involved in the #inflammation, #senescence & #stressresponse pathways.

nature.com/articles/s4358…
Read 4 tweets
My sincerest & humblest apologies all! For the first time in my life, ever, 9pm, Christmas Eve & i actually just realised what day it was! 😱⚠️
No, i have no idea either but i guess that's what 2 years of near isolation can do to you (throw in painkillers, CF, fibro & depression)
Never assume that because you don't hear from someone everything is ok (the old, "no news is good news" {as all must be ok!}, they're just busy! Especially when it's such a landmark day & ppl are invariably wrapped up with their families. That's not always the case!
Why am i isolating at Christmas? 2 reasons:
🔵 many NHS staff appear to be falling ill despite being triple jabbed &
🔵 Studies seem to be showing effectiveness behind to wane a bit after 10 weeks.

So do you go meet your elderly mum, who's allowing my nephew to shuttle between..
Read 10 tweets
Be sure to join us TOMORROW here on @ckd_ce for our first ORIGINAL accredited content . . . from none other than @edgarvlermamd . . . whom you #kidney-oriented clinicians will know as a comforting and familiar presence and as an AWESOME teacher. He'll be talking about ...
...IgA nephropathy (#IgAN) from the ... perspective of the 2021 @goKDIGO #guidelines. Lots to learn about this common cause of #CKD worldwide! Free CE/#CME for #physicians #nurses #PAsDoThat #nursepractitioner @ANNAnurses @neph_PAs @pharmacists @nephondemand @IgAN_JBarratt
Read 35 tweets
1)
... more from the #ESCCongress2021 from the @GoggleDocs #Takeover of the @cardiomet_CE

Next up the EMPEROR-Pooled analysis and some of the questions it asks

How does empagliflozin compare with ARNI (sacubitral/valsartan
2)
EMPEROR-Pooled was a prespecified analysis of the two 'sister' studies

EMPEROR-Reduced Trial
nejm.org/doi/full/10.10…

and

EMPEROR-Preserved Trial
nejm.org/doi/full/10.10…

With very similar #HeartFailure populations, separated by an ejection fraction cut off of 40%
3)

As you can see

📍Very similar results in terms of the primary and secondary #HeartFailure outcomes.

‼️ Although clear attenuation of benefit seen in pople with higher ejection fractions (EF)
Read 9 tweets
1/
👻 AKI in patients with a kidney transplant can sometimes be “SCARI”

🧵Let’s talk about an approach I recently learned to some common causes of late (>3 months) allograft dysfunction to overcome the fear together #Tweetorial #NephTwitter
2/
🎃 Allograft dysfunction is defined by a rise in serum Cr of approximately 25%

🎃 It is often asymptomatic, identified on routine blood work

🎃 It can also present with nonspecific symptoms such as nausea, vomiting or diarrhea.
3/
Let's start with a not-so-SCARI case!

👨🏽 50 y/o M with ESKD due to DM2 s/p deceased donor kidney transplant 5 yrs ago

🧪 Cr 2.0 (176 umol/L) baseline Cr 1.3 (115 umol/L). No change in urinary frequency, amount or color. No recent illness

What kidney imaging do you suggest?
Read 21 tweets
The latest from our team:

A deep dive into the long-term consequences of #COVID19 on kidney function and disease

#longcovid #PASC

@VAResearch @vahsrd @WUSTL @WUSTLpubhealth @WUSTLmed @WUSTLnews @VREFSTL
@Biostayan @BCBowe @JASN_News @ASNKidney

jasn.asnjournals.org/content/early/…

🧵
We previously provided a high dimensional characterization of post-acute sequelae of COVID-19

We showed that #LongCovid can affect nearly every organ system.

@Nature @NaturePortfolio

#COVID19 #PASC

nature.com/articles/s4158…
What happens to long term kidney function in people who survive acute #COVID19 ?

And are they at increased risk of #kidney disease?

To address this, we built a cohort of 89,216 US veterans with #COVID19 and 1,637,467 non-infected controls.

jasn.asnjournals.org/content/early/…
Read 9 tweets
Thread:
Some Phramacokinetics, Geno- & Reprotoxicity highlights, Moderna's report to EMA, mostly animal studies
ema.europa.eu/en/documents/a…
P. 47: "Low levels of #mRNA could be detected in all examined tissues except the #kidney, this included heart, lung, testis & also ..
2./ #brain tissues, indicating mRNA/LNP platform crossed the blood/brain barrier..liver is a common target organ of LNPs.."
P. 49: ".. coagulation changes included increase in fibrinogen, activated partial thromboplastin time .".
(generic image) 
P. 50, Genotoxicity: "significant
3./ increases in micronucleated erythrocytes were reported in both sexes" (Note: chance of genetic chromosomal damage to red blood cells)

P. 51, ReproToxicity: "The mRNA-1273-related non-adverse effects were limited to an increase in the number of foetuses with common skeletal
Read 8 tweets
The Webinar on "Monoclonal gammopathy and its significance for kidneys" is about to begin!
There is still time to test your knowledge by solving the @ISNeducation quiz ➡️ bit.ly/3j7U5cn
Starting now!
Webinar: "Monoclonal Gammopathy of Renal Significance - Clinical Perspective" with
@arzuvelix and Serhan Tuglular
#ISNwebinar
Welcome Dr @arzuvelix and Dr Serhan Tuglular
Webinar: "Monoclonal Gammopathy of Renal Significance -Clinical Perspective" with

#ISNwebinar
Read 44 tweets
An inconvenient truth: 2–7 million people with kidney failure worldwide die prematurely because they do not have access to kidney replacement therapy (dialysis/transplantation) #ISNWCN @WHO
#Kidney #disease is the third fastest-growing cause of death, projected from the current 16th position to 5th in less than 20 years
There are huge inequities in access to kidney replacement therapy worldwide, with 94% patients being in high and upper-middle income countries
Read 9 tweets
1/17 Taking forward the theme of #WorldKidneyDay let’s discuss what it means for “#WOMEN to live well with #kidney disease” 💃
🧵ahead is for anyone who cares about 💃!
@womeninnephro #womenempowerment #WomensDay #WomensHistoryMonth
Q-Do kidney diseases affect women differently?
2/17
Women have
⬆️Autoimmune diseases (SLE, RA, Systemic Scleroderma)
In #Women of Color that's 2- 3X commoner, early-onset with⬆️ complications

⬆️UTI due to short urethra
In #Pregnancy ⬆️risk of pyelonephritis and sepsis

karger.com/Article/FullTe…
3/17 Pregnancy poses a high risk of #kidney injury due to various etiologies (see pic) which can progress to CKD in the future.
#Preeclampsia is a definite risk factor for #CKD and #ESKD in mother and also for #cardiovascular disease
pubmed.ncbi.nlm.nih.gov/26342729/
Read 17 tweets
1/A horrific patient scene today. A #kidney #transplant patient doing well since 2015. Had fall and fracture of foot. Underwent surgery,improving. Asked for physio sessions to continue at home. Asks around,finds #ayurvedic traditional healer. He does external works.
2/ patient feels better. #Ayurveda healer gets his trust. Says post transplant infections and diabetes worsen (patient was already diabetic kidney disease for which transplant was done). Says #natural is safest way. Patient falls for healers confidence. Starts #herbal drugs.
3/ Drugs and potions prepared at home from locally sourced plants. Small fee Healer also advise nutritional changes. More like starvation. No proteins. Remember patient is post kidney transplant. #weightloss in 1 mo. Loss of appetite in 2 months. Then came something unexpected.
Read 9 tweets
Latest paper is up! We fed mice high protein diets for 24 weeks and measured the #microbiome 🦠, #kidney function and #gut leakiness. Here's what we found: onlinelibrary.wiley.com/doi/abs/10.100… @sihmin_tan @MelindaCoughlan @MonashDiabetes
1) high protein diets alter the microbiome...but what's interesting is when we looked at the predicted metagenomes (using picrust2) we saw⬇️BCAA synthesis and⬆️urea cycle pathway.
2) the high protein diet caused inflammation and intestinal permeability:
⬆️ plasma endotoxin
⬆️ plasma MCP1
⬆️ TNFα expression in jejunum and ileum
⬇️ occludin expression in jejunum
Read 5 tweets
#fraud #pseudoscience products such as these are available on @amazonIN and @amazon. This #ayurvedic product is advertised as #immunitybooster which is very wrong. @amazonIN must have moral values to its customers. Wrong descriptions, faked #science claims must be removed.
1/3
#herbal ingredients and concentrations and their herb-herb interactions aren't studied, short/long #healthy benefit, side effects unknown. At risk #patients ➡️ organ failures.
➡️O.tenuiflorum has liver toxic eugenol
➡️A.indica(neem) in certain doses injure liver #Ayurveda
2/3 Image
➡️Glycyrrhiza (licorice) can cause muscle injury, #kidney #failure
➡️Tinospora cordifolia EASILY confused wit T. crispa latter cause liver failure
Products like these,@amazonIN & consumers beaware of what they sell & put in their bodies respectively.
#livertwitter #MedTwitter
3/3 Image
Read 3 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
So this #Stupidity hits close to home. So a #discussion on #arsenicum album 30.
📌30 means 30 times diluted, standard for #Homeopathy
📌What is #diluted? ➡️ #Arsenic trioxide
📌#homeopath says only 0.443mg of compound per pellet
📌Thats #safety levels right? ➡️ NO.
Read on
2/n
#Arsenic whatever form, concentration, level, is #dangerous #harmful to #humans.
📌Even LOW DOSE intermediate to #long use can lead to #Cancer
📌Actually, many types of #Cancers - #skin, #liver, #bladder, #kidney, #lung
📌Those with #diabetes #heartdisease its #deathwish
👇
3/n
📌NOT one proper #study on this #drug in #Medical #history
📌Read artilce @AltNewsScience debunking fake evidence: bit.ly/2Xra5KY
📌#traditional use was in #diarrhea
📌#pseudoscience at its best
👇 Arsenic is As and not ARS
🔥Even though arsenicum album is #crap
4/n
Read 5 tweets
Why #kidney function does not equal #GFR (and certainly not Cr), making it an elusive target in clinical practice & the latter a poor surrogate outcome, despite its robust correlation with prognosis. Caring for kidneys versus improving Cr/GFR. A thread below:
The kidneys in essence have 3 functions:
1. Glomerular function = Clearance
2. Tubular function = Homeostasis
3. Neurohumoral function

GFR mainly reflects 1. So why do we take GFR (or its estimate Cr) as a surrogate for renal function?
Look at GFR determinants (=N x snGFR).

In stable circumstances, GFR mainly reflects the number of functional nephrons.

Starting from 1 million per kidney at birth, one loses 5,000-10,000 per year with aging: age-related GFR decline <1 mL/min/1.73m²/y

ncbi.nlm.nih.gov/pmc/articles/P…
Read 9 tweets
From Times: “Some 2.4 million patients have missed out on cancer tests and treatments due to a backlog caused by the coronavirus pandemic, charities have said.
According to Cancer Research UK 2.1 million patients are” awaiting screening appointments for breast, cervical and
“bowel cancer and another 290,000 have not had referrals for tumours. It is also estimated that about 21,600 patients have had surgery, chemotherapy or radiotherapy postponed in the past nine weeks.
Sarah Woolnough, policy chief at Cancer Research UK, warned that hospitals faced“
a “huge backlog to clear”. She told the Daily Mail: “It’s a massive backlog of services and treatment to deliver. It’s absolutely huge, it’s thousands and thousands.”
A No Deal #Brexit will make backlog even worse. Add #diabetes #epilepsy #kidney patients to the list= Seismic!
Read 6 tweets
#Remdesivir begins distribution in the #USA today via #EUA.

I thought would write down some practical #tips based on my #qualitative anecdotal experience after personally treating close to 200 patients with #COVID19.

For quantitative results, wait for the papers¬—thread
“this juice works, doc!” When you hear similar expressions 1-2 days after starting #remdesivir multiple times, you start to wonder. Don't recall a similar proportion of patients smile after feeling so sick 1-2 days earlier with #COVID19. x/n? Wait for the papers.
Like #treatment for any severe infectious disease (meningitis, Gram-negative bacteremia, influenza pneumonia, etc), earlier is always better. #COVID19 is no different. #Remdesivir stops #SARS-CoV2 replication, but won’t heal the lung injury.
Read 13 tweets
Hey #tipsfornewdocs #medtwitter folks! I wanted to review side effects of immune checkpoint inhibitors (ICIs) for a non-#oncology audience. Immune-related adverse events (irAEs) present across all medicine specialties so we are all in this together. 1/x
The most common ICIs are against PD-1 (e.g. nivolumab, pembrolizumab) and PD-L1 (e.g. atezolizumab, durvalumab). I use a blanket term “PD-1” throughout. Anti-CTLA-4 (ipilimumab) is a distant second; often in combo or directly after PD-1 in #melanoma #lung #kidney cancers. 2/x
They have led to pharma riches and Nobel Prizes and lots of TV commercials because they work really well for some patients. People with advanced #melanoma, #lcsm etc who used to live ~1 year now can hope to live for several years or more. 3/x
Read 17 tweets

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