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Edgar V. Lerma πŸ‡΅πŸ‡­ Profile picture
@edgarvlermamd
May 17, 2019 β€’ 16 tweets β€’ 20 min read β€’ Read on X
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This is on my reading list for this week
πŸ“Œ Not all elevations in serum creatinine portend bad outcomes‼️
#Nephpearls #NephSAP #AKIinICU
πŸ‘‰πŸΌ asn-online.org/api/download/h… ImageImage
At the current time, there is no consensus regarding the role of early initiation of RRT and its impact on patient outcomes in the setting of AKI

πŸ‘‰πŸΌ Awaiting ⏳ πŸ‘‰πŸΌ STARRT-AKI trial
#Nephpearls #NephSAP
πŸ‘‰ slideplayer.com/slide/8918419/… ImageImageImageImage
.@goKDIGO Clinical Practice Guidelines for AKI recommend that during CRRT a minimum effluent flow of 20 to 25 ml/kg per hour should be provided
#Nephpearls #NephSAP
πŸ‘‰πŸΌ kdigo.org/wp-content/upl… ImageImage
Components of the @goKDIGO care bundle
#Nephpearls #NephSAP
πŸ‘‰πŸΌ nature.com/articles/nrnep… ImageImage
Furosemide Stress Test
#Nephpearls #NephSAP
πŸ‘‰πŸΌ karger.com/Article/Pdf/44… ImageImage
The presence of significant proteinuria prior to the onset of dialysis requiring AKI decreases the chances of renal recovery
#Nephpearls #NephSAP
πŸ‘‰πŸΌ ncbi.nlm.nih.gov/m/pubmed/29352… Image
Renal Functional Reserve
πŸ“Œ The difference between the stress (peak) GFR achieved by stimulation & the baseline GFR
πŸ“Œ Identifies the capacity of the kidney to compensate or increase its function in states of demand or disease
#Nephpearls #NephSAP
πŸ‘‰πŸΌ karger.com/Article/Pdf/36… ImageImage
Renal Functional Reserve and Renal Recovery after AKI ca. 2014
#Nephpearls #NephSAP
πŸ‘‰πŸΌ karger.com/Article/Pdf/36… ImageImageImageImage
Renal functional reserve testing can identify at-risk individuals for postoperative AKI
#Nephpearls #NephSAP
πŸ‘‰πŸΌ annalsthoracicsurgery.org/article/S0003-… ImageImageImageImage
AKI Risk Prediction Score ca. 2017 from @astute_kidney @MacedoEtienne @NDTsocial
#Nephpearls #NephSAP
πŸ‘‰πŸΌ academic.oup.com/ndt/article/32… ImageImage
Electronic AKI alerts and care decision support systems improve patient out- comes in the setting of clinical AKI
#Nephpearls #NephSAP
πŸ‘‰πŸΌ cjasn.asnjournals.org/content/clinja… ImageImage
Balanced solutions appear to minimally decrease the risk of major adverse kidney events in critically ill ICU patients and emergency room patients
#Nephpearls #NephSAP Image
Drug-induced AKI phenotypes from @jaykoyner @CharuThakar
#Nephpearls #NephSAP Image
PERAZELLA: Drug-induced AKI can occur at multiple sites along the nephron
#NKFClinicals πŸ‡ΊπŸ‡Έ #Nephpearls
πŸ‘‰πŸΌ cjasn.asnjournals.org/content/clinja… ImageImage
PERAZELLA: Drug-induced AKI
πŸ“Œ Kidney specific factors
πŸ“Œ Drug specific factors
πŸ“Œ Patient specific factors
#NKFClinicals πŸ‡ΊπŸ‡Έ #Nephpearls
πŸ‘‰πŸΌ cjasn.asnjournals.org/content/clinja… ImageImageImageImage
PRESERVE Trial: NaHCO3 βž• Acetylcysteine ~ NO significant difference across groups in death, need for dialysis or >/= 50% increase in creatinine at 90 days
#Nephpearls #NephSAP
#VisualAbstract from @NEJM
πŸ‘‰πŸΌ nejm.org/doi/pdf/10.105… ImageImage

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More from @edgarvlermamd

Edgar V. Lerma πŸ‡΅πŸ‡­ Profile picture
Feb 26, 2022
Advancing Evidence-Based Care in Diabetes and CKD
#ISNWCN πŸ‡²πŸ‡Ύ #Nephpearls

πŸ‘‰ kdigo.org/wp-content/upl…
Holistic approach for improving outcomes in patients with Diabetes and CKD
#ISNWCN πŸ‡²πŸ‡Ύ #Nephpearls
Glucose-lowering agents in Type 2 Diabetes (T2D) and CKD: Indications and dose adjustments
#ISNWCN πŸ‡²πŸ‡Ύ #Nephpearls
Read 9 tweets
Edgar V. Lerma πŸ‡΅πŸ‡­ Profile picture
Feb 26, 2022
.@goKDIGO Glomerular Diseases Guideline: Reflections on a Decade of Progress with @adrianliew8 @ReichHeather @Dr_KeishaGibson
#ISNWCN πŸ‡²πŸ‡Ύ #Nephpearls

πŸ‘‰ kdigo.org/wp-content/upl…
IgA Nephropathy: A 1st step is in treating IgA Nephropathy is assessing "prognosis" based on data available at the time of biopsy

@goKDIGO suggest using the "prediction tool" that was derived from the largest & most geographically diverse cohort to date

#ISNWCN πŸ‡²πŸ‡Ύ #Nephpearls
IgA Nephropathy: The @goKDIGO treatment algorithm recommends consideration of use of corticosteroids in patients with "persistent proteinuria >1g/day" if the risk/benefit profile is favorable

πŸ“Œ A GFR of 30 is considered a threshold for treatment

#ISNWCN πŸ‡²πŸ‡Ύ #Nephpearls
Read 13 tweets
Edgar V. Lerma πŸ‡΅πŸ‡­ Profile picture
Feb 23, 2022
First clinical-grade porcine πŸ– kidney xenotransplant using a human decedent model ca. 2022 from @amjtransplant #NephJC #Nephpearls

#VisualAbstract by @NamrataYParikh

πŸ‘‰πŸΌ pubmed.ncbi.nlm.nih.gov/35049121/ Image
Attitudes to Clinical Pig Kidney Xenotransplantation among Medical Providers and Patients ca. 2020 from @ASNKidney360 #Nephpearls

kidney360.asnjournals.org/content/1/7/657 ImageImage
Paving the Path toward Porcine Organs for Transplantation ca. 2017 from @NEJM #NephJC #Nephpearls

nejm.org/doi/full/10.10… ImageImage
Read 4 tweets
Edgar V. Lerma πŸ‡΅πŸ‡­ Profile picture
Jan 30, 2022
Nephrolithiasis 101: When to order a 24-hour urine collection #Nephpearls

Multiple or metabolically active stones (stones that increase in size/ number w/in a year)

Children

Demographic groups not typically prone to stone formation

Stones other than those containing calcium ImageImage
Interpretation of urine chemistries to identify lithogenic risk factors and assess the contribution of diet to the formation of kidney stones ca. 2016 from @ravineja #Nephpearls

sciencedirect.com/science/articl… Image
Neglected analytes in the 24 hour urine: ammonium and sulfate ca. 2021 from @CO_Neph_Hype @ravineja #Nephpearls

πŸ‘‰ pubmed.ncbi.nlm.nih.gov/34798636/ ImageImageImageImage
Read 4 tweets
Edgar V. Lerma πŸ‡΅πŸ‡­ Profile picture
Jan 26, 2022
PREDNOS 2: Evaluation of Daily Low-Dose Prednisolone During URTI to Prevent Relapse in Children w/ Relapsing Steroid-Sensitive Nephrotic Syndrome ca, 2022 from @JAMAPediatrics #NephJC #IPNAJC #Nephpearls

#VisualAbstract by @drM_sudha

jamanetwork.com/journals/jamap…
Low-dose versus conventional-dose prednisolone for nephrotic syndrome relapses: a randomized controlled non-inferiority trial ca. 2022 from @Ped_Neph #NephJC #IPNAJC #Nephpearls

#VisualAbstract by @md_abdulqader83

link.springer.com/article/10.100…
PREDNOS: Sixteen-week versus standard eight-week prednisolone therapy for childhood nephrotic syndrome ca. 2019 from @bmj_latest #NephJC #IPNAJC #Nephpearls

#VisualAbstract by @jbda19

pubmed.ncbi.nlm.nih.gov/31156083/
Read 5 tweets
Edgar V. Lerma πŸ‡΅πŸ‡­ Profile picture
Nov 17, 2021
Clinical Practice Guideline for the Management of Glomerular Diseases ca. 2021 from @goKDIGO #NephJC #Nephpearls
#VisualGraphics by @michaelturk6

Executive Summary pubmed.ncbi.nlm.nih.gov/34556300/
Full Guideline pubmed.ncbi.nlm.nih.gov/34556256/
The spectrum of glomerular diseases from @neilturn #NephJC #Nephpearls

πŸ‘‰ global.oup.com/academic/produ…
Nephrotic range proteinuria does "not always" mean nephrotic syndrome #NephJC #Nephpearls

πŸ‘‰ pubmed.ncbi.nlm.nih.gov/34556256/
Read 4 tweets

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