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22 Oct, 10 tweets, 6 min read
It seems I can’t get enough of #sglt2i The Who, what and where for SGLT2i in DM #KidneyWk
David Cherney from @UHN is the first speaker #SGLT2i is it for everyone? #KidneyWk
Nice pic form @brendonneuen summarizing all the data. #KidneyWk
Impressive results of CREDENCE and DAPA-CKD. SGLT2i are very safe. No signal for volume issues #KidneyWk
We are familiar with the initial deep in the GFR. It hasn’t been associated with adverse outcomes #KidneyWk
My internet died!!!! 😱
Back on-line!!!! Beware of DKA, is real and hard to diagnose since hyperglycaemia can be absent. Remeber sick day rules!!! #Kidneywk
Amazing schema to guide our therapy with practical advices! #KidenyWk
Who should not receive SGLT2i Maybe one of the most important slides #KidneyWK
Closing remarks of this excellent talk. Looking forward for the results of EMPA-KIDNEY #KidneyWk

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More from @NephroGuy

Alex Meraz Profile picture
23 Oct
Fluid overload is bad news for patients:
1. Causes AKI
2. Prevents organ and patient recovery
3. Increases mortality

Ill share some of the data masterfully presented by @criticalbeansmd today at #KidneyWk starting with the take home points, in case this is the only tweet you see Image
Fluid Overload is very common, is all over the place and it has several definitios.

Patients accumulate weight at least for the first 7 days if the ICU doesn’t have some sort of FLUID STEWARDSHIP program in place. Remember fluids are drugs #KidneyWk. ImageImage
There is no single situation in which Fluid overload is beneficial for patients. On the contrary. It is bad in every situation, doesnt matter how we slice or present the data. Liberal fluid strategies are always worse #KidneyWk ImageImageImageImage
Read 13 tweets
Alex Meraz Profile picture
23 Oct
All nephrologists should be learning #POCUS now. It is safe, reproducible, cheap!!! Some uses are:
1. Rule out obstruction
2. Dx cause of hemodynamic inestability
3. To guide vascular access

@WBeaubien #KidneyWk ImageImage
Beyon the basic applications in #AKI
1. Assessment of kidney perfussion
2. Detection of early AKI
3. Prediction ofpersistent AKI
4. Detect kidney congestion

2D US is ok, but using other modalities like doppler we can get more granular data on kidney hemodynamics.

#kidneywk ImageImageImage
However using only color doppler or power doppler is not good enough. #KidneyWk ImageImage
Read 9 tweets
Alex Meraz Profile picture
23 Oct
#EmperorReduced. Patients enrolled with eGFR as low as 20 ml/min #Kidneywk ImageImageImage
Impresive MAKEreduction #kidenywk ImageImageImage
Results of EMPEROR #Kidneywk ImageImageImageImage
Read 7 tweets
Alex Meraz Profile picture
23 Oct
#Fidelio is now being presented #Kidenywk ImageImage
Finerenone reduces decline of GFR and key secondary outcomes. Hyperkalemia was not really an issue #Kidneywk ImageImageImageImage
Very safe drug in a trial context. Less hyperK than with spironolactone #kidneywk ImageImageImageImage
Read 6 tweets
Alex Meraz Profile picture
23 Oct
PetervRatcliffe presenting Homer W. Simith State of the Art Lecture. #KidneyWk Image
Rejected by @nature once, but he did’t falter. Which reminds me that success is never a straight line #KidneyWk Image
VHL was key for his work, the missing link if you will. #KidneyWk ImageImage
Read 6 tweets
Alex Meraz Profile picture
22 Oct
🚬Smoking increases 10x the risk of ESKD in #IgAN #Kidneywk Image
Steroids are no walk in the park in #IgAN. With very good supporting care loss of kidney function is very mild (-1.6 ml/min/year). Testing had to be terminated prematurely due to adverse events. #KidneyWk ImageImage
10 year follow up of #STOPIgA. No differences. And now with #SGLT2i or hydroxichloroquine thess curves may separate without the use of steroids. #KidneyWk Image
Read 4 tweets

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