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Edgar V. Lerma πŸ‡΅πŸ‡­ Profile picture
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5 Nov, 4 tweets, 5 min read
Mineralocorticoid receptor (MR) has a role in:
πŸ‘‰ BP regulation
πŸ‘‰ Electrolyte Homeostasis

Overactivation of MR leads to:
πŸ‘‰ Inflammation and Fibrosis
πŸ‘‰ Sodium retention

#KidneyWk #Nephpearls #Cardiorenal ImageImage
Finerenone: potent and selective non-steroidal MR antagonist (MRA) that is distinct from steroidal MRAs

#KidneyWk #Nephpearls #Cardiorenal ImageImage
FIDELITY pre-specified pooled analysis
πŸ‘‰ FIDELIO-DKD
πŸ‘‰ FIGARO-DKD
#KidneyWk #Nephpearls #Cardiorenal ImageImageImageImage
Finerenone effects on:
πŸ‘‰Blood Pressure (BP)
πŸ‘‰Potassium (K)

#KidneyWk #Nephpearls #Cardiorenal ImageImageImage

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More from @edgarvlermamd

Edgar V. Lerma πŸ‡΅πŸ‡­ Profile picture
13 Oct
New Creatinine- and Cystatin C–Based Equations to Estimate GFR without Race ca. 2021 from @NEJM #NephJC #Nephpearls
#VisualAbstract by @MdYoshinosuke

nejm.org/doi/full/10.10… ImageImage
A Unifying Approach for GFR Estimation: Recommendations of the @nkf @ASNKidney Task Force on Reassessing the Inclusion of Race in Diagnosing Kidney Disease ca. 2021 from @JASN_News #NephJC #Nephpearls

jasn.asnjournals.org/content/early/… ImageImage
Nice table comparing the different equations used to estimate kidney function #NephJC #Nephpearls
Credit: @michaelturk6 and @nefron1310 Image
Read 5 tweets
Edgar V. Lerma πŸ‡΅πŸ‡­ Profile picture
12 Sep
On the road again

Chapter 5: Functions of the Distal Nephron #Nephpearls

πŸŽ™ rosebook.club
Gitelman syndrome: diagnostic criteria #Nephpearls
πŸ‘‰πŸΌ pubmed.ncbi.nlm.nih.gov/28003083/
Whenever I hear Gitelman and Gordon in one sentence, I remember this nice table from @RenalFellowNtwk @docpro89 #Nephpearls

πŸ‘‰πŸΌ renalfellow.org/2018/11/19/raa…
Read 6 tweets
Edgar V. Lerma πŸ‡΅πŸ‡­ Profile picture
23 Jun
Efficacy and safety of voclosporin versus placebo for #lupus nephritis (AURORA 1): a double-blind, randomised, multicentre, placebo-controlled, phase 3 trial from @TheLancet @BradRovin #NephJC #Nephpearls
#VisualAbstract by @katierizzolo
πŸ‘‰πŸΌ thelancet.com/journals/lance…
Voclosporin: Hope on the Horizon for #Lupus Nephritis ⁉️ from @KidneyNews February 2021 issue #Nephpearls #NephJC
πŸ‘‰ asn-online.org/publications/k…
AURA-LV: A randomized, controlled double-blind study comparing the efficacy and safety of dose-ranging voclosporin with placebo in achieving remission in patients with active lupus nephritis ca. 2018 from @Kidney_Int @BradRovin #Nephpearls #NephJC
πŸ‘‰πŸΌ kidney-international.org/article/S0085-…
Read 6 tweets
Edgar V. Lerma πŸ‡΅πŸ‡­ Profile picture
17 Jun
Happening now‼️
@NKFIllinois Controversies in #Nephrology #Nephpearls Image
Balanced crystalloids vs saline in critically ill & non-critically ill adult patients from @NEJM #Nephpearls
#VisualAbstract by @aakashshingada
πŸ‘‰πŸΌ SALT-ED pubmed.ncbi.nlm.nih.gov/29485926/
πŸ‘‰πŸΌ SMART pubmed.ncbi.nlm.nih.gov/29485925/ ImageImageImage
Urgent-start PD is defined as initiation of PD in patients w/ newly diagnosed ESKD who are not yet on dialysis and who require dialysis initiation < 2 weeks (as little as 24-48 hours) after PD catheter placement but do not require emergent dialysis #Nephpearls Image
Read 5 tweets
Edgar V. Lerma πŸ‡΅πŸ‡­ Profile picture
7 Jun
Tweetorial: @goKDIGO Level 2B Recommendation - We suggest that adults w/ high BP & CKD be treated with a target SBP <120, when tolerated, using standardized office BP measurement (1/9) #Nephpearls
πŸ‘‰ kdigo.org/guidelines/blo…
There is evidence that targeting SBP <120 when measured under standardized conditions, reduces CV events & all-cause mortality in CKD

πŸ“Œ In most people w/ high BP (incl. frail & elderly), these benefits appear to outweigh the risks of harm (hypotension & AKI) (2/9) #Nephpearls
There is however, some uncertainty that the benefits outweigh the harms in certain scenarios (3/9) #Nephpearls
πŸ‘‰ kdigo.org/guidelines/blo…
Read 11 tweets
Edgar V. Lerma πŸ‡΅πŸ‡­ Profile picture
9 Apr
MOE: Phosphorus or Phosphate
πŸ‘‰ PROXIMAL Tubule: Main site for regulation of phosphate (some is reabsorbed with Na and H20; most is regulated by change in FGF23)
πŸ‘‰ DISTAL Tubule: Main site for regulation of calcium and potassium
#NKFClinicals #Nephpearls #CKDMBD ImageImageImage
Phosphorus bioavailability "varies" by source
#NKFClinicals #Nephpearls Image
Active Intestinal Phosphate Transport and Passive Intestinal Phosphate (Paracellular) Transport
πŸ“Œ Note that in these tight junctions, there are 5 groups of proteins that regulate this: occludens, claudins, JAMA, E-cadherin, desmosomes
#NKFClinicals #Nephpearls ImageImage
Read 6 tweets

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