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Swapnil Hiremath @hswapnil@bsky.social Profile picture
@hswapnil
Apr 29, 2023 • 6 tweets • 5 min read • Read on X
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Tony @tony_breu holding court on renal physiology in ATN at #ApExPathshala
Is TGF in ischemic ATN good or bad? Image
The seminal paper of course is Klaus Thurau on Acute Renal Success
#ApExPathshala pubmed.ncbi.nlm.nih.gov/961698/ ImageImage
Without TGF, we would not have Acute Renal Success, we would have ‘complete renal failure’
@tony_breu At #ApExPathshala Image
To summarize, oliguria in ATN is a bunch of reasons
@tony_breu at #ApExPathshala Image
The obligatory #Tweetorial on the topic of decreased GFR in ATN

#ApExPathshala

As an aside - if you thought his #tweetorials are wonderful - watching @tony_breu in live action is a treat. What an engaging & engrossing educator!
#ApExPathshala Image

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More from @hswapnil

Swapnil Hiremath @hswapnil@bsky.social Profile picture
May 24, 2024
The FLOW trial results are live at @nejm as well

#ERA24



Primary composite kidney ✅
CV Death✅
All cause death ✅
GFR slope ✅
First MACE ✅
Kidney specific composite ✅ nejm.org/doi/full/10.10…
Image
Pretty consistent in all subgroups

FLOW at #ERA24 Image
Note the GFR slope even by Cystatin C

So not about loss of muscle mass

FLOW at #ERA24 Image
Read 14 tweets
Swapnil Hiremath @hswapnil@bsky.social Profile picture
Sep 9, 2023
First up is @SanthiKGanesh on FMD molecular and genetic mechanisms
This is a *systemic* arteriolopathy not just renal
#hypertension23
Image
Image
Broad classifications - from
And how the presentations vary
@FMDartery @FMDChat
#Hypertension23 ahajournals.org/doi/10.1161/01…

Image
Image
@FMDartery @FMDChat From genetics - only one mono genie variant published so far
Pretty rare - but severe phenotype per @SanthiKGanesh
#Hypertension23 pubmed.ncbi.nlm.nih.gov/32938213/
Image
Read 7 tweets
Swapnil Hiremath @hswapnil@bsky.social Profile picture
Apr 29, 2023
JC @VelezNephHepato blows up the IAC criteria for defining #Hepatorenal syndrome

Really impractical and not useful
#ApExPathshala Image
Interestingly enough, norepinephrine is possibly very similar to Terlipressin in hepatorenal syndrome as long as the MAP goes up (which is key!) @VelezNephHepato at
#ApExPathshala Image
Don’t miss abdominal compartment syndrome
@VelezNephHepato dates himself by mentioning this entity didn’t exist when he went to med school (neither for me 👴🏻
#ApExPathshala Image
Read 5 tweets
Swapnil Hiremath @hswapnil@bsky.social Profile picture
Apr 28, 2023
The #Tweetorial guru @tony_breu up next with a fresh tweetorial presentation (he will post it tomorrow for the rest of you)

#ApExPathshala Image
Tony @tony_breu walking us through his research that underlies a single tweetorial

It’s intense.

Why? is a tough question.

#ApExPathshala
This was a master class of physiology with several citations and lots of data and logical thinking 🤯

Watch out for @tony_breu tweetorial to drop in a few hours.

#ApExPathshala
Read 4 tweets
Swapnil Hiremath @hswapnil@bsky.social Profile picture
Oct 19, 2022
Published! (Months after being FDA approved) by @IgAN_JBarratt et al

The phase 3A part of targeted release budesonide (called Nefecon) in IgA

kidney-international.org/article/S0085-…

They included IgA with proteinuria > 1g and GFR 35 to 90 + max supported RASi

see how that worked out:

1/ Image
Safety on all presented (note more AEs in Nefecon group)

Efficacy on those with 9 month follow up

2/ Image
Proteinuria goes down nicely with Nefecon aka budesonide

3/ Image
Read 9 tweets

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