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Alex Meraz Profile picture
Alex Meraz
@NephroGuy
Critical Care Nephrology fellow at St. Michael’s Hospital — #UofT | #AKI | #OncoNephrology | #DiuresisJedi | #NSMC2019 | Host of @MD_impacto | Tweets are my own
Oct 23, 2020 • 13 tweets • 12 min read
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 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.
Oct 23, 2020 • 9 tweets • 9 min read
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 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
Oct 23, 2020 • 7 tweets • 6 min read
#EmperorReduced. Patients enrolled with eGFR as low as 20 ml/min #Kidneywk Impresive MAKEreduction #kidenywk
Oct 23, 2020 • 6 tweets • 5 min read
#Fidelio is now being presented #Kidenywk Finerenone reduces decline of GFR and key secondary outcomes. Hyperkalemia was not really an issue #Kidneywk
Oct 23, 2020 • 6 tweets • 5 min read
PetervRatcliffe presenting Homer W. Simith State of the Art Lecture. #KidneyWk Rejected by @nature once, but he did’t falter. Which reminds me that success is never a straight line #KidneyWk
Oct 22, 2020 • 4 tweets • 4 min read
🚬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
Oct 22, 2020 • 13 tweets • 12 min read
Dr. Jardine on side effects of SGLT2i. Where is evidence coming from? #Kidneywk Mostly is coming from CREDECE since it has the largest population of advanced CKD. Side effects are not different across different stages of CKD #Kidneywk
Oct 22, 2020 • 9 tweets • 6 min read
Interplay between CKD, DM, HF. Not a good combination. Good thing SGLT2i works for all of them. #KidneyWk How do they work? we have a good idea of what heppens in the kidney, we is that the whole story? I don’t think so… #kidneyWk
Oct 22, 2020 • 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