Edgar V. Lerma πŸ‡΅πŸ‡­ Profile picture
Chicago Sports Fan... Nephrologist by day. My tweets are not medical advice. The views expressed here are my own and not those of my employer.
Azeem Ahamed MD Profile picture A. PODA, MD Profile picture Mohamed Yahya, MD Profile picture DJ  Abdelhamid Profile picture Georgina Guerrero Profile picture 11 added to My Authors
15 Apr 20
Touch contamination: The overall rate of peritonitis was low after contamination (2012)

πŸ“Œ Wet contamination was asso. w/ ⬆️ risk of peritonitis

πŸ“Œ Prophylactic antibiotics after wet contamination were effective in preventing peritonitis #Nephpearls

πŸ‘‰πŸΌ ncbi.nlm.nih.gov/pmc/articles/P…
Touch contamination: Prophylactic antibiotics are usually recommended after wet contamination (if dialysis solution is infused after contamination, or if catheter administration set was open for an extended period) ca. 2016 from @ISPD1 #Nephpearls
πŸ‘‰πŸΌ pdiconnect.com/content/36/5/4…
Touch contamination: Algorithm ca. 2006 from @Kidney_Int #Nephpearls
πŸ‘‰πŸΌ kidney-international.org/article/S0085-…
Read 5 tweets
29 Mar 20
Lupus nephritis: To re-biopsy or not ...
#NKFClinicals #Nephpearls
Lupus nephritis: On β€œFor Cause” repeat renal biopsy
#NKFClinicals #Nephpearls
Read 11 tweets
27 Mar 20
FSGS: The Basics
#NKFClinicals #Nephpearls
Proposed diagram to differentiate between Primary vs Secondary FSGS based on clinical presentation and EM πŸ”¬ examination ca. 2015 from @NDTsocial @SethiRenalPath @GlassockJ @fervenzafernan1
#NKFClinicals #Nephpearls
πŸ‘‰πŸΌ pubmed.ncbi.nlm.nih.gov/24589721/
FSGS: Histologic variants and its implications
#NKFClinicals #Nephpearls
πŸ‘‰πŸΌ pubmed.ncbi.nlm.nih.gov/22187987/?from…
Read 10 tweets
21 Dec 19
Preparing for a 45-minute lecture on Review of Nephrology Literature 2019
πŸ“Œ Please recommend noteworthy publications
πŸ”² Fluids & Electrolytes, Acid-Base
πŸ”² CKD
πŸ”² Hypertension
πŸ”² Glomerular Diseases
πŸ”² Cystic Disorders
πŸ”² Kidney Transplant
πŸ”² AKI
#Nephpearls #AskRenal
CREDENCE: Canagliflozin reduces the risk of kidney failure or death due to CV or kidney disease by 30% compared to current standard of care ca. 2019 from @NEJM
#VisualAbstract by @brendonneuen
#Nephpearls
πŸ‘‰πŸΌ nejm.org/doi/pdf/10.105…
Randomized Controlled Trial of Long-Term Safety and Efficacy of Veverimer for Treatment of Metabolic Acidosis
#Nephpearls
Read 18 tweets
10 Aug 19
Hemodialysis 101: Venous Catheter Access #Nephpearls #DialysisDirector
HD Catheters: Nominal flow > 400 mL/min (actual flow 350 mL/min) can rarely be obtained and usually flow is limited to a range closer to 300 mL/min
#Nephpearls #DialysisDirector
HD Catheters: Order of preference for various sites of insertion
πŸ“Œ Optimal site is R IJ since venous pathway to the RA is relatively short and straight
πŸ“Œ Avoid SC Vein due to ⬆️ rate of insertion related complications
πŸ“Œ L IJ is not optimal
#Nephpearls #DialysisDirector
Read 12 tweets
7 Aug 19
Hemodialysis 101: AVF/ AVG
#Nephpearls #DialysisDirector
Sites for AVF creation in the upper extremity #Nephpearls #NephJC
Various configurations and sites for AVG placement #Nephpearls #DialysisDirector
Read 14 tweets
5 Aug 19
Hemodialysis 101: Apparatus
πŸ“Œ From the patient, blood is pumped via the vascular access thru an ARTERIAL blood line (INFLOW) to the dialyzer
πŸ“Œ Blood is returned to the patient from the dialyzer via a VENOUS blood line (OUTFLOW)
#Nephpearls #DialysisDirector
Redsense sensor is used to detect blood leakage at the site of potential line separation
πŸ“Œ For those who are at high risk for line separation
#Nephpearls #DialysisDirector
πŸ‘‰πŸΌ redsensemedical.com/index.php/cont…
The VENOUS PRESSURE can be used to monitor the state of coagulation.
It is a function of:
πŸ“Œ BFR
πŸ“Œ Blood viscosity
πŸ“Œ Downstream access (needle or catheter) resistance
#Nephpearls #DialysisDirector
Read 8 tweets
11 May 19
FRANCIS: Hemolytic Uremic Syndrome
#NKFClinicals πŸ‡ΊπŸ‡Έ #Nephpearls
Clinical and laboratory manifestations of atypical HUS (aHUS)
#NKFClinicals πŸ‡ΊπŸ‡Έ #Nephpears
πŸ‘‰πŸΌ openurologyandnephrologyjournal.com/contents/volum…
Mimics of aHUS
#NKFClinicals πŸ‡ΊπŸ‡Έ #Nephpearls
πŸ‘‰πŸΌ sciencedirect.com/science/articl…
Read 9 tweets