@arankin.bsky.social
Reposted
In the EVERDAC trial involving patients with shock, results for death at day 28 indicated that management without early arterial catheter insertion was noninferior to early catheter insertion. Full trial results and Research Summary: nej.md/3LmOO0D
#MedSky #PulmSky
#MedSky #PulmSky
November 1, 2025 at 1:01 PM
In the EVERDAC trial involving patients with shock, results for death at day 28 indicated that management without early arterial catheter insertion was noninferior to early catheter insertion. Full trial results and Research Summary: nej.md/3LmOO0D
#MedSky #PulmSky
#MedSky #PulmSky
Reposted
Check out the latest @kireports.bsky.social community blog from @husamjz.bsky.social
Anticoagulantion in ESRD patients with atrial fibrillation:
www.kireportscommunity.org/post/bleeding-clotting-and-kidney-disease-in-atrial-fibrillation-can-factor-xi-inhibitors-change-the-g
Anticoagulantion in ESRD patients with atrial fibrillation:
www.kireportscommunity.org/post/bleeding-clotting-and-kidney-disease-in-atrial-fibrillation-can-factor-xi-inhibitors-change-the-g
Bleeding, Clotting, and Kidney Disease in Atrial Fibrillation: Can Factor XI Inhibitors Change the Game?
By. Husam Alzayer, MD, MSc, MRCPIReviewed by Sophia Ambruso, DOIntroduction Bleeding and thrombosis represent one of the many paradoxes faced by patients with kidney disease. As kidney function declin...
www.kireportscommunity.org
September 8, 2025 at 11:36 PM
Check out the latest @kireports.bsky.social community blog from @husamjz.bsky.social
Anticoagulantion in ESRD patients with atrial fibrillation:
www.kireportscommunity.org/post/bleeding-clotting-and-kidney-disease-in-atrial-fibrillation-can-factor-xi-inhibitors-change-the-g
Anticoagulantion in ESRD patients with atrial fibrillation:
www.kireportscommunity.org/post/bleeding-clotting-and-kidney-disease-in-atrial-fibrillation-can-factor-xi-inhibitors-change-the-g
Reposted
Landscape of subclinical rejection in a large international cohort of pediatric kidney transplant (kTx) recipients buff.ly/7DynrzY
September 8, 2025 at 6:26 PM
Landscape of subclinical rejection in a large international cohort of pediatric kidney transplant (kTx) recipients buff.ly/7DynrzY
Reposted
As cystatin C use becomes more common - note other drugs (not just steroids) which can have an effect
@alexchangmd.bsky.social and colleagues
www.ajkd.org/article/S027... in @ajkd.bsky.social
acetaminophen, opioids, lithium, furosemide among others
#NephSky
@alexchangmd.bsky.social and colleagues
www.ajkd.org/article/S027... in @ajkd.bsky.social
acetaminophen, opioids, lithium, furosemide among others
#NephSky
September 8, 2025 at 3:59 PM
As cystatin C use becomes more common - note other drugs (not just steroids) which can have an effect
@alexchangmd.bsky.social and colleagues
www.ajkd.org/article/S027... in @ajkd.bsky.social
acetaminophen, opioids, lithium, furosemide among others
#NephSky
@alexchangmd.bsky.social and colleagues
www.ajkd.org/article/S027... in @ajkd.bsky.social
acetaminophen, opioids, lithium, furosemide among others
#NephSky
Reposted
Measuring BP over a sweater sleeve? As accurate as the optimal method!
But using a non-validated device or leaving the arm unsupported? Expect higher readings than what’s actually seen on awake ABPM.
Underpowered pilot study, so hoping to confirm this in larger trials soon!
But using a non-validated device or leaving the arm unsupported? Expect higher readings than what’s actually seen on awake ABPM.
Underpowered pilot study, so hoping to confirm this in larger trials soon!
July 17, 2025 at 6:10 PM
Measuring BP over a sweater sleeve? As accurate as the optimal method!
But using a non-validated device or leaving the arm unsupported? Expect higher readings than what’s actually seen on awake ABPM.
Underpowered pilot study, so hoping to confirm this in larger trials soon!
But using a non-validated device or leaving the arm unsupported? Expect higher readings than what’s actually seen on awake ABPM.
Underpowered pilot study, so hoping to confirm this in larger trials soon!
Reposted
❓ Can we measure #bloodpressure in the arm with a closed AV #fistula after kidney transplant?
✅ YES! Here is our our latest study published in Hypertension @ahajournals.bsky.social showing no significant BP difference between arms post-AVF closure
👉🏼 www.ahajournals.org/doi/10.1161/...
✅ YES! Here is our our latest study published in Hypertension @ahajournals.bsky.social showing no significant BP difference between arms post-AVF closure
👉🏼 www.ahajournals.org/doi/10.1161/...
Reliability of Blood Pressure Measurement After Arteriovenous Fistula Closure in Kidney Transplant Recipients | Hypertension
www.ahajournals.org
July 17, 2025 at 5:44 AM
❓ Can we measure #bloodpressure in the arm with a closed AV #fistula after kidney transplant?
✅ YES! Here is our our latest study published in Hypertension @ahajournals.bsky.social showing no significant BP difference between arms post-AVF closure
👉🏼 www.ahajournals.org/doi/10.1161/...
✅ YES! Here is our our latest study published in Hypertension @ahajournals.bsky.social showing no significant BP difference between arms post-AVF closure
👉🏼 www.ahajournals.org/doi/10.1161/...
Reposted
🧵1/9
Could we improve kidney care by rethinking who gets referred to a nephrologist?
Our latest study in @ndt-era.bsky.social suggests: yes — if we base it on predicted risk rather than fixed eGFR/ACR cutoffs.
📄 t.co/xVcR8LEnhn
#nephrology #KDIGO #KFRE #NephJC #NephSky #Nephpearls
Could we improve kidney care by rethinking who gets referred to a nephrologist?
Our latest study in @ndt-era.bsky.social suggests: yes — if we base it on predicted risk rather than fixed eGFR/ACR cutoffs.
📄 t.co/xVcR8LEnhn
#nephrology #KDIGO #KFRE #NephJC #NephSky #Nephpearls
https://shorturl.at/0CzNq
t.co
July 14, 2025 at 12:06 PM
🧵1/9
Could we improve kidney care by rethinking who gets referred to a nephrologist?
Our latest study in @ndt-era.bsky.social suggests: yes — if we base it on predicted risk rather than fixed eGFR/ACR cutoffs.
📄 t.co/xVcR8LEnhn
#nephrology #KDIGO #KFRE #NephJC #NephSky #Nephpearls
Could we improve kidney care by rethinking who gets referred to a nephrologist?
Our latest study in @ndt-era.bsky.social suggests: yes — if we base it on predicted risk rather than fixed eGFR/ACR cutoffs.
📄 t.co/xVcR8LEnhn
#nephrology #KDIGO #KFRE #NephJC #NephSky #Nephpearls
Reposted
2A/ 🚨Our topic from @KIReports: Early determination of Tacrolimus Concentration-Dose ratio identifies risk of allograft loss in kidney transplantation
There are no conflicts of interest. #Medsky #nephsky @theisn.org
www.kireports.org/article/S246...
There are no conflicts of interest. #Medsky #nephsky @theisn.org
www.kireports.org/article/S246...
June 20, 2025 at 6:46 AM
2A/ 🚨Our topic from @KIReports: Early determination of Tacrolimus Concentration-Dose ratio identifies risk of allograft loss in kidney transplantation
There are no conflicts of interest. #Medsky #nephsky @theisn.org
www.kireports.org/article/S246...
There are no conflicts of interest. #Medsky #nephsky @theisn.org
www.kireports.org/article/S246...
Reposted
Scotland is high on incremental hemodialysis. You can read all about it if you scroll to the middle of the article, @hswapnil.medsky.social.
www.gov.scot/publications...
www.gov.scot/publications...
Realistic Medicine and Value Based Health and Care Casebook
The Realistic Medicine Casebook shows how teams across Scotland are putting Realistic Medicine into practice. It’s a practical guide offering inspiration and support for those adopting its principles ...
www.gov.scot
May 14, 2025 at 6:19 PM
Scotland is high on incremental hemodialysis. You can read all about it if you scroll to the middle of the article, @hswapnil.medsky.social.
www.gov.scot/publications...
www.gov.scot/publications...
Reposted
In the @annalsofim.bsky.social
www.acpjournals.org/doi/10.7326/... from @ucalgarymed.bsky.social team
Saline suppression test not useful in confirming primary #aldosteronism - go straight to AVS if planning Sx (and ramp up MRA to target renin if Medical management)
#NephSky #EndoSky
www.acpjournals.org/doi/10.7326/... from @ucalgarymed.bsky.social team
Saline suppression test not useful in confirming primary #aldosteronism - go straight to AVS if planning Sx (and ramp up MRA to target renin if Medical management)
#NephSky #EndoSky
Confirmatory Testing for Primary Aldosteronism: A Study of Diagnostic Test Accuracy: Annals of Internal Medicine: Vol 0, No 0
Background: Confirmatory testing to verify the diagnosis of primary aldosteronism (PA) in patients who have an abnormal screening result is of uncertain benefit. Objective: To perform a blinded assess...
www.acpjournals.org
May 6, 2025 at 10:34 AM
In the @annalsofim.bsky.social
www.acpjournals.org/doi/10.7326/... from @ucalgarymed.bsky.social team
Saline suppression test not useful in confirming primary #aldosteronism - go straight to AVS if planning Sx (and ramp up MRA to target renin if Medical management)
#NephSky #EndoSky
www.acpjournals.org/doi/10.7326/... from @ucalgarymed.bsky.social team
Saline suppression test not useful in confirming primary #aldosteronism - go straight to AVS if planning Sx (and ramp up MRA to target renin if Medical management)
#NephSky #EndoSky
Reposted
Procalcitonin- the more we learn, the less we love it 💔
▪️94% of non-septic AKI pts had a Pct >0.5 prior to commencing CRRT
▪️Even using a threshold of >3.2 the specificity was only 38% 🗑️
“Pct in pts with AKI/ESRD should not be measured”
#EMIMCC
ccforum.biomedcentral.com/articles/10....
▪️94% of non-septic AKI pts had a Pct >0.5 prior to commencing CRRT
▪️Even using a threshold of >3.2 the specificity was only 38% 🗑️
“Pct in pts with AKI/ESRD should not be measured”
#EMIMCC
ccforum.biomedcentral.com/articles/10....
Procalcitonin levels in septic and nonseptic subjects with AKI and ESKD prior to and during continuous kidney replacement therapy (CKRT) - Critical Care
Background Procalcitonin is a 14.5 kDa protein used clinically as a marker of sepsis and therapeutic response to antibiotic therapy. However, its utility in critically ill patients with either acute k...
ccforum.biomedcentral.com
May 8, 2025 at 3:26 PM
Procalcitonin- the more we learn, the less we love it 💔
▪️94% of non-septic AKI pts had a Pct >0.5 prior to commencing CRRT
▪️Even using a threshold of >3.2 the specificity was only 38% 🗑️
“Pct in pts with AKI/ESRD should not be measured”
#EMIMCC
ccforum.biomedcentral.com/articles/10....
▪️94% of non-septic AKI pts had a Pct >0.5 prior to commencing CRRT
▪️Even using a threshold of >3.2 the specificity was only 38% 🗑️
“Pct in pts with AKI/ESRD should not be measured”
#EMIMCC
ccforum.biomedcentral.com/articles/10....
Reposted
A one year delay in diagnosis of #hypertension!
Clear illustration of the importance of measuring BP in both arms
www.ahajournals.org/doi/10.1161/... in @ahajournals.bsky.social Hypertension
Clear illustration of the importance of measuring BP in both arms
www.ahajournals.org/doi/10.1161/... in @ahajournals.bsky.social Hypertension
April 24, 2025 at 11:56 PM
A one year delay in diagnosis of #hypertension!
Clear illustration of the importance of measuring BP in both arms
www.ahajournals.org/doi/10.1161/... in @ahajournals.bsky.social Hypertension
Clear illustration of the importance of measuring BP in both arms
www.ahajournals.org/doi/10.1161/... in @ahajournals.bsky.social Hypertension
Reposted
Does the over rapid correction of hypernatraemia really cause cerebral oedema in adults❓
Most guidelines suggest a rate of correction < 10mmol/L per day, and whilst there is evidence of risk in children (with tighter, more vulnerable brains) the evidence of risk in adults is scant
1/
Most guidelines suggest a rate of correction < 10mmol/L per day, and whilst there is evidence of risk in children (with tighter, more vulnerable brains) the evidence of risk in adults is scant
1/
two cartoon characters with big brains are standing next to each other in front of a brick wall
ALT: two cartoon characters with big brains are standing next to each other in front of a brick wall
media.tenor.com
April 17, 2025 at 11:12 AM
Does the over rapid correction of hypernatraemia really cause cerebral oedema in adults❓
Most guidelines suggest a rate of correction < 10mmol/L per day, and whilst there is evidence of risk in children (with tighter, more vulnerable brains) the evidence of risk in adults is scant
1/
Most guidelines suggest a rate of correction < 10mmol/L per day, and whilst there is evidence of risk in children (with tighter, more vulnerable brains) the evidence of risk in adults is scant
1/
Reposted
Very proud of this ASN Guidance on outpatient AKI-D care; an exceptional group of colleagues including co-chair Michael Heung. Some practical points- warm hand-off, AKI specific orders (avoid “DW”), prevent dialytrauma, active monitoring for renal recovery.
journals.lww.com/jasn/fulltex...
journals.lww.com/jasn/fulltex...
ASN Kidney Health Guidance on the Outpatient Management of... : Journal of the American Society of Nephrology
An abstract is unavailable.
journals.lww.com
March 1, 2025 at 5:21 PM
Very proud of this ASN Guidance on outpatient AKI-D care; an exceptional group of colleagues including co-chair Michael Heung. Some practical points- warm hand-off, AKI specific orders (avoid “DW”), prevent dialytrauma, active monitoring for renal recovery.
journals.lww.com/jasn/fulltex...
journals.lww.com/jasn/fulltex...
Reposted
Albumin adjustment formulae for calcium continue to suck
jamanetwork.com/journals/jam...
In @jama.com network open
jamanetwork.com/journals/jam...
In @jama.com network open
January 22, 2025 at 11:59 AM
Albumin adjustment formulae for calcium continue to suck
jamanetwork.com/journals/jam...
In @jama.com network open
jamanetwork.com/journals/jam...
In @jama.com network open
Reposted
Before you freak reflexively order IV hydralazine for that BP of 180/90, remember that people get BPs up to 480/350 (yes that is in mmHg) while weight lifting and don't "stroke out"
pubmed.ncbi.nlm.nih.gov/3980383/
pubmed.ncbi.nlm.nih.gov/3980383/
December 28, 2024 at 2:54 PM
Before you freak reflexively order IV hydralazine for that BP of 180/90, remember that people get BPs up to 480/350 (yes that is in mmHg) while weight lifting and don't "stroke out"
pubmed.ncbi.nlm.nih.gov/3980383/
pubmed.ncbi.nlm.nih.gov/3980383/
Reposted
Rant #5 Please don't tell me what the PaO2 is...
Less experienced critical care staff members are frequently exercised by arterial blood gas PaO2 readings.
What is the SpO2 I genially ask? In our target range? Well that's fine then.
Staff member shifting uneasily, "but the PaO2..."
Here we go...
Less experienced critical care staff members are frequently exercised by arterial blood gas PaO2 readings.
What is the SpO2 I genially ask? In our target range? Well that's fine then.
Staff member shifting uneasily, "but the PaO2..."
Here we go...
Over the years I've developed a number of "rants" (aka teaching) that seem to resonate with trainees on #ICUsky ward round.
This pedogogical style might make educationalists wince but keeps me and (crucially) trainees, interested
Interested in any counter rants, refined rants or rant affirmation
This pedogogical style might make educationalists wince but keeps me and (crucially) trainees, interested
Interested in any counter rants, refined rants or rant affirmation
November 25, 2024 at 9:16 PM
Rant #5 Please don't tell me what the PaO2 is...
Less experienced critical care staff members are frequently exercised by arterial blood gas PaO2 readings.
What is the SpO2 I genially ask? In our target range? Well that's fine then.
Staff member shifting uneasily, "but the PaO2..."
Here we go...
Less experienced critical care staff members are frequently exercised by arterial blood gas PaO2 readings.
What is the SpO2 I genially ask? In our target range? Well that's fine then.
Staff member shifting uneasily, "but the PaO2..."
Here we go...
Reposted
"Drink more water!" It's the easiest health advice around. Tired? Headache? Trying to be like Tom Brady? Just drink more water. But as a nephrologist, I get asked all the time: How much is the right amount? And the truth is... we don't really know. 🧵
November 26, 2024 at 6:35 PM
"Drink more water!" It's the easiest health advice around. Tired? Headache? Trying to be like Tom Brady? Just drink more water. But as a nephrologist, I get asked all the time: How much is the right amount? And the truth is... we don't really know. 🧵
Reposted
Great thread from Dylan on Canada’s new diabetes guidelines.
Their guidelines say you can’t initiate SGLT2i at eGFR<20 - but I’ve just taught all our local north east England renal registrars the opposite.
Quick thread to justify why I think I’m right👇
#NephSky
Their guidelines say you can’t initiate SGLT2i at eGFR<20 - but I’ve just taught all our local north east England renal registrars the opposite.
Quick thread to justify why I think I’m right👇
#NephSky
No more red yellow green stop light colours anymore in the tables and figures because of Red Green colour blindness in the tables and tools (finally because one of the authors had RG colour blindness)
November 22, 2024 at 4:46 PM
Great thread from Dylan on Canada’s new diabetes guidelines.
Their guidelines say you can’t initiate SGLT2i at eGFR<20 - but I’ve just taught all our local north east England renal registrars the opposite.
Quick thread to justify why I think I’m right👇
#NephSky
Their guidelines say you can’t initiate SGLT2i at eGFR<20 - but I’ve just taught all our local north east England renal registrars the opposite.
Quick thread to justify why I think I’m right👇
#NephSky