Gurmukteshwar Singh, MD
@drmootravardhak.bsky.social
Nephrologist (kidney doctor), Director of post-AKI care, Clinician-researcher-educator-father. Home dialysis champion. Views are personal, not employer’s. #Nephsky
Reposted by Gurmukteshwar Singh, MD
And why did finerenone get away with it? Kerendia is being prescribed right and left now because they had the RCT data and FDA approval. But it’s very clear to me that old MRAs r just as protective, just lacked the RCT data for non medical circumstances. An unpopular opinion, but I own it.
October 20, 2025 at 2:13 AM
And why did finerenone get away with it? Kerendia is being prescribed right and left now because they had the RCT data and FDA approval. But it’s very clear to me that old MRAs r just as protective, just lacked the RCT data for non medical circumstances. An unpopular opinion, but I own it.
My initial thoughts about aldosterone synthase inhibitors: why spend $$$$ to achieve what $4 of spironolactone can also achieve? Am I missing something?
#askrenal
#askrenal
October 19, 2025 at 4:49 AM
My initial thoughts about aldosterone synthase inhibitors: why spend $$$$ to achieve what $4 of spironolactone can also achieve? Am I missing something?
#askrenal
#askrenal
Reposted by Gurmukteshwar Singh, MD
IgA is pronounced eye-gee-ay
The reason the disease should be called "eye-gee-ay nephropathy" is because IgA is central to the pathogenic mechanism.
Moving to eye-gan is moving away from describing the disease by its pathogenic mechanism.
The reason the disease should be called "eye-gee-ay nephropathy" is because IgA is central to the pathogenic mechanism.
Moving to eye-gan is moving away from describing the disease by its pathogenic mechanism.
October 11, 2025 at 9:19 PM
IgA is pronounced eye-gee-ay
The reason the disease should be called "eye-gee-ay nephropathy" is because IgA is central to the pathogenic mechanism.
Moving to eye-gan is moving away from describing the disease by its pathogenic mechanism.
The reason the disease should be called "eye-gee-ay nephropathy" is because IgA is central to the pathogenic mechanism.
Moving to eye-gan is moving away from describing the disease by its pathogenic mechanism.
Reposted by Gurmukteshwar Singh, MD
‘Booty’ and ‘butt’ are synonyms.
‘Call’ and ‘dial’ are synonyms.
But, a ‘booty call’ and a ‘butt dial’ are VERY different things.
‘Call’ and ‘dial’ are synonyms.
But, a ‘booty call’ and a ‘butt dial’ are VERY different things.
September 12, 2025 at 3:18 PM
‘Booty’ and ‘butt’ are synonyms.
‘Call’ and ‘dial’ are synonyms.
But, a ‘booty call’ and a ‘butt dial’ are VERY different things.
‘Call’ and ‘dial’ are synonyms.
But, a ‘booty call’ and a ‘butt dial’ are VERY different things.
Reposted by Gurmukteshwar Singh, MD
Mother: I have twins.
Doctor: Oh, so they were born on the same day?
Mother: No, they were born with the same propensity score.
Doctor: Oh, so they were born on the same day?
Mother: No, they were born with the same propensity score.
September 5, 2025 at 7:49 PM
Mother: I have twins.
Doctor: Oh, so they were born on the same day?
Mother: No, they were born with the same propensity score.
Doctor: Oh, so they were born on the same day?
Mother: No, they were born with the same propensity score.
Funny highlight of today’s road trip
August 9, 2025 at 2:50 AM
Funny highlight of today’s road trip
Time to make a polypill for CKD? Telmisartan+ #flozin + finerinone + statin+ oral semaglutide?
Call it Tel-em-fine-at-tide
Telemfinatide?
At least for countries with affordable pharma price negotiations.
Call it Tel-em-fine-at-tide
Telemfinatide?
At least for countries with affordable pharma price negotiations.
June 6, 2025 at 10:55 AM
Time to make a polypill for CKD? Telmisartan+ #flozin + finerinone + statin+ oral semaglutide?
Call it Tel-em-fine-at-tide
Telemfinatide?
At least for countries with affordable pharma price negotiations.
Call it Tel-em-fine-at-tide
Telemfinatide?
At least for countries with affordable pharma price negotiations.
Lately, I don’t enjoy @nkf-professionals.bsky.social or @asnkidney.bsky.social meetings as much as @renalphysicians.bsky.social
First 2 are about “cool drugs that cost a million and improve 1% of patients by 30%”
rather than
“How to survive & thrive as a burnt out specialty no one wants to join”
First 2 are about “cool drugs that cost a million and improve 1% of patients by 30%”
rather than
“How to survive & thrive as a burnt out specialty no one wants to join”
April 26, 2025 at 2:45 PM
Lately, I don’t enjoy @nkf-professionals.bsky.social or @asnkidney.bsky.social meetings as much as @renalphysicians.bsky.social
First 2 are about “cool drugs that cost a million and improve 1% of patients by 30%”
rather than
“How to survive & thrive as a burnt out specialty no one wants to join”
First 2 are about “cool drugs that cost a million and improve 1% of patients by 30%”
rather than
“How to survive & thrive as a burnt out specialty no one wants to join”
Reposted by Gurmukteshwar Singh, MD
Funny that tool looks familiar… downloaded from the RPA store
April 19, 2025 at 11:23 AM
Funny that tool looks familiar… downloaded from the RPA store
“If you have abdominal pain on the right, upper or lower, around belly button or lower, severe, throbbing, in one spot or moving around, go to the ER (not PCP or urgent care)”- HuffPost
Next article coming soon: “Crisis: How ER visits drive up healthcare costs”
www.huffpost.com/entry/stomac...
Next article coming soon: “Crisis: How ER visits drive up healthcare costs”
www.huffpost.com/entry/stomac...
If Your Stomach Pain Feels Like This, It's Time To Go To The ER
Don't dismiss these red flags — they could warrant medical attention.
www.huffpost.com
March 24, 2025 at 12:09 PM
“If you have abdominal pain on the right, upper or lower, around belly button or lower, severe, throbbing, in one spot or moving around, go to the ER (not PCP or urgent care)”- HuffPost
Next article coming soon: “Crisis: How ER visits drive up healthcare costs”
www.huffpost.com/entry/stomac...
Next article coming soon: “Crisis: How ER visits drive up healthcare costs”
www.huffpost.com/entry/stomac...
Reposted by Gurmukteshwar Singh, MD
“officials regularly ignore the rankings, leapfrogging over hundreds or even thousands of people when they give out kidneys, livers, lungs and hearts. These organs often go to recipients who are not as sick, have not been waiting nearly as long…”
www.nytimes.com/interactive/...
www.nytimes.com/interactive/...
March 2, 2025 at 8:16 PM
“officials regularly ignore the rankings, leapfrogging over hundreds or even thousands of people when they give out kidneys, livers, lungs and hearts. These organs often go to recipients who are not as sick, have not been waiting nearly as long…”
www.nytimes.com/interactive/...
www.nytimes.com/interactive/...
Adult nephrologists, with your hospital administration and state malpractice environment, would you feel comfortable dialyzing a kid coming in with toxic ingestion if asked to? Why/ why not?
#askrenal
#askrenal
Comparison of children receiving extracorporeal treatments for poisoning at United States centers with and without a pediatric nephrologist pubmed.ncbi.nlm.nih.gov/39911112/
February 28, 2025 at 3:23 PM
Adult nephrologists, with your hospital administration and state malpractice environment, would you feel comfortable dialyzing a kid coming in with toxic ingestion if asked to? Why/ why not?
#askrenal
#askrenal
Reposted by Gurmukteshwar Singh, MD
Once upon a time, some villagers came across a large, ornate wooden box in the local woods. On the side of the box was a message:
“Whatever money you put in this box will, in future, grow to become 2.5 times larger.”
1/
“Whatever money you put in this box will, in future, grow to become 2.5 times larger.”
1/
February 23, 2025 at 10:11 AM
Once upon a time, some villagers came across a large, ornate wooden box in the local woods. On the side of the box was a message:
“Whatever money you put in this box will, in future, grow to become 2.5 times larger.”
1/
“Whatever money you put in this box will, in future, grow to become 2.5 times larger.”
1/
Reposted by Gurmukteshwar Singh, MD
Interesting thread by James Heather about the indirect rate caps by the #NIH .
It is not the first time this comes up e.g. both the Obama and the 1st DJT admin tried to cap them (with fierce discussions on Twitter back in 2017).
It is not the first time this comes up e.g. both the Obama and the 1st DJT admin tried to cap them (with fierce discussions on Twitter back in 2017).
JAMES HEATHERS (@jamesheathers.bsky.social)
I have a piece half-done on the entire world of indirect costs. It's too big an endeavor to finish now, in the middle of the night, when this problem *that was always a live grenade with a…
buff.ly
February 8, 2025 at 9:55 AM
Interesting thread by James Heather about the indirect rate caps by the #NIH .
It is not the first time this comes up e.g. both the Obama and the 1st DJT admin tried to cap them (with fierce discussions on Twitter back in 2017).
It is not the first time this comes up e.g. both the Obama and the 1st DJT admin tried to cap them (with fierce discussions on Twitter back in 2017).
US nephrologists, while discussing incoming fellow quality with regional faculty, most seem to be disappointed (big picture, everyone has many bright spots). New meds but worries about doc quality. How do you see the future of nephrology in 10 years? Stable/ascendant/declining?Why?
#askrenal#nephsky
#askrenal#nephsky
January 30, 2025 at 11:11 PM
US nephrologists, while discussing incoming fellow quality with regional faculty, most seem to be disappointed (big picture, everyone has many bright spots). New meds but worries about doc quality. How do you see the future of nephrology in 10 years? Stable/ascendant/declining?Why?
#askrenal#nephsky
#askrenal#nephsky
Things used in nephrology without evidence or despite evidence of futility:
Urine eosinophils
Urine anion gap
Albumin correction for anion gap and calcium
Slow correction for mild-moderate hyponatremia
Vitamin D for renal bone disease
Anything else to add to list?
#askrenal
Urine eosinophils
Urine anion gap
Albumin correction for anion gap and calcium
Slow correction for mild-moderate hyponatremia
Vitamin D for renal bone disease
Anything else to add to list?
#askrenal
January 22, 2025 at 7:44 PM
Things used in nephrology without evidence or despite evidence of futility:
Urine eosinophils
Urine anion gap
Albumin correction for anion gap and calcium
Slow correction for mild-moderate hyponatremia
Vitamin D for renal bone disease
Anything else to add to list?
#askrenal
Urine eosinophils
Urine anion gap
Albumin correction for anion gap and calcium
Slow correction for mild-moderate hyponatremia
Vitamin D for renal bone disease
Anything else to add to list?
#askrenal
“Even mildly elevated serum phosphate levels of >3.5 or >4.0 mg/dL should receive attention”
What do we mean by attention? Identify phos as risk factor when stratifying-maybe. But pretty please don’t let it mean use phos binders to lower phos below 4 in ADPKD
What do we mean by attention? Identify phos as risk factor when stratifying-maybe. But pretty please don’t let it mean use phos binders to lower phos below 4 in ADPKD
Researchers wanted to determine whether serum phosphate levels could predict kidney outcomes in patients with ADPKD. #nephrology #nephsky #kidney #ADPKD #serumphosphate
Hyperphosphatemia and Kidney Outcomes in ADPKD | Docwire News
A study examined whether serum phosphate levels could predict kidney outcomes in patients with autosomal polycystic kidney disease (ADPKD).
buff.ly
January 17, 2025 at 6:50 PM
“Even mildly elevated serum phosphate levels of >3.5 or >4.0 mg/dL should receive attention”
What do we mean by attention? Identify phos as risk factor when stratifying-maybe. But pretty please don’t let it mean use phos binders to lower phos below 4 in ADPKD
What do we mean by attention? Identify phos as risk factor when stratifying-maybe. But pretty please don’t let it mean use phos binders to lower phos below 4 in ADPKD
Nephrologists/physicians, what licenses do you need to keep working and what dues do you pay to remain a member? Lets document costs.For me:
State license:$360
DEA: $888
Special CME for dea/ state: $550
ABIM: $340
ASN: $475
RPA: $435
1 meeting/ year: $2000
AMA: free (institution)
#askrenal #medsky
State license:$360
DEA: $888
Special CME for dea/ state: $550
ABIM: $340
ASN: $475
RPA: $435
1 meeting/ year: $2000
AMA: free (institution)
#askrenal #medsky
January 16, 2025 at 6:36 PM
My extortion notice with the associated gangster threat has arrived.
January 16, 2025 at 12:55 AM
My extortion notice with the associated gangster threat has arrived.
US nephrologists, how are you posting urine sediment pics given CLIA law requiring special microscope handling/regulatory training and retraining?
A- What? I wasn’t aware
B- I use my lab’s stuff and document regular re-training
C- Keep department microscope with CLIA compliant records
#askrenal
A- What? I wasn’t aware
B- I use my lab’s stuff and document regular re-training
C- Keep department microscope with CLIA compliant records
#askrenal
January 7, 2025 at 1:31 PM
US nephrologists, how are you posting urine sediment pics given CLIA law requiring special microscope handling/regulatory training and retraining?
A- What? I wasn’t aware
B- I use my lab’s stuff and document regular re-training
C- Keep department microscope with CLIA compliant records
#askrenal
A- What? I wasn’t aware
B- I use my lab’s stuff and document regular re-training
C- Keep department microscope with CLIA compliant records
#askrenal
Reposted by Gurmukteshwar Singh, MD
Happy to share our paper in @asnpublications.bsky.social examining COL4A5 X-linked Alport Syndrome in an unselected health system-based population. Phenotypic spectrum of X-linked Alport syndrome is wider than previously known. Risk lower for Gly624Asp variant. 1/ journals.lww.com/jasn/fulltex...
January 3, 2025 at 2:33 PM
Happy to share our paper in @asnpublications.bsky.social examining COL4A5 X-linked Alport Syndrome in an unselected health system-based population. Phenotypic spectrum of X-linked Alport syndrome is wider than previously known. Risk lower for Gly624Asp variant. 1/ journals.lww.com/jasn/fulltex...
Controversial take: the social worker role in dialysis should be completely revamped. Stop wasting their time on worthless KDQOL data collection and certify them in psychotherapy and CBT instead so dialysis patients have weekly access to therapy sessions.
#Nephsky
jamanetwork.com/journals/jam...
#Nephsky
jamanetwork.com/journals/jam...
Pain Coping Skills Training for Patients Receiving Hemodialysis
This randomized clinical trial evaluates the effectiveness of pain coping skills training, a cognitive behavioral intervention, on pain interference among people receiving maintenance hemodialysis.
jamanetwork.com
December 31, 2024 at 2:35 AM
Controversial take: the social worker role in dialysis should be completely revamped. Stop wasting their time on worthless KDQOL data collection and certify them in psychotherapy and CBT instead so dialysis patients have weekly access to therapy sessions.
#Nephsky
jamanetwork.com/journals/jam...
#Nephsky
jamanetwork.com/journals/jam...
Suggested 2025 nephrology research resolution: any institution/ investigator asking for new funding for another Vitamin D trial in nephrology should be personally responsible to return the waste of funding dollars if the trial results are similar to the past 149 trials.
#StopResearchFundWaste
#StopResearchFundWaste
December 23, 2024 at 2:50 PM
Suggested 2025 nephrology research resolution: any institution/ investigator asking for new funding for another Vitamin D trial in nephrology should be personally responsible to return the waste of funding dollars if the trial results are similar to the past 149 trials.
#StopResearchFundWaste
#StopResearchFundWaste