Juan Carlos Q Vélez, MD
@juancarlosqvelez.bsky.social
🩺 Academic Nephrologist, Ochsner Health, New Orleans, LA, USA
🎓Professor of Medicine, Ochsner Clinical School - The University of Queensland, QLD, Australia
🔬Self-proclaimed Pisse Prophet
🎓Professor of Medicine, Ochsner Clinical School - The University of Queensland, QLD, Australia
🔬Self-proclaimed Pisse Prophet
Reposted by Juan Carlos Q Vélez, MD
CASE REPORT: Hypokalemic Quadriparesis for Nephrologist
A woman in her mid-20s presented to the ER with sudden-onset weakness in all limbs, unable to stand from sitting position. She'd had lower abdominal pain, vomiting & leg muscle pain for one week.
What was causing this dramatic presentation? 🧵
A woman in her mid-20s presented to the ER with sudden-onset weakness in all limbs, unable to stand from sitting position. She'd had lower abdominal pain, vomiting & leg muscle pain for one week.
What was causing this dramatic presentation? 🧵
December 21, 2025 at 2:10 PM
CASE REPORT: Hypokalemic Quadriparesis for Nephrologist
A woman in her mid-20s presented to the ER with sudden-onset weakness in all limbs, unable to stand from sitting position. She'd had lower abdominal pain, vomiting & leg muscle pain for one week.
What was causing this dramatic presentation? 🧵
A woman in her mid-20s presented to the ER with sudden-onset weakness in all limbs, unable to stand from sitting position. She'd had lower abdominal pain, vomiting & leg muscle pain for one week.
What was causing this dramatic presentation? 🧵
Reposted by Juan Carlos Q Vélez, MD
12 Days of Lupus Scoring Findings Countdown!
Day 5: Fibrous crescents: Fibrous (old/inactive) crescents indicate that at one point the patient had active disease in the form of cellular/fibrocellular crescents and are scored separately from global and segmental glomerulosclerosis.
Day 5: Fibrous crescents: Fibrous (old/inactive) crescents indicate that at one point the patient had active disease in the form of cellular/fibrocellular crescents and are scored separately from global and segmental glomerulosclerosis.
December 20, 2025 at 4:02 PM
12 Days of Lupus Scoring Findings Countdown!
Day 5: Fibrous crescents: Fibrous (old/inactive) crescents indicate that at one point the patient had active disease in the form of cellular/fibrocellular crescents and are scored separately from global and segmental glomerulosclerosis.
Day 5: Fibrous crescents: Fibrous (old/inactive) crescents indicate that at one point the patient had active disease in the form of cellular/fibrocellular crescents and are scored separately from global and segmental glomerulosclerosis.
Reposted by Juan Carlos Q Vélez, MD
Agree re CS and CNI for initial treatment, but perhaps RTX in addition to these? It is being tested in the UK, but don’t know the status of the trial.
link.springer.com/article/10.1...
In Denmark 1 g of RTX x 2 (biosimilar) comes to approx $2,500 US, so low cost for us
link.springer.com/article/10.1...
In Denmark 1 g of RTX x 2 (biosimilar) comes to approx $2,500 US, so low cost for us
A randomised, two-arm (1:1 ratio), double blind, placebo controlled phase III trial to assess the efficacy, safety, cost and cost-effectiveness of Rituximab in treating de novo or relapsing NS in pati...
Background Minimal Change Disease (MCD) and Focal Segmental Glomerulosclerosis (FSGS) are a spectrum of disease causing the nephrotic syndrome (NS), characterised by proteinuria with debilitating oede...
link.springer.com
December 16, 2025 at 8:17 PM
Agree re CS and CNI for initial treatment, but perhaps RTX in addition to these? It is being tested in the UK, but don’t know the status of the trial.
link.springer.com/article/10.1...
In Denmark 1 g of RTX x 2 (biosimilar) comes to approx $2,500 US, so low cost for us
link.springer.com/article/10.1...
In Denmark 1 g of RTX x 2 (biosimilar) comes to approx $2,500 US, so low cost for us
Important study validating what has become my standard practice for relapsing MCD-NS
Response to Rituximab as a Maintenance Therapy in Adult Idiopathic Nephrotic Syndrome: A French Multicenter Cohort Study
bit.ly/4pDdIsn
bit.ly/4pDdIsn
December 16, 2025 at 5:40 PM
Important study validating what has become my standard practice for relapsing MCD-NS
Reposted by Juan Carlos Q Vélez, MD
Commentary
Berger disease redux
Richard J Glassock
doi.org/10.1016/j.kint.2025.09.021
Original article: doi.org/10.1016/j.kint.2025.07.038
#MedSky #NephSky
Berger disease redux
Richard J Glassock
doi.org/10.1016/j.kint.2025.09.021
Original article: doi.org/10.1016/j.kint.2025.07.038
#MedSky #NephSky
December 15, 2025 at 4:08 PM
Commentary
Berger disease redux
Richard J Glassock
doi.org/10.1016/j.kint.2025.09.021
Original article: doi.org/10.1016/j.kint.2025.07.038
#MedSky #NephSky
Berger disease redux
Richard J Glassock
doi.org/10.1016/j.kint.2025.09.021
Original article: doi.org/10.1016/j.kint.2025.07.038
#MedSky #NephSky
Reposted by Juan Carlos Q Vélez, MD
A sample from the pathology teaching slide set on Anti-neutrophil Cytoplasmic Antibody Associated (ANCA) Vasculitis, jointly prepared by Arkana Laboratories and @goKDIGO. http://KDIGO.org/guidelines/gd/
#KDIGO #pathology #renal #kidneypath
#KDIGO #pathology #renal #kidneypath
December 11, 2025 at 2:02 PM
A sample from the pathology teaching slide set on Anti-neutrophil Cytoplasmic Antibody Associated (ANCA) Vasculitis, jointly prepared by Arkana Laboratories and @goKDIGO. http://KDIGO.org/guidelines/gd/
#KDIGO #pathology #renal #kidneypath
#KDIGO #pathology #renal #kidneypath
Reposted by Juan Carlos Q Vélez, MD
𝗜𝗡𝗦𝗜𝗚𝗛𝗧 is out! 🌍
✨ How ISN committees are driving the future how you can be part of it
✨ Kidney International Case Reports (KICR) journal launch
✨ Vote for the 2026 ISN Community Film Event until January 6, 2026
… and more ➡️ http://lite.spr.ly/6...
✨ How ISN committees are driving the future how you can be part of it
✨ Kidney International Case Reports (KICR) journal launch
✨ Vote for the 2026 ISN Community Film Event until January 6, 2026
… and more ➡️ http://lite.spr.ly/6...
December 8, 2025 at 4:30 PM
𝗜𝗡𝗦𝗜𝗚𝗛𝗧 is out! 🌍
✨ How ISN committees are driving the future how you can be part of it
✨ Kidney International Case Reports (KICR) journal launch
✨ Vote for the 2026 ISN Community Film Event until January 6, 2026
… and more ➡️ http://lite.spr.ly/6...
✨ How ISN committees are driving the future how you can be part of it
✨ Kidney International Case Reports (KICR) journal launch
✨ Vote for the 2026 ISN Community Film Event until January 6, 2026
… and more ➡️ http://lite.spr.ly/6...
Excited about this @theisn.org initiative, especially under the leadership of @hswapnil.medsky.social as EIC. Nephrology needed this
www.theisn.org/blog/2025/12...
www.theisn.org/blog/2025/12...
Turning clinical experience into shared knowledge: ISN launches Kidney International Case ReportsTM - International Society of Nephrology
www.theisn.org
December 9, 2025 at 4:11 AM
Excited about this @theisn.org initiative, especially under the leadership of @hswapnil.medsky.social as EIC. Nephrology needed this
www.theisn.org/blog/2025/12...
www.theisn.org/blog/2025/12...
Reposted by Juan Carlos Q Vélez, MD
1/n Recently attended an international congress about Urinalysis in Santiago, Chile 🇨🇱. I was expecting a small meeting. I was wrong. Pleasantly surprised with the size of the meeting and the energy and interest from the participants. Let me share the highlights of my experience:
November 21, 2025 at 5:24 PM
1/n Recently attended an international congress about Urinalysis in Santiago, Chile 🇨🇱. I was expecting a small meeting. I was wrong. Pleasantly surprised with the size of the meeting and the energy and interest from the participants. Let me share the highlights of my experience:
Reposted by Juan Carlos Q Vélez, MD
#UrinarySediment from a pt with #AKI #RPGN due to suspected MPO-AAV-GN inspected with Sternheimer-Malbin stain: RBC cast (bright field), WBC cast (oblique illumination), fibrinous cast (dark field), and renal tub epi cell cast (oblique). #OchsnerNephrology
November 22, 2025 at 9:22 PM
#UrinarySediment from a pt with #AKI #RPGN due to suspected MPO-AAV-GN inspected with Sternheimer-Malbin stain: RBC cast (bright field), WBC cast (oblique illumination), fibrinous cast (dark field), and renal tub epi cell cast (oblique). #OchsnerNephrology
Reposted by Juan Carlos Q Vélez, MD
#UrinarySediment from a pt with #AKI #RPGN due to suspected MPO-AAV-GN inspected with Prescott-Brodie stain: RBC cast (bright field, 2 WBCs in cast), WBC cast (bright field, a few RBCs in it), lipid cast (dark field), and renal tub epi cell cast (oblique, many WBCs in blue around) #OchsnerNephrology
November 22, 2025 at 9:26 PM
#UrinarySediment from a pt with #AKI #RPGN due to suspected MPO-AAV-GN inspected with Prescott-Brodie stain: RBC cast (bright field, 2 WBCs in cast), WBC cast (bright field, a few RBCs in it), lipid cast (dark field), and renal tub epi cell cast (oblique, many WBCs in blue around) #OchsnerNephrology
Reposted by Juan Carlos Q Vélez, MD
#UrinarySediment from a pt with #AKI #RPGN due to suspected MPO-AAV-GN inspected with Sternheimer stain: WBC cast (bright field), broad RBC cast (bright), waxy cast (bright), and granular cast w/Ca Oxalate monohydrate crystals (oblique). #OchsnerNephrology #UrineMicroscopy
November 22, 2025 at 9:31 PM
#UrinarySediment from a pt with #AKI #RPGN due to suspected MPO-AAV-GN inspected with Sternheimer stain: WBC cast (bright field), broad RBC cast (bright), waxy cast (bright), and granular cast w/Ca Oxalate monohydrate crystals (oblique). #OchsnerNephrology #UrineMicroscopy
Heading back to #NOLA after a delightful and productive trip to KUMC. Had a chance to meet @alanyuneph.bsky.social and learn about some of his recent stellar work.
December 4, 2025 at 6:37 PM
Heading back to #NOLA after a delightful and productive trip to KUMC. Had a chance to meet @alanyuneph.bsky.social and learn about some of his recent stellar work.
Reposted by Juan Carlos Q Vélez, MD
Now out @jclinicalinvest led by Christine_Behm with fantastic team of collaborators👇
We discover a corticomedullary gradient for Ca in kidney and show a critical role for claudin-2, with implications for kidney stone disease.
@kumedcenter.bsky.social
www.jci.org/articles/vie...
We discover a corticomedullary gradient for Ca in kidney and show a critical role for claudin-2, with implications for kidney stone disease.
@kumedcenter.bsky.social
www.jci.org/articles/vie...
December 3, 2025 at 4:54 PM
Now out @jclinicalinvest led by Christine_Behm with fantastic team of collaborators👇
We discover a corticomedullary gradient for Ca in kidney and show a critical role for claudin-2, with implications for kidney stone disease.
@kumedcenter.bsky.social
www.jci.org/articles/vie...
We discover a corticomedullary gradient for Ca in kidney and show a critical role for claudin-2, with implications for kidney stone disease.
@kumedcenter.bsky.social
www.jci.org/articles/vie...
Reposted by Juan Carlos Q Vélez, MD
~15 years ago, Dr. Fred Coe put forward the “vas washdown” model for explaining kidney stone formation
@alanyuneph.bsky.social & team now report on a new mouse model, showing kidney-specific Cldn-2 KO leads to medullary nephrocalcinosis—supporting the vas washdown model: doi.org/10.1172/JCI1...
@alanyuneph.bsky.social & team now report on a new mouse model, showing kidney-specific Cldn-2 KO leads to medullary nephrocalcinosis—supporting the vas washdown model: doi.org/10.1172/JCI1...
December 3, 2025 at 5:15 PM
~15 years ago, Dr. Fred Coe put forward the “vas washdown” model for explaining kidney stone formation
@alanyuneph.bsky.social & team now report on a new mouse model, showing kidney-specific Cldn-2 KO leads to medullary nephrocalcinosis—supporting the vas washdown model: doi.org/10.1172/JCI1...
@alanyuneph.bsky.social & team now report on a new mouse model, showing kidney-specific Cldn-2 KO leads to medullary nephrocalcinosis—supporting the vas washdown model: doi.org/10.1172/JCI1...
Reposted by Juan Carlos Q Vélez, MD
A trial of pegcetacoplan, a C3 and C3b inhibitor, in patients with C3 glomerulopathy or primary immune-complex membranoproliferative glomerulonephritis showed that the drug significantly reduced proteinuria. Full VALIANT phase 3 trial results: nej.md/4pmT67G
#MedSky #Nephrology
#MedSky #Nephrology
December 3, 2025 at 10:40 PM
A trial of pegcetacoplan, a C3 and C3b inhibitor, in patients with C3 glomerulopathy or primary immune-complex membranoproliferative glomerulonephritis showed that the drug significantly reduced proteinuria. Full VALIANT phase 3 trial results: nej.md/4pmT67G
#MedSky #Nephrology
#MedSky #Nephrology
Reposted by Juan Carlos Q Vélez, MD
Podocyte specific exon skipping after disease onset improves kidney pathology and function in a mouse model of #Alport syndrome pmc.ncbi.nlm.nih.gov/articles/PMC...
Podocyte specific exon skipping after disease onset improves kidney pathology and function in a mouse model of Alport syndrome
Alport syndrome (AS) is a hereditary kidney disorder caused by mutations in COL4A3, COL4A4, and COL4A5, which often lead to progressive renal failure. Although angiotensin II receptor blockers are available for symptomatic treatment, no radical or ...
pmc.ncbi.nlm.nih.gov
December 1, 2025 at 7:17 PM
Podocyte specific exon skipping after disease onset improves kidney pathology and function in a mouse model of #Alport syndrome pmc.ncbi.nlm.nih.gov/articles/PMC...
Reposted by Juan Carlos Q Vélez, MD
Points acknowledged but the graph allows one to see the relative changes and the shape of things that came/to come. The losartan curve is our progress vs placebo, while the others show the progress against losartan. Overall one may expect an effect similar to losartan under single agent adoption
December 1, 2025 at 2:04 AM
Points acknowledged but the graph allows one to see the relative changes and the shape of things that came/to come. The losartan curve is our progress vs placebo, while the others show the progress against losartan. Overall one may expect an effect similar to losartan under single agent adoption
Reposted by Juan Carlos Q Vélez, MD
An aldosterone synthase (CYP11B2 enzyme)–specific 18F-labeled radioligand to help lateralize in PA
www.nejm.org/doi/full/10....
very cool science and technology
Any comments from the Aldo experts? @anandvaidya17.bsky.social
#NephSky #EndoSky
www.nejm.org/doi/full/10....
very cool science and technology
Any comments from the Aldo experts? @anandvaidya17.bsky.social
#NephSky #EndoSky
November 28, 2025 at 3:56 PM
An aldosterone synthase (CYP11B2 enzyme)–specific 18F-labeled radioligand to help lateralize in PA
www.nejm.org/doi/full/10....
very cool science and technology
Any comments from the Aldo experts? @anandvaidya17.bsky.social
#NephSky #EndoSky
www.nejm.org/doi/full/10....
very cool science and technology
Any comments from the Aldo experts? @anandvaidya17.bsky.social
#NephSky #EndoSky
Reposted by Juan Carlos Q Vélez, MD
Cholemic Nephropathy aka Cholemic Nephrosis aka Bile Acid/ Bile Cast Nephropathy ca. 2024
#Nephpearls #NephSky
👉🏼 pubmed.ncbi.nlm.nih.gov/38649215/
#Nephpearls #NephSky
👉🏼 pubmed.ncbi.nlm.nih.gov/38649215/
November 26, 2025 at 10:43 PM
Cholemic Nephropathy aka Cholemic Nephrosis aka Bile Acid/ Bile Cast Nephropathy ca. 2024
#Nephpearls #NephSky
👉🏼 pubmed.ncbi.nlm.nih.gov/38649215/
#Nephpearls #NephSky
👉🏼 pubmed.ncbi.nlm.nih.gov/38649215/
Reposted by Juan Carlos Q Vélez, MD
Sibeprenlimab: First @fda.gov approved therapy targeting B cells which produce the abnormal antibodies responsible for #IgAN, addressing the fundamental cause
#Nephpearls #NephSky
#VisualAbstract by @nephroseeker.medsky.social
👉🏼 www.fda.gov/drugs/news-e...
👉🏼 pubmed.ncbi.nlm.nih.gov/41211929/
#Nephpearls #NephSky
#VisualAbstract by @nephroseeker.medsky.social
👉🏼 www.fda.gov/drugs/news-e...
👉🏼 pubmed.ncbi.nlm.nih.gov/41211929/
November 27, 2025 at 2:40 AM
Sibeprenlimab: First @fda.gov approved therapy targeting B cells which produce the abnormal antibodies responsible for #IgAN, addressing the fundamental cause
#Nephpearls #NephSky
#VisualAbstract by @nephroseeker.medsky.social
👉🏼 www.fda.gov/drugs/news-e...
👉🏼 pubmed.ncbi.nlm.nih.gov/41211929/
#Nephpearls #NephSky
#VisualAbstract by @nephroseeker.medsky.social
👉🏼 www.fda.gov/drugs/news-e...
👉🏼 pubmed.ncbi.nlm.nih.gov/41211929/
Reposted by Juan Carlos Q Vélez, MD
(1/2) The picture shows tissue submitted for routine immunofluorescence (fibrinogen stain is shown). Careful inspection confirms that this is an artery cross section which contains abnormal intraluminal tissue elements with numerous cleft-like spaces (see arrow).
#TeachingPoints #kidneypath #renal
#TeachingPoints #kidneypath #renal
November 25, 2025 at 5:21 PM
(1/2) The picture shows tissue submitted for routine immunofluorescence (fibrinogen stain is shown). Careful inspection confirms that this is an artery cross section which contains abnormal intraluminal tissue elements with numerous cleft-like spaces (see arrow).
#TeachingPoints #kidneypath #renal
#TeachingPoints #kidneypath #renal
Reposted by Juan Carlos Q Vélez, MD
An announcement
www.nephjc.com/news/2025/11...
#NephJC
@kidneyboy.bsky.social and moi hand over the @nephjc.bsky.social reigns to @nephroseeker.medsky.social & @brianrifkin.bsky.social
www.nephjc.com/news/2025/11...
#NephJC
@kidneyboy.bsky.social and moi hand over the @nephjc.bsky.social reigns to @nephroseeker.medsky.social & @brianrifkin.bsky.social
Taking the reigns — NephJC
In April 2014, Swapnil and I launched NephJC—and within weeks we were overwhelmed by the sheer work of running a twice-monthly, Twitter-based journal club. Fortunately, we also had a deep bench of fri...
www.nephjc.com
November 25, 2025 at 12:03 PM
An announcement
www.nephjc.com/news/2025/11...
#NephJC
@kidneyboy.bsky.social and moi hand over the @nephjc.bsky.social reigns to @nephroseeker.medsky.social & @brianrifkin.bsky.social
www.nephjc.com/news/2025/11...
#NephJC
@kidneyboy.bsky.social and moi hand over the @nephjc.bsky.social reigns to @nephroseeker.medsky.social & @brianrifkin.bsky.social
Reposted by Juan Carlos Q Vélez, MD
That was quick!
The US FDA approves Sibeprenlimab aka Voyxact for reducing proteinuria in IgA
www.fda.gov/drugs/novel-...
#NephSky
#TopNephrology
The US FDA approves Sibeprenlimab aka Voyxact for reducing proteinuria in IgA
www.fda.gov/drugs/novel-...
#NephSky
#TopNephrology
November 26, 2025 at 12:21 AM
That was quick!
The US FDA approves Sibeprenlimab aka Voyxact for reducing proteinuria in IgA
www.fda.gov/drugs/novel-...
#NephSky
#TopNephrology
The US FDA approves Sibeprenlimab aka Voyxact for reducing proteinuria in IgA
www.fda.gov/drugs/novel-...
#NephSky
#TopNephrology
Reposted by Juan Carlos Q Vélez, MD
even in their 2024 guidelines they downgrade the level of evidence for resistant hypertension.
Yes, spiro causes hyperK but that is easily managed with diuretics, especially in CKD.
Yes, spiro causes hyperK but that is easily managed with diuretics, especially in CKD.
November 23, 2025 at 4:08 PM
even in their 2024 guidelines they downgrade the level of evidence for resistant hypertension.
Yes, spiro causes hyperK but that is easily managed with diuretics, especially in CKD.
Yes, spiro causes hyperK but that is easily managed with diuretics, especially in CKD.