Thank you for sharing this anecdote sir. I can imagine it being a challenging and exhilarating experience to expand the possibilities in nephrology back then.

True sir.
What do you mean by jugaad in dialysis vascaths? Can you please elaborate

- Renal Denervation not recommended if eGFR < 40 ( No studies done).

In pregnancy - BP > 160/110 is now emergency (previously it was > 170/110).

- Don't use beta blocker or alpha blocker in > 85 yrs, unless necessary.

- Check for orthostatic hypotension -
1. Before starting antihypertensives
2. Before escalation of antihypertensives.

- In left sided cardiac valve diseases - prefer RAASi.

- Start antihypertensives for anyone with BP > 140/90 (irrespective of CVD risk, lifestyle changes).

- Target SBP 120 to 129, also target DBP 70-79 mmHg.

- For young (< 40 yrs) -
If obese - Evaluate OSA,
For non-obese - Evaluation for secondary HTN.

- Consider adding a potassium based salt - if the individual has high daily sodium intake. ( In non ckd).

- If CVD risk is high (>10% at 10 yrs) - Start medications if Sbp >130/80 (after 3 months of lifestyle changes).

Difference b/w ”actual” and ”standard” HCO3 in indicates that the resp component (pCO2) is contributing to acid-base status.
An element of resp acidosis is indicated if actual HCO3
– is higher than std HCO3
An element of resp alkalosis is indicated if actual HCO3
– is lower than std HCO3.