… and the approximate 5th percentile CKD-EPI 2009 reference values are easy to memorize👇👇👇👇

The contrarian effect on urine pH in calcium and uric acid stone formers, despite parallel effects on urine citrate is quite interesting 🤔

3/5 Results

2/5 Flow chart and baseline characteristics

1/5 The #SWEETSTONE results were presented at the Swiss Society of Nephrology meeting:

Impact of #empagliflozin on urinary supersaturations in kidney stone formers.
Randomised, double-blind, placebo-controlled, cross-over trial.

#nephsky #nephrolithiasis #flozinator

A handful of kidney stones, that were composed mostly of brushite (90%) and some calcium oxalate monohydrate (10%).

Nomenclature of the crystalline components can be confusing, as they are often (see above) described by either their chemical or mineral name.

#nephsky #skyneph

🔬 Muddy brown casts, a highly specific #urinarysediment finding of acute tubular injury (bright field, x400).

#nephsky #skyneph

Monophasic, non-pulsatile hepatic vein flow.

Flow in hepatic vein usually mirrors right atrial pressure during cardiac cycle.
⬆️ liver stiffness due to fat, fibrosis, or tumor can uncouple this relation. When most severe, flow becomes monophasic with no pulsations. Also seen w Valsalva.

#POCUS

The lectures are freely available here:

iiif.wellcomecollection.org/pdf/b24975060

I’m a firm believer in adjusting dialysate[K] according to plasma[K] for every single dialysis session (scheme below).

So it really is a pity to miss this week’s #NephJC chat on the ADAPT trial. Looking forward to retrace it later.

Cystine crystals (bright field, x400).

Their presence in #urinarysediment is pathognomonic for #cystinuria, the most common kidney stone disease with Mendelian genetics.

While perfectly specific, the sensitivity of cystine crystalluria is quite low. 

#nephsky #skyneph

The original tracing (with aliasing) looked like this:

Two “Cannon A waves” in hepatic vein Doppler tracing.

Cannon A waves occur in atrioventricular dissociation with the right atrium contracting against a closed tricuspid valve.

#POCUS

My favorite birding pick from this years #KidneyWk

Anna’s Hummingbird 🚹
(Calypte anna)
10-2024, San Diego

This classic 1863 study on composition of the human body makes for some grim reading & real GCP-nightmare:
Using corpse of executed prisoner and providing his name and date of execution.

👉 Google: field laborer, murdered farmer; killed by guillotine in last public execution in Munich.
#MedHistory

Working on talk about #VEXUS score for upcoming #ultrasound course of Swiss Society of Nephrology.
Still no interventional trials looking at patient outcomes by using venous Doppler assessment.
Or did I miss something @argaiz.bsky.social ?
#POCUS