excellent review of complement based therapies in ...IgA Nephropathy in @ajkd.bsky.social from @sstoneman.bsky.social et al www.ajkd.org/article/S027... Fig 1 with the 4-hit theory 1/

3/n although the lobulated nuclei made it clear that the cells were leukocytes, we still confirmed it with Prescott-Brodie stain

1/n young adult gets transferred to our hospital for higher level of care. Had presented to a rural institution with weakness; found to have Hgb 7.5, serum Cr 2.6 mg/dL, hematuria. Prompted a positive p-ANCA. Nephrology is consulted on arrival

a man wearing a shirt that says sticker giant on it

ALT: a man wearing a shirt that says sticker giant on it

media.tenor.com

We really don’t think BigPAK makes sense From our journal club at @uottawa.ca into a #NephJC shorts www.nephjc.com/news/2025/12...

BigPAK or a bundle of balderdash? — NephJC

We break down the latest salvo from Zarbock et al on a supposedly wonderful ‘bundle’

nephjc.com

7. Personal level. Beyond his talent and expertise, I met an extraordinary man. Humble, altruistic, wise, friendly, and with a great sense of humor. I brought him a vacuolar cast tie as a present and he wore it proudly right away 🤩

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:

A study that could only happen in the US jamanetwork.com/journals/jam... in @jamanetworkopen.com Offering outpatient dialysis to uninsured peeps with kidney failure might help save $$ by reducing LoS #NephSky

Hospital Hemodialysis Unit Flexibility and Hospital Length of Stay

This quality improvement study evaluates the association of hospital length of stay with a first-in-state model in which an inpatient hemodialysis unit received regulatory approval to provide temporar...

jamanetwork.com

Dual-Antigen Membranous Nephropathy doi.org/10.1016/j.kint.2025.10.006 #NephSky #MedSky #membranousnephropathy @mayoclinicpath.bsky.social @arkanalabs.bsky.social @lynncornell.bsky.social @aaronstorey.bsky.social

🔬for the diagnosis of glowmrulonephritis, searching for urinary acanthocytes only using bright field illumination is clearly suboptimal compared to utilizing dark field illumination or phase contrast microscopy. #UrinarySediment #UrineMicroscopy karger.com/gdz/article/...

The urine in glomerulonephritis really glows ✨ #urinarySediment

Juan Carlos Q Vélez, MD@juancarlosqvelez.bsky.social · 9mo ago

🔬for the diagnosis of glowmrulonephritis, searching for urinary acanthocytes only using bright field illumination is clearly suboptimal compared to utilizing dark field illumination or phase contrast microscopy. #UrinarySediment #UrineMicroscopy karger.com/gdz/article/...

Thanks @amyaimei.bsky.social for giving an excuse to share some #UrinarySediment pics. See below for context 👇🏼

Not hugely practice-changing, as many folks are already using bicarb to reduce dialysis risk based on BICAR-ICU-1 Lack of mortality impact is unsurprising given how difficult it is to prove in ICU (discussed: emcrit.org/pulmcrit/mor...) Reduced dialysis & bacteremia are important pt-centered wins

a baby is crying while being held by a woman in a crowd .

ALT: a baby is crying while being held by a woman in a crowd .

media.tenor.com

Renal tubular epithelial cell cast (Sternheimer-Malbin stain) under 1000x bright field. Pt with nephrotic range proteinuria, suspected GN. Note small lipid droplets on most inferior cell in the cast.

This is great! Renal biopsy by the nephrologists!

Juan Carlos Q Vélez, MD@juancarlosqvelez.bsky.social · 9mo ago

Real-time ultrasound-guided kidney biopsy performance, simulation lab at Ochsner Nephrology #NephSky #KidneyBiopsyAcademy workshop available at @kidneycon.bsky.social

Interesting case from the Skeleton Key Group which just keeps pumping out the #FOAMed www.renalfellow.org/2025/09/28/s...

Skeleton Key Group Case #40: Cosmetic Calcium

Author: Nikitha (Niki) Cherayil, MD A. The Stem A middle-aged woman with chronic kidney disease stage 3 in the setting of hypertension and recurrent kidney st

renalfellow.org

Largest ever study of peripheral 23.4% NaCl with 863 administrations 😀 Some extravasation did occur, but it *didn't* lead to any major problems (tissue necrosis etc) If someone is having an ICP crisis, you should worry about their BRAIN and not their ARM - their arm will be fine #EMIMCC

Neurocritical Care@neurocritcarej.bsky.social · 9mo ago

Silva et al: Safety of Peripherally Administered 23.4% Sodium Chloride Link: link.springer.com/ar... @neurocritical #neurocritcare

Mixed cellular containing RBCs, WBCs (blue) and RTECs (fuchsia) in the #UrinarySediment from a patient with suspected IgA nephropathy 🔬bright field (500x) and oblique illumination (1000x) #UrineMicroscopy #OchsnerNephrology

I was just reminded that I once made an autoportrait of my distal LAD flow in 3D (and got it published!) #echosky #cardiosky pubmed.ncbi.nlm.nih.gov/29993929/

Following #KidneyWk I’ll be flying to Santiago, Chile, for a #UrinarySediment Microscopy conference 🔬 citem.cl/congreso-int...

Key point from my invasive CO talk the other day #CHEST2025

A famous nephrologist getting ready to go see the most famous guy who plays a nephrologist @glaucomflecken.bsky.social @stanforddeptmed.bsky.social Grand Rounds!

We are thrilled to announce that we have generously received funding for a one-year hypertension fellowship, and we are recruiting now for a candidate to start fellowship July 1, 2026 . med.stanford.edu/hypertension/e… -Jehan Zahid Bahrainwala HTN Fellowship Program Director

Go to Stanford and learn from the best for hypertension! #NephSky

Vivek Bhalla, MD, FASN, FAHA@bhallaresearch.bsky.social · 10mo ago

We are thrilled to announce that we have generously received funding for a one-year hypertension fellowship, and we are recruiting now for a candidate to start fellowship July 1, 2026 . med.stanford.edu/hypertension/e… -Jehan Zahid Bahrainwala HTN Fellowship Program Director

Secondly, loop diuretics act as venodilators, which means if you look at vena cava shortly after a diuretic dose, vena cava (and RAP/CVP for that matter) may suggest normovolemia even if the patient is still volume overloaded. www.ahajournals.org/doi/10.1161/...

Direct Vascular Effects of Furosemide in Humans | Circulation

Background In humans, hemodynamic changes observed within minutes after systemic administration of furosemide are often referred to as direct vasoactivity. However, these immediate changes do not per ...

ahajournals.org

First of all, I think it’s well overdue that we abandon the use of vena cava size (or at least downgrade it). It’s the poorest parameter! Vena cava circularity/sphericity is much better! pubmed.ncbi.nlm.nih.gov/28065586/

Estimation of Central Venous Pressure Using the Ratio of Short to Long Diameter from Cross-Sectional Images of the Inferior Vena Cava - PubMed

S/L of an IVC cross-section measured using three-dimensional echocardiography may be a reliable parameter to estimate CVP compared with standard grading by 2DE.

pubmed.ncbi.nlm.nih.gov

Some thoughts on this study on using vena cava to guide in-patient treatment of deconpensated heart failure and why it will not change the way I diurese (I use vena cava wisely). #emimcc #cardiosky

Damien BARRAUD@damienbarraudmd.bsky.social · 11mo ago

La veine cave inférieure n'est pas un bon examen pour décider de remplir un malade ? En toute logique, elle n'est pas meilleure pour guider la vidange... www.jacc.org/doi/10.1016/...

☝️DIGIT trial shows benefit from digitoxin in HFrEF (even in context of reasonable GDMT) numerous limitations but consistent w/ the seminal DIG trial (👇 hospitalizations) digitoxin is hepatically metabolized making dosing easier (not available in USA) #1/2 #EMIMCC www.medscape.com/viewarticle/...

Five Big Messages From the DIGIT-HF Trial

Will reassuring safety data and a good efficacy signal increase use of digoxin in heart failure? John Mandrola MD reviews the DIGIT- HF trial from the 2025 European Society of Cardiology congress.

medscape.com

for those of you worried about the safety of PPIs among critically ill patients: this RCT evaluated the effect of using insanely ridiculously ginormous mega-doses of esomeprazole in septic patients and... ...absolutely nothing happened. #EMIMCC journals.lww.com/ccmjournal/f...

Case in point: vasopressin is probably only a wise choice if EF is supranormal pubmed.ncbi.nlm.nih.gov/37030157/

Echocardiographic profiles and hemodynamic response after vasopressin initiation in septic shock: A cross-sectional study - PubMed

Pre-drug echocardiographic profiles differed in hemodynamic responders after vasopressin initiation versus non-responders.

pubmed.ncbi.nlm.nih.gov

Extremely striking difference in utilisation of Impella in the US vs UK and Canada. #cardiosky #cccsky #emimcc jamanetwork.com/journals/jam...