Prabhav Bhansaly, MD

@JasmineNephro @NiranjanAV11 @_harbirkohli @raja_1980 @DivyaveerSSNeph @manirath Thank you @JasmineNephro mam

Happy makar sakranti #kidneybalance#health#education#pongal

4 pillars of interventional nephrology

🫘🙌Interpretetion of SPEP ⏬Full link to our blog onconephindia.in/pdf/SPEP-blog.… @KidneyBalance @VinBhargava #OncoNephrology

@JasmineNephro Thal/SCA

⁉️Diagnosis

@JasmineNephro Hair on end

KDIGO is pleased to announce the publication of the 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease (CKD). Read the news release: kdigo.co/CKD-Guideline-… Download the guideline: kdigo.co/2024-CKD-Guide… Read the guideline in Kidney International: kdigo.co/CKD-Guideline-… The KDIGO 2024 CKD Guideline was co-chaired by @adeeralevin and @KidneysRU. The Executive Summary will be published in the April 2024 issue of @Kidney_Int. “We are thrilled to publish this eagerly anticipated update, which comes during a transformative period in nephrology, offering new hope for people living with kidney disease," said Dr. Levin. “Recent advancements in GFR evaluation, risk prediction, and the arrival of novel treatments are poised to enhance CKD prognosis and management. We also hope the guideline’s emphasis on multidisciplinary teamwork, patient engagement, and a holistic, evidence-based approach to care will help catalyze positive change, resulting in more coordinated CKD care management worldwide. By integrating the latest evidence and expert consensus, we aim to empower healthcare professionals, and patients with actionable recommendations to optimize patient outcomes and enhance quality of life.” “As Co-Chairs, we would like to recognize the outstanding efforts of the Guideline Work Group and extend our thanks to the Evidence Review Team from Johns Hopkins, without whom this guideline would not have been possible," said Dr. Stevens. "The Work Group was diverse, multinational, highly experienced, and exceptionally committed, and we are grateful for their contributions to both this guideline and to global nephrology.”

🦴🦴 Steroid induced Osteoporosis 🛎️Doses as low as 2.5 mg daily for 3-6 months can lead to fractures ✅FRAX-Fracture risk assessment tool -Calculates 10 year probability of fracture 🙏For Adults > 40 on steroids > 6 months-FRAX score should be done 👍 ccjm.org/content/87/7/4…

Renal 🫘histopathology 🔬in ANCA vasculitis.. A. Necrotizing extracapillary proliferation/ crescents 🌙 B. Periglomerular granulomas🫘✨ C. Interstitial granulomas and tubulitis⭐️💥 D. Segmental fibrinoid necrosis in interlobular arteries 🩸💥

Great lecture on PALF and CRRT modality by Dr Akash Deep @aakashdeeparora at PGI, Chandigarh. Thank you sir for the wonderful insights.

😖CKD assoc pruritis CKDaP🔥 ⁉️Inadequate HD/⬆️PO4/Hyperpara/Xerosis ✏️⬆️Mu/⬇️Kappa opioid receptor 💊Optimize HD-HDF 👍 Step wise 👇 1️⃣Skin emollient 2️⃣Topical analgesic-pramoxine/capsaicin 3️⃣antihistamin 4️⃣Gabapentin 5️⃣Refractory-Difelikefalin K agonist 🤩Definite-Tx

✍️Dual ANCA/Anti GBM(DPP) ⬆️multiorgan in DPP>anti GbM 🥸🔬crescentic GN+linear IgG 🥶Chronicity⬆️s/o old flares 👏Prognosis DPP👌>anti gbm ⬆️Recurrence DPP-maintenance✅ ✍️Initial 💊 like GBM-Steroid+Cyclo +PLEX 🔥Neutrophil ⬆️by ANCA-ROS-GBM rupture-expose anti gbm Ag

@JasmineNephro @NiranjanAV11 @witch_doc @dr_vaish26 Can it be given to liver failure patients?

🚽 Furosemide stress test in AKI 💉Give iv furosemide-1mg/kg bolus 🅰️2 hours post test- Urine output>200 ml- ✅Test passed-Pre renal AKI 🅱️UO<200 ml in 2 hrs post test-Test 😞failed-intrinsic AKI 😳💀Failed stress test-less tubular functional reserve-⬆️Severe AKI/⬆️RRT need

@JasmineNephro @NiranjanAV11 @dr_vaish26 Currant jelly, klebsiella

🍇🍇A middle aged CKD ESKD 🧕 admitted with respiratory distress and cough/sputum production (sputum like👇) #MedTwitter 👇CXR🩻 🤨⁉️Can you guess organism responsible for pneumonia from figures

2/2 #MedTwitter #Nephpearls 🎯Absent TPMT enzyme activity (0.3% population)-Homozygous variant-Avoid Aza🚫 🔥Homozygous variant of NUDT15 gene-intolerant of AZA ✅🙏TPMT/NUDT15 genotype/phenotype testing should be done before starting Aza

@nkf Stop taking salt.

What is one thing you'd tell someone who's just been diagnosed with kidney disease?

Seach water in your camera roll and post the first pic with a quote.. pondicherry waters

@doc_nephron This was childhood onset NS to begin with

@KidneyBalance 16wks by definition.

A 17 year old male presents with relapse of iCONS which was steroid responsive and infrequent relapses. Next step? kidney bx or steroids?#askrenal

@doc_nephron How much time will you wait before declaring steroid resistance, 4 weeks 6 weeks or 16 weeks?

@KidneyBalance Steroids. Biopsy if steroid resistant.