Gerren Hobby

1/14 Tweetorial alert 📢 Evaluating patients for AKI is important, but the vast possible etiologies can make this difficult. Here is the diagnostic method @TracyMullis1 and I teach residents rotating with us as outlined in our brand new pocket guide we give to our residents.

Look what's hiding among these dense "muddy brown" granular casts, rendered visible by polarized light: hundreds of calcium oxalate monohydrate crystals ! #UrineMicroscopy #UrinarySediment

I never knew this occurred 🤯 Obviously massive energy savings from not running a Na/K ATPase, but I guess you lose the ability for a strong membrane potential and muscle movements and advanced nervous systems? Seems like a good trade off for something just sitting on coral though!

@kidney_boy Maybe he’s a marine biologist and we’re speaking about marine vertebrates such as mollusks and starfish which have a high sodium content in their cells

And every nephrologist weeped

Proactive vs Reactive DDAVP: The Clamp Finally Faces an RCT Thank you Thai Air Force for doing the trials that need to be done! pbfluids.com/2026/03/proact…

Our VESPER team, led by Dr. @john_basmaji have recruited the first two patients into our RCT of venous congestion guided resuscitation in septic shock!! Our goal is to understand how venous congestion can be used to guide decisions surrounding fluids, inotropes, RV support in septic shock. Focus for VESPER right now is feasibility but we have already recruited two patients in the first week live!

Well Jonathan , sometimes an AVG is still needed but most of the the the transformed AVG from the venous counterpart is good enough . We provide explanations in our paper. Thank you for posting and the App is being launched !

Happy to see our commentary with @jbrianbyrd suggesting that Angiotensin II should be part of the evaluation of primary hyperaldosteronism @HyperAHA @NUFeinbergMed @NU_Nephrology ahajournals.org/doi/10.1161/HY…

#VExUS score Is Associated with Worsening Renal Function and Reduced Natriuretic Response in Patients with Acute #HeartFailure #POCUS #FOAMed #Nephpearls 🔗 J. Clin. Med. 2024, 13(20), 6272; doi: 10.3390/jcm13206272

Age-specific reference values of eGFR for European adults by Megan E. Astley, @jjcarrero1, Elke Schäffner, Kitty Jager et al should further question current CKD definition by eGFR < 60. Instead, lower eGFR limits should be defined in octo- & nonagenarians. kidney-international.org/article/S0085-…

On Tuesday I received the NOA (notice of award) for an @nih_nhlbi R01 grant submitted back in Feb 2024 and marked pending after the Oct 2024 Council meeting. Let me tell you the story of the 15 years it took to get here:

Beautiful animation of metabolic flux in the mitochondrial Kreb (TCA) cycle The three "CO2" coming off the cycle is how you lose weight: carbon from your material body coming off as gas you end up breathing out By @janetiwasa

SCCM guideline update on critical care #Ultrasound. Honored to be part of this expert panel—an incredible learning experience. Grateful to the co-chairs @Jose_Diaz_Gomez @NikraDoc for the opportunity! #POCUS #FOAMed #Nephpearls 🔗journals.lww.com/ccmjournal/ful…

1/5 What’s all the buzz about femoral vein doppler? A recent paper (PMID: 37165284) by @drvimalzenICU and @ThinkingCC showed that femoral vein doppler had good accuracy in detecting venous congestion and moderately correlated with #VEXUS scores

🌟HIT! High Impact Clinical Trials – What and Why First Rajiv Agarwal @AgarwalRajivMD Combination Effect of Finerenone and Empagliflozin in Participants With Chronic Kidney Disease and Type 2 Diabetes Using a UACR Endpoint Study (CONFIDENCE)—Baseline Characteristics

1/ 🚨 NEW #BehindTheScenesInterviews: Monoclonal Gammopathies Let’s review our favorite alphabet soup! 🎥: youtube.com/playlist?list=… 🖥️: coreimpodcast.com/2025/01/26/mon…

Check out our new book from @SpringerClinMed focusing on Kidney Disease in the Elderly- a growing population with unique clinical needs. H/T @kramer_holly @edgarvlermamd

Take a look at this nice tweetorial by @MChanMD 👇

Happy to announce the launch of our book - Understanding Kidney Diseases: A Simplified Approach, at the grand Inauguration Ceremony of Association of Physicians of India Conference - APICON 2025 in Kolkata! 📷 This comprehensive, user-friendly guide simplifies nephrology for clinicians, students, physicians, and residents. Packed with infographics, clinical insights, and expert contributions from across India, it’s designed to make diagnosing and managing kidney diseases easier in everyday practice. Available now on notionpress bit.ly/UKDbook (USE CODE KIDNEY20) and Amazon amzn.to/40r7Sie EDITORS Drs - Priti Meena, Garima Aggarwal, Urmila Anandh, Edwin Fernando, Vinant Bhargava, NP Singh, Anupam Prakash Thank you to all the authors, this is testament to your expertise and dedication.

Simple 2nd concept: MPGN - Subendothelial injury with Ig, complement= leukocyte infiltration =inflammation - Remember GBM protects! - So, the glomerulus makes NEW GBM below deposits= double contour=new GBM walls off deposits =thus reduces leukocyte influx= less/no inflammation

Simple concept of GN. It’s all about location! 1. Subendothelial deposits/injury by Ig, immune-complexes, complement, other mechanism leads to influx of leukocytes= inflammation=GN 2. Subepithelial deposits/injury= protected by GBM & endothelial cells=no inflammation=No GN. 1/3

Close up view of the interior of a mixed cellular cast containing RBC's, WBC's (both non viable and "glitter cells") tubular epithelial cells, and fibrin - brightfield with SM stain - #UrineMicroscopy #UrinarySediment