If you are looking for fourth opinion, go back to the first one. And so on.....
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Dr. Prashant.C.Dheerendra
1.2K posts
Dr. Prashant.C.Dheerendra
@prashantnephro
Kidney doctor. Founder of Dharma Kidney Care. Adjunct associate professor at Apollo Hospitals,BG Road, Bangalore. Making life easier for kidney patients.
Bengaluru South, India Katılım Haziran 2015
401 Takip Edilen1.3K Takipçiler
Thankfully urine albumin hasn't been reported in pico or femtograms.
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@katiewiskar Difficult for me to agree with this. Low intake by itself shouldn't cause hyponatremia. A very good thread indeed!
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8. Don't underestimate how bland a hospital diet is
I see this quite often in patients who develop slow, moderate hyponatremia while hospitalized.
A hospital diet is typically extremely low in sodium (as least where I practice), such that patients can truly develop hypoNa from low solute intake during prolonged hospitalization.
I usually prescribe some takeout food and a bag of chips 😜
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Confession: I LOVE hyponatremia 🤓
(I know, I know. What can I say, I'm a true internist!)
HypoNa is often feared, maligned, and misunderstood - but I promise it doesn't have to be scary!
Here are my top 10 hyponatremia tips and tricks - a 🧵
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Dr. Prashant.C.Dheerendra retweetledi
CM: Bhai Factory to Kafi badhiya banayi hai, koi dikkat ho to mujhe direct call karna
Owner: Thank you Sir, aap Devta hain
CM: 1000 jodi (pairs of shoes) to ban jati hongi ek din mein?
Owner: Nahin Sir, 5000 jodi banti hain ☺️
CM: Wah. Tujhe to CM award milna chahiye. 10 Rupaye Jodi bach jaate hain?
Owner: Nahin Sir, 35 se 40/- bach jate hain 🤦♂️
🧵
Indonesia
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A lot of Indian Nephrologists and doctors are on Twitter/X.
We will miss NephJC here.
Have any of you opened a BlueSky account 🤔 @arvindcanchi @raja_1980 @prashantnephro
Nephrology Journal Club@NephJC
See you on the other side 🦋 nephjc.com/news/2024/11/1… #NephJC #NephSky #SkyNeph
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Dr. Prashant.C.Dheerendra retweetledi
Join us on Nov 8th, 6:30 PM IST for the #ISOTeduConnect event! Demonstration of the innovative ISOT Swap Software, followed by a panel discussion with experts Dr. K S Nayak and Dr. Satish Balan
us06web.zoom.us/j/81343024813?…
#ISOT #ISOTSWAP
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We live in an age of too much noise and few signals. We were better at managing edema before so many tests became available. There's no signal that's more useful than a patient who feels better with decreasing weight and diuresis.
Joel M. Topf, MD FACP@kidney_boy
One of the common criticisms of NephroCheck and other biomarkers of AKI is that since we don't have a treatment for AKI, checking these do not change what we do. But I think this view isn't thoughtful. Given that most of the contrast associated nephropathy we see after cardiac cath has been shown to be meaningless hemodynamic changes in creatinine and not actual tubular damage, we could have avoided scaring a generation of doctors in to believing in contrast nephropathy had we evolved from creatinine to biomarkers. Similarly, how many heart failure patients have gotten inadequate diuresis because of panic over a bump in creatinine? I suspect, had we transitioned to biomarkers of kidney injury, cardiologists and nephrologists would have been more confident in pressing forward with needed diuresis. Better diagnosis would allow better management despite not having an AKI pill (yet).
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Article publication day is a good day to celebrate🍾
Renal Physiology Education via Podcast: Channel Your Enthusiasm
kidneymedicinejournal.org/article/S2590-…
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@sakthinephro @purvabavikar @IndiaSoTx @DrKSNayak @iamnephrologist @drvivekkute @IamGopambuj @BeheraVineet @arvindcanchi @AmolBhawane @Amit_Nephro @balwani__manish @drshyambansal @dakidneydoc @priti899 @JasmineNephro @Jithukurian6 @ajaynephro @drmanishasahay @nephromythri @MSR_Urosurgeon That's laudable. Sooner the better. 👍
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@prashantnephro @purvabavikar @IndiaSoTx @DrKSNayak @iamnephrologist @drvivekkute @IamGopambuj @BeheraVineet @arvindcanchi @AmolBhawane @Amit_Nephro @balwani__manish @drshyambansal @dakidneydoc @priti899 @JasmineNephro @Jithukurian6 @ajaynephro @drmanishasahay @nephromythri @MSR_Urosurgeon It's done for an altruistic purpose sir .We are planning to give it to NOTTO for free of cost...
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Dr. Prashant.C.Dheerendra retweetledi
🌸ISOT's swap transplant software facilitates donor-recipient matching, optimizing compatibility for kidney and liver transplants using advanced matching algorithms.
🔆@sakthinephro briefs about the software
💥Interview by @purvabavikar
#ISOT2024
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@sakthinephro @purvabavikar @IndiaSoTx @DrKSNayak @iamnephrologist @drvivekkute @IamGopambuj @BeheraVineet @arvindcanchi @AmolBhawane @Amit_Nephro @balwani__manish @drshyambansal @dakidneydoc @priti899 @JasmineNephro @Jithukurian6 @ajaynephro @drmanishasahay @nephromythri @MSR_Urosurgeon @sakthinephro any cost implications for the patients/nephrologists/hospitals? I think the tool must be used without further delay and the respective states should take the lead.
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@purvabavikar @IndiaSoTx @DrKSNayak @iamnephrologist @drvivekkute @IamGopambuj @BeheraVineet @drvivekkute @arvindcanchi @AmolBhawane @Amit_Nephro @balwani__manish @drshyambansal @dakidneydoc @purvabavikar @priti899 @prashantnephro @iamnephrologist @JasmineNephro @Jithukurian6 @ajaynephro @drmanishasahay @nephromythri @MSR_Urosurgeon
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@captainchloride Only diuresis and make the family/patient understand the risk of contrast administration.
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Patient with an eGFR of 20, HF, significantly volume overloaded. They are going to get a CT angiogram. To reduce the risk of contrast associated nephropathy (this is not a discussion on if it exists or not) do you:
#nephtwitter
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@HinduofOdisha @priti899 @KIReports @ISNkidneycare @kdjhaveri @vjha126 @AnandhUrmila @myadla @SaynaNorouzi @PanktiMehta24 @Indian__doctor @arvindcanchi Will written and eye opening!
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@priti899 @KIReports @ISNkidneycare @kdjhaveri @vjha126 @AnandhUrmila @myadla @SaynaNorouzi @PanktiMehta24 @Indian__doctor @arvindcanchi Just think if people will be cured who will pay you daily consultation charges?
After all pharma companies pay every dr and they are meant to write prescription not to cure patient.
Please visit gastro and liver center by Dr Alok 😂
Reel ❌
Real✔️
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🔥Fairness creams may promise glowing skin,🧖♀️ but did you know they could be harming your kidneys? 🧴⚠️🤯
In our latest articles in @KIReports @ISNkidneycare we uncovers the hidden dangers of toxic ingredients in these products.
👍Protect your health by knowing what you're putting on your skin. 👎🌬
Embrace your natural skin, and prioritize your health over harmful products.
#TrueBeauty #SelfLove #HealthAlert #KidneyHealth #ToxicBeauty"
sciencedirect.com/science/articl…
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@hswapnil @Jwaitz @nephdrkishan @kidney_boy @VelezNephHepato @AnnaGaddy @chetanmudrabett @JasmineNephro @fearingforties @srikanthnephro @drmanishasahay @LeticiaRolonMD @NephroMD @signindoc Spot on! Crewman Darnell it is and Dr. McCoy his physician. It used to air on Doordarshan when I was in kindergarten. Wish "it" had survived and sent back to its planet with tonnes of salt. Life's craving for salt depicted splendidly. A reco on Netflix.
tinyurl.com/337xwy9e
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@prashantnephro @Jwaitz @nephdrkishan @kidney_boy @VelezNephHepato @AnnaGaddy @chetanmudrabett @JasmineNephro @fearingforties @srikanthnephro @drmanishasahay @LeticiaRolonMD @NephroMD Darnell (a red shirt) from Star Trek S1E1
en.m.wikipedia.org/wiki/The_Man_T…
Right @signindoc ?
GIF
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Can you name the first man to succumb to anatremia (Yes, you read it right, Na= 0)? And his physician? @nephdrkishan @kidney_boy @VelezNephHepato @AnnaGaddy @Jwaitz @chetanmudrabett @JasmineNephro @fearingforties @srikanthnephro @drmanishasahay @LeticiaRolonMD @NephroMD
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@Jwaitz @nephdrkishan @kidney_boy @VelezNephHepato @AnnaGaddy @chetanmudrabett @JasmineNephro @fearingforties @srikanthnephro @drmanishasahay @LeticiaRolonMD @NephroMD Incorrect. He is one of many men who have succumbed to the box office.
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@Teknofiliac Aspirate as much as possible with a two cc syringe. Flush very, very slowly.
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#askrenal
HD catheter locked with citrate. Nurse not able to aspirate lock and wants to flush it with saline.
What do you do?
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@LangoteAmit @nephdrkishan @JasmineNephro @SreejithDr @melhoenig @arvindcanchi @LeticiaRolonMD @Jwaitz @raja_1980 @VijayKher8 @ajaynephro @chetanmudrabett @Dr_Kristin_G @krithicism pubmed.ncbi.nlm.nih.gov/7271402/
pubmed.ncbi.nlm.nih.gov/3761074/
Used something like this contraption from Amazon in the ward.
amzn.in/d/5jgcnGM
Have used in two very refractory nephrotic patients. 2-3 days into the process and both of them became diuretic sensitive! Lukewarm water. 4h/day
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@prashantnephro @nephdrkishan @JasmineNephro @SreejithDr @melhoenig @arvindcanchi @LeticiaRolonMD @Jwaitz @raja_1980 @VijayKher8 @ajaynephro @chetanmudrabett @Dr_Kristin_G @krithicism Can you explain how it was practically done ? Was it cold water ?
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This was a patient with FSGS that we managed two years ago. 10 kgs over recent weight and e
uncomfortable because of edema. Usual measures plus high diuretic doses -- 240 mg Lasix IV, metolazone 10mg and spiro 100mg with albumin didn't move the needle over 5-6 days. Over the next
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@nephdrkishan @JasmineNephro @SreejithDr @melhoenig @arvindcanchi @LeticiaRolonMD @Jwaitz @raja_1980 @VijayKher8 @ajaynephro @chetanmudrabett @Dr_Kristin_G @krithicism We used head out water immersion with good results.
jamanetwork.com/journals/jamai…
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@prashantnephro @JasmineNephro @SreejithDr @melhoenig @arvindcanchi @LeticiaRolonMD @Jwaitz @raja_1980 @VijayKher8 @ajaynephro @chetanmudrabett @Dr_Kristin_G @krithicism I feel remission or reduction in proteinuria in a significant fraction may be the reason for achieving dry weight. In high-grade proteinuria no matter what may be the diuretic response will be blunted. Steroids would be the reason for this magical response 🤔
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@Endoananth @nephdrkishan @JasmineNephro @SreejithDr @melhoenig @arvindcanchi @LeticiaRolonMD @Jwaitz @raja_1980 @VijayKher8 @ajaynephro @chetanmudrabett @Dr_Kristin_G @krithicism Haven't used it for diuresis alone.
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