Pawan Rao MD, FASN🩺

#BlackFridaySales for lab work. Anyone interested?
#SkyNeph #SkyMed

Its time for a new paradigm in hyponatremia The latest salvo in the hyponatremia wars takes off where Seethapathy left us (NEJM Evidence | NephJC). Last week, Juan Carlos Ayus published his latest study (JAMA Intezrnal Medicine) on hyponatre…

The latest salvo in the hyponatremia wars takes off where Seethapathy left us (NEJM Evidence | NephJC). Last week, Juan Carlos Ayus published his latest study (JAMA Internal Medicine) on hyponatremia, a meta analysis of patient outcomes in the management of hyponatremia

pbfluids.com/2024/11/its-...

GLP-1 Receptor Agonists and Cirrhosis in Metabolic Dysfunction-Associated Steatotic Liver Disease This cohort study aims to determine whether use of glucagon-like peptide 1 receptor agonists are associated with lower risk of developing cirrhosis and its complications, including decompensation and ...

jamanetwork.com/journals/jam...

GLP-1 RAs may reduce the risk of cirrhosis progression and complications in patients with MASLD and DM, especially when started early. No benefit observed if initiated after cirrhosis onset. #LiverHealth #DiabetesCare #metabolicsyndrome

Dear #AskRenal friends - Finally, I have a feed up and running!
Still trying to get the repost and like feature working.
Feed: bsky.app/profile/did:...

Questions - DM me - @drnikhilshah.bsky.social
#NephSky

#MedSky

@nephjc.bsky.social l @hswapnil.bsky.social l @kidneyboy.bsky.social

bsky.app/profile/did:...

Here we go!!
#askrenal is back!

Will #finerenone become MRA of choice in #CHF for GDMT? Often these pts w soft BPs and unable to use #spironolactone in addition to ARNI. Also compelling if diabetic & proteinuric as well! Can titrate up to 40mg. #medsky #nephsky #AHA24

Kaplan Meier survival curves showing no CV benefit from Spironolactone post MI

Another fail for Spironolactone 😰
Post MI
CLEAR trial, funded by CIHR

www.nejm.org/doi/full/10....

From #AHA24

Congratulations. Please consider dialysis.

10/10
Final thoughts:
⭐ Finerenone In DKD = ⬇️CV /Kidney outcomes

⭐ Finerenone in HFpEF =⬇️ CV death +HF events

⭐ Small % patients on background #flozin /GLP-1

⏰It’s Time to do some trials with combination therapy #flozin + finerenone ! #CONFIRMATIONHF #CONFIDENCE

Another feather in the cap! Benefits are endless. #flozin #SGLT2i #medsky #nephsky

Tirzepatide for Heart Failure with Preserved Ejection Fraction and Obesity | NEJM Obesity increases the risk of heart failure with preserved ejection fraction. Tirzepatide, a long-acting agonist of glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor...

Another GLP-1 drug success. Tirzepatide in heart failure with preserved ejection fraction (HFpEF) with longer term follow-up than 2 previous trials with semaglutide
nejm.org/doi/full/10....
in people with BMI >30; no data yet for HFpEF in people without obesity

Albuminuria, an established biomarker of the progression of CKD, is also recognized as a biomarker for the risk of CVD (ca. 2024)
#Nephpearls #NephSky #Cardiorenal

👉🏼 pubmed.ncbi.nlm.nih.gov/38214258/

Have followed multiple people across different specialties. Thanks to the starter packs! #medsky

#LBCT #SUMMIT trial #AHA24
💥 Treatment with tirzepatide led to ⤵️risk of a composite of death from cardiovascular 🫀 causes or worsening heart failure 🆚 placebo and improved health status in patients with HFpEF+obesity
📎 @NEJM www.nejm.org/doi/full/10....

So exciting! #SUMMIT trial, the first #HFpEF trial of incretin therapy with HF clinical outcomes as prespecified primary outcome. And #tirzepatide reduced CV death or worsening HF by significant 38%! Improvement in KCCQ quality of life by 7 pts, wt loss 12%, hsCRP reduction by 35%! #AHA24 #CardioSky

Intensive Blood-Pressure Control in Patients with Type 2 Diabetes | NEJM Effective targets for systolic blood-pressure control in patients with type 2 diabetes are unclear. We enrolled patients 50 years of age or older with type 2 diabetes, elevated systolic blood press...

www.nejm.org/doi/full/10....
BROAD trial Presented at #AHA24
#skyneph

Aquaporin-1 and Osmosis: From Physiology to Precision in... : Journal of the American Society of Nephrology ion and/or trafficking are key to sustain osmosis in multiple tissues. Here, we review the convergent evidence demonstrating that aquaporin-1 (AQP1) facilitates water transport across endothelial cell...

The discovery of the #aquaporin #AQP family of water channels has provided a molecular counterpart to the movement of water across biological membranes. This JASN review, discusses the concept of osmosis and its central relevance for #PeritonealDialysis. journals.lww.com/jasn/fulltex...

University of Washington Division of Nephrology Welcome to the UW Division of Nephrology! We work hard to improve the lives of people with kidney disease. The University of Washington is passionate about all things related to health and disease pre...

Just posting some great #Nephsky references here:

UW Nephrology Grand Rounds:
www.youtube.com/@universityo...

University of Ottawa Nephrology Grand Rounds:
www.youtube.com/@ottawanephr...

Rush University Biopsy Conference:
www.youtube.com/@rumc-biopyc...

Nephropocus
nephropocus.com

Slidedeck from an internal presentation on diabetic kidney disease 👇

Nephrologist's take on the effect and impact of SGLT-2 inhibitors, GLP-1 RAs and ns-MRA on #Kidney Disease in people with #diabetes #flozin #sglt2i #MRA #GLP1RA
#MedEd #MedSky #NephSky

www.slideshare.net/slideshow/ne...