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Melvin Chan @mchanmd.bsky.social · 9d

A great read on the history and upcoming anticoagulation targets especially for our dialysis patients! #NephSky

www.kireportscommunity.org/post/bleedin...

Bleeding, Clotting, and Kidney Disease in Atrial Fibrillation: Can Factor XI Inhibitors Change the Game?

Explore how we are uncoupling hemostasis and thrombosis via Factor XI inhibitors and how it is may change anticoagulation for atrial fibrillation in kidney disease

www.kireportscommunity.org

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Melvin Chan @mchanmd.bsky.social · 14d

Looks like tirzepatide have benefits for those with T1DM, with insulin needs reduced within 2 weeks of treatment. #NephSky #MedSky

www.medscape.com/viewarticle/...

First Randomized Trial of Tirzepatide in T1D Shows Benefits

Tirzepatide reduced weight, A1c, and insulin dose in type 1 diabetes in a small randomized controlled trial.

www.medscape.com

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Melvin Chan @mchanmd.bsky.social · 22d

So exciting! Also it’s a non peptide form so you don’t have to fast!

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Melvin Chan @mchanmd.bsky.social · 24d

Yup! Especially if it synchronizes with telmisartan. Only barrier is the cost of it. But hopeful it will come down, especially with oral formulations coming out in 1-2 years! Orfoglipron showing 13% weight loss and no need to fast! #NephJC

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Melvin Chan @mchanmd.bsky.social · 24d

Wonderful job team!! #NephJC

two cartoon characters giving each other a high five in front of a blue background that says high five

ALT: two cartoon characters giving each other a high five in front of a blue background that says high five

media.tenor.com

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Melvin Chan @mchanmd.bsky.social · 24d

That’s really interesting. I wonder why? Feel like most PCP I see still use lisinopril the most and then use ARB #NephJC

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Melvin Chan @mchanmd.bsky.social · 24d

I refer to Dr Rifkin. One of the reasons I didn’t choose adult nephrology

a baby is making a funny face with his mouth open

ALT: a baby is making a funny face with his mouth open

media.tenor.com

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Melvin Chan @mchanmd.bsky.social · 24d

Do people have specific ACE/ARBs they prefer? Seems like olmesartan has been the most popular why, not sure why though. #NephJC

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Melvin Chan @mchanmd.bsky.social · 24d

Agree feels like this is overly complicated and will decrease adoption of these guidelines #NephJC

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Melvin Chan @mchanmd.bsky.social · 24d

That’s great! For those who use ABPMs regularly, how often do you repeat? #NephJC

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Melvin Chan @mchanmd.bsky.social · 24d

I saw those but feels a bit overkill. Maybe if there blood pressure is severe or needing multiple drugs? #NephJC

Melvin Chan @mchanmd.bsky.social · 24d

Feel like it may add a lot of anxiety especially because I assume the reads are based on the wrist? #NephJC.

Funny personal story, my dentist used to always charge me $10 when they checked my wrist BP during clean. I debated with them and now they have a big FYI not to do BP check for me.

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Melvin Chan @mchanmd.bsky.social · 24d

That’s great! I feel like moving away from it is a big loss especially with missing nocturnal hypertension #NephJC

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Melvin Chan @mchanmd.bsky.social · 24d

How many nephrologist still do 24 hour monitoring? When I talk with adult doctors they seem to moving away from it #NephJC

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Melvin Chan @mchanmd.bsky.social · 24d

Prior to the last 5 years, in pediatrics, we only correlated HTN with LVH, cIMT, pWV. But now we have hard outcomes including one from JAMA #NephJC

jamanetwork.com/journals/jam...

High Blood Pressure in Childhood and Premature Cardiovascular Disease Mortality

This cohort study examines the association of elevated blood pressure at age 7 years with cardiovascular disease mortality later in life.

jamanetwork.com

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Melvin Chan @mchanmd.bsky.social · 24d

Your travel adventures are always so crazy. What was your longest travel time?

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Melvin Chan @mchanmd.bsky.social · 24d

Melvin, Peds Nephrology in CO, interested in cardiorenal syndrome. No COI. Looking forward to the discussions #NephJC

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Melvin Chan @mchanmd.bsky.social · 24d

Do most nephrologist prescribe GLP1? Here in the US, there’s a lot of financial obstacles to get it

Reposted by Melvin Chan

Nephrology Journal Club @nephjc.bsky.social · 26d

Change is in the Autumn air 🌬️🍂
Join use only on #Bluesky on 9/16/25 at 9pm EST.
We're discussing the 2025 ACC/AHA Hypertension Guideline Update. 🫀🫘🧠 #NephSky #MedSky
www.nephjc.com/news/accaha2025-klno3

PREVENT, Detect, Treat: What’s New in the 2025 Hypertension Toolkit — NephJC

This week, we will discuss the AHA/ACC 2025 hypertension guideline update. Wow, have eight years flown by?

www.nephjc.com

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Melvin Chan @mchanmd.bsky.social · 27d

There’s continued growing evidence that childhood onset hypertension leads to worse outcomes.

JAMA @jama.com · 27d

In a large sample of US children born between 1959 and 1966, higher #BloodPressure at age 7 years was associated with greater risk of premature #cardiovascular disease mortality.

ja.ma/4meFZCO

JAMA "High Blood Pressure in Childhood and Premature Cardiovascular Disease Mortality" research letter. Graphs show cumulative incidence of mortality vs. age, stratified by blood pressure. Hypertension, elevated BP, and normal BP are compared.

Melvin Chan @mchanmd.bsky.social · Sep 11

Totally agree with you @hswapnil.medsky.social. Just to add controversy, there was a recent abstract in Europe that showed CV benefits regardless of weight loss in a sub-analysis of SELECT (ie those losing than 5% weight). I can't find the publication but here is an article: easo.org/semaglutide-...

Semaglutide: 4-Year Weight Loss and Cardiovascular Benefits - EASO

Two important studies based on the largest and longest clinical trial of the effects of semaglutide on weight in over 17,000 adults with overweight and obesity but not diabetes find patients lost on a...

easo.org

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Melvin Chan @mchanmd.bsky.social · Sep 11

Thoughts about Wegovy vs Zepbound for MACE Reduction? #MedSky #NephSky

Finding:
-Semaglutide showed 29% reduction in MACE

Limits:
-Small # of events
-Retrospective

Implications:
-Wegovy may be better for those with ASCVD
-Does GIP have any CV benefits?

sciencehub.novonordisk.com/content/dam/...

sciencehub.novonordisk.com

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Reposted by Melvin Chan

Brian Rifkin @brianrifkin.bsky.social · Sep 8

Check out the latest @kireports.bsky.social community blog from @husamjz.bsky.social
Anticoagulantion in ESRD patients with atrial fibrillation:
www.kireportscommunity.org/post/bleeding-clotting-and-kidney-disease-in-atrial-fibrillation-can-factor-xi-inhibitors-change-the-g

Bleeding, Clotting, and Kidney Disease in Atrial Fibrillation: Can Factor XI Inhibitors Change the Game?

By. Husam Alzayer, MD, MSc, MRCPIReviewed by Sophia Ambruso, DOIntroduction Bleeding and thrombosis represent one of the many paradoxes faced by patients with kidney disease. As kidney function declin...

www.kireportscommunity.org

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Reposted by Melvin Chan

Nephrology Journal Club @nephjc.bsky.social · Sep 6

🤔 How often is end-stage kidney disease in patients with MCD/ FSGS? #NephSky #MedSky

@brianrifkin.bsky.social dissected the conclusions from the RaDar study in this #NephJCshorts

*the original article from @asnpublications.bsky.social

www.nephjc.com/news/nephjc-...

NephJC Shorts: MCD and FSGS Outcomes — NephJC

A NephJC Shorts discussion of the long term data on kidney failure in FSGS and MCD

www.nephjc.com

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Reposted by Melvin Chan

Nephrology Journal Club @nephjc.bsky.social · Sep 1

Check out the ACHIEVE visual abstract by @nephromommy-akshu.bsky.social

www.nephjc.com/news/2025/8/...

The ACHIEVE visual abstract — NephJC

the use of spironolactone in patients on dialysis did not alter mortality or hospitalizations for heart failure. Similar results were seen in the simultaneously released ALCHEMY trial.

www.nephjc.com

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