Swapnil Hiremath 🍁🇨🇦
@hswapnil.medsky.social
Nephrologist = kidney doctor
MD, MPH
Professor, University of Ottawa/Ottawa Hospital 🇨🇦
He/Him/His
#NephJC co-creator, @FreelyFiltered.bsky.social pod panelist
#NephSky
https://www.swapnilhiremath.com
MD, MPH
Professor, University of Ottawa/Ottawa Hospital 🇨🇦
He/Him/His
#NephJC co-creator, @FreelyFiltered.bsky.social pod panelist
#NephSky
https://www.swapnilhiremath.com
Pinned
If you are a nephrology or kidney disease or renal professional or interested in the field - make sure you have liked/followed/pinned the nephrology feed
bsky.app/profile/did:...
Thanks again to @richardferro.xyz for creating & updating this! It’s a one-stop shop for nephrology needs
#NephSky
bsky.app/profile/did:...
Thanks again to @richardferro.xyz for creating & updating this! It’s a one-stop shop for nephrology needs
#NephSky
Update
Link changed (will not change again)
So if you liked/pinned the old feed, please do it again!
bsky.app/profile/did:...
#NephSky
Link changed (will not change again)
So if you liked/pinned the old feed, please do it again!
bsky.app/profile/did:...
#NephSky
Reposted by Swapnil Hiremath 🍁🇨🇦
Interesting. We see the same pattern when you cross into the pediatric population. Girls have higher mortality. Doesn’t make sense to me. pmc.ncbi.nlm.nih.gov/articles/PMC...
November 26, 2025 at 1:11 AM
Interesting. We see the same pattern when you cross into the pediatric population. Girls have higher mortality. Doesn’t make sense to me. pmc.ncbi.nlm.nih.gov/articles/PMC...
Reposted by Swapnil Hiremath 🍁🇨🇦
I think relative risks can be misleading. Look at how wide the CI are... Need to couple relative comparison with the absolute risk estimate to interpret.
November 26, 2025 at 1:22 AM
I think relative risks can be misleading. Look at how wide the CI are... Need to couple relative comparison with the absolute risk estimate to interpret.
That was quick!
The US FDA approves Sibeprenlimab aka Voyxact for reducing proteinuria in IgA
www.fda.gov/drugs/novel-...
#NephSky
#TopNephrology
The US FDA approves Sibeprenlimab aka Voyxact for reducing proteinuria in IgA
www.fda.gov/drugs/novel-...
#NephSky
#TopNephrology
November 26, 2025 at 12:21 AM
That was quick!
The US FDA approves Sibeprenlimab aka Voyxact for reducing proteinuria in IgA
www.fda.gov/drugs/novel-...
#NephSky
#TopNephrology
The US FDA approves Sibeprenlimab aka Voyxact for reducing proteinuria in IgA
www.fda.gov/drugs/novel-...
#NephSky
#TopNephrology
Reposted by Swapnil Hiremath 🍁🇨🇦
I did say this.
I also said that RFK Jr is “one of the world’s most dangerous anti-vaccine activists and conspiracy theorists, and she [Nuzzi] made light of that and really downplayed it and defanged his extreme views. She allowed him to argue that he’d just simply been misunderstood.”
I also said that RFK Jr is “one of the world’s most dangerous anti-vaccine activists and conspiracy theorists, and she [Nuzzi] made light of that and really downplayed it and defanged his extreme views. She allowed him to argue that he’d just simply been misunderstood.”
“In elevating someone who has now become essentially the most powerful person in public health in the country and who is taking a wrecking ball to public health institutions, she has done untold damage." – @gavinyamey.bsky.social in @melodyschreiber.com's piece.
Olivia Nuzzi’s Real Victims
More than her fiancé, or fellow female journalists, the public will pay the price for these misdeeds. RFK Jr. will see to that.
newrepublic.com
November 25, 2025 at 9:37 PM
I did say this.
I also said that RFK Jr is “one of the world’s most dangerous anti-vaccine activists and conspiracy theorists, and she [Nuzzi] made light of that and really downplayed it and defanged his extreme views. She allowed him to argue that he’d just simply been misunderstood.”
I also said that RFK Jr is “one of the world’s most dangerous anti-vaccine activists and conspiracy theorists, and she [Nuzzi] made light of that and really downplayed it and defanged his extreme views. She allowed him to argue that he’d just simply been misunderstood.”
Reposted by Swapnil Hiremath 🍁🇨🇦
Opinion from Alphaville: OpenAI is a money pit with a website on top. That much we know already, but since OpenAI is a private company, there’s a lot of guesswork required when estimating the depth of the pit. on.ft.com/44xy39L
November 25, 2025 at 9:32 PM
Opinion from Alphaville: OpenAI is a money pit with a website on top. That much we know already, but since OpenAI is a private company, there’s a lot of guesswork required when estimating the depth of the pit. on.ft.com/44xy39L
Reposted by Swapnil Hiremath 🍁🇨🇦
I think you need to control for cause of CKD 5. Without that, not sure what to make of the findings. The risk adjust not relevant at young age. I also don't find the ratio to standardized mortality relevant. The reason males have higher mortality at a lower age will be swamped by CKD5 mortality.
November 25, 2025 at 7:51 PM
I think you need to control for cause of CKD 5. Without that, not sure what to make of the findings. The risk adjust not relevant at young age. I also don't find the ratio to standardized mortality relevant. The reason males have higher mortality at a lower age will be swamped by CKD5 mortality.
Reposted by Swapnil Hiremath 🍁🇨🇦
Whoa. That is stark. Are some of it people hand waving symptoms off in women?? Does it persist across social/economic class? Does race matter? I have a lot of questions.
November 25, 2025 at 7:18 PM
Whoa. That is stark. Are some of it people hand waving symptoms off in women?? Does it persist across social/economic class? Does race matter? I have a lot of questions.
I did not know it was this bad
Look at the mortality in younger females (versus males) in CKD 5
jamanetwork.com/journals/jam... in @jamainternalmed.com from Alberta
#NephSky #GenderDisparities
Look at the mortality in younger females (versus males) in CKD 5
jamanetwork.com/journals/jam... in @jamainternalmed.com from Alberta
#NephSky #GenderDisparities
November 25, 2025 at 7:14 PM
I did not know it was this bad
Look at the mortality in younger females (versus males) in CKD 5
jamanetwork.com/journals/jam... in @jamainternalmed.com from Alberta
#NephSky #GenderDisparities
Look at the mortality in younger females (versus males) in CKD 5
jamanetwork.com/journals/jam... in @jamainternalmed.com from Alberta
#NephSky #GenderDisparities
Reposted by Swapnil Hiremath 🍁🇨🇦
(2/2) Although no immune deposits are present, the tissue clefts represent the outlines of cholesterol crystals which have lodged within the vascular lumen. This finding is diagnostic of cholesterol microemboli, and it explains the patient’s acute renal failure.
November 25, 2025 at 5:21 PM
(2/2) Although no immune deposits are present, the tissue clefts represent the outlines of cholesterol crystals which have lodged within the vascular lumen. This finding is diagnostic of cholesterol microemboli, and it explains the patient’s acute renal failure.
Reposted by Swapnil Hiremath 🍁🇨🇦
(1/2) The picture shows tissue submitted for routine immunofluorescence (fibrinogen stain is shown). Careful inspection confirms that this is an artery cross section which contains abnormal intraluminal tissue elements with numerous cleft-like spaces (see arrow).
#TeachingPoints #kidneypath #renal
#TeachingPoints #kidneypath #renal
November 25, 2025 at 5:21 PM
(1/2) The picture shows tissue submitted for routine immunofluorescence (fibrinogen stain is shown). Careful inspection confirms that this is an artery cross section which contains abnormal intraluminal tissue elements with numerous cleft-like spaces (see arrow).
#TeachingPoints #kidneypath #renal
#TeachingPoints #kidneypath #renal
Reposted by Swapnil Hiremath 🍁🇨🇦
Unraveling the mechanism behind the probable extinction of the B/Yamagata lineage of influenza B viruses
www.nature.com/articles/s41...
www.nature.com/articles/s41...
Unraveling the mechanism behind the probable extinction of the B/Yamagata lineage of influenza B viruses - Nature Communications
Influenza B/Yamagata lineage has rarely been detected since COVID-19 non-pharmaceutical interventions were introduced, while transmission of other influenza lineages resumed. Here, the authors investi...
www.nature.com
November 25, 2025 at 2:09 PM
Unraveling the mechanism behind the probable extinction of the B/Yamagata lineage of influenza B viruses
www.nature.com/articles/s41...
www.nature.com/articles/s41...
Reposted by Swapnil Hiremath 🍁🇨🇦
This ecosystem is really the way forward for much of CME and residency education. It has the right structure of not being too reliant on anyone individual, while offering reasonable diverse perspectives.
An announcement
www.nephjc.com/news/2025/11...
#NephJC
@kidneyboy.bsky.social and moi hand over the @nephjc.bsky.social reigns to @nephroseeker.medsky.social & @brianrifkin.bsky.social
www.nephjc.com/news/2025/11...
#NephJC
@kidneyboy.bsky.social and moi hand over the @nephjc.bsky.social reigns to @nephroseeker.medsky.social & @brianrifkin.bsky.social
Taking the reigns — NephJC
In April 2014, Swapnil and I launched NephJC—and within weeks we were overwhelmed by the sheer work of running a twice-monthly, Twitter-based journal club. Fortunately, we also had a deep bench of fri...
www.nephjc.com
November 25, 2025 at 12:59 PM
This ecosystem is really the way forward for much of CME and residency education. It has the right structure of not being too reliant on anyone individual, while offering reasonable diverse perspectives.
An announcement
www.nephjc.com/news/2025/11...
#NephJC
@kidneyboy.bsky.social and moi hand over the @nephjc.bsky.social reigns to @nephroseeker.medsky.social & @brianrifkin.bsky.social
www.nephjc.com/news/2025/11...
#NephJC
@kidneyboy.bsky.social and moi hand over the @nephjc.bsky.social reigns to @nephroseeker.medsky.social & @brianrifkin.bsky.social
Taking the reigns — NephJC
In April 2014, Swapnil and I launched NephJC—and within weeks we were overwhelmed by the sheer work of running a twice-monthly, Twitter-based journal club. Fortunately, we also had a deep bench of fri...
www.nephjc.com
November 25, 2025 at 12:03 PM
An announcement
www.nephjc.com/news/2025/11...
#NephJC
@kidneyboy.bsky.social and moi hand over the @nephjc.bsky.social reigns to @nephroseeker.medsky.social & @brianrifkin.bsky.social
www.nephjc.com/news/2025/11...
#NephJC
@kidneyboy.bsky.social and moi hand over the @nephjc.bsky.social reigns to @nephroseeker.medsky.social & @brianrifkin.bsky.social
Reposted by Swapnil Hiremath 🍁🇨🇦
#NephJCshort on BICAR-ICU2 #Medsky #Nephsky
✍️ By @nephroseeker.medsky.social
🎭 Bicarbonate makes the picture look cleaner: better pH, more time. But beneath the smoother numbers, the patient hasn't changed. It's the same story, just told in softer colors
www.nephjc.com/news/2025/10...
✍️ By @nephroseeker.medsky.social
🎭 Bicarbonate makes the picture look cleaner: better pH, more time. But beneath the smoother numbers, the patient hasn't changed. It's the same story, just told in softer colors
www.nephjc.com/news/2025/10...
Dialysis deferred, logic recycled: BICAR ICU2 — NephJC
NephJC short on BICAR-ICU2
www.nephjc.com
November 25, 2025 at 12:19 AM
#NephJCshort on BICAR-ICU2 #Medsky #Nephsky
✍️ By @nephroseeker.medsky.social
🎭 Bicarbonate makes the picture look cleaner: better pH, more time. But beneath the smoother numbers, the patient hasn't changed. It's the same story, just told in softer colors
www.nephjc.com/news/2025/10...
✍️ By @nephroseeker.medsky.social
🎭 Bicarbonate makes the picture look cleaner: better pH, more time. But beneath the smoother numbers, the patient hasn't changed. It's the same story, just told in softer colors
www.nephjc.com/news/2025/10...
Reposted by Swapnil Hiremath 🍁🇨🇦
The 2025 #ASNJASN #ASNCJASN and #ASNKidney360 Trainees of the Year are Benoit Brilland, Thomas Bais, and Yuhei Noda! This prize celebrates the best article submitted to each journal by a trainee as the first author.
See more about the contest and this year's winners: kidney.pub/TraineeOf...
See more about the contest and this year's winners: kidney.pub/TraineeOf...
November 6, 2025 at 8:00 PM
The 2025 #ASNJASN #ASNCJASN and #ASNKidney360 Trainees of the Year are Benoit Brilland, Thomas Bais, and Yuhei Noda! This prize celebrates the best article submitted to each journal by a trainee as the first author.
See more about the contest and this year's winners: kidney.pub/TraineeOf...
See more about the contest and this year's winners: kidney.pub/TraineeOf...
Reposted by Swapnil Hiremath 🍁🇨🇦
Calling all Fellows & Physicians in Training!
ASDIN’s Annual Scientific Meeting includes a special Fellows Education Course just for you!
Click here to see the full schedule! 💻✨
cdn.ymaws.com/www.asdin.or...
ASDIN’s Annual Scientific Meeting includes a special Fellows Education Course just for you!
Click here to see the full schedule! 💻✨
cdn.ymaws.com/www.asdin.or...
November 24, 2025 at 9:07 PM
Calling all Fellows & Physicians in Training!
ASDIN’s Annual Scientific Meeting includes a special Fellows Education Course just for you!
Click here to see the full schedule! 💻✨
cdn.ymaws.com/www.asdin.or...
ASDIN’s Annual Scientific Meeting includes a special Fellows Education Course just for you!
Click here to see the full schedule! 💻✨
cdn.ymaws.com/www.asdin.or...
Reposted by Swapnil Hiremath 🍁🇨🇦
Reminder to schedule a colonoscopy
November 22, 2025 at 7:40 PM
Reminder to schedule a colonoscopy
Reposted by Swapnil Hiremath 🍁🇨🇦
Trimethoprim-sulfamethoxazole carries a very low (but real) risk of causing ARDS.
Duration of therapy is a risk factor (>7 days).
Could likely be minimized by avoiding unnecessarily long courses.
TMP-SMX is usually well tolerated, but can wreak havok (SJS, ARDS, drug-induced meningitis). #EMIMCC
Duration of therapy is a risk factor (>7 days).
Could likely be minimized by avoiding unnecessarily long courses.
TMP-SMX is usually well tolerated, but can wreak havok (SJS, ARDS, drug-induced meningitis). #EMIMCC
November 24, 2025 at 8:48 PM
Trimethoprim-sulfamethoxazole carries a very low (but real) risk of causing ARDS.
Duration of therapy is a risk factor (>7 days).
Could likely be minimized by avoiding unnecessarily long courses.
TMP-SMX is usually well tolerated, but can wreak havok (SJS, ARDS, drug-induced meningitis). #EMIMCC
Duration of therapy is a risk factor (>7 days).
Could likely be minimized by avoiding unnecessarily long courses.
TMP-SMX is usually well tolerated, but can wreak havok (SJS, ARDS, drug-induced meningitis). #EMIMCC
Reposted by Swapnil Hiremath 🍁🇨🇦
For #flozins I would add this individual-level meta:
1. Hypothesizing: they work across subgroups, in patients with lower UACR, in pts with HF, etc
2. Shows us that we don't completely understand their mechanisms
pubmed.ncbi.nlm.nih.gov/41082889/
1. Hypothesizing: they work across subgroups, in patients with lower UACR, in pts with HF, etc
2. Shows us that we don't completely understand their mechanisms
pubmed.ncbi.nlm.nih.gov/41082889/
Effects of empagliflozin on conventional and exploratory acute and chronic kidney outcomes: an individual participant-level meta-analysis - PubMed
None.
pubmed.ncbi.nlm.nih.gov
November 24, 2025 at 10:52 PM
For #flozins I would add this individual-level meta:
1. Hypothesizing: they work across subgroups, in patients with lower UACR, in pts with HF, etc
2. Shows us that we don't completely understand their mechanisms
pubmed.ncbi.nlm.nih.gov/41082889/
1. Hypothesizing: they work across subgroups, in patients with lower UACR, in pts with HF, etc
2. Shows us that we don't completely understand their mechanisms
pubmed.ncbi.nlm.nih.gov/41082889/
Reposted by Swapnil Hiremath 🍁🇨🇦
I'm not sure yet, because I think many similar studies will come: one step closer to GDMT implementation- CONFIDENCE and MIRO-CKD trials #TopNephrology
www.thelancet.com/journals/lan...
www.thelancet.com/journals/lan...
Balcinrenone in combination with dapagliflozin compared with dapagliflozin alone in patients with chronic kidney disease and albuminuria: a randomised, active-controlled double-blind, phase 2b clinica...
In participants with chronic kidney disease at increased risk of disease progression,
a fixed dose combination of balcinrenone and dapagliflozin was superior to dapagliflozin
alone in reducing albumin...
www.thelancet.com
November 24, 2025 at 9:53 PM
I'm not sure yet, because I think many similar studies will come: one step closer to GDMT implementation- CONFIDENCE and MIRO-CKD trials #TopNephrology
www.thelancet.com/journals/lan...
www.thelancet.com/journals/lan...
Surrogate outcomes
Screening versus prevention schools of thought
And much more in this extremely readable @hildabast.bsky.social post absolutelymaybe.plos.org/2025/11/24/t...
(Remember Nordic Cochrane aka Gøtzsche went off the rails a few years ago? This is the outcome)
Screening versus prevention schools of thought
And much more in this extremely readable @hildabast.bsky.social post absolutelymaybe.plos.org/2025/11/24/t...
(Remember Nordic Cochrane aka Gøtzsche went off the rails a few years ago? This is the outcome)
This Evidence Fundamentally Shifts the Debate About the HPV Vaccine - Absolutely Maybe
We’ve had to wait a long time to get to this point. If cervical cancer develops after HPV infection, it will take…
absolutelymaybe.plos.org
November 24, 2025 at 11:59 AM
Surrogate outcomes
Screening versus prevention schools of thought
And much more in this extremely readable @hildabast.bsky.social post absolutelymaybe.plos.org/2025/11/24/t...
(Remember Nordic Cochrane aka Gøtzsche went off the rails a few years ago? This is the outcome)
Screening versus prevention schools of thought
And much more in this extremely readable @hildabast.bsky.social post absolutelymaybe.plos.org/2025/11/24/t...
(Remember Nordic Cochrane aka Gøtzsche went off the rails a few years ago? This is the outcome)
Reposted by Swapnil Hiremath 🍁🇨🇦
Oral semaglutide disappoints in the two evoke trials, failing to reduce the rate of cognitive decline #Alzheimers disease #Dementia www.novonordisk.com/content/nnco...
November 24, 2025 at 11:31 AM
Oral semaglutide disappoints in the two evoke trials, failing to reduce the rate of cognitive decline #Alzheimers disease #Dementia www.novonordisk.com/content/nnco...
After cycling through HP, Epson and Canon (via cheap deals and google first page refs) I finally got a Brother 2 years ago.
Amen to this post (which is hilarious to read even if you are not buying a printer)
www.theverge.com/tech/641940/...
Amen to this post (which is hilarious to read even if you are not buying a printer)
www.theverge.com/tech/641940/...
Best printer 2025: just buy a Brother laser printer, the winner is clear, middle finger in the air
Best Printer 2025: wireless laser home office supply shop now Brother
www.theverge.com
November 24, 2025 at 11:43 AM
After cycling through HP, Epson and Canon (via cheap deals and google first page refs) I finally got a Brother 2 years ago.
Amen to this post (which is hilarious to read even if you are not buying a printer)
www.theverge.com/tech/641940/...
Amen to this post (which is hilarious to read even if you are not buying a printer)
www.theverge.com/tech/641940/...
Reposted by Swapnil Hiremath 🍁🇨🇦
This chart (which applies even more to social media than it did to TV) lives in my head rent free.
Social media enveloping traditional media means everything and everyone is now competing in the entertainment market. Boring stuff like policy that affects millions of lives doesn’t stand a chance.
Social media enveloping traditional media means everything and everyone is now competing in the entertainment market. Boring stuff like policy that affects millions of lives doesn’t stand a chance.
November 23, 2025 at 8:24 PM
This chart (which applies even more to social media than it did to TV) lives in my head rent free.
Social media enveloping traditional media means everything and everyone is now competing in the entertainment market. Boring stuff like policy that affects millions of lives doesn’t stand a chance.
Social media enveloping traditional media means everything and everyone is now competing in the entertainment market. Boring stuff like policy that affects millions of lives doesn’t stand a chance.
Reposted by Swapnil Hiremath 🍁🇨🇦
If I’m understanding this correctly, X is owned by a white nationalist who pays poor people of color in developing countries to pretend to be working class white Americans to scare other white Americans into being afraid poor people of color from developing countries are going to ruin America?
November 23, 2025 at 7:30 PM
If I’m understanding this correctly, X is owned by a white nationalist who pays poor people of color in developing countries to pretend to be working class white Americans to scare other white Americans into being afraid poor people of color from developing countries are going to ruin America?