Swapnil Hiremath ππ¨π¦
@hswapnil.medsky.social
Nephrologist = kidney doctor
MD, MPH
Professor, University of Ottawa/Ottawa Hospital π¨π¦
He/Him/His
#NephJC co-creator; @FreelyFiltered.bsky.social pod panelist; KICR EiC
https://www.swapnilhiremath.com
MD, MPH
Professor, University of Ottawa/Ottawa Hospital π¨π¦
He/Him/His
#NephJC co-creator; @FreelyFiltered.bsky.social pod panelist; KICR EiC
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! Itβs a one-stop shop for nephrology needs
#NephSky
bsky.app/profile/did:...
Thanks again to @richardferro.xyz for creating & updating this! Itβs 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
for the 'avoid magnesium if GFR 20-30 or lower' how strong is the data? I can't imagine a single dose to cause that much harm (and hypomagnesemia is such a huge issue overall)
We are even doing a 'give more Mag in dialysis' RCT pubmed.ncbi.nlm.nih.gov/41393273/
@kidneyboy.bsky.social #EMIMCC
We are even doing a 'give more Mag in dialysis' RCT pubmed.ncbi.nlm.nih.gov/41393273/
@kidneyboy.bsky.social #EMIMCC
Outcomes of Adopting a Higher Versus Lower Concentration of Hemodialysate Magnesium as a Center-Wide Policy (Dial-Mag): A Clinical Research Protocol of a Pragmatic, Registry-Based, Cluster Randomized Trial - PubMed
www.clinicaltrials.gov; identifier: NCT04079582.
pubmed.ncbi.nlm.nih.gov
February 10, 2026 at 5:49 PM
for the 'avoid magnesium if GFR 20-30 or lower' how strong is the data? I can't imagine a single dose to cause that much harm (and hypomagnesemia is such a huge issue overall)
We are even doing a 'give more Mag in dialysis' RCT pubmed.ncbi.nlm.nih.gov/41393273/
@kidneyboy.bsky.social #EMIMCC
We are even doing a 'give more Mag in dialysis' RCT pubmed.ncbi.nlm.nih.gov/41393273/
@kidneyboy.bsky.social #EMIMCC
Reposted by Swapnil Hiremath ππ¨π¦
are you using a DEFCON-based strategy to manage bowel motility in hospitalized patients?
having a clear, evidence-based treatment strategy improves efficacy & saves time
you don't need to redesign the wheel for every patient
& helpful to avert thermonuclear war
emcrit.org/ibcc/constip... #EMIMCC
having a clear, evidence-based treatment strategy improves efficacy & saves time
you don't need to redesign the wheel for every patient
& helpful to avert thermonuclear war
emcrit.org/ibcc/constip... #EMIMCC
February 10, 2026 at 2:32 PM
are you using a DEFCON-based strategy to manage bowel motility in hospitalized patients?
having a clear, evidence-based treatment strategy improves efficacy & saves time
you don't need to redesign the wheel for every patient
& helpful to avert thermonuclear war
emcrit.org/ibcc/constip... #EMIMCC
having a clear, evidence-based treatment strategy improves efficacy & saves time
you don't need to redesign the wheel for every patient
& helpful to avert thermonuclear war
emcrit.org/ibcc/constip... #EMIMCC
are there any direct effects of retatrutide on calcium oxalate supersaturation or indirect effect as it changes your diet?
February 10, 2026 at 1:10 PM
are there any direct effects of retatrutide on calcium oxalate supersaturation or indirect effect as it changes your diet?
Reposted by Swapnil Hiremath ππ¨π¦
The Effect of SGLT2 Inhibitors aka #Flozins on Blood Pressure in Relation to Baseline Kidney Function: A Systematic Literature Review and Data Analysis
π academic.oup.com/ajh/article-... π
π academic.oup.com/ajh/article-... π
The Effect of SGLT2 Inhibitors on Blood Pressure in Relation to Baseline Kidney Function: A Systematic Literature Review and Data Analysis
AbstractBACKGROUND. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) reduce both systolic blood pressure (SBP) and diastolic blood pressure (DBP). The gl
academic.oup.com
February 10, 2026 at 12:01 PM
The Effect of SGLT2 Inhibitors aka #Flozins on Blood Pressure in Relation to Baseline Kidney Function: A Systematic Literature Review and Data Analysis
π academic.oup.com/ajh/article-... π
π academic.oup.com/ajh/article-... π
much more has been written about the gut microbiome actually - eg oxalobaxter in gut breaks down oxalate - but havenβt seen much clinically useful yet - @weddellite.bsky.social (aka Dr Calcium Oxalate) may say more
Cocktail Party Nephrology
Kidney stones are often not taken seriously, even by those afflicted with them. When my vocational interests as a lithologist are revealed at a dinner gathering or cocktail party, a nidus of stone for...
jamanetwork.com
February 10, 2026 at 11:50 AM
much more has been written about the gut microbiome actually - eg oxalobaxter in gut breaks down oxalate - but havenβt seen much clinically useful yet - @weddellite.bsky.social (aka Dr Calcium Oxalate) may say more
the urinary microbiome in calcium oxalate stones?
www.medscape.com/s/viewarticl... @medscape.com covers a PNAS story with comments from @weddellite.bsky.social
#nephsky
www.medscape.com/s/viewarticl... @medscape.com covers a PNAS story with comments from @weddellite.bsky.social
#nephsky
Hidden Bacteria Found in Common Kidney Stones
Researchers identify live bacteria within calcium kidney stones, raising new questions about stone formation and suggesting new targets for prevention and treatment.
www.medscape.com
February 10, 2026 at 11:26 AM
the urinary microbiome in calcium oxalate stones?
www.medscape.com/s/viewarticl... @medscape.com covers a PNAS story with comments from @weddellite.bsky.social
#nephsky
www.medscape.com/s/viewarticl... @medscape.com covers a PNAS story with comments from @weddellite.bsky.social
#nephsky
related case reports
cashews www.cmaj.ca/content/189/... in @cmaj.ca
Iced tea in @nejm.org www.nejm.org/doi/10.1056/...
cashews www.cmaj.ca/content/189/... in @cmaj.ca
Iced tea in @nejm.org www.nejm.org/doi/10.1056/...
Oxalate nephropathy from cashew nut intake
A 63-year-old woman was referred to a nephrologist for evaluation of decreased kidney function. The patient had no specific urinary symptoms or history of recurrent urinary tract infections, leg edema...
www.cmaj.ca
February 10, 2026 at 11:12 AM
related case reports
cashews www.cmaj.ca/content/189/... in @cmaj.ca
Iced tea in @nejm.org www.nejm.org/doi/10.1056/...
cashews www.cmaj.ca/content/189/... in @cmaj.ca
Iced tea in @nejm.org www.nejm.org/doi/10.1056/...
seems the unfortunate death of the Canadian man in ICE custody was from AKI - oxalate nephropathy
www.theglobeandmail.com/canada/artic... in the @theglobeandmail.com
www.theglobeandmail.com/canada/artic... in the @theglobeandmail.com
Autopsy of Canadian in ICE custody indicates his death was preventable, experts say
Johnny Novielloβs kidney failure would have prompted symptoms of illness in the hours or days before his death
www.theglobeandmail.com
February 10, 2026 at 10:46 AM
seems the unfortunate death of the Canadian man in ICE custody was from AKI - oxalate nephropathy
www.theglobeandmail.com/canada/artic... in the @theglobeandmail.com
www.theglobeandmail.com/canada/artic... in the @theglobeandmail.com
provider of word salad making grifting
February 10, 2026 at 2:15 AM
provider of word salad making grifting
Reposted by Swapnil Hiremath ππ¨π¦
Republicans getting destroyed by a bunny at halftime
February 9, 2026 at 8:57 AM
Republicans getting destroyed by a bunny at halftime
yeah - that grifter, now into AI and bitcoins
who would have seen that coming π
who would have seen that coming π
February 10, 2026 at 2:10 AM
yeah - that grifter, now into AI and bitcoins
who would have seen that coming π
who would have seen that coming π
Reposted by Swapnil Hiremath ππ¨π¦
The govt announced four new private orthopedic surgery facilities as part of a $125m scheme over two years to increase for-profit involvement. This is the largest single injection of public $ into for-profit health care in Ontβ& likely Cdnβhistory.
www.policyalternatives.ca/news-researc...
www.policyalternatives.ca/news-researc...
In Ontario, itβs a time of plenty for private health care while public hospitals starve - CCPA
Ontario public hospitals face large deficits even as the provincial government doles out more cash to for-profit providers.
www.policyalternatives.ca
February 10, 2026 at 1:54 AM
The govt announced four new private orthopedic surgery facilities as part of a $125m scheme over two years to increase for-profit involvement. This is the largest single injection of public $ into for-profit health care in Ontβ& likely Cdnβhistory.
www.policyalternatives.ca/news-researc...
www.policyalternatives.ca/news-researc...
Reposted by Swapnil Hiremath ππ¨π¦
Take away Spanish and there's no San Francisco or Los Angeles or Sacramento, no San Diego or Santa Rosa or Sierra nevada and actually there's no California, because that's a Spanish word...
February 10, 2026 at 1:44 AM
Take away Spanish and there's no San Francisco or Los Angeles or Sacramento, no San Diego or Santa Rosa or Sierra nevada and actually there's no California, because that's a Spanish word...
Reposted by Swapnil Hiremath ππ¨π¦
BI = empagliflozin
but they also have Vicadrostat (EASiKidney ongoing) - and i suspect this is them giving money to ADA, ASN, NKF etc - fits with the CKM angle which is the current fashionable term
but they also have Vicadrostat (EASiKidney ongoing) - and i suspect this is them giving money to ADA, ASN, NKF etc - fits with the CKM angle which is the current fashionable term
February 10, 2026 at 1:40 AM
BI = empagliflozin
but they also have Vicadrostat (EASiKidney ongoing) - and i suspect this is them giving money to ADA, ASN, NKF etc - fits with the CKM angle which is the current fashionable term
but they also have Vicadrostat (EASiKidney ongoing) - and i suspect this is them giving money to ADA, ASN, NKF etc - fits with the CKM angle which is the current fashionable term
Reposted by Swapnil Hiremath ππ¨π¦
Just imagine a world where i'm not called a provider compared to our current reality.
February 10, 2026 at 12:38 AM
Just imagine a world where i'm not called a provider compared to our current reality.
provider, physician, clinician, doctor, heakth professional, salt whisperer, blood cleaner
i honestly donβt care what i get called
thin skinned academics (and this issue is perhaps even bigger outside academia) can fill pages with silly inconsequential articles
i honestly donβt care what i get called
thin skinned academics (and this issue is perhaps even bigger outside academia) can fill pages with silly inconsequential articles
a penguin standing next to a piece of paper that says " nobody cares "
Alt: a penguin standing next to a piece of paper that says " nobody cares "
media.tenor.com
February 10, 2026 at 12:43 AM
provider, physician, clinician, doctor, heakth professional, salt whisperer, blood cleaner
i honestly donβt care what i get called
thin skinned academics (and this issue is perhaps even bigger outside academia) can fill pages with silly inconsequential articles
i honestly donβt care what i get called
thin skinned academics (and this issue is perhaps even bigger outside academia) can fill pages with silly inconsequential articles
Reposted by Swapnil Hiremath ππ¨π¦
This literally doesn't matter at all. Might things be a touch clearer if we had definitions for these words; sure. Literally nothing would change.
February 10, 2026 at 12:35 AM
This literally doesn't matter at all. Might things be a touch clearer if we had definitions for these words; sure. Literally nothing would change.
Reposted by Swapnil Hiremath ππ¨π¦
In ranking the problems with medicine in the πΊπΈ; i wouldn't rank this in the top 10k.
www.acpjournals.org/doi/10.7326/...
www.acpjournals.org/doi/10.7326/...
ACP Journals
www.acpjournals.org
February 10, 2026 at 12:33 AM
In ranking the problems with medicine in the πΊπΈ; i wouldn't rank this in the top 10k.
www.acpjournals.org/doi/10.7326/...
www.acpjournals.org/doi/10.7326/...
this kind of research is so much BS
if we criticize poor studies of ivermectin and autism, we should also criticize 99% of nutritional epidemiology studies - or be silent and not promote them?
#EpiSky
if we criticize poor studies of ivermectin and autism, we should also criticize 99% of nutritional epidemiology studies - or be silent and not promote them?
#EpiSky
February 9, 2026 at 11:14 PM
this kind of research is so much BS
if we criticize poor studies of ivermectin and autism, we should also criticize 99% of nutritional epidemiology studies - or be silent and not promote them?
#EpiSky
if we criticize poor studies of ivermectin and autism, we should also criticize 99% of nutritional epidemiology studies - or be silent and not promote them?
#EpiSky
Reposted by Swapnil Hiremath ππ¨π¦
There are few absolute rules in medicine but Β«never treat sinus tachycardia, treat the causeΒ» has extremely few exceptions.
#emimcc #cardiosky #medsky
#emimcc #cardiosky #medsky
Fresh Blog: Mythbusting the use of beta-blockers for sinus tachycardia in thyroid storm
This is one of the most dangerous & pervasive myths currently in circulation about acute care
B-bl commonly precipitate shock or even arrest in these patients...(#1/2)
blog: emcrit.org/pulmcrit/tst... #EMIMCC
This is one of the most dangerous & pervasive myths currently in circulation about acute care
B-bl commonly precipitate shock or even arrest in these patients...(#1/2)
blog: emcrit.org/pulmcrit/tst... #EMIMCC
February 9, 2026 at 6:40 PM
There are few absolute rules in medicine but Β«never treat sinus tachycardia, treat the causeΒ» has extremely few exceptions.
#emimcc #cardiosky #medsky
#emimcc #cardiosky #medsky
Reposted by Swapnil Hiremath ππ¨π¦
In a patient with AKI and hematuria, what is your diagnosis?
#DiagnoseThis #nephsky #pathsky #renal #kidneypath
#DiagnoseThis #nephsky #pathsky #renal #kidneypath
February 9, 2026 at 2:01 PM
In a patient with AKI and hematuria, what is your diagnosis?
#DiagnoseThis #nephsky #pathsky #renal #kidneypath
#DiagnoseThis #nephsky #pathsky #renal #kidneypath
Reposted by Swapnil Hiremath ππ¨π¦
Somewhat subtle case of light chain cast nephropathy by LM. Mostly fine granular casts. Rare PAS pale + two toned color casts. No cellular reaction. IF with K restricted casts confirmatory. EM demonstrates LC precipitation with uromodulin. #renalpath #nephsky #pathsky
February 9, 2026 at 4:32 PM
Somewhat subtle case of light chain cast nephropathy by LM. Mostly fine granular casts. Rare PAS pale + two toned color casts. No cellular reaction. IF with K restricted casts confirmatory. EM demonstrates LC precipitation with uromodulin. #renalpath #nephsky #pathsky
Reposted by Swapnil Hiremath ππ¨π¦
Reposted by Swapnil Hiremath ππ¨π¦
The Apple Watch has the potential to capture many undetected cases of hypertension, but with 200 million Apple Watch users worldwide, a HUGE number of people with hypertension will remain unawareβ¦ and potentially falsely reassured π€·ββοΈ
4/n
4/n
February 9, 2026 at 5:21 PM
The Apple Watch has the potential to capture many undetected cases of hypertension, but with 200 million Apple Watch users worldwide, a HUGE number of people with hypertension will remain unawareβ¦ and potentially falsely reassured π€·ββοΈ
4/n
4/n