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Nayan Arora

@captainchloride.bsky.social

1.2K followers 240 following 1.1K posts

Associate Professor and APD @pdxkidney.bsky.social | Cardiorenal enthusiast | Whisky drinker, runner, dad | Filtrate on Freely Filtered 🎙️

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Nayan Arora @captainchloride.bsky.social · Nov 17

When was the last time you were paged about a serum Cl- level? Probably never.

Despite being the most abundant anion in the body, Cl- is under appreciated

🔥Here’s why it matters (esp in heart failure!)

#tweetorial #medtwitter #nephtwitter #cardiotwitter #NSMC

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Nayan Arora @captainchloride.bsky.social · 19d

I would accept a UNa

Nayan Arora @captainchloride.bsky.social · 19d

Good luck getting an accurate weight. Plus are you going to wait 24 hours before dose escalation? And then there’s 👇🏾

pubmed.ncbi.nlm.nih.gov/25595470/

Substantial Discrepancy Between Fluid and Weight Loss During Acute Decompensated Heart Failure Treatment - PubMed

Considerable discrepancy between fluid balance and weight loss is common in patients treated for acute decompensated heart failure. Awareness of the limitations inherent to these commonly used metrics...

pubmed.ncbi.nlm.nih.gov

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Reposted by Nayan Arora

Boback Ziaeian @boback.bsky.social · Aug 26

Going to add this to my lecture slides.

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Nayan Arora @captainchloride.bsky.social · 22d

Interesting diuretic resistance study. Adunctive thiazides take the lead over loop intensification? Nice discussion on mechanisms of DR, both practical and hypothetical. #nephsky

journals.lww.com/jasn/abstrac...

Loop Diuretic Dose Intensification versus Adjuvant Thiazide ... : Journal of the American Society of Nephrology

g diuretic resistance mechanism could optimize diuretic response. Methods: Patients hospitalized with heart failure and diuretic resistance (6-hour cumulative natriuresis <100 mmol after IV loop di...

journals.lww.com

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Nayan Arora @captainchloride.bsky.social · Aug 14

🤔 I happen to know @jordybc.bsky.social is a scotch aficionado

www.cnn.com/2025/08/14/h...

New blood pressure guidelines recommend skipping alcohol and an earlier start to treatment | CNN

The next time you get your blood pressure checked, expect your medical provider to be a little more aggressive about high levels. And if you like a glass of wine with dinner or a cocktail on the weeke...

www.cnn.com

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Nayan Arora @captainchloride.bsky.social · Aug 14

You can try and avoid chloride but you will suffer the wrath of God

Nayan Arora @captainchloride.bsky.social · Aug 12

Seems like a bit of a line in the sand. When kidney function worsens > than a certain threshold with decongestion you have to wonder about low flow states, pre-capillary pHTN, etc. Also not clear to me if they assessed GDMT use post d/c and if creatinine went up >40% perhaps less use of these meds?

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Reposted by Nayan Arora

Joel Topf @kidneyboy.bsky.social · Aug 8

Latest episode of @freelyfiltered.bsky.social is live! This one on the two RCTs of DDAVP to prevent renal biopsy bleeding. We had special guest Vandana Niyyar join us. @medpeedskidneys.bsky.social @captainchloride.bsky.social

www.nephjc.com/freelyfilter...

FF 82 DDAVP up the nose to prevent biopsy bleeding — NephJC

Nasal DDAVP to prevent bleeding complications from renal biopsy, the results of two randoized, placebo controlled, trials.

www.nephjc.com

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Nayan Arora @captainchloride.bsky.social · Aug 6

Thank you to @asnpublications.bsky.social #JASN for letting us write this. Important topic that's unfortunately devoid of robust data for many of our patients. #nephsky

journals.lww.com/jasn/abstrac...

Remote Measurement of Volume Status in Heart Failure : Journal of the American Society of Nephrology

ed with telemedicine services, have failed to improve outcomes. Implantable hemodynamic monitors allow clinicians to obtain meaningful, objective data, with an opportunity for early intervention to im...

journals.lww.com

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Nayan Arora @captainchloride.bsky.social · Jul 22

Ugh you’re right! Fat fingers strike again

Nayan Arora @captainchloride.bsky.social · Jul 21

Interesting study in pts w/T1D w/ or w/out flozins and comp. With healthy controls. Less glomerulomegaly on routine biopsies. Flozins impacted metabolic transcripts throughout the nephron - ie the effect wasn’t isolated to the proximal tubule. Showing they are powerful metabolic drugs. #nephsky

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Nayan Arora @captainchloride.bsky.social · Jul 17

Yikes - gotta switch to the British baking show - unless you have some dirt on that too…

Nayan Arora @captainchloride.bsky.social · Jul 17

If you're applying to a Nephrology fellowship, let @glaucomflecken.bsky.social tell you why you need to come to @pdxkidney.bsky.social. Then let us tell you what makes it such a great and unique training program! #nephsky

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Nayan Arora @captainchloride.bsky.social · Jun 21

100% - sacubitril/valsartan is underutilized and makes a huge difference. In the clinic world it is much more common for us to de-escalate diuretics with appropriate GDMT rather than need to escalate.

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Nayan Arora @captainchloride.bsky.social · Jun 21

We use this for some patients in our cardiorenal clinic. Not sure it has reduced admissions but makes us feel better and patients seem to like it

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Nayan Arora @captainchloride.bsky.social · Jun 20

Our fellows taste testing tap water vs. RO water! #nephsky

Nayan Arora @captainchloride.bsky.social · Jun 19

#nephsky

OHSU Nephrology @pdxkidney.bsky.social · Jun 19

Congratulations to all our incredible graduating fellows! Excited to see what comes next for these wonderful individuals.

Nayan Arora @captainchloride.bsky.social · Jun 6

Oh yea totally incorrect thread - was talking about ACHIEVE

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Nayan Arora @captainchloride.bsky.social · Jun 6

The only way to potentially get a positive trial is to do this in patients with HFrEF on dialysis

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Nayan Arora @captainchloride.bsky.social · Jun 6

Im not that surprised. Did they show what % of patients had heart failure?

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Nayan Arora @captainchloride.bsky.social · Jun 3

Do you feel like you need all 3 to attain adequate natriuresis in these folks or just a believer in more balanced diuresis?

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Nayan Arora @captainchloride.bsky.social · Jun 3

It would be a positive study and maybe even show decreased length of stay by avoiding interruptions in diuresis

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Nayan Arora @captainchloride.bsky.social · Jun 3

The main study I quote is the Shweta Bansal one Joel highlighted. It works but you need high doses and there’s lag time so better to use amiloride for ADHF

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Nayan Arora @captainchloride.bsky.social · May 27

Are we going to get emails from you with the subject line “fork in the road”?

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Reposted by Nayan Arora

Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · May 27

ICYMI

@captainchloride.bsky.social on the art of decongestion in heart failure
Embracing hypercreatininemia
Flozins or Acetazolamide
How to use Urine Na+
Do we believe the Italian HTS RCTs?

www.youtube.com/watch?v=3m2b...

#NephGR

The Art of Decongestion with Dr. Nayan Arora

YouTube video by Ottawa Nephrology

www.youtube.com

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