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hswapnil.medsky.social
Swapnil Hiremath 🍁🇨🇦
@hswapnil.medsky.social
5.4K followers 3.1K following 3.2K posts
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
www.swapnilhiremath.com
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hswapnil.medsky.social
Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 28d
Update

Link changed (will not change again)

So if you liked/pinned the old feed, please do it again!

bsky.app/profile/did:...

#NephSky
hswapnil.medsky.social
Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · Sep 5
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
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hswapnil.medsky.social
Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 3h
Another diethylene glycol causing (so far 20) children’s deaths in India

www.ndtv.com/india-news/c...

Note these kind of (masala) cocktails are pretty useless - and should not be used by anyone

#MedSky #PharmSky
A picture of coldrif cough syrup containing acetaminophen, phenylephrine and dipheniramine
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Reposted by Swapnil Hiremath 🍁🇨🇦
drmaypole.bsky.social
Drmaypole @drmaypole.bsky.social · 4h
The doorknob moment files: how not to end the doctor visit.

#medsky #graphicmedicine
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Reposted by Swapnil Hiremath 🍁🇨🇦
lloydalter.bsky.social
Lloyd Alter @lloydalter.bsky.social · 6h
I saw my first Mercedes Econic garbage truck in Newcastle the other day and was so excited! This is the kind of vehicle we should be demanding in Canada to stop the killing of pedestrians and cyclists. Canada has hewed to the USA safety standards, but now is the time to go our own way.
Canada should make side guards on trucks mandatory; the usual excuse no longer works
Now that we are plotting an independent course from the USA, it’s time to develop our own safety strategies and standards.
lloydalter.substack.com
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Reposted by Swapnil Hiremath 🍁🇨🇦
kidneynerd.bsky.social
Adam HORRORster 🎃 @kidneynerd.bsky.social · 17h
Really interesting study. I would be curious to know what the average travel distance is for in centre hemodialysis given the 36% estimated contribution from travel to the overall carbon footprint

www.ajkd.org/article/S027...
Carbon Emissions From Different Dialysis Modalities: A Life Cycle Assessment
As the health impacts of climate change intensify, the health care sector faces growing pressure to minimize its carbon footprint. Achieving this goal requires understanding of the carbon impact of wi...
www.ajkd.org
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Reposted by Swapnil Hiremath 🍁🇨🇦
christosargyrop.bsky.social
Christos Argyropoulos MD, PhD, FASN 🇺🇸 0kale/acc @christosargyrop.bsky.social · 11h
The screenshots are so cool (discussed mortality up to the end of 2023)

Interview in late 2025 discusses excess deaths (estimated as 2% by the interviewee and attributed to long covid) and drops in mortality due to glp1ra estimated to be ~6% by 2030.

insurancenewsnet.com/innarticle/s...
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Reposted by Swapnil Hiremath 🍁🇨🇦
christosargyrop.bsky.social
Christos Argyropoulos MD, PhD, FASN 🇺🇸 0kale/acc @christosargyrop.bsky.social · 13h
Nice write-up. Comment: Dula is mostly used as a 4.5 mg drug as opposed to a 1.5mg drug. Having said that, one may guestimate the effect of the 4.5 mg based on AWARD-11 . Which is why I think insurances will likely implement step-up therapies for this indication.
@hswapnil.medsky.social
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Reposted by Swapnil Hiremath 🍁🇨🇦
christosargyrop.bsky.social
Christos Argyropoulos MD, PhD, FASN 🇺🇸 0kale/acc @christosargyrop.bsky.social · 9h
Eplerenone for those who don't want to grow boobs.

About to start someone on eple+aprocitentan too
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Reposted by Swapnil Hiremath 🍁🇨🇦
runningkidneys.bsky.social
Rolando Claure @runningkidneys.bsky.social · 2d
🌿 Herbal medicine: tradition… but also risk.
Some plants are nephrotoxic and can injure the kidneys.

📖 In Tropical Nephrology 2025, we review mechanisms of kidney injury linked to medicinal plants.

🔗 link.springer.com/chapter/10.1...

#Nephrology #TropicalMedicine #KidneyHealth
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hswapnil.medsky.social
Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 15h
the Lars corollary to the Hickam’s dictum?
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Reposted by Swapnil Hiremath 🍁🇨🇦
juliambisome.bsky.social
Julian Ventres, PharmD BCPS @juliambisome.bsky.social · 20h
Caveat: some meds are designed with certain pharmacokinetic goals in mind. Aminoglycosides, for example generally work better with higher peak concentrations, so splitting the dose up is counterproductive despite achieving a smoother concentration
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Reposted by Swapnil Hiremath 🍁🇨🇦
pulmcrit.bsky.social
josh farkas 💊 @pulmcrit.bsky.social · 20h
pharmacokinetics trick:

let’s say a med (eg metoprolol) is used q12hr as an outpatient

if you’re worried about causing instability, you *can* cut the dose in half and give it q6hr

there is no law that it MUST be given q12hr

smaller intervals = smoother effect & greater titratability

#EMIMCC
a close up of a man 's face with the word smoooooth written on it .
ALT: a close up of a man 's face with the word smoooooth written on it .
media.tenor.com
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Reposted by Swapnil Hiremath 🍁🇨🇦
christosargyrop.bsky.social
Christos Argyropoulos MD, PhD, FASN 🇺🇸 0kale/acc @christosargyrop.bsky.social · 23h
I commented about memorization in medical school curricula and why it is unavoidable since the post in the screenshot (and commenters) don't understand the work specs

mastodon.social/@ChristosArg...

x.com/ChristosArgy...
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hswapnil.medsky.social
Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 15h
agree, he seems to be mostly posting provocative click bait, which is not my schtick to follow
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Reposted by Swapnil Hiremath 🍁🇨🇦
jakescottmd.bsky.social
Jake Scott, MD @jakescottmd.bsky.social · 1d
“We have 1,544 measles cases this year, 92% in unvaccinated people, and 3 deaths. The problem isn’t the vaccine — it’s that people aren’t getting it. O’Neill hasn’t offered a single scientific rationale for breaking up MMR.”

@aniloza.bsky.social
@statnews.com
www.statnews.com/2025/10/06/t...
Acting CDC director calls for MMR vaccine to be broken up into three shots
There's no evidence that breaking up the MMR shot would make the immunization safer or more effective.
www.statnews.com
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Reposted by Swapnil Hiremath 🍁🇨🇦
jci.org
Journal of Clinical Investigation @jci.org · 21h
The reno-protective effects of SGLT2 inhibitors cannot be fully explained by their glucose-lowering actions.

Quaggin & team now show SGLT2 inhibition increases tissue levels of SAM, resulting in enhanced H3K27 trimethylation & repression of inflammatory genes: www.jci.org/articles/vie...
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Reposted by Swapnil Hiremath 🍁🇨🇦
odedrechavi.bsky.social
Oded Rechavi @odedrechavi.bsky.social · 1d
Fwd: Fwd: “I hope this email finds you well”
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Reposted by Swapnil Hiremath 🍁🇨🇦
peeingredagain.bsky.social
Maurice Khayat @peeingredagain.bsky.social · 1d
This encapsulates my feelings on FeNa reasonably well. It still has some good use-cases, but we need to stop using it indiscriminately for every AKI!

(Ref below, VA markup/emphasis mine)

pmc.ncbi.nlm.nih.gov/articles/PMC...
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hswapnil.medsky.social
Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 23h
The Globe did excellent investigative work tracking the spread: bsky.app/profile/hswa...
hswapnil.medsky.social
Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 16d
The ongoing spread of the most recent #Measles epidemic in North
America

From Thailand to a wedding in New Brunswick, then Ontario and Texas, Alberta

Excellent storytelling - with plenty of lessons

apple.news/Ar28W-6-hTFa... from Globe/Mail
Tracing the virus: How the measles made its way back to Canada — The Globe and Mail
The Globe travelled 40,000 kilometres to find the origin of the disease’s resurgence in North America
apple.news
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hswapnil.medsky.social
Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 1d
a cartoon of patrick and spongebob with the words team work below them
Alt: a cartoon of patrick and spongebob with the words team work below them
media.tenor.com
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Reposted by Swapnil Hiremath 🍁🇨🇦
amjhypertension.bsky.social
American Journal of Hypertension @amjhypertension.bsky.social · 1d
Potential Therapeutic Drug Targets for Hypertension Identified Using Proteomics and Mendelian Randomization

academic.oup.com/ajh/article-...
Potential Therapeutic Drug Targets for Hypertension Identified Using Proteomics and Mendelian Randomization
AbstractBACKGROUND. Hypertension (HT) is the most prevalent risk factor for cardiovascular disease (CVD) worldwide. Despite being a highly heritable trait,
academic.oup.com
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Reposted by Swapnil Hiremath 🍁🇨🇦
rnflex.bsky.social
FlexNP @rnflex.bsky.social · 1d
I'll still keep prescribing spiro thanks to the knowledge you and #NephJC have imparted upon me.

It's a fun magic trick when I switch an uncontrolled HTN patient maxed on 3 meds to spiro, and suddenly they have perfect BP. They think I have some veiled magic knowledge 😂
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hswapnil.medsky.social
Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 1d
Though in your country, if they get an indication, your perverted healthcare system will then be forced to pay for these drugs, rather than for spironolactone.

The rest of the sane world of course we’ll just use spiro 🤷🏽‍♂️
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hswapnil.medsky.social
Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 1d
Absolutely

And for hypertension we know that spironolactone, which cost pennies, is effective for lowering blood pressure in resistant hypertension.
These guys have not done a head to trial with spiro , quite clearly since it will not show superiority

www.nephjc.com/pathway/
Pathway — NephJC
Aldosterone Antagonists, on the Pathway to blood pressure control
www.nephjc.com
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hswapnil.medsky.social
Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 1d
The NHS deprescribes their excellent deprescribing program

www.bmj.com/content/391/... @bmj.com $locked

#pharmsky
“Fantastic” deprescribing programme closes due to lack of funding
The National Polypharmacy Programme, a successful patient safety programme set up by doctors and pharmacists and run by the NHS’s Health Innovation Network to cut the number of medicines patients take...
www.bmj.com
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hswapnil.medsky.social
Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 1d
Another baxdrostat new/press release www.reuters.com/business/hea...

Not sure how different these findings are from this: www.nephjc.com/news/2025/9/... covered by @brianrifkin.bsky.social

Funniest nugget, AZ expects $5 billion sales 😂.

If that truly happens it will be a spiro-shame 😭
ASIs Advance: NephJC Shorts on BaxHTN — NephJC
A NephJC short on the latest baxdrostat trial
www.nephjc.com
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