Precious Bodily Fluids
225 FOLLOWERS
I am a board certified clinical nephrologist in Detroit. I am a partner at St Clair Nephrology. I am an Assistant Clinical Professor at Oakland University William Beaumont School of Medicine and part of the faculty for The St John Hospital and Medical Center Nephrology Fellowship.
Precious Bodily Fluids
4M ago
Today I was honored to give Medicine Grand Rounds at MedStar Health in Baltimore. Here is a wlk through and bibliography for this talk. Title slide. Slides are available for download at: Keynote What’s New in Nephron Town (31.7 MB) PowerPoint What’s New in Nephron Town (16.9 MB) Note: I create, rehearse and deliver the presentation in Keynote. The ..read more
Precious Bodily Fluids
5M ago
This summer I was really optimistic. I was riding a #Flozin high that was being further buoyed by the successes of finerenone. Long dormant fields were yielding fresh life. How long has it been since we’ve had this much investigation into glomerulonephritis? So many trials. So many agents. This is how I started a letter ..read more
Precious Bodily Fluids
5M ago
I have been workshopping this one for awhile in my mind and today I carved out a few hours to create it. It starts here Part of the inspiration for this came from an epic message on the Channel Your Enthusiasm back channel by Roger Rodby Here is the draft of the script. Diffusive vs ..read more
Precious Bodily Fluids
5M ago
I have a long-time patient who came in yesterday and we were reviewing their labs together and noted a tremendous success. The patient’s albuminuria has fallen 90% since 2018. This is due to adding and then maximizing losartan, adding dapagliflozin, and most recently starting finerenone. Here is the albuminuria over time: Over that time their ..read more
Precious Bodily Fluids
7M ago
It saddens me that #MedTwitter is dissolving but sometimes the old #MedTwitter shines through. A few weeks ago I published a Tweetorial on Gadolinium. Great comments. Great engagement. https://x.com/kidney_boy/status/1703404139819000031?s=20 ..read more
Precious Bodily Fluids
8M ago
I create all of my presentations in Keynote. In the past I was able to present them in Keynote but due to construction and having to give lectures in 156 of North Foundation I had to convert the presentations to PowerPoint. And then hope that PowerPoint on the PC was mostly like PowerPoint on the ..read more
Precious Bodily Fluids
8M ago
This is a frequent cause of confusion. I know myself was confused about this, and I believe the source of this was poor teaching by misinformed mentors when I was a medical student. Take this ABG: pH: 7.26 PaCO2: 80 HCO3: 39 The Henderson-Hasselbalch variables are moving in discordant directions (pH down, pCO2 and HCO3 ..read more
Precious Bodily Fluids
8M ago
No. You will be provided an equation cheat sheet. Here is the one we used last year. I don’t expect there to be a change this year ..read more
Precious Bodily Fluids
9M ago
How does hyperkalemia or even alkalosis suppress NH3 production? So the mechanism is not completely worked out but the conventional explanation is… Hypokalemia causes potassium to shift out of the cells. Hydrogen ions then move on the opposite direction into cells to maintain electroneutrality. This causes intracellular acidosis. The intracellular acidosis causes the cells of ..read more
Precious Bodily Fluids
9M ago
If you are a reader and need a book to help you understand renal physiology, may I suggest: Renal Physiology by the Bruces (Koeppen and Stanton) Amazon It is well written and is targeted at pre-clinical medical students. We are using it for our fellow renal physiology class and I don’t love it for that ..read more