Atul Bali, MD, CHS, FASN, FNKF

Nephrologist, Certified Hypertension Specialist, Rural Healthcare Advocate.

All views expressed are my own.

[Atul Bali, MD, CHS, FASN, FNKF @AtulBaliMD]

@Muppet_Father @DGlaucomflecken That's a salt.

[Atul Bali, MD, CHS, FASN, FNKF @AtulBaliMD]

@realarainmd @jbspadoni @SripalBangalore @evandrofilhobr @aspergian1 @ziadalinyc @rajivxgulati @jedicath @ESHLOF @Laserrman @MauroCarlino3 @DrBIqbal @tadano98 @MichaelMegalyMD @Hragy @stefan_harb @SarahFairley7 @TWilsonMD @jl35wilsonMD @MarekRadomski71 @KovacicMihajlo @DrIHHashmi1 @ABaliMD I think it's the former. This is why the risk of contrast nephropathy is very low in outpatient procedures in clinically stable patients. But I'm not ready to abandon the idea of risk in acutely ill, volume depleted patients, and those with CKD in the inpatient setting.

[Atul Bali, MD, CHS, FASN, FNKF @AtulBaliMD]

@realarainmd @jbspadoni @SripalBangalore @evandrofilhobr @aspergian1 @ziadalinyc @rajivxgulati @jedicath @ESHLOF @Laserrman @MauroCarlino3 @DrBIqbal @tadano98 @MichaelMegalyMD @Hragy @stefan_harb @SarahFairley7 @TWilsonMD @jl35wilsonMD @MarekRadomski71 @KovacicMihajlo @DrIHHashmi1 @ABaliMD Don't fear the contrast my friend!

https://t.co/RV1TqzQa3E

#SayNoToRenalism

[Atul Bali, MD, CHS, FASN, FNKF @AtulBaliMD]

@realarainmd @jbspadoni @SripalBangalore @evandrofilhobr @aspergian1 @ziadalinyc @rajivxgulati @jedicath @ESHLOF @Laserrman @MauroCarlino3 @DrBIqbal @tadano98 @MichaelMegalyMD @Hragy @stefan_harb @SarahFairley7 @TWilsonMD @jl35wilsonMD @MarekRadomski71 @KovacicMihajlo @DrIHHashmi1 Did you tag me to see if I cringe at the sight of contrast?

Or were you looking for my doppelganger, @ABaliMD?

[Atul Bali, MD, CHS, FASN, FNKF @AtulBaliMD]

@kidney_boy That seems purposely dismissive. Would it be fair to make a similar graph for mortality from COVID-19, as a percentage of total infections?

[Atul Bali, MD, CHS, FASN, FNKF @AtulBaliMD]

@MobiusDick @kidney_boy I'm primarily referencing etiology.

A serum sodium of 120 mEq/L has very different clinical implications in beer potomania vs SIADH vs advanced liver cirrhosis.

[Atul Bali, MD, CHS, FASN, FNKF @AtulBaliMD]

@kidney_boy I would hate to have someone misinterpret these results as "let's correct hyponatremia faster because slow correction leads to death, and rapid correction rarely leads to ODS".

[Atul Bali, MD, CHS, FASN, FNKF @AtulBaliMD]

@kidney_boy All hyponatremia is not the same, of course.

Slow correction often occurs when the factor(s) causing hyponatremia are advanced, irreversible, or difficult to reverse. Think malignancy or liver cirrhosis.

[Atul Bali, MD, CHS, FASN, FNKF @AtulBaliMD]

@kidney_boy It only took me 10 minutes to get to Supplement 3.

I don't see the problem here.

Probably because of all the tears welling up in my eyes, obscuring my vision.

[Atul Bali, MD, CHS, FASN, FNKF @AtulBaliMD]

@kidney_boy As the nephrologist, you're the only qualified to put "p" where there isn't any.

[Atul Bali, MD, CHS, FASN, FNKF @AtulBaliMD]

"It was only after the @nytimes correction was issued, that the protesting members of the @ASNKidney called off the hunger strike."

[Kam Kalantar-Zadeh, MD, MPH, PhD @kamkalantar]

In Extreme Heat, Do You Need More Electrolytes?
"A @nytimes correction:
An earlier version of this story .... also incorrectly described having too little sodium in the blood due to lost electrolytes as hyponatremia. it occurs when the sodium in the blood is diluted by too much water, regardless of the amount of sodium in the body."
https://t.co/g70qURXV2V
@weddellite

[Kam Kalantar-Zadeh, MD, MPH, PhD @kamkalantar]

In Extreme Heat, Do You Need More Electrolytes?
"A @nytimes correction:
An earlier version of this story .... also incorrectly described having too little sodium in the blood due to lost electrolytes as hyponatremia. it occurs when the sodium in the blood is diluted by too much water, regardless of the amount of sodium in the body."
https://t.co/g70qURXV2V
@weddellite

[Atul Bali, MD, CHS, FASN, FNKF @AtulBaliMD]

@acweyand *Pro tip

[Atul Bali, MD, CHS, FASN, FNKF @AtulBaliMD]

@kidney_boy Hold my Empagliflozin.

[Atul Bali, MD, CHS, FASN, FNKF @AtulBaliMD]

@alexchangmd Watching the debate with your little one?

[Atul Bali, MD, CHS, FASN, FNKF @AtulBaliMD]

@NephRodby I heard you speak on acid base balance on BRCU in 2014, and I still enjoy calling the lungs "dumb little dialyzers" much to the chagrin of the ICU staff. Thank you for that memorable lecture!

[Atul Bali, MD, CHS, FASN, FNKF @AtulBaliMD]

@kidney_boy My critique of the KFRE was from the perspective of patients trying to understand its implications to their health and perhaps getting a kidney-centric understanding without realizing the implications to their cardiac health.

[Atul Bali, MD, CHS, FASN, FNKF @AtulBaliMD]

@kidney_boy I'm also glad that albuminuria is only a biomarker for kidney disease and has no implications whatsoever on cardiovascular outcomes.

[Atul Bali, MD, CHS, FASN, FNKF @AtulBaliMD]

@Beandoc2 @kidney_boy I have often wondered that!

[Atul Bali, MD, CHS, FASN, FNKF @AtulBaliMD]

@KatieKwonMD @GlassockJ @kidney_boy I can't take credit for it! It's been in use for a few years now.