AdolfoDíazC

Residente de Nefrología en el @NefroINCMNSZ| Medicina Interna en el @ABCcentromedico | Entusiasta de la educación médica continua en #medtwitter

[Ale Orozco @Ale_OrozcoINPer]

Acompáñenos a descubrir 8tips que todo nefrólogo debe saber sobre embarazo y enfermedad renal. Save the date! Los esperamos!

[AdolfoDíazC @adolfodiazca]

@JonathanNefro Cloruro es la clave!

[Pablo Galindo @galindozip]

Les comparto nuestro nuevo artículo en @CKJsocial
Colaboración de @IntervenNephMx , @Issemym Ecatepec y @hgm_nefrologia 🇲🇽

Seguridad y factibilidad de:
DIÁLISIS INMEDIATA (< 24 h al inicio de diálisis)
-80% <6 horas
-Percutaneo > Quirúrgico

https://t.co/T7GxvfOoMu

[AdolfoDíazC @adolfodiazca]

@Ale_OrozcoINPer @NefroINCMNSZ @NefrologiaINC @hgm_nefrologia @HospitalJuarezM Gracias a ti por tu tiempo y esfuerzo!! Es un privilegio y un orgullo poder aprender de ti. 🫶🏼

[Ale Orozco @Ale_OrozcoINPer]

Thank you to all the nephrologists and gynecologists who visited us this year to learn a little obstetric nephrology, they are a pride for us. Many congratulations! Este año formamos en nefro obstétrica a más de 30 nefrólogos y a 20 obstetras.Muchas felicidades!

[Eduardo R Argaiz @ArgaizR]

Fantastic work from our friends in 🇨🇱!

So proud to have collaborated on this 🇨🇱🇲🇽🇬🇧

https://t.co/LbDGdzXMZq

[Ashley Miller @icmteaching]

1️⃣
We can remove fluid at rates up to 12 mL/kg/h and blood pressure often holds.
That limit isn’t arbitrary – it comes from dialysis data showing steep rises in hypotension and mortality above it.
It marks the upper boundary of how fast plasma can be refilled from the interstitium and lymph 👇

[Ashley Miller @icmteaching]

1️⃣We talk endlessly about “capillary leak” – but most of what we say about it is wrong.

Here’s what actually drives fluid movement across the microcirculation – and why Starling’s model needed an upgrade. A 🧵👇

[Ashley Miller @icmteaching]

Excellent response from Tom Woodcock – the real expert behind the extended Starling concept.
He’s spot on: this paper repeats several old misunderstandings.

Kinetic “volumes” (Vt1, Vt2) are fitted parameters, not anatomical spaces.
Re-labelling the slow-exchange compartment as a “third space” confuses maths with physiology.

At true steady state you can’t be oedematous and intravascularly dry – that’s a transient disequilibrium or an externally driven loss (bleeding, ultrafiltration). (Detailed thread coming on this soon)
Calling it a “third space” ignores mass balance and extended Starling physiology.

The irony is in the albumin section: the paper admits that hyper-oncotic albumin expands plasma by increasing lymph return, not by venular re-absorption.
That’s exactly what the extended Starling model predicts – refill without re-absorption.

Good kinetics ≠ good physiology.
Until we see paired Pc, Pi, πc and lymph-flow data, “slow-exchange space” remains a curve-fit artefact, not a rediscovered compartment.

#MedX #FluidTherapy #Physiology

[ANDROMEDA-SHOCK @AndromedaShock]

Our 6th Hemodynamic Monitoring and Tissue Perfusion Course (online, bilingual) is coming soon (Nov 19-21)! ANDROMEDA-SHOCK-2 will be extensively discussed there😍. Link in the poster below

[Daniel Coyne @DrDanMO]

I told you IV iron was safe and effective. Now we have a observational evidence (propensity matched study in about 15,000 pts with MRSA infections and 27,000 with pneumonia) that it may be beneficial.

[Ashley Miller @icmteaching]

@rajathadrihr @ThinkingCC @khaycock2 @PulmCCM @ross_prager https://t.co/f5otzzoUUo

[Ross Prager @ross_prager]

(1/x) Andromeda-Shock 2 was just published in JAMA and is the most important septic shock trial in the past DECADE.

They found that phenotyped resuscitation improves the composite outcome of mortality, vital support, and hospital LOS.

Here's how you can apply this protocol to your practice 👇

[Dr. Miguel Ibarra-Estrada @DrMiguelIbarra1]

The ANDROMEDA-SHOCK-2 is finally released!! We found that a personalized resuscitation targeting capillary refill time through simple bedside hemodynamic tools was superior to usual care for the composite of mortality/vital support/hospital stay and for faster decrease in SOFA.

[Pablo Galindo @galindozip]

Les comparto nuestro nuevo Artículo Original

Describimos, validamos y automatizamos un método para predecir urea y electrolitos post hemodiálisis, únicamente con la prescripción https://t.co/8PV9lLzB8G

BMC nephrology 2025

Léelo gratis 👇
https://t.co/YCCTj3Ovds

[Ashley Miller @icmteaching]

1️⃣
Some patients with severe venous congestion have almost no oedema — and that’s confusing at first.
It only starts to make sense once you unpack the physiology. 👇

[AdolfoDíazC @adolfodiazca]

@drahmedmohsen85 Tips

[Ahmed Mohsen @drahmedmohsen85]

💊 Tips & Tricks in Beta-Blockers
🔹 Nebivolol: most selective β1 → best for asthma/COPD
🔹 Bisoprolol/Metoprolol: best rate control
🔹 Nebivolol: lowest ED risk
🔹 Carvedilol/Nebivolol: best BP effect

📘 From my book: Tips and Tricks in Cardiology
✉️ Type “tips” if interested

[Brenda Delgado @Bren_981]

“Glomerular Diseases and Onconephrology: A Case-Base Review”

Thanks to @Nephr0s for sharing your clinical and academic expertise in this expanding field.

🫘@NefroINCMNSZ

[Muthu Vaduganathan @mvaduganathan]

🔥 New in @NatureMedicine

How do you communicate lifetime benefits expected with HFpEF therapies?

New data from 3 RCTs (#DELIVER #FINEARTS #PARAGON) estimate up to *5 years* of event-free survival w combination Rx

#GDMT for HFpEF has finally arrived!

🔗https://t.co/ozSx3UwkLN