Dr Saikumar Doradla 🇮🇳

Consultant Nephrologist at Aster Ramesh hospital, Guntur
Alumini of SGPGI Lucknow, JIPMER

[Dr Saikumar Doradla 🇮🇳 @saikum37]

@fly91_IN Ok

[Dr Saikumar Doradla 🇮🇳 @saikum37]

@fly91_IN Request for rescheduling of my flight

PNR: M22ALX
Flight Number: IC3306
Current Travel Date: 19 June
VGA TO HYD
Current Timing: 17:40 hrs – 18:50 hrs

I would like to change my booking to the FLY91 flight operating on 20 June on the same time 17.40-18.50 on 20th june

[Dr. Chacón-Lozsán F .'. @franciscojlk]

🩻Contrast-induced AKI:
one of the biggest myths still shaping clinical decisions

For decades we were taught:

👉 “Contrast damages the kidneys”
👉 “Avoid CT with contrast in CKD”
👉 “Hydrate, protect, delay imaging if needed”

But what if… most of this is wrong?🤔

->The uncomfortable reality

Modern evidence shows:

👉 Low-osmolar contrast rarely causes true nephrotoxicity
👉 Even in CKD, AKI, and ICU patients
👉 The risk is often overestimated—or nonexistent

So where did the fear come from?

📍 1950s high-osmolar contrast (actually toxic)
📍 Poorly controlled observational studies
📍 “Creatinine rise = contrast injury” assumption

👉 Correlation became causation
👉 And the dogma stayed

⚠️What recent data tells us

✔ No difference in AKI rates with vs without contrast
✔ No benefit from bicarbonate, NAC, or aggressive hydration
✔ Even ICU and AKI patients show no worsening outcomes

->Translation to real life

👉 The patient was going to develop AKI anyway...Not because of contrast!!

->The real problem: “Renalism”

👉 Avoiding necessary imaging
👉 Delaying diagnosis
👉 Choosing inferior tests

And that leads to:

❌ Missed PE
❌ Delayed sepsis source control
❌ Worse outcomes

->Clinical mindset shift

Instead of asking:

👉 “Will contrast harm the kidneys?”

We should ask:

👉 “Will NOT doing the scan harm the patient?”

->Who still deserves caution?

✔ eGFR <30
✔ Severe hemodynamic instability
✔ Multiple nephrotoxins

Even then:

👉 Optimize volume
👉 Minimize dose
👉 Don’t delay critical imaging

🤓Bottom line

✔ Contrast nephrotoxicity exists… but is rare
✔ The fear is bigger than the risk
✔ The harm of NOT imaging is often greater

In critical care

👉 We don’t treat creatinine
👉 We treat patients

And sometimes…

👉 The most dangerous thing is NOT the contrast

👉 It’s hesitation.

📃Reference
Florens N, Demiselle J.
Kidney360 7: 445–449, 2026. doi: https://t.co/CWzi7WC9Wx

[Dr. Hardik Patel 🩺💉 @hardik4u24]

💥 #CriticalCare Nephrology Myths vs Reality🫘

📸A brilliant snapshot busting 10 persistent false beliefs in #AKI &amp; #RRT —and what the evidence actually tells us

Essential read for every ICU &amp; nephro clinician

🔗https://t.co/WAlObLYu6B

#NephroTwitter #ICU #RRT #MedEd

[Dr Saikumar Doradla 🇮🇳 @saikum37]

#ISOT2025 Very Nice talk on Immunological aspects of retransplant by @SajithNarayan16

[Jasmine Sethi @JasmineNephro]

🫘💎 Drug therapy for Nephrolithiasis in adults

@ERAkidney Neph Manual 👇

✅Calcium stone former-Thiazide diuretics/alkali

✅Struvite-Antibiotics

✅Uric acid stone-Xanthine oxidase inhibitors

[Anjana Gopal, MBBS, MD, DM Nephrology, FASN @AnjanaGopal9]

Zigakibart is a humanised monoclonal antibody for treatment of IgA nephropathy.
Dr Jonathan Barratt discussed the phase 1/2 trial results of Zigakibart at #isnwcn
Eagerly waiting for the phase 3 BEYOND trial results.

[Dr Saikumar Doradla 🇮🇳 @saikum37]

Target bp for initiating anti HTN therapy in pregnancy is 140/90 mm hg (CHAP trail 2022) not 160/90mmHg

[Dr Saikumar Doradla 🇮🇳 @saikum37]

Talk by @silvishah on pregnancy and ckd

[Dr Saikumar Doradla 🇮🇳 @saikum37]

Excellent talk by Teerawat Thanachayanont on Drug stewardship and symptom management in CKD
#ISNWCN

[Dr Saikumar Doradla 🇮🇳 @saikum37]

@AnjanaGopal9 They can also cause hypercalcemia which is less known than AIN

[Dr Saikumar Doradla 🇮🇳 @saikum37]

Do you know immune check point inhibitors can cause hypercalcemia

[Dr Saikumar Doradla 🇮🇳 @saikum37]

Hypercalcemia #ISNWCN

[Dr Saikumar Doradla 🇮🇳 @saikum37]

DKD Management 2025 @ISNWCN

[Dr Saikumar Doradla 🇮🇳 @saikum37]

@MushtaqBilalPhD Mzs

[Indian Society of Nephrology @isn_india]

TTS Education Committee in collaboration with the Indian Society of Nephrology presents a Webinar on - Urinary Tract Infections after Transplantation.
#nephtwitter
Friday, Aug 23, 2024 - 09:00 AM (Montreal Time), 6.30 PM IST.
Link to Register 👉 https://t.co/Y5j6kSVo7u