The UK has the best hyperkalaemia guidelines in the world, and they’ve just been updated. No one can cover all 171 pages, but here are 3 quick important bits in a thread👇 ukkidney.org/sites/renal.org…

There's still time to reserve your place at the Interventional #Nephrology Pre-course! A day of lectures, multi-professional workshops & hands-on learning for all healthcare professionals. 📅 Sunday 4 June 🕗 8:30 - 17:30 📍 @ICCWales 🎟️ bit.ly/430pmlt

People with fatty liver disease keep asking me in my DM's for treatment advice. Here are 10 points that you can do to modify/reverse fatty liver. 1. Exercise Three types of exercise have benefits on fatty liver. Aerobic exercise, resistance training, high-intensity interval training. Include any in your routine. ▶️pubmed.ncbi.nlm.nih.gov/3380… 2. Diet It is not the carbohydrates or the fat, but the calories. Low calorie dietary interventions are most effective. Low-calorie = 1000 to 1500 calories/d with deficits of 500-750 calories/d. Apart from low-calorie deficits, the only other diet intervention with proven use is Mediterranean type without alcohol. ▶️pubmed.ncbi.nlm.nih.gov/3594… 3. Sleep Poor sleep, inadequate sleep (< 6h), non-restorative sleep and daytime napping >60 mins are all independently associated with new onset or worsening fatty liver. Pamper your liver by getting some good sleep in your routine. ▶️pubmed.ncbi.nlm.nih.gov/3591… 4. Coffee Much to the offence and annoyance of tea connoisseurs, coffee intake has been shown to reduce fatty liver disease independent of other dietary modifications [limited evidence vs no evidence]. Ideally, it is black coffee, no sugar, no milk, a minimum of 3 cups a day, complete intake before late evening & never into the night. This dose will not affect your blood pressure, in fact may reduce it. ▶️pubmed.ncbi.nlm.nih.gov/3457… 5. Alcohol The most common cause of fatty liver is possibly alcohol use. The safest level of alcohol in preventing fatty liver is ZERO. Stop alcohol use and switch to non-alcoholic alcohol-like low calorie beverages instead. ▶️pubmed.ncbi.nlm.nih.gov/3670… 6. Sugar-sweetened beverages and fructose-containing processed foods Stay away from these two. These can increase liver fat immensely and has been linked to fatty liver in both children and adults. ▶️pubmed.ncbi.nlm.nih.gov/3588… 7. Artificial sweeteners Artificial sweeteners are safer to use than natural sugars, even though preclinical studies have shown increased liver fat in animal models due to action on gut bacteria. Stevia is supposedly the safest bet among artificial sweeteners. In case of diabetes/obesity, speak with your specialist before you want to use them. ▶️pubmed.ncbi.nlm.nih.gov/3221… 8. Drug therapy There are NO approved drugs for the treatment of fatty liver disease. Recommended drugs include vitamin E and pioglitazone. NO OTHER DRUGS ARE USEFUL. These are not used life long, but only until other associated risk factors are well-controlled. Drug therapy should be initiated in only those with CONFIRMED NASH (ideally biopsy proven or Fibroscan/Shearwave). NEVER initiate treatment based on ONLY ultrasound scan fatty liver identification. ▶️pubmed.ncbi.nlm.nih.gov/3672… 9. Rational approach Fatty liver disease is a misnomer. It is really not a disease, but an association. Treatments should be aimed at controlling causes of fatty liver disease (alcohol use, diabetes, obesity, hypothyroidism, sleep disorder, sedentary life etc.) rather than liver. pharmacytimes.com/view/revie… [see management/updates section] 10. What does NOT work? Ursodeoxycholic acid, milk-thistle, green tea, omega-3 supplements, detox products, yoga (because it is not aerobic), fruitarian diets, crash diets, turmeric/cinnamon supplements, shifting to honey or coconut sugars, herbal formulations, multiherbal products, any product with "liver detox" written on it & any product or advertisement with "reverse fatty liver" written on it.

KDIGO is pleased to announce the publication of the 2022 Diabetes Management in CKD Guideline. Read the Guideline: kdigo.co/2022-Diabetes-in-CK… Read the Executive Summary: kdigo.co/2022-Diabetes-Guide… Read the News Release: kdigo.co/News-Release-2022-D… #diabetes #CKD

I'd like to nominate @jamiekwillows for the #NephKJCKidneys MVP for creating the #10TweetTweetorial for NephJC.

Management guidelines for acute pancreatitis recommend early aggressive fluid resuscitation, yet evidence supporting this approach is limited. New research findings are summarized in a short video. nej.md/3xabY0j

I’m just starting to use cystatin C as a marker for renal function, particularly in cases where Cr is probably not reliable, but I’m not super familiar with it. What should a Hospitalist know about cystatin C for gfr? @kidney_boy

Link between hypokalemia & risk of peritonitis ⁉️ ca. 2022 from @AJKDonline @BethPiraino1 #Nephpearls 👉🏼 ajkd.org/article/S0272-6386(…

In this simple 🧵: I will do my best to inflict damage on a standard 0.032" central line wire by using the #11 scalpel blade that comes with the kit. There is one minor bit of clinical relevance to this, and it is somewhat counterintuitive... (1/)

I was recently talking with my students about epilepsy and the atypical presentations auras and seizures can have... From hallucinations to deja vus, and even ... happiness?? Dostoevsky explains 👇🏽👇🏽 #NeuroTwitter #ArtTwitter

Drink coffee (at least 2 cups/day), prevent acute kidney injury kireports.org/action/showPdf…

To celebrate 1 yr of taking referrals as the renal registrar on-call, it’s time for some kidney-themed #tipsfornewdocs covering high K, AKI, “nephrotoxins”, medications, iv contrast, hypertension, & caring for kidney transplant & dialysis patients. #nephpearls (thread)

31M presents for a routine health assessment. You notice a scar in the RLQ. What would you be thinking? Open this thread and I'll share my approach. @MedTweetorials #MedTwitter @AndreMansoor @grepmed @geekymedics

Got that Saturday morning I want to hit something feeling (ideally pads)... If you haven’t already please checkout and subscribe to the Krav Maga Newcastle YouTube Channel. #selfdefence #kravmaga #youtubechannel #newcastle youtu.be/0Eyv_QUpNT8

It’s out! Teaching More About Less: Preparing Clinicians for Practice amjmed.com/article/S0002-934… #MedTwitter @Gurpreet2015 #ReadPierce

Another fantastic week at Krav Maga Newcastle! Great work with the team and fantastic to see everyone improving 👊 #KravMaga #Newcastle #Selfprotection #Selfdefence #Fitness #Challenge #Beginners

Highlight of the year @jamiekwillows

DKA in Patients on Dialysis and Anuria: Beautiful review, reinforcing our prior findings @jamiekwillows @simonjsmiths renalfellow.org/2021/10/30/d…