missing sepsis - bad
misdiagnosing another catastrophe as “sepsis” - also bad
it almost makes me think that maybe we should specially train people how to identify and differentiate these disease processes and provide personalized care 🤔
B-cell therapies deserve to have a good chance at taking the title!
I will say that’s a harmful attitude to take for a specialty having such difficulty recruiting. Most of the VEXUS-AKI data is being led by intensivists, not nephrologists.
Personally I don’t think we should forfeit skills
Listen to this special #NephMadness episode of @coreimpodcast.bsky.social to hear @shreyatrivedimd.bsky.social, @noahmarkewitz11.bsky.social , and @jrkott27.bsky.social discuss all things POCUS:
www.coreimpodcast.com/2026/03/23/p...
Stop guessing, start scanning!
Read more about POCUS in Nephrology ⬇️
ajkdblog.org/2026/03/01/n...
#nephmadness
Our patient? Now safely on diuretics. 🌊➡️🟡
#POCUS takes the guesswork out of your management.
🟢IVC/#VExUS is just the beginning.
You can take it even further and evaluate:
1️⃣ RV Pressure/Function
2️⃣ LV Systolic Function/Output
3️⃣ LV Diastolic Function/Pressure
And more!
Our patient?
🔴 Portal Vein: >50% Pulsatility
🔴 Intrarenal Vein: Loss of systolic flow
This is #VExUS Grade 3! 🚨🌊
Despite being "net even" and having no peripheral edema, the kidneys are congested.
This isn't just ATN! It's Congestive Nephropathy.
#VExUS lets us see how that high pressure is affecting flow through our major organs. 🩸🌊
Is the kidney "congested" or just the IVC?
See the "how-to" and grading below, courtesy of
@nephropocus.bsky.social
:
🔗 nephropocus.com/2020/12/12/w...
#NephMadness #MedTwitter
👀The IVC was large and non-variable with respiration.
Great, so CVP is high. Does that mean our AKI is more than just ATN?
Well, lets take it one step further with #VExUS.
Is that pressure is actually "backing up" and causing our AKI? 🌊
Let's start with our 🍞 & 🧈: Inferior Vena Cava (IVC) US.
IVC is our surrogate for CVP:
🔴 Big + non-variable = ⬆️ CVP
🔴 Small + variable = ⬇️ CVP
⚠️ Remember: IVC 🚫🟰 Fluid responsiveness.
So, how does our patient look?
We dove deep into the data for the #NephMadness POCUS Region this year, but let's talk real-world implementation
👴CKD3b
🫁 Septic shock
💧 3 days in, "net even," no edema. On RA
📉 Cr 3.3 ➡️ 4.5.
Easy diagnosis of ATN, right?
Fluids? Diuretics? Watch and Wait? or #POCUS!
🧵👇
POCUS for Vascular access is a win-win. Both dialysis patients and nurses agree: POCUS makes fistula cannulation easier and more precise. 💉
#Nephmadness
Read more about how POCUS can help individualize your patient care ⬇️
ajkdblog.org/2026/03/01/nep…
#Nephmadness @nephmadness.bsky.social
Worried about obstruction? POCUS cuts diagnosis from hours to minutes. ⏱️
Rising Cr during diuresis or SOB at "dry weight"? Stop guessing with physical exams and I/Os. POCUS gives you real-time volume assessment when it matters most.
#POCUS #NephMadness #Nephrology
“It’s not what you look at that matters, it’s what you see”
#POCUS is a non-invasive tool, that allows us to see physiology in motion and track how our treatments transform it in real time.
#ER / #CriticalCare have lead the way, but how does it fit in nephrology?
#Nephmadness
Stop guessing, start scanning. 🔍 POCUS is changing the game for our sickest patients by bringing real-time physiology to the bedside. Dive into the @NephMadness POCUS region now! ⤵️
ajkdblog.org/2026/03/01/nep…
#nephmadness
#NephMadness 2026: Meet the Gamemakers
bit.ly/3Nk10Ap
@nephrosparks.bsky.social @annaburgner.bsky.social @kidneywars.bsky.social @jrkott27.bsky.social @catochita.bsky.social @ssfarouk.bsky.social
Coming down to last few days! Make sure to submit your bracket!
www.tourneytopia.com/AJKD/NephMad...
#nephmadness
#NephMadness Commentary on Hemodialysis Region by Mariana Murea:
The Future of Dialysis Personalization
bit.ly/NM25MureaCommentary
Great day to break out the 2023 #nephmadness champion shirt!
@ssfarouk.bsky.social
#NephMadness 2025: Hemodialysis Region
bit.ly/NM25Hemodial...
Teams:
- Hemodiafiltration
- Incremental Dialysis
Expert: Mariana Murea
Writer: Manasi Bapat
Execs: @jrkott27.bsky.social & Dia Waguespack
#NephMadness 2025 is here!!! ajkdblog.org/2025/03/01/w...
Happy #Nephmadness!
Check out ajkdblog.org/2025/03/01/w... for everything kidney related! We have 8 great regions this year!