Why I believe KDIGO erred in defining AKI One should not ignore physiology

I have just posted on substack - why I believe KDIGO made an error with the label AKI. Would love to hear your comments.

leadingrounds.substack.com/p/why-i-beli...

Great question I think it’s a little bit of all three

Hard to say. Probably not properly diagnosing the cause of CKD

Spironolactone vs Amiloride for Resistant Hypertension This randomized trial assesses whether amiloride is noninferior to spironolactone in reducing home-measured systolic blood pressure among patients with resistant hypertension.

Amiloride is back.
Now for resistant HT👏
jamanetwork.com/journals/jam...

Annals On Call - Chronic Kidney Disease: What Generalists Need to Know | Annals of Internal Medicine

#UncleBob proudly presents my first soliloquy podcast

Annals On Call - Chronic Kidney Disease: What Generalists Need to Know (Annals of Internal Medicine) www.acpjournals.org/doi/10.7326/...

He Was Sure Dialysis Had Caused His Belly Pain. But Why? The patient’s symptoms had sent him to the emergency room 22 times in the past year.

Cool diagnosis in a dialysis patient

www.nytimes.com/2025/05/02/w...

@rmcentor.bsky.social in the NYT

H/t @doctorajgu.medsky.social

#NephSky

Build sustainable schedules to support physician well-being Physician schedules often fail to account for time spent on nonpatient-facing tasks. R. John Sawyer, PhD, of Ochsner Health, shares what to change.

Build sustainable schedules to support physician well-being www.ama-assn.org/practice-man...

Podcast

Annals On Call - Lack of Control and Physician Burnout Annals of IM www.acpjournals.org/doi/10.7326/...
featuring Dr. Chris Sinsky

Please share with every administrator you know.

I have not been giving furosemide more than once daily. If I increase I increase the dose. If 40 mg isn’t working then 40mg bid won’t work either. Furosemide is a threshold drug

Severe Acute Pharyngitis Caused by Group C Streptococcus Adult group C beta-hemolytic streptococcal pharyngitis has a prevalence of approximately 5%. It can present with a broad spectrum of severity. We report a 30-year-old woman who presented with severe G...

Recently had a relative (adolescent) with a severe sore throat, despite antibiotics (had a + strep test), was not improving. Embedded in this case report is how I think about worsening sore throat - pmc.ncbi.nlm.nih.gov/articles/PMC...

The main differential was PTA vs mono - he had mono and strep!

Back in 1975 I was taught to first check a urine Na and K. If the urine K was greater than Na - start spironalactone at 100 and recheck. Until the urine Na was greater than the urine K, increase the spironalactone. Once urine Na > K, then start 40 mg furosemide each day. I still use this model.

Roberta Flack, Virtuoso Singer-Pianist Behind ‘Killing Me Softly,’ Dies at 88 (Gift Article) With majestic anthems like “Killing Me Softly” and “The First Time Ever I Saw Your Face,” Ms. Flack, a former schoolteacher, became one of the most widely heard artists of the 1970s.

Explore this gift article from The New York Times. You can read it for free without a subscription. www.nytimes.com/2025/02/24/a...
Wonderful tribute to an outstanding singer.

Annals On Call - Teaching Diagnostic Reasoning | Annals of Internal Medicine

Annals On Call - Teaching Diagnostic Reasoning | Annals of Internal Medicine www.acpjournals.org/doi/10.7326/...

very worthwhile discussion with Rabih Geha and Reza Manesh

Wonderful morning (after a brutal windy storm overnight). Went for a long walk using the Peloton app. Listened to a walking outside featuring the music of Chaka Khan. It was 30 minutes, and I used it twice. Walked over 3.3 miles
Any #PeletonDocs out there?

Bobby Darin - Mack The Knife (1959) YouTube video by 1950s MUSIC

As I recall, this was the first song that I totally obsessed over. I was released in 1959 when I was 10. Just could not listen to it enough.

Bobby Darin - Mack The Knife (1959) youtu.be/rRnXE6Z6NaQ?... via @YouTube

As you probably know, I host Annals on Call - based on articles from the Annals of Internal Medicine. While I often use new articles, sometimes I go back to classics. Do you have an old Annals article that you think would make a good podcast?
Thanks in advance.

@kidneyboy.bsky.social has taught be this, but Perplexity has helped:

To provide 15 mEq of bicarbonate using baking soda:
• 1/2 teaspoon of baking soda contains approximately 27 mEq of bicarbonate .
• Therefore, 1/4 teaspoon of baking soda would provide roughly 13.5 mEq, close to 15 mEq.

Annals On Call - Evidence-Based Treatment of Low Back Pain | Annals of Internal Medicine

Annals On Call - Evidence-Based Treatment of Low Back Pain | Annals of Internal Medicine www.acpjournals.org/doi/10.7326/...

Very useful discussion of this frustrating problem

I was asked to host Annals on Call in 2018. Loving podcasts myself, I wanted to see if I could do this well. Continued positive feedback has encouraged me to record (over 150 episodes).

There is nothing like having a conversation with an expert to learn something.

Hoping some rheumatologists here. 30 years ago I had a patient with classic symptoms of PMR and sero-negative RA. The rheumatology primer mentioned that this was an overlap syndrome. PT responded dramatically to low dose prednisone.

Has anyone else seen this?
AI argues NOT

Monday at morning report, an intern asked a question & apologized because it was slightly off topic. I smiled, and said it was OK because my MR was like James Joyce. About 15 med students, interns & residents) stared. Not one of them had heard of JJ. Do you find that sad? #MedEd

I went to Brooklyn to stand in solidarity with the owner of Miriam, an Israeli restaurant that became the target of antisemitic vandalism.

Jew-hatred will find no refuge in the City of New York. A hate crime against the Jewish community is a hate crime against all of us.

One more chalk talk enhanced by Napkin AI. Would love feedback and questions?

How I teach Hypercalcemia diagnosis!