Mechanical Engineering | Clinical & Interventional Nephrology | Golfing, surfing, Kobe, MJ, and urine #MambaMentality #meraki Tweets are my own.

San Juan, Puerto Rico
Joined April 2011
Traits I’ll try to exemplify in a doctor: 1. #Humility (Keeps asking opinions of others) 2. #Compassion (No one cares how much you know, until they know how much you care) 3. #Diligence (Keeps working the problem) 4. #Integrity (Does what they say they will do) @GavinPrestonMD 🙏🏼
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Approach to Hematuria: Core Curriculum 2026 bit.ly/4zwhmsw (FREE) @anna_zisman
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Ten tips for the management of vascular access in hemodialysis patients doi.org/10.1093/ckj/sfag366
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Creatine use is surging, but what does the evidence say about kidney safety? A new review found creatine supplementation may raise serum creatinine without evidence of impaired kidney function in healthy adults. kidney.pub/KN1809-08 #ASNKidneyNews @captainchloride
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Are we too focused on avoiding overcorrection of hyponatremia? New evidence suggests undercorrection may carry its own risks, raising important questions about how aggressively hyponatremia should be treated. kidney.pub/KN1809-06 #ASNKidneyNews
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Replying to @kidney_boy
Of course. El Bumetazo! 👌
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CKM syndrome is rising fastest where resources are scarcest. A new #ASNCJASN #perspective calls for community-based care, integrated digital health systems, and outcome-driven payment models to deliver scalable, equitable care, especially in low- and middle-income countries. kidney.pub/CJASN1222
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The majority of CKD cases in CKM syndrome are attributable to diabetes, hypertension, and other metabolic risk factors. However, kidney-protective therapies such as angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers and sodium glucose cotransporter 2 inhibitors have demonstrated kidney and cardiovascular benefits for patients with CKD from metabolic etiologies as well as from some other causes. Therefore, the CKM staging construct is relevant for all patients with CKD. professional.heart.org/en/sc… ✍🏼 @ChiadiNdumele @HeartDocSadiya @kardiologykazi @noshreza @virani_md @biykemb @NutritionHF @mandeepbajaj65 @KatherineTuttl8 @RangaswJ @lisaVWMD @KBreathettMD @EmoryFamMed @ShoaClarke @mad_sters @jmortonmd @sripalbangalore @AnumSaeedMD
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🎙️ @BernardoCSilva: "Jugar en un club que tiene 15 Champions no es para todos".
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ARHF remains underrecognized despite vascular access accounting for 23% of high-output HF cases, with 58% 5-year mortality. This review covers pathophysiology, diagnostics, risk assessment, and treatment strategies to improve patient outcomes. kidney.pub/KID1320?utm_sourc… #ASNKidney360
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The Skin Pinch Test @wasse_m
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After many conversations about our shared passion for vascular access, @wasse_m and I are proud to share the first episode of Nephro-Logic. Because dialysis access should make sense. youtu.be/0f0OjDw83GY?si=Pjfn…
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Precio de la gasolina en bomba – Viernes, 17 de abril de 2026. En DACO seguimos vigilantes para que los precios reflejen los costos reales y se cumpla con el reglamento. Recuerda que aunque no fijamos los precios, sí fiscalizamos que estén dentro del margen permitido.
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Precio de la gasolina en bomba – Lunes, 6 de abril de 2026. En DACO seguimos vigilantes para que los precios reflejen los costos reales y se cumpla con el reglamento. Recuerda que aunque no fijamos los precios, sí fiscalizamos que estén dentro del margen permitido.
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Don’t miss the ISPD NAC Day at @AnnualDialysis 2026! 🩺 Join us in Kansas City (Feb 26 - Mar 1) to explore the future of peritoneal dialysis, from sustainability to policy debates. 🏛️✨ 🔗 Register now:annualdialysisconference.org… @ISPD1
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This #ASNKidney360 study explored the relationship between arterial and venous blood gas parameters to develop formulas for estimating arterial values from venous samples. Read more: kidney.pub/KID1113
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No winter storm here ☀️
Escape to the Sunshine State for the 22nd Annual Scientific Meeting in Florida.
📅 February 20–22, 2026
📍 WDW Swan | Lake Buena Vista, FL 👉 Register here: asdin.org/mpage/22ndannual
#ASDIN2026
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Although often used interchangeably, dehydration & volume depletion are not the same #Nephpearls 📌 Dehydration refers to “loss of total body water” (leads to hypertonicity) 📌 Volume depletion refers to an ECFV deficit 👉🏼 pubmed.ncbi.nlm.nih.gov/2170…
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🤩Check out the January issue of NDT! academic.oup.com/ndt 👍Editor's choice: Anti-glomerular basement membrane disease—treatment standard doi.org/10.1093/ndt/gfaf190
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We are pleased to share the publication of the KDIGO 2026 Clinical Practice Guideline for Anemia in Chronic Kidney Disease (CKD), a comprehensive update to the 2012 guideline. Read the guideline in @Kidney_Int: kdigo.co/KDIGO-Anemia-in-CKD… Visit the KDIGO Anemia in CKD Guideline website to download the guideline, executive summary, and news release: kdigo.org/guidelines/anemia-… Co-chaired by Dr. Jodie Babitt (US) and Dr. Marcello Tonelli (CA), the guideline provides evidence-based recommendations for diagnosing and managing anemia across the CKD continuum, including dialysis and kidney transplantation. “This guideline represents a major step forward in how we approach anemia in CKD,” said Dr. Babitt. “It emphasizes a systematic evaluation of anemia and iron deficiency, clearer guidance on when and how to use oral and intravenous iron, and integrates new evidence on emerging therapies while reinforcing the need to avoid overtreatment and to prioritize safety and shared decision-making.” “This guideline reflects a decade of new evidence and the increasing complexity of anemia management in people with chronic kidney disease,” said Dr. Tonelli. “We evaluated a large body of randomized trial data across iron therapies, ESAs, HIF-PHIs, and transfusion strategies, with careful attention to both benefits and harms, to support consistent, evidence-informed anemia care across diverse healthcare systems, resource settings, and patient populations worldwide.” #anemia #CKD
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