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Reposted by Srikanth Bathini

ISNkidneycare @theisn.org · Jun 30

𝗜𝗦𝗡 𝗩𝗜𝗗𝗘𝗢 𝗔𝗕𝗦𝗧𝗥𝗔𝗖𝗧 𝗦𝗘𝗥𝗜𝗘𝗦: APOL1 genotype and HIV infection: 20 year outcomes for CKD, CVD and hypertension. 2025 from @kireports.bsky.social‬ www.kireports.org/ar...

#VideoAbstract by
‪@drsumanbehera.bsky.social‬ & @dakidneydoc.bsky.social‬

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Reposted by Srikanth Bathini

myadla.bsky.social @myadla.bsky.social · May 5

Friends ! Check this survey on Pregnancy AKI
Available in 20 languages
Do share in your groups qualtrics.kcl.ac.uk/jfe/form/SV_...

@dramiliflores.bsky.social @hswapnil.medsky.social @divyaveerssneph.bsky.social @kajareeg.bsky.social @dakidneydoc.bsky.social

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Reposted by Srikanth Bathini

Dr. Suman Behera @drsumanbehera.bsky.social · Apr 25

Hypoelectrolytemia. Low K, Mg Ca, Na and P.

Did you have to use more than the conservative measures for management?

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Srikanth Bathini @dakidneydoc.bsky.social · Apr 25

Yup…

Conservative management failed

Neostigmine trial failed

Colonoscopic decompression-> improved

Colonic dilatation recurred as potassium fell after stopping Spironolactone

Repeated aggressive potassium correction and a Colonoscopic decompression

Slower weaning of Spironolactone helped

Srikanth Bathini @dakidneydoc.bsky.social · Apr 25

That’s amazing!

How were the electrolytes ?

#ECNeph

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Reposted by Srikanth Bathini

Dr. Suman Behera @drsumanbehera.bsky.social · Apr 25

Sounds like pseudoobstruction... seen in patients with Ogilvie syndrome. Can also cause severe electrolyte dysfunction. But quite rare.. mostly diagnosed by GI before the nephrologists get to see them

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Srikanth Bathini @dakidneydoc.bsky.social · Apr 25

Well, these cases are rare.

But dealing with this patient’s case helped to diagnose and treat a similar case pretty fast and effectively.

The second patient required Spironolactone+IV + Oral KCL

Weaned to Spironolactone and Oral KCL over a week

Later only oral KCL

Now, none…

#ECNeph

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Srikanth Bathini @dakidneydoc.bsky.social · Apr 25

A big thanks to @myadla.bsky.social @dramiliflores.bsky.social @dilushiwijay.bsky.social @kajareeg.bsky.social @theisn.org @nephroseeker.medsky.social
Thanks to the wonderful #NephSky community for tuning in!

#ECNeph

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Srikanth Bathini @dakidneydoc.bsky.social · Apr 25

A glimpse at the causes of an Acquired Bartter Defect too! #ECNeph

@myadla.bsky.social @dramiliflores.bsky.social @dilushiwijay.bsky.social @kajareeg.bsky.social @theisn.org @nephroseeker.medsky.social

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Srikanth Bathini @dakidneydoc.bsky.social · Apr 25

How do we manage Ogilvie’s syndrome?

@myadla.bsky.social @dramiliflores.bsky.social @dilushiwijay.bsky.social @kajareeg.bsky.social @theisn.org @nephroseeker.medsky.social

#ECNeph

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Srikanth Bathini @dakidneydoc.bsky.social · Apr 25

❓ What is this Acute Pseudo colonic Obstruction (Ogilvie’s syndrome)?

👉 Several theories have been proposed

@myadla.bsky.social @dramiliflores.bsky.social @dilushiwijay.bsky.social @kajareeg.bsky.social @theisn.org @nephroseeker.medsky.social
#ECNeph

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Srikanth Bathini @dakidneydoc.bsky.social · Apr 25

👉 In vitro studies suggest that colonic Maxi – K channels are upregulated

👉 These are the same channels upregulated in CKD, enhancing gut excretion of potassium

👉 In ESRD, the colonic excretion of Potassium is 3-fold that of normal individuals
#ECNeph
@myadla.bsky.social @dramiliflores.bsky.social

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Srikanth Bathini @dakidneydoc.bsky.social · Apr 25

Here are some of the case reports describing hypokalemia in Ogilvie’s syndrome

@myadla.bsky.social @dramiliflores.bsky.social @dilushiwijay.bsky.social @kajareeg.bsky.social @theisn.org @nephroseeker.medsky.social
#ECNeph

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Srikanth Bathini @dakidneydoc.bsky.social · Apr 25

Several confounders in this case

Investigations will be confusing when the case is evolving

Better to hold on to your horses 🐴 and wait till the patient settles

#ECNeph

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Srikanth Bathini @dakidneydoc.bsky.social · Apr 25

Can there be any other cause for hypokalemia in this case?
There are several case reports of Ogilvie’s syndrome being associated with severe hypokalemia
@myadla.bsky.social @dramiliflores.bsky.social @dilushiwijay.bsky.social @kajareeg.bsky.social @theisn.org @nephroseeker.medsky.social
#ECNeph

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Srikanth Bathini @dakidneydoc.bsky.social · Apr 25

Hmmm… Ease of availability, low cost and the fact that short term use doesn’t cause too many adverse effects

#ECNeph

New MRA —> not studied for these though —> But hold that thought ☝🏻

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Srikanth Bathini @dakidneydoc.bsky.social · Apr 25

Here’s an infographic describing the various mechanisms of hypokalemia

Highlighted in brown = Present in this case

Shout out to @dana_m_larsen , my Nephrologist colleague from UCSF for the amazing infographic
#ECNeph

@myadla.bsky.social @dramiliflores.bsky.social @dilushiwijay.bsky.social