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Swapnil Hiremath 🍁🇨🇦

@hswapnil.medsky.social

5.4K followers 3.1K following 3.2K posts

Nephrologist = kidney doctor MD, MPH Professor, University of Ottawa/Ottawa Hospital 🇨🇦 He/Him/His #NephJC co-creator, @FreelyFiltered.bsky.social pod panelist #NephSky https://www.swapnilhiremath.com

www.swapnilhiremath.com

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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · Sep 9

Update

Link changed (will not change again)

So if you liked/pinned the old feed, please do it again!

bsky.app/profile/did:...

#NephSky

Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · Sep 5

If you are a nephrology or kidney disease or renal professional or interested in the field - make sure you have liked/followed/pinned the nephrology feed

bsky.app/profile/did:...

Thanks again to @richardferro.xyz for creating & updating this! It’s a one-stop shop for nephrology needs

#NephSky

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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 25m

They are doing some more interesting trials
- BaxPA in primary aldosteronism
- ARCTIC/PACIFIC in CKD with dapa
- EASiKidney of vicardrostat with empa
The latter are clinical outcome trials

Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 25m

Aprocitentan was licensed - www.nephjc.com/news/aprocit... - though their trial design was fantastic

I do expect these (also Lorundrostat) to get licensed

I will not use them over spironolactone however 🤷🏽‍♂️

PRECISION Targeting in Resistant Hypertension — NephJC

This week, we will discuss the first new BP lowering drug in decades. Aprocitentan, a dual endothelin antagonist in a meticulously designed trial in resistant hypertension.

www.nephjc.com

Reposted by Swapnil Hiremath 🍁🇨🇦

Chris Hill @dochill1982.bsky.social · 1d

Curious to know what North American folks think about whether a drop in BP will be enough to get Baxdrostat licensed? In UK suspect NICE will want to see MACE data first to do cost-effectiveness analysis. #medsky #askrenal #nephjc

Efficacy and Safety of Baxdrostat in Uncontrolled and Resistant Hypertension | NEJM

Aldosterone dysregulation plays an important pathogenic role in hard-to-control hypertension. In several studies, baxdrostat, an aldosterone synthase inhibitor, reduced the seated systolic blood pr...

www.nejm.org

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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 4h

And coverage in TorStar as well (paywalled)

They pick a perfect example: an MSc in Clin Epi from McGill is worth nothing worth two years of high school in Canada 🤯

apple.news/ARADGNtBlRwm...

#cdnpoli #onpoli

Hormoz Nassiri Kigloo has studied and passed the qualifying exams for a shot at a medical residency spot in Ontario in order to return to his practice as a family physician.
The competition is intense and the Iranian immigrant, now a citizen, has been passed over for a match in four previous attempts. He has recently graduated with a master's degree in epidemiology from McGill University and hoped the additional Canadian credentials and research experience would give him a better chance this year.
Follow Toronto Star on Apple News
But three months after the matching process opened for the 2026 positions, the Ontario Ministry of Health abruptly changed the rule on Oct. 8. To be considered for the first of two rounds of matching, an international medical graduate is required to have attended an accredited Ontario high school for two or more years.

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Reposted by Swapnil Hiremath 🍁🇨🇦

FlexNP @rnflex.bsky.social · 5h

That being said, CEO of Eli Dave Ricks has said they will trial any indication for GLP-1 meds if they believe it can help and they seem evidence of benefit in their own trials. Which is why there's also a trial for orforglipron in hypertension too!

Wild times in big pharma.

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Reposted by Swapnil Hiremath 🍁🇨🇦

Jonathan Douglas PhD CPsych @jonathanconp.bsky.social · 10h

So let’s get this straight. The Ontario government want physicians to have attended an Ontario high school for two years, thus excluding immigrants from residency programs, while the Fairness Commissioner claims the College of Psychologists is racist…

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Reposted by Swapnil Hiremath 🍁🇨🇦

Medlife Crisis (Rohin) @medcrisis.bsky.social · 11h

Still no Indian news coverage on bluesky. Maybe for the best, another grim story about a medical student gang raped, in Durgapur, West Bengal. Just one year on from the brutal rape and murder of a resident doctor in the same state. Nothing is improving.
www.ndtv.com/india-news/3...

www.ndtv.com

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Reposted by Swapnil Hiremath 🍁🇨🇦

Medlife Crisis (Rohin) @medcrisis.bsky.social · 12h

That country is utterly lost. God this is so bleak. Combined with yesterday’s deeply upsetting story about Kingsley Bimpong dying from a stroke in police custody, the video of which is so horrific I cannot imagine how his family felt watching it, the US plumbs new depths every day. Don’t go there.

Lynn Becker @cmgiulini.bsky.social · 18h

After spending 43 years in prison for a crime he didn't commit, evidence hidden by the prosecution reversed his conviction. Rather than finally enjoying freedom, ICE abducted him for deportation

Depraved.

www.miamiherald.com/news/local/i...

He was wrongfully imprisoned for 43 years. Moments after being released, ICE took him

Subramanyam “Subu” Vedam now faces deportation.

www.miamiherald.com

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Reposted by Swapnil Hiremath 🍁🇨🇦

American Journal of Hypertension @amjhypertension.bsky.social · 11h

The endocannabinoid system as a target for thiazide diuretics?

academic.oup.com/ajh/advance-...

#WeekendReads from the #AdvanceArticles section

State of the Art Review: Thiazide Diuretics Exploit the Endocannabinoid System via NAPE-PLD

Abstract. The present State of the Art Review will take stock of targeting the endocannabinoid system (ECS) in the management of hypertension and vascular

academic.oup.com

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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 19h

Need to incorporate April in the title 😏

‘APRIL as a harbinger of spring for IgAN’

‘APRIL may be the key of unlocking IgAN’

Need Rodby for some more fun suggestions

@kidneyboy?

#NephSky

Reposted by Swapnil Hiremath 🍁🇨🇦

Edgar V. Lerma 🇵🇭 @edgarvlermamd.bsky.social · 1d

Trying to catch up with #IgAN trials⁉️

Check out “IgAN: An Overview of the Clinical Trials” ca. 2025 from @kidneymed.bsky.social
#Nephpearls #RKDSummit #NephSky

👉 pubmed.ncbi.nlm.nih.gov/41050133/

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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 21h

I see a lot of the Indian medical community (not diaspora - I think that means something else - I would be in the Indian diaspora!) is on the Meta platforms…which are more hierarchical or unidirectional, but not conversational?

Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 21h

2015-2021? Maybe 2022 if we stretch it a bit

Lot of fun discussions! Conference tweeting, journal clubs, tweetorials

A lot of medical people have (appropriately) turned off all social media and discussions as it so unpleasant now.

Reposted by Swapnil Hiremath 🍁🇨🇦

Joel Topf @kidneyboy.bsky.social · 1d

New episode of Channel Your Enthusiasm, part 2 of 3 on metabolic acidosis. Episode with chapter art, chapters, and fully referenced

www.rosebook.club/episodes/202...

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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 1d

Ontario changing IMG admission rules to restrict them to Canadian ‘IMGs’

This is a full scale perversion of the original IMG program

apple.news/Ai4fx6JnyQBi... in Globe/Mail

cc @jddneary.bsky.social

#OnPoli

Ontario is limiting first-round applications for residency positions from international medical graduates to only those who completed at least two years of high school in the province before studying abroad.
The Ontario government announced the change on Wednesday, midway through the application period that ends on Nov. 27. International medical graduates, or IMGs, who did not attend an Ontario high school must now wait until the second round to apply for any unfilled positions.
Ema Popovic, spokeswoman for Ontario Health Minister Sylvia Jones, said in a Thursday statement that this change will support Ontario-educated residents.

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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 1d

Underfunding the public healthcare system, Saskatchewan edition

www.cbc.ca/news/canada/...

#Saskpoli

Reposted by Swapnil Hiremath 🍁🇨🇦

Jeffrey Wagner @drjeffmdmcr.bsky.social · 1d

Efficiencies?! 🤦
Providing public health through a lens of scalable business is short sighted and, well, counter to the mission.

Much worse in 🇺🇸. the pulling back of public safety net in larger society (housing, education, etc) coincides with move to align care models based on ROI

Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 1d

What is likely to happen is more insidious

Which journals are included in PubMed? You should expect to see the NIH director’s bloggy pseudo journal pop up there soon based on these criteria

In that post, I also discussed my concern about PubMed’s vulnerability to a political misinformation agenda. A key point of influence was the National Library of Medicine committee that advised on what journals should be approved for inclusion in MEDLINE. MEDLINE journals provide the main stream of articles in PubMed.
Since then, that committee has been terminated. In September, the NLM announced that they are reviewing their new MEDLINE journal selection system. That process is a couple of consultants advising on whether a journal meets the MEDLINE scientific and editorial standards.
This is the same process that’s been used for years for the second set of journals that feed articles into PubMed: Open access journals in PMC. (There are over 2,700 non-MEDLINE journals in PMC at the moment. MEDLINE has nearly double that many journals.) I heard that moving to the PMC process had been planned before the regime change, but I haven’t seen that reported publicly.
I think this change in system would make it much simpler to politicize journal inclusion in PubMed. The NLM Director can make their own decisions and reject the advice of the consultants, without having to bother with overhauling a committee’s membership and the unpredictability of members. We don’t know who the person with that power will ultimately be – there’s still only an Acting Director. But at least for now, it’s so far so good for PubMed users.

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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 1d

There is still no need to panic about the effect of #USGovtShutdown and #PubMed. Yet.

hildabastian.wordpress.com/2025/10/10/t... as @hildabast.bsky.social points out

#MedSky

There’s been some panic about PubMed again, since a notice on the website warned it could be out of date because of the US government shutdown. Shutdown is dreadful, in so many ways. But that notice doesn’t mean PubMed has been de-funded, or that it’s not being maintained. The notice is the same as the one displayed during a shutdown in 2018. (I’ve put together records on previous shutdowns here.)
PubMed is produced by the National Library of Medicine (NLM) at the NIH. The NIH designated as critical NLM data services that are “essential for the provision of non-Federal health care,” thereby exempting a small proportion of its staff from the shutdown. PubMed fits that description. These days, the process of keeping PubMed up-to-date is largely automated and/or done by journal publishers, and it doesn’t look as though there has been a major disruption so far.* The longer the shutdown goes, though, the more likely being on a skeleton crew will have an impact.

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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 1d

Indian and Nepali men were (are) fighting in the Russian army?

Old story, but had no idea this was happening 😳

www.theguardian.com/world/2024/m...

‘He had no idea he was being sent to a war zone’: the Indian and Nepali men on frontlines in Ukraine

Signing up for jobs in Russia, Germany or Dubai, young men have been ‘made to join the Russian military’, their families say

www.theguardian.com

Reposted by Swapnil Hiremath 🍁🇨🇦

Sheryl Gay Stolberg @sherylnyt.bsky.social · 1d

FULL STORY HERE: Emails began flooding CDC inboxes late Friday night announcing dozens of layoffs. HR people brought back from furlough to oversee the RIFs. Disease detectives, entire Washington office, global health, injury prevention, MMWR staff among those hit.
www.nytimes.com/2025/10/11/u...

Trump Administration Lays Off Dozens of C.D.C. Officials

www.nytimes.com

67 820 1.5K

Reposted by Swapnil Hiremath 🍁🇨🇦

Edgar V. Lerma 🇵🇭 @edgarvlermamd.bsky.social · 2d

I just donated to the @nephjc.bsky.social Fall 🍂 Drive

Looking forward to learning more #Nephpearls

#NephSky

👉 www.nephjc.com

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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 1d

And this will be used as an excuse to open more
- private imaging centres
- private surgical centres
#onpoli

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Reposted by Swapnil Hiremath 🍁🇨🇦

Joel Topf @kidneyboy.bsky.social · 2d

What was peak #MedTwitter?

What was the moment of greatest optimism for the idea of social media as a major driver of medial education?

I have my answer, but I'm going to keep my powder dry while I listen for your answers (but since this is BlueSky, I wonder if this will generate much heat)

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Reposted by Swapnil Hiremath 🍁🇨🇦

Gurmukteshwar Singh, MD @drmootravardhak.bsky.social · 2d

Is calling “I-G-A nephropathy” “Eye-GAN” mainstream now? I am really struggling to accept that.

#askrenal

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