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Nayan Arora

@captainchloride.bsky.social
1.2K followers 241 following 1.2K posts

Associate Professor and APD @pdxkidney.bsky.social | Cardiorenal enthusiast | Whisky drinker, runner, dad | Filtrate on Freely Filtered 🎙️

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Nayan Arora @captainchloride.bsky.social · 24/08/2026
English is my second language
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Nayan Arora @captainchloride.bsky.social · 16/12/2025
Hey @amyaimei.bsky.social I got to write about acetazolamide! academic.oup.com/ckj/advance-...
academic.oup.com
Use of Acetazolamide in Volume Overload: Start at the Beginning
Abstract. The treatment of volume overload has vexed physicians for centuries. References to herbal remedies for the treatment of fluid retention date as f
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OHSU Nephrology @pdxkidney.bsky.social · 03/12/2025
If you are a resident who didn’t match today, a hospitalist looking for change, or anyone looking to join an amazing and innovative fellowship program in an unbeatable location we have a Nephrology spot open for you! Contact us if you are interested! ohsu.edu/school-of-medi…
ohsu.edu
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Joel Topf @kidneyboy.bsky.social · 01/12/2025
Time to grill Charmaine Lok about fish oil for the next Freely Filtered with @nephcrit.bsky.social and @hswapnil.medsky.social
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Nayan Arora @captainchloride.bsky.social · 10/11/2025
We need goat yoga for after the #kidneywk run next year
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grahamabra.bsky.social @grahamabra.bsky.social · 07/11/2025
Agreed - already have some proactive DMI folks on Finerenone - has been safe and lowers proteinuria in my hands
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Nayan Arora @captainchloride.bsky.social · 07/11/2025
Agreed - seems a little “fishy”
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Nayan Arora @captainchloride.bsky.social · 07/11/2025
This is like the Rockies winning the World Series….
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Nayan Arora @captainchloride.bsky.social · 07/11/2025
We are 2 for 2 with positive trials so far. LIBERATE-D shows benefit with a conservative vs conventional dialysis strategy in AKI-D. The difference in mortality is concerning though? Simultaneous pub 👇🏾 #kidneywk jamanetwork.com/journals/jam...
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Nayan Arora @captainchloride.bsky.social · 07/11/2025
Shocking first high impact trial of the day. Fish oil reduces CV events in dialysis patients! #Pisces #kidneywk Simultaneous pub in NEJM www.nejm.org/doi/full/10....
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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 06/11/2025
For finerenone in type 1 DKD I think albuminuria is OK For Atacicept - this is preliminary data which gets them accelerated FDA approval and a few months of making 💰until the GFR slope analysis comes through? #KidneyWk
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Kevan Polkinghorne 🇳🇿 @dialysisbloke.bsky.social · 06/11/2025
While I agree, here in Australia the drugs will not get funded by the govt without the harder endpoints unless of course the price is okay which of course is not going to happen. It’s exciting to see all these new therapeutics but unless the cost comes down I doubt we will see them in Australia soon
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Nayan Arora @captainchloride.bsky.social · 06/11/2025
Finerenone has already shown benefit in type 2 DM and the benefit was primarily driven by albuminuria reduction. To me the type 1 diabetes trial was simply a safety trial since there’s no reason to believe the mechanism would be any different so I’m fine with the albuminuria surrogate
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Nayan Arora @captainchloride.bsky.social · 06/11/2025
@sophia-kidney.bsky.social is working really hard at this conference #kidneywk
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Nayan Arora @captainchloride.bsky.social · 06/11/2025
Midodrine and octreotide should not be first line therapy for HRS-AKI #kidneywk
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Nayan Arora @captainchloride.bsky.social · 06/11/2025
@sophia-kidney.bsky.social got shoved into a corner by ASN but well worth the trek to check out her poster and try out abcKidney #kidneywk
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Nayan Arora @captainchloride.bsky.social · 06/11/2025
Move on - once it became approved as a surrogate endpoint there is zero incentive for trials to use hard endpoints as primary outcomes. Trials are shorter and more importantly cheaper.
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Nayan Arora @captainchloride.bsky.social · 06/11/2025
Small trial of lysine chloride in euvolemic patients with heart failure. Median furosemide dose was 80mg. Chloride supplementation reduced plasma volume and improved diuretic response. Interesting but maybe not the population I would use it in? #kidneywk
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Nayan Arora @captainchloride.bsky.social · 06/11/2025
All of them
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Nayan Arora @captainchloride.bsky.social · 06/11/2025
#kidneywk has puppies!
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Nayan Arora @captainchloride.bsky.social · 06/11/2025
We have a new therapy for type 1 diabetes! FINE-ONE with significant proteinuria reduction compared to placebo on a background of RASi with an acceptable safety profile. Where’s the simultaneous pub?? Sglt2 inhibitors are next…#kidneywk
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Nayan Arora @captainchloride.bsky.social · 06/11/2025
Interim analysis of atacicept (dual BAFF/APRIL inhibitor) shows successful proteinuria reduction vs placebo. Also reduced Gd-IgA1 levels. Adding to the IgA armamentarium. Simultaneous pub 👇🏾 #kidneywk www.nejm.org/doi/full/10....
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Joel Topf @kidneyboy.bsky.social · 21/10/2025
New episode of Freely Filtered with @brendonneuen.bsky.social @hswapnil.medsky.social @captainchloride.bsky.social @sophia-kidney.bsky.social and author Muth Vaduganathan discussing the CONVINCE trial www.nephjc.com/freelyfilter... With chapters, refs, and pictures
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Nayan Arora @captainchloride.bsky.social · 20/09/2025
I would accept a UNa
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Nayan Arora @captainchloride.bsky.social · 20/09/2025
Good luck getting an accurate weight. Plus are you going to wait 24 hours before dose escalation? And then there’s 👇🏾 pubmed.ncbi.nlm.nih.gov/25595470/
pubmed.ncbi.nlm.nih.gov
Substantial Discrepancy Between Fluid and Weight Loss During Acute Decompensated Heart Failure Treatment - PubMed
Considerable discrepancy between fluid balance and weight loss is common in patients treated for acute decompensated heart failure. Awareness of the limitations inherent to these commonly used metrics...
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Boback Ziaeian @boback.bsky.social · 26/08/2025
Going to add this to my lecture slides.
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Nayan Arora @captainchloride.bsky.social · 17/09/2025
Interesting diuretic resistance study. Adunctive thiazides take the lead over loop intensification? Nice discussion on mechanisms of DR, both practical and hypothetical. #nephsky journals.lww.com/jasn/abstrac...
journals.lww.com
Loop Diuretic Dose Intensification versus Adjuvant Thiazide ... : Journal of the American Society of Nephrology
g diuretic resistance mechanism could optimize diuretic response. Methods: Patients hospitalized with heart failure and diuretic resistance (6-hour cumulative natriuresis <100 mmol after IV loop di...
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Nayan Arora @captainchloride.bsky.social · 14/08/2025
🤔 I happen to know @jordybc.bsky.social is a scotch aficionado www.cnn.com/2025/08/14/h...
cnn.com
New blood pressure guidelines recommend skipping alcohol and an earlier start to treatment | CNN
The next time you get your blood pressure checked, expect your medical provider to be a little more aggressive about high levels. And if you like a glass of wine with dinner or a cocktail on the weeke...
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Nayan Arora @captainchloride.bsky.social · 14/08/2025
You can try and avoid chloride but you will suffer the wrath of God
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Nayan Arora @captainchloride.bsky.social · 12/08/2025
Seems like a bit of a line in the sand. When kidney function worsens > than a certain threshold with decongestion you have to wonder about low flow states, pre-capillary pHTN, etc. Also not clear to me if they assessed GDMT use post d/c and if creatinine went up >40% perhaps less use of these meds?
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Joel Topf @kidneyboy.bsky.social · 08/08/2025
Latest episode of @freelyfiltered.bsky.social is live! This one on the two RCTs of DDAVP to prevent renal biopsy bleeding. We had special guest Vandana Niyyar join us. @medpeedskidneys.bsky.social @captainchloride.bsky.social www.nephjc.com/freelyfilter...
nephjc.com
FF 82 DDAVP up the nose to prevent biopsy bleeding — NephJC
Nasal DDAVP to prevent bleeding complications from renal biopsy, the results of two randoized, placebo controlled, trials.
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Nayan Arora @captainchloride.bsky.social · 06/08/2025
Thank you to @asnpublications.bsky.social #JASN for letting us write this. Important topic that's unfortunately devoid of robust data for many of our patients. #nephsky journals.lww.com/jasn/abstrac...
journals.lww.com
Remote Measurement of Volume Status in Heart Failure : Journal of the American Society of Nephrology
ed with telemedicine services, have failed to improve outcomes. Implantable hemodynamic monitors allow clinicians to obtain meaningful, objective data, with an opportunity for early intervention to im...
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Nayan Arora @captainchloride.bsky.social · 22/07/2025
Ugh you’re right! Fat fingers strike again
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Nayan Arora @captainchloride.bsky.social · 21/07/2025
Interesting study in pts w/T1D w/ or w/out flozins and comp. With healthy controls. Less glomerulomegaly on routine biopsies. Flozins impacted metabolic transcripts throughout the nephron - ie the effect wasn’t isolated to the proximal tubule. Showing they are powerful metabolic drugs. #nephsky
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Nayan Arora @captainchloride.bsky.social · 17/07/2025
Yikes - gotta switch to the British baking show - unless you have some dirt on that too…
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Nayan Arora @captainchloride.bsky.social · 17/07/2025
If you're applying to a Nephrology fellowship, let @glaucomflecken.bsky.social tell you why you need to come to @pdxkidney.bsky.social. Then let us tell you what makes it such a great and unique training program! #nephsky
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Nayan Arora @captainchloride.bsky.social · 21/06/2025
100% - sacubitril/valsartan is underutilized and makes a huge difference. In the clinic world it is much more common for us to de-escalate diuretics with appropriate GDMT rather than need to escalate.
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Nayan Arora @captainchloride.bsky.social · 21/06/2025
We use this for some patients in our cardiorenal clinic. Not sure it has reduced admissions but makes us feel better and patients seem to like it
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Nayan Arora @captainchloride.bsky.social · 20/06/2025
Our fellows taste testing tap water vs. RO water! #nephsky
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Nayan Arora @captainchloride.bsky.social · 19/06/2025
#nephsky
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Nayan Arora @captainchloride.bsky.social · 06/06/2025
Oh yea totally incorrect thread - was talking about ACHIEVE
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Nayan Arora @captainchloride.bsky.social · 06/06/2025
The only way to potentially get a positive trial is to do this in patients with HFrEF on dialysis
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Nayan Arora @captainchloride.bsky.social · 06/06/2025
Im not that surprised. Did they show what % of patients had heart failure?
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Nayan Arora @captainchloride.bsky.social · 03/06/2025
Do you feel like you need all 3 to attain adequate natriuresis in these folks or just a believer in more balanced diuresis?
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Nayan Arora @captainchloride.bsky.social · 03/06/2025
It would be a positive study and maybe even show decreased length of stay by avoiding interruptions in diuresis
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Nayan Arora @captainchloride.bsky.social · 03/06/2025
The main study I quote is the Shweta Bansal one Joel highlighted. It works but you need high doses and there’s lag time so better to use amiloride for ADHF
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Nayan Arora @captainchloride.bsky.social · 27/05/2025
Are we going to get emails from you with the subject line “fork in the road”?
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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 27/05/2025
ICYMI @captainchloride.bsky.social on the art of decongestion in heart failure Embracing hypercreatininemia Flozins or Acetazolamide How to use Urine Na+ Do we believe the Italian HTS RCTs? www.youtube.com/watch?v=3m2b... #NephGR
youtube.com
The Art of Decongestion with Dr. Nayan Arora
YouTube video by Ottawa Nephrology
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Nayan Arora @captainchloride.bsky.social · 23/05/2025
Should be relatively rare for cast nephropathy right? Definitely see Nephrologists making the dx first in other forms of MGRS but usually cast nephropathy is more overt - unless I’m missing a bunch 😮
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