iiinova — where your digital self keeps evolving

Humberto Luna @renalguy.bsky.social · 08/06/2026

How do you dialyze chronic HD patients at high bleeding risk? Recent surgery, upcoming surgery, active bleeding, etc At our center: short heparin-free HD when feasible, or citrate CVVHD in ICU for selected cases Do you use saline flushes, citrate IHD, heparin-coated filters, or something else?

000

Humberto Luna @renalguy.bsky.social · 04/06/2026

At my center, nephrologists place temporary dialysis catheters, but tunneled catheters are placed by surgeons. I’d love to see nephrologists take a more active role in tunneled catheter and PD catheter placement. Interventional nephrology has so much potential

000

Humberto Luna @renalguy.bsky.social · 03/06/2026

Question for nephrologists: Who places tunneled dialysis catheters at your institution? * Nephrology * Interventional radiology * Vascular surgery At my center, nephrologists are not involved. Curious how common this is.

622

Humberto Luna @renalguy.bsky.social · 03/06/2026

I’d love to see more interventional nephrology at my center. I think tunneled dialysis and PD catheter placement are valuable skills for nephrologists Are both tunneled HD catheters and PD catheters placed by urologists at your institution?

100

Humberto Luna @renalguy.bsky.social · 03/06/2026

000

Humberto Luna @renalguy.bsky.social · 31/05/2026

Preliminary IMMUPROT data from Uniklinik Halle T-cell responses appear similar in CKD patients with severe albuminuria and those with „just“ reduced eGFR. Kidney dysfunction may be more relevant for T-cell immunity than albuminuria. Further analyses are ongoing. #Nephrology #CKD

000

Humberto Luna @renalguy.bsky.social · 25/02/2026

5 kidney transplants in 48 hours. University Hospital Halle

010

Reposted by Humberto Luna

JAMA Network Open @jamanetworkopen.com · 19/02/2026

In #ChronicKidneyDisease, higher urinary protein to creatinine ratio was more strongly associated with increased risk of cognitive impairment than lower eGFR, suggesting the importance of proteinuria in cognitive risk assessment. ja.ma/3OvDzof

Four bar graphs show hazard ratios for cognitive impairments based on UPCR levels and eGFR. Graph A: Impairment in global cognition (3MS). Graph B: Impairment in verbal memory. Graph C: Impairment in attention. Graph D: Impairment in executive function.

054

Humberto Luna @renalguy.bsky.social · 24/07/2025

Id like to hear your point of view. Would you have gone for plasma exchange despite normal haptoglobin/bilirubin and a positive Coombs test?

010

Humberto Luna @renalguy.bsky.social · 09/12/2024

💡 Chronische Nierenerkrankung schwächt das Immunsystem 🛡️ – Proteinurie 🧪 könnte eine Schlüsselrolle spielen. In meiner Doktorarbeit erforsche ich, wie Proteinurie und Immunfunktion zusammenhängen, um neue Ansätze 🩺 zur Risikominimierung und Behandlung zu entwickeln

010

Humberto Luna @renalguy.bsky.social · 09/12/2024

ein typischer Tag im Labor: Forschung und Präzision. 🧪🔬 Nephrologie bedeutet nicht nur Patientenkontakt, sondern auch intensive Arbeit im Labor, um die Nieren besser zu verstehen. #Medizin #Nephrologie #Forschung

010

Humberto Luna @renalguy.bsky.social · 29/11/2024

Is it too on the nose to bring my colleagues these Christmas cookies shaped like kidneys? Or should I just embrace the nephro-cheesiness? 🎄🍪 #NephrologyLife

000

Humberto Luna @renalguy.bsky.social · 26/11/2024

Thanks for clarifying! Would you then rely on urinary sodium to differentiate CHF from SIADH? Also, do you find fractional uric acid excretion useful in these cases?

100

Humberto Luna @renalguy.bsky.social · 26/11/2024

Is copeptin the missing link in diagnosing SIADH, or is it an overhyped biomarker with limited use? How often do you use it for managing hyponatremia? Would love to hear the thoughts of @kidneyboy.bsky.social and @captainchloride.bsky.social !

100

Humberto Luna @renalguy.bsky.social · 25/11/2024

Thanks for sharing, Joel and Sarah! At my institution, we use xipamide and high-dose furosemide, and if these fail, we escalate directly to CVVHD as we have no experience with 3% NaCl in this setting. How do you decide when to use hypertonic saline?

100

Humberto Luna @renalguy.bsky.social · 25/11/2024

Thanks, Joel. Sequential nephron blockade sounds comprehensive! Have you had experience combining proximal, loop, and distal tubule blockers simultaneously (e.g., acetazolamide, loop diuretics, and thiazides)? Curious how effective and safe you’ve found this approach

200

Humberto Luna @renalguy.bsky.social · 25/11/2024

Great point. Do you think there’s ever a scenario where the albumin-furosemide combo is justified, or is it best avoided entirely? Would love to hear your approach in these tough cases

100

Humberto Luna @renalguy.bsky.social · 25/11/2024

Rituximab in GPA/MPA: 375 mg/m² weekly x4 vs. 1g twice, 2 weeks apart. Is BSA dosing truly better, or does fixed dosing offer equal outcomes with more simplicity? What does your practice prefer?

010

Humberto Luna @renalguy.bsky.social · 24/11/2024

When diuretics fail, the albumin-furosemide combo is often considered—but is it science or just tradition? Evidence for its routine use is shaky at best. Are we truly helping our patients or just inflating costs and risks?

161

Humberto Luna @renalguy.bsky.social · 16/11/2024

This multicenter observational study recommends a sodium correction of at least 10 mmol/L in patients with severe hyponatremia who have no risk factors. I would be interested to hear Dr. Joel Topf’s @kidneyboy.bsky.social opinion on the matter. evidence.nejm.org/doi/full/10....

evidence.nejm.org

Severe Hyponatremia Correction, Mortality, and Central Pontine Myelinolysis

In clinical practice, sodium correction rates are frequently limited in patients with severe hyponatremia to prevent neurologic complications. The implications of correction rates on overall mortal...

140