iiinova — where your digital self keeps evolving

Hemily Zandybell, MD @zandybellnefro.bsky.social · 26/09/2026

Cusco + nephrologists + a microscope = the perfect combo 🏔️🔬🫘 So happy to have spoken at the XIX Peruvian Congress of Nephrology about urinary sediment ✨ Thanks for the casts, the laughs, and the coca tea ☕🌿 #Nephrology #UrinarySediment #Cusco 🇵🇪

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Hemily Zandybell, MD @zandybellnefro.bsky.social · 16/09/2026

Under polarized light, oval fat bodies in urine can show a striking cross-shaped pattern — the 'Maltese cross.' A classic, low-cost marker of lipiduria, often seen with nephrotic-range proteinuria. #UrinarySediment #urinarymicroscopy

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Hemily Zandybell, MD @zandybellnefro.bsky.social · 13/09/2026

🎓 This week we had a key Urinary Sediment course at Hospital Almenara, @albertogs.bsky.social Perú 🇵🇪, backed by ISN @theisn.org and the academic quality of @juancarlosqvelez.bsky.social 🙌 🇵🇪🇺🇲 Grateful for all the knowledge shared. #UrinarySediment #Nephrology #ISN

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Reposted by Hemily Zandybell, MD

Mythri Shankar @nephromythri.bsky.social · 11/08/2026

New open-access review out now 🧬🔬 “Beyond the Bladder: Recognising Glomerular Hematuria and the Role of Genetic Testing in Clinical Practice” A practical guide for clinicians: when to refer, when to test, and how to counsel patients. 📖 doi.org/10.5528/wjtm... #Nephrology #GeneticTesting

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Hemily Zandybell, MD @zandybellnefro.bsky.social · 09/08/2026

✨ Two great days at ISN's Primer Course in Glomerular Diseases, Montevideo 🇺🇾. Updating on glomerular disease management alongside colleagues from Latin America 🧬. Grateful to ISN @theisn.org and all speakers 🙏 #Nephrology #ISN

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Hemily Zandybell, MD @zandybellnefro.bsky.social · 13/05/2026

👩🏻 patient, 39 yo, IgA nephropathy, dysmorphic hematuria 🩸 #UrinarySediment #urineMicroscopy

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Hemily Zandybell, MD @zandybellnefro.bsky.social · 12/05/2026

Are these clustered uric acid crystals? 🫣 pH: 5.0 sG:1020 Male with a history of kidney stones #UrinarySediment

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Hemily Zandybell, MD @zandybellnefro.bsky.social · 30/04/2026

Bilirubin-stained renal tubular epithelial cell cast. Patient with AKI and cirrhosis. #UrinarySediment #urineMicroscopy

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Hemily Zandybell, MD @zandybellnefro.bsky.social · 10/03/2026

I requested a urine sediment analysis because of elevated serum uric acid… . . …and received this sample. 👀 Can you guess what we found under the microscope? 🔬 #UrinarySediment

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Reposted by Hemily Zandybell, MD

Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 05/03/2026

Finally, FINEONE shows Finerenone reduces albuminuria in T1DM www.nejm.org/doi/full/10.... @nejm.org #NephSKy

figure of albuminuria reduction with finerenone

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Reposted by Hemily Zandybell, MD

Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 01/03/2026

It’s March once again … #Nephmadness has begun #Nephpearls #NephSky 👉🏼 ajkdblog.org 👉🏼 If you don’t know what it’s about, then it’s time to checkout this 📺 m.youtube.com/watch?v=tZUR...

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Hemily Zandybell, MD @zandybellnefro.bsky.social · 31/01/2026

Female, 40 yo, LES class IV, cr 3.11 (previous 0.8), hematuria, proteinuria. U-Sed: RBC cast, presence of leukocytes (glitter cells?) #Urinarysediment #urineMicroscopy

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Hemily Zandybell, MD @zandybellnefro.bsky.social · 14/01/2026

First case of the Year 🫶 Male, 50 years old, recently started dialysis, persistent hematuria? Ph 8.0 sg: 1005 hb + 💦 Urinary sediment: leukocytes, some macrophages, and triple phosphate crystals. No RBC Urine culture pending #UrinarySediment #urineMicroscopy

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Hemily Zandybell, MD @zandybellnefro.bsky.social · 31/12/2025

Woman, 71 yo, allopurinol user, U-Sed: Uric acid crystals. *First time I've seen crystals; How beautiful these crystals are! 😍 can't imagine how excited I am. Maybe only a few will understand 🤭 Happy New Year 2026! May there be more urinary sediments to explore #urinarysediment #urinarymicroscopy

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Reposted by Hemily Zandybell, MD

ISNkidneycare @theisn.org · 18/11/2025

🌍 From Tajikistan to Peru, Rwanda, India, the Maldives, and Pakistan. ISN Educational Ambassadors are helping close gaps in kidney care worldwide. These collaborations show what’s possible when global experts and local clinicians work together to advance kidney health. 🔗 lite.spr.ly/6...

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Hemily Zandybell, MD @zandybellnefro.bsky.social · 19/12/2025

Woman 👩, 67 yo, No medical history, Cr ↗️ 1.4 -> 2.8 -> 3.5, oliguria, ESR 124. HTLV1 (+) ANCA (-) C3 and C4 normal, Prot 20g/24h U-sed: glomerular hematuria (10% acanthocytes) + bacteriuria.

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Hemily Zandybell, MD @zandybellnefro.bsky.social · 14/12/2025

Christmas Urinary Microscopy 🎄🔬🫶

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Hemily Zandybell, MD @zandybellnefro.bsky.social · 14/11/2025

Another day here! at the Urinary Sediment Unit, we continue learning 😎 #UrinarySediment

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Hemily Zandybell, MD @zandybellnefro.bsky.social · 10/11/2025

I'm delighted to have attended and participated in one of the best international conferences 🇺🇲. See you next year in Denver. Let's continue to advance nephrology! @asnkidney.bsky.social @lluncornefro.bsky.social #kidneywk

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Hemily Zandybell, MD @zandybellnefro.bsky.social · 06/11/2025

Day 1, #kidneywk 25, We attended the poster presentation, which focused on an important topic: Reducing gaps and strengthening training in urinary sediment analysis. We were joined by someone passionate about U-sed. @juancarlosqvelez.bsky.social , @roxnonna23.bsky.social .

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Reposted by Hemily Zandybell, MD

Juan Carlos Q Vélez, MD @juancarlosqvelez.bsky.social · 23/10/2025

Clinic visit, pt w/type 2 diabetes + nephrotic range proteinuria. Persistent hematuria noted (normal cysto 3 mo ago) not c/w diabetic nephropathy. #UrinarySediment 🔬is performed: numerous acanthocytes and a few WBC casts. Serum IgA elevated. Normal C3/C4. Other tests pending. Kidney biopsy planned

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Hemily Zandybell, MD @zandybellnefro.bsky.social · 23/10/2025

U-Sed Case 👨‍⚕️ 46M with uveitis + acute kidney injury (Cr 0.7 → 4.4 mg/dL) 💬 Symptoms: cough, dyspnea, vomiting, 10-kg weight loss 🧪 Urinalysis: pathologic 🩻 Kidneys: normal size 💭 Could this uveitis + AKI pattern suggest a systemic autoimmune process?

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Reposted by Hemily Zandybell, MD

Nephrology Journal Club @nephjc.bsky.social · 21/09/2025

5/10 A figure paints 🖼️ a 1000 words! Here’s the infographic: Top 10 nephrology takeaways on HTN prevention & management. From albuminuria to renal denervation it’s all here: VA by @sejalplakhani.bsky.social:thanks for the visual clarity

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Hemily Zandybell, MD @zandybellnefro.bsky.social · 22/09/2025

👩🏻 48-year-old woman 📌 History: membranous nephropathy, hypothyroidism, morbid obesity 📈 Admitted for: Massive proteinuria: 10 g/24 h 🧪 Creatinine: 1.4 mg/dL 🟡 Automated urine: no red blood cells We performed urinary sediment and found the following:

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Hemily Zandybell, MD @zandybellnefro.bsky.social · 19/09/2025

👩🏻 75-year-old woman - History of epilepsy 📈 Creatinine: 2.36 → 7.3 mg/dL in 9 days 🧪 Positive MPO ANCA (61.06)

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Hemily Zandybell, MD @zandybellnefro.bsky.social · 19/09/2025

An acanthocyte is a dysmorphic red blood cell characterized by vesicles or spike-like protrusions or "Mickey ears" on its membrane. It is considered a highly specific marker of glomerular hematuria.

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Hemily Zandybell, MD @zandybellnefro.bsky.social · 19/09/2025

I'm starting a new chapter sharing urinary sediment cases here on. I'm just getting started with this platform and these types of publications, so the idea is to learn together. 💡

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Hemily Zandybell, MD @zandybellnefro.bsky.social · 15/09/2025

Today I reviewed more than 10 urinary sediment samples. 👀 Each sample is like a small universe that tells me the patient's story. #NefroLife

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Hemily Zandybell, MD @zandybellnefro.bsky.social · 09/08/2025

Our research on urinary sediment has been accepted as a poster at #KidneyWeek 2025 🩺🔬. Careful analysis of sediment remains key to diagnosis and management in nephrology. @roxnonna23.bsky.social #TeamNefrologiaAlmenara #Urinalysis #ASN #Nephrology

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Hemily Zandybell, MD @zandybellnefro.bsky.social · 08/03/2025

Ultrasound-guided CVC placement: precision and safety in clinical practice 👇👌 . #CVC #UltrasoundGuided #InterventionalNephrology #Precision #Safety

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Hemily Zandybell, MD @zandybellnefro.bsky.social · 31/01/2025

Excellent way to finish the diploma in CRT therapies, a practical workshop at the height that allowed us to reinforce everything we learned during these months. Thanks to everyone who made this possible. Keep learning 🫶 🇵🇪🇲🇽 @diplomadoTRRC

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Hemily Zandybell, MD @zandybellnefro.bsky.social · 25/01/2025

I have no words to express my gratitude to this excellent nephrologist who, with his enthusiasm and patience, has transmitted to us his knowledge about urinary sediment. see you soon and thank you Dr Fogazzi 🫶 #PHACO #urinarySediment #theBeginning #teamAlmenara

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Reposted by Hemily Zandybell, MD

Kidney International @kidneyint.bsky.social · 23/01/2025

Amoxicillin crystalluria during endocarditis treatment doi.org/10.1016/j.kint.2024.07.029 #KINephrologyImage #MedSky #NephSky #nephrotoxicity

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Hemily Zandybell, MD @zandybellnefro.bsky.social · 23/01/2025

Starting in this world of urinary sediment 🤩, it is never too late to learn. The beginning of the beginning #peruvianNeprologhists 🇵🇪 @romina21.bsky.social @juancarlosqvelez.bsky.social

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Reposted by Hemily Zandybell, MD

Juan Carlos Q Vélez, MD @juancarlosqvelez.bsky.social · 28/12/2024

Leukocyte (neutrophil) casts can be found in pyelonephritis, interstitial nephritis and glomerulonephritis. But in this case, there’s only one clear possibility. Can you tell? #UrinarySediment #UrineMicroscopy #PisseProphet

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Reposted by Hemily Zandybell, MD

Jade Teakell, MD @jmteakell.bsky.social · 14/11/2024

Since Swifties have moved en masse, I’d like to re-present one of my favorite threads 😍 Inspired by beautiful #urinemicroscopy pictures posted elsewhere... I present to you ⭐️Taylor Swift as #urinarysediment 🔬⭐️ findings... 1/ Bilirubin pigmented RTEC (renal epithelial cell cast) 🧵 #NephSky #MedSky

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Reposted by Hemily Zandybell, MD

Boris Jegorović, MD, PhD, DTMH @bjegorovic.bsky.social · 27/12/2024

#nephsky #urinesediment Patient with chronic HCV infection, now with icterus. During hospitalization developed oliguric AKI, but also received high volume of fluid. There is hypoalbuminemia (18 g/L). The spleen is normal size, but liver is very large. Here are pictures of urinary sediment 👇🏼

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Reposted by Hemily Zandybell, MD

Juan Lluncor @lluncornefro.bsky.social · 12/12/2024

Ayer en Huánuco 🇵🇪 con @zandybellnefro.bsky.social difundiendo la diálisis peritoneal. 📌Implante de TKF: técnica percutaneo ecoguiado📸🎮📌 por el Nefrólogo✅️ #InterventionalNephrology #PDFirst #PocusPerucho🇵🇪

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Hemily Zandybell, MD @zandybellnefro.bsky.social · 19/11/2024

Does anyone recognize this sign? What happened to the lung? 🫁 #pocus #lus

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Reposted by Hemily Zandybell, MD

kireports.bsky.social @kireports.bsky.social · 13/11/2024

🧑‍🎓Skytorial Alert 🧑‍🎓 1/ Hey #NephSky! Welcome to a 🆕 #BlueSky #Skytorial brought to you by @kireports.bsky.social

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Reposted by Hemily Zandybell, MD

Jonathan Zuckerman MD PhD @jzrenalpath.bsky.social · 13/11/2024

Classic case of kidney biopsy in a patient with Fabry disease. Foamy podocyte and tubular cytoplasm. Myelin inclusions in lysosomes by EM (no gloms for EM; but tubules still useful). #renalpath #nephrology #pathsky

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