Dog dad | PGY2 @IMResidencyDuke via @MedicalCollege 🩺 @UWMadison 🦡 @MHIF_Heart 🫀 | Aspiring nephrologist 🫘| Runner🏃♂️, cyclist 🚴, @Strava fan
Durham, NC
Joined September 2020
- Tweets743
- Following619
- Followers351
- Likes4.1K
Pinned Tweet
Someone tell this little boy amidst his cancer treatment that he's going to be an internist!!! Can't wait to sign my first furosemide order in a few months!
Thanks to everyone's mentorship who got me here, especially @AnnaGaddy
#Match2025
Test yourself at NephroPOCUS.com with VExUS cases and more.
I’ve been lucky to learn from @NephroP @MedicalCollege and to continue to learn #POCUS from him continuously through social media while @IMResidencyDuke. It’s what keeps #MedTwitter worth having!
1
2
95
@nephroP moving forward to the next interface, consider lung POCUS. Reminder of the improved fidelity of lung US compared to CXR from the previous session
1
1
34
Off and rolling at #KidneyWk with perspective from @ssfarouk on utilizing social media to address nephrology workforce needs — #nephrologyiscool
1
2
165
See you at #KidneyWk run club Friday and Saturday!
Been getting in the hiking miles in RMNP the last few days
5
220
Chris Gitter, MD retweeted
Finally, hematologists won’t be badgered to give EPO+Iron+Folate cocktails in desperately sinking JW acute bleeders. I welcome this development, but mourn the unnecessary loss of lives for those who died on this hill.
jw.org/finder?wtlocale=E&doc…
Chris Gitter, MD retweeted
Queen of Hearts Now FDA Approved!!
What’s her take on this “Non-diagnostic” ECG?
drsmithsecgblog.com/queen-of…
@PMcardioApp
Chris Gitter, MD retweeted
A new era in the rapid diagnosis of STEMI/STEMI equivalents has begun. Rapid diagnosis of ACS that needs immediate, emergent intervention can only be done by the ECG. FDA authorization for the queen of hearts. “deNovo “ means it is the first device of its kind in the world.
Chris Gitter, MD retweeted
Silo Season 3 concludes with the highest rated episode of the show, cementing it as one of the greatest sci-fi shows ever made.
On, Wisconsin!
You can’t spell Wisconsin Welcome without… well, you know 👐
Say cheese, #UWMadison Class of 2030! #WIWelcome
ALT An overhead wide shot of thousands of incoming students wearing red shirts assembled on the field at Camp Randall Stadium to form a massive Motion W logo.
1
157
Chris Gitter, MD retweeted
Can chronic kidney disease give you a false-positive renal venous Doppler?
That is an important concern when using intrarenal venous flow as a marker of venous congestion.
Kondo et al. studied 228 patients with heart failure who had intrarenal venous Doppler, echocardiography and right-heart catheterisation performed within 24 hours.
29% had discontinuous intrarenal venous flow.
Those patients had higher:
• mean right atrial pressure
• mean pulmonary artery pressure
• pulmonary artery wedge pressure
The important finding was that this relationship persisted across different stages of chronic kidney disease.
In multivariable analysis, higher mean RAP, higher mean PAP and at least moderate tricuspid regurgitation were independently associated with discontinuous renal venous flow.
Why does this matter?
We already know that renal venous Doppler patterns are primarily markers of venous pressure transmission, not intravascular volume.
But a reasonable worry is that chronic renal disease might itself distort the intrarenal venous waveform and produce a “congested” pattern even when central venous pressures are not elevated.
This study is reassuring: abnormal intrarenal venous flow continued to track invasively measured haemodynamic congestion despite worsening CKD.
That does not mean every abnormal renal venous waveform equals high RAP, and it certainly does not mean “abnormal waveform = needs diuresis”.
But it strengthens the case that renal venous Doppler remains a useful haemodynamic signal even in patients with chronic kidney disease.
Key takeaway: CKD does not appear to make intrarenal venous Doppler uninterpretable. A discontinuous waveform still seems to reflect congestion rather than simply intrinsic renal disease.
Kondo K, Nishikawa T, Imai A, et al. Clinical Applicability of an Intrarenal Venous Flow Analysis for the Diagnosis of Impaired Hemodynamics regardless of the Chronic Kidney Disease Stage. Internal Medicine. 2026. DOI: 10.2169/internalmedicine.7559-26
@ThinkingCC @NephroP @ArgaizR @khaycock2
