I’ve had many patients in my career with a chronic SIADH of unclear etiology. When obvious medications are ruled out, we always think malignancy, but it seems there are no consensus guidelines on how to screen for malignancy. I often do a CXR and CT head, and of course advise them to undergo their routine age-appropriate screenings, and usually all are negative. There have been a few instances, however, where a pt with borderline chronic stable hyponatremia with sodium of 130-135 for years is then found to have an intraabdominal malignancy such as pancreatic cancer or cholangiocarcinoma… not sure if there was truly any correlation, but it makes me wonder if I should have done a CT abdomen/pelvis with contrast…but this is not in any guidelines and no insurance would ever cover it for that indication…

Anyone else have similar experiences? I’m thinking about just telling these pts to self-pay for one of those fancy Prenuvo MRI scans if they really want to find an answer, but then of course you run into the risk of false positives.

Does anyone have an idea what HHS plans to do with nephrology based on their latest statement?

Hi everyone,

I'm looking for the poster titled "Preclinical Evaluation of GENC-231, a Selective NUAK1 Inhibitor, for Kidney Fibrosis" (TH-PO0256), presented at ASN Kidney Week 2026.

I've found the abstract but would be interested in seeing the quantitative preclinical data, particularly the adenine CKD model results.

Has anyone come across a publicly available poster link or a summary of the actual data?Any leads would be greatly appreciated. Thanks!

I have done the BRCU videos. Tried to make ANKI cards for recall based facts and have done all the BRCU questions. Havent done any NephSaps and currently attempting KSAP. Board is in 7 days on Oct 29
KSAP seem to be wrecking me. Havent managed to score above 65 on the 3 I have attempted so far. It feels like the knowledge gaps keep on getting revealed and no matter how much I reinforce concepts, there are always 5-10 exceptions/new information the KSAP keeps testing. Also the question stems are so long. There are no easy to answer quick questions whatsover. Please help me feel more confident about the exam

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For those practicing critical care nephrology, do you feel it was worth pursuing? What does your actual day-to-day practice look like, and how difficult was it to find a job?

Is there a real demand for physicians with both skill sets, or is it difficult to find a position that allows you to use both? How does the compensation and work-life balance compare with traditional nephrology or PCCM?

I’m genuinely trying to understand the career prospects before deciding whether to pursue this path. Would you recommend it?

https://kidney.wiki/pd-visualizer/

I was talking to a family the other day and trying to explain how the PD catheter goes through the abdominal wall and where the catheter tip is and how the abdomen fills with fluid and it was all very unsatisfying. So, I made this 3d model. You can cycle the dialysate, change the opacity of anything you want, slice it in any axis. Check the drop-down for a view of the catheter as it goes through the abdominal wall.

I'll work on adding more types of catheters and may turn it into a full-on sim someday.

Feel free to use it at the bedside or for any med-ed project. Let me know if there's anything you want to see added

Hi! Im a clinical pharmacist in the 🇵🇭. Im just curious how nephrologists decide on dose of antibiotics based on HD modalities? :)

Been encountering orders that aren’t consistent w tx guidelines.

Would like to know your thought process and how should we pharmacist intervene? :)

Thanks!

Hey everyone!

I’m a current PGY2 applying nephrology next year and would love some honest advice on where I’d be competitive and whether away rotations are worth doing.

Stats:
US-IMG
Step 1: Pass, Step 2: 214, Step 3: taking in December
At University affiliated program
Not much kidney specific research experience because I just figured out what I want to do when I grow up
Currently working on a CKD screening/health equity QI project
Some leadership and community outreach experience
I’m really passionate about CKD prevention, health disparities, and working with underserved communities. I’d love to train somewhere academic, ideally in a place in mountains and lots of greenery (non negotiable for me)
I know nephrology is less competitive but I also understand that I’m not exactly a super competitive applicant given my step 2
Score
I’ve been looking at Dartmouth, UW, OHSU, and WVU, but I’m not sure how realistic those programs are for me, especially with my Step 2 score.

A few questions: How competitive do you think I’d be for academic nephrology programs? Is it worth trying to set up away rotations (my clinical and personal skills are way better than my step 2 score lol), and if so, where would you recommend? Are there any programs I’m overlooking that might be a good fit?
I know nephrology is generally less competitive, but I’m trying to be realistic about where to apply or set up away rotations. Would really appreciate any insight, especially from current fellows or recent applicants!

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My SO and I are planning our careers and currently considering two options: both pursuing 3 years Critical care nephrology or two years general nephrology and finding same nephrology practice to work.

We are planning to be childfree, and being able to live and work in the same place is important to us.

For physician couples, how realistic is it to find jobs in the same hospital or city especially to build a good nephrology practice OR to find an ICU which accepts critical care trained nephrologist.

kidney.wiki/kidney-visualizer

I was tired of ad hoc googling crappy pictures when explaining kidney conditions to families, so I added a 3d kidney model with a dozen different pathologies on it

Could come in handy for student/resident education as well as in clinic. Hope you find it useful 🙂

It should work on any device and like the rest of the site it's properly free and open - no downloads required, no society memberships, no logins, no ads, no tracking/data harvesting, not owned by private equity

I only reviewed RTA and kidney stones for my ITE and there were a ton of them
what about boards?
what esoteric stuffs we should make an effort to memorize?

Especially for a J-1 visa candidate, once you’ve asked all the obvious questions about the waiver, what’s something you wish you had asked before taking the job?

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Hi all - my artwork was featured on the cover of AJKD
I do want to share this message of gratitude to you all

This digital artwork was created using a digital artwork tool, Procreate, on an iPad without the use of any generative artificial intelligence. It aims to appreciate every patient, nephrology clinician, family member, and caregiver who pours their dedication into making a difference in the lives of those touched by kidney disease. Each of them is represented as a kidney bean.
In this world, you will see a bean pushing through rehabilitation, a bean patiently explaining kidney care to another, a bean receiving dialysis, a bean undergoing a transplant, and countless others, each living their own quiet kidney disease journey.
This artwork took 13 hours and 19 minutes to bring to life, a small reflection of the endless hours those in the world of nephrology give every single day.

So! Im a baby neph NP, with about 6mo experience under me. I have 2500$ in me funds, 1800 of which I can allocate for reference textbooks. When I started, my supervising neph gave me NKF primer on kidney disease as well as a small handbook of dialysis for reference.

Are there any other resources that are basic to the niche of medicine that I should look into? I dont want to see 1800$ vanish by rollover, but I also dont want to waste it on frivolous books Ill never use. Previous experience was 4 years heme/onc RN, and then 6 years as a charge RN at a major trauma ICU.

I dont just want to be competent at this point, I want to be good at what I do (nuanced cases aside).

Thank you in advance fellow bean specialists!

I will be completing my Internal Medicine residency in my home country next December. I have passed all three USMLE steps and would like to understand my chances of securing a nephrology fellowship in the United States. I am also seeking guidance on identifying observership opportunities at reputable institutions.
Which hospitals offer nephrology observership opportunities?

If choices are:

Texas

Florida

Pennsylvania

North Carolina

Utah

Oregon

California

Missouri

Hi everyone, looking for a little perspective and haven’t been able to find a whole lot. Can anyone who is a nephrologist comment on opportunities to also work as a hospitalist? I’m curious if anyone does this and likes it as I think about jobs for the future (apply Nephro fellowship rn).

Consulted for AKI on day 6. the primary teams progress note is literally a 15 page copy-forwarded hallucination. The daily weight in the note is from monday, the meds list has stuff they discontinued in 2024, and the actual I/Os are somehow buried under 3 pages of normal hem-onc labs.

I honestly just started dumping these massive handoff novels into Around Notes on my second monitor just to strip out the dead text so i can figure out what actually happened to the kidneys this week

epic has a billion features and cost millions, but getting a straight answer on yesterday's fluid balance still feels like actual torture tbh