Links:
Leaping into the week-end with a potassium of 9.5
— Joel M. Topf, MD FACP (@kidney_boy) July 10, 2026
Intern: How much calcium should we give?
Me: All of it. pic.twitter.com/x2p1xZaexE
AI:
Music:
All Melody by Nils Frahm
The Medieval Drone Society III by Laura Cannell
Nephro:
Apps:
Gear:
Music:
Felt (Special Edition) by Nils Frahm
From Sleep by Max Richter
Orphée by Jóhann Jóhannsson
re:member by Ólafur Arnalds
Elements (Deluxe) by Ludovico Einaudi
Rays by Aleksi Perälä
Music:
Northspring by The Last Ambient Hero — Four-track ambient album via Bandcamp.
Murmurations by Ruby Colley
Smooth Jazz Piano — Spotify playlist by funkyjlo.
Nephro:
Music:
New Ambient — Spotify's ambient playlist. Fresh releases for focus and drift.
Piano in the Background — Spotify editorial. Soft piano for working.
Max Cooper: Solace in Form — Curated by Max Cooper.
Les Idées by Phloe — On Kordel Records via Bandcamp.
Nephro:
Here is today's #eyeSCANdy! Scanning EM of a normal glomerulus showing a glomerular capillary loop with interdigitating podocyte foot processes. Photo courtesy of Dr. Stephen Bonsib. #renal #pathology #kidneypath
— Arkana Labs (@arkanalabs.bsky.social) 2026-03-11T13:03:53.073601Z
Here is today's #eyeSCANdy! Urine – calcium oxalate crystals Photo courtesy of Dr. Stephen Bonsib. #renal #pathology #kidneypath
— Arkana Labs (@arkanalabs.bsky.social) 2026-04-10T13:04:09.973945Z
Reading:
The PREVENT Calculator shows how 10-year ASCVD risk can change dramatically even with a urine albumin level in the "normal" range. Compare a urine albumin of 0 with a urine albumin of 29:
Did you know that if you type "trend eGFR" in Epic's search bar, you get this?
Nephro:
An updated eGFR Percentile Explorer App. egfr-percentile-explorer.netlify.app
— Joshua Schwimmer, MD (@joshuaschwimmer.bsky.social)
[link]
Tools:
Juicy — Beautiful Mac battery alerts and health monitoring.This eGFR Percentile Explorer is gratefully built on the work of Antoine Créon and the Stockholm Creatinine Measurements Project. (This modified work is released under the GNU Affero General Public License v3.0 (AGPL-3.0), consistent with the license of the original work.)
Tools:
Music:
AURORAE by Laura Cannell — Baroque violin and recorder, haunted and beautiful.
The Medieval Drone Society II by Laura Cannell — More drone and early music. Good pairing with AURORAE.
Sea Island by Loscil — Ambient electronics. Dense, patient, immersive.
Spotify Daily Mix — Today's algorithmic offering.Apps:
The Way — Guided Zen meditation.
Waking Up — Theory and practice of meditation.
Streaks — Track up to 24 daily habits.Nephro:
Useful for IgAN therapy: A calculator to estimate 24-hour urine protein from a spot protein-to-creatinine ratio. www.kidneynotes.com/2026/04/a-ca...
— Joshua Schwimmer, MD (@joshuaschwimmer.bsky.social)
[link]
Office Music:
Estimates 24-hour urine protein from spot UPCR using the validated multivariate Chen 2019 equation.
Chen et al. PLoS ONE 2019;14(4):e0214614Clinical caveat: Validated for proteinuria <3 g/day. Agreement with measured 24h UP weakens above this threshold (Bland-Altman). For suspected nephrotic-range disease, a timed 24h collection remains the reference standard.
| Variable | Coefficient | Encoding |
|---|---|---|
| log₁₀(UPCR) | 0.814 | UPCR in mg/mg |
| Gender | +0.110 | Male = 1, Female = 0 |
| Age | −0.004 | years |
| Weight | +0.004 | kg |
| CKD Stage Coeff | +0.002 | G1=1, G2=2, G3a=3.1, G3b=3.2, G4=4, G5=5 |
| Intercept | −0.018 | — |
Apps:
Readwise Reader — Read-later app that syncs highlights from Kindle, articles, PDFs, and RSS feeds.
Fantastical — The best calendar app on Apple platforms. Natural language event creation.
RANDOM.ORG — True random number generator. Uses atmospheric noise.
Countdown — Pretty progress bars for upcoming events and deadlines.Projects:
Reading:
Apps:
Paste — Clipboard manager for Mac, iPhone, and iPad. Keeps everything you copy searchable and synced.
Timer+ — Multiple simultaneous timers and stopwatches.
WaterMinder — Water intake tracking with Apple Health sync.Now Playing:
Music for Intersecting Planes by Kali Malone & Leila Bordreuil — drone and cello.
Tools:
Reading:
Office Music:
Apps:
Speechify — Text-to-speech for Kindle books, PDFs, and web articles.
Wispr Flow — AI voice dictation that works in any app. Mac, Windows, iPhone, Android.Now Playing:
Honora by Flea — new solo album, out this week.
Reading:
📱 Apps:
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Jomo — screen time blocker |
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Routinery — routine planner, habit tracker |
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StressWatch — AI stress monitor |
itms-apps://apps.apple.com/updates. Bypasses the front page, which I never want to see.Link blogging is new again: KidneyNotes.com
— Joshua Schwimmer, MD (@joshuaschwimmer.bsky.social) 2026-03-27T22:16:29.751Z
A KDIGO commentary on B Cell and Complement guided therapy in IgAN www.kidney-international.org/article/S008... in Kidney Int Perfectly timed for #NephMadness (and this will be the champion)
— Swapnil Hiremath 🍁🇨🇦 (@hswapnil.medsky.social) 2026-03-26T09:19:01.296Z
Here is today's #eyeSCANdy! Scanning EM of a normal glomerulus showing a glomerular capillary loop with interdigitating podocyte foot processes. Photo courtesy of Dr. Stephen Bonsib. #renal #pathology #kidneypath
— Arkana Labs (@arkanalabs.bsky.social) 2026-03-25T13:03:16.071396Z
With the stroke of a pen, his wait time moved from late 2021 to early 2018. An additional three years. This was enough to thrust him near to the top of the list. In September of 2024, Norris got his kidney and three days later he was home with a falling creatinine, feeling better than he had in years. A lot of people worked hard to remove race from eGFR equations. It can feel like an abstract policy debate. But sometimes it looks like this.
Nephrogram.com is live in time for Kidney Week: real-time, high-impact nephrology updates expertly curated by dozens of AI agents. Enjoy.
Estimating kidney function by calculating the estimated glomerular filtration rate (eGFR) is important, and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine-cystatin C equation (CKD-EPIcr-cys) is one of the most accurate ways of estimating eGFR. However, after reviewing thousands of laboratory tests from institutions nationwide, I've seen only ONE lab automatically calculate the eGFR using CKD-EPIcr-cys.
Instead, labs typically calculate eGFR using either the CKD-EPI creatinine equation (CKD-EPIcr) based on serum creatinine or the CKD-EPI cystatin C equation (CKD-EPIcys) based on serum cystatin C. But if you want the more accurate CKD-EPIcr-cys? You're on your own, and you must calculate CKD-EPIcr-cys using a website like the National Kidney Foundation.
A more practical and quicker method to estimate the eGFR of CKD-EPIcr-cys is to average the eGFR values obtained from CKD-EPIcr and CKD-EPIcys. This method is almost as accurate and significantly faster.
Consider an 81-year-old man with a serum creatinine level of 1.6 mg/dL and a serum cystatin C level of 2.2 mg/L.
Using the equations from the NKF website:
The estimated eGFR by averaging these values is (43 + 25) / 2 = 34 mL/min/1.73 m².
For comparison, the calculated eGFR using CKD-EPIcr-cys is approximately 33 mL/min/1.73 m², showing a difference of only 1 mL/min/1.73 m².
In this example, the difference in eGFR was only 1. Using the average eGFR of CKD-EPIcr and CKD-EPIcys -- both printed on most lab tests -- is usually an excellent way to estimate the eGFR of CKD-EPIcr-cys.
You can also create a macro to automate the averaging process, reporting the estimated eGFR in patient charts as "eGFR = X (avg. of CKD-EPIcr & CKD-EPIcys)."
“Intelligent Breakthrough & Silencing” is the best feature of Apple Intelligence in iOS 18.1 beta.
Apple Watch tip: you can create up to 50 watch faces (!) and randomly switch between them using this shortcut: https://www.icloud.com/shortcuts/a5a0df6d068444e5b1fe8e926c44fbad. With the Apple Watch Ultra, you can even assign this shortcut to the action button. Great for rediscovering favorite faces.