
IMRes @UICDOM; @OSUPublichealth; Hypertension+Neph @BWHKidney @MGHKidneys ‘09; @Chicagobooth; Let’s make things better! #EPluribusUnum
New York, USA
Joined January 2010
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Presented at #ScientificSessions26:
In patients with type 2 diabetes and high cardiovascular risk, a systolic blood-pressure target below 120 mm Hg did not result in fewer major cardiovascular events than a target below 140 mm Hg. Full OPTIMAL-DIABETES trial results: nej.md/3UZYKCy
@AHAScience

ALT A graph from the Original Article "Intensive Blood-Pressure Lowering in Patients with Type 2 Diabetes.” The trial name, OPTIMAL-DIABETES, is in parentheses after the title. The graph shows Kaplan–Meier curves for the primary outcome. The trial results are being presented at the American Heart Association Scientific Sessions 2026. The logo of the New England Journal of Medicine is at the bottom.
TEJAS PATEL MD, MBA, MPH retweeted
it’s incredible that in the relentless march of progress forward in creating a healthier population, doctors have made so few mistakes that they can be summed up in a tweet
The year is 1873. Your wife tires easily and reads too much. The doctor prescribes the rest cure: six weeks flat in bed, no books, no visitors, fed on milk, forbidden to sit up without his permission. The man who devised it is the most famous nerve specialist in America, and the women come out of it quieter, which is taken as the cure.
The year is 1915. The hospital has a new way of delivering your child. Morphine, then scopolamine, and the mother wakes two days later with a baby she cannot remember having. They call it twilight sleep. The women are strapped into padded cots so they do not hurt themselves while they scream, and the straps are the modern part. The babies arrive blue and slow to breathe.
The year is 1945. The truck comes down your street fogging DDT, and the children run behind it in the white cloud because the man on the back says it is harmless. At the beach it is sprayed over the bathers on their towels. It goes on the cattle, over the barn, and across the kitchen table.
The year is 1948. Your son has trouble with his ears. The doctor slides a rod tipped with radium up each nostril and holds it there for the best part of ten minutes, and you bring him back three more times. Hundreds of thousands of American children get the same treatment. The cancers arrive in their fifties.
The year is 1962. The health visitor tells you breastfeeding is old-fashioned and the formula is scientific. By 1972 fewer than one American baby in four is breastfed at all. The formula is skimmed milk and sugar, with the milk fat taken out and vegetable oil put in.
The year is 1971. The family planning clinic fits a small plastic crab called the Dalkon Shield. Its tail is a bundle of fibres that wicks bacteria up into the womb. 2.8 million are fitted in America before it is withdrawn, and the company goes bankrupt under the claims. It had been sold as safe and superior.
The year is 1983. The doctor says your arteries are the butter's fault. The dripping tin goes in the bin, the yolks go to the dog, the margarine goes in the fridge, and you have the heart attack anyway, on skimmed milk, having done everything right.
The year is 2001. Your 15-year-old is low, and the doctor prescribes Paxil, because the trial in the journal says it is effective and well tolerated in adolescents. The raw data, reanalysed 14 years later, shows more suicidal thinking on the drug than on the sugar pill. The company pays $3 billion to settle. Nobody rings the house.
The year is 2009. The government has spent around £500 million stockpiling Tamiflu for the pandemic, on the strength of the manufacturer's trials. When the trials are finally prised loose five years later, the drug shortens flu by about half a day and nothing shows it keeps anyone out of hospital. The stockpile goes out of date in a warehouse.
The year is 2026. The doctor has ten minutes and a screen. The number is high, so the tablet is for life. The weight is high, so the injection is for life. The meat is bad for the planet and the oil is good for the heart, and the person in the chair is as certain as everyone who ever sat in it.
Every one of those was settled, by a committee, in a journal, with a doubter somewhere being laughed at. The rest cure, the straps, the fog, the rod, the formula, the crab, the margarine, the trial, the stockpile. All of it certain, all of it printed, all of it done to somebody who had asked for help.
You were never the one who was wrong. You were the one it was done to, and the only person in the story who did as they were told every single time.
The apology comes a generation late, in a footnote, addressed to nobody.
The next one is being drafted now.
TEJAS PATEL MD, MBA, MPH retweeted
The prevalence of large language model-associated words rose substantially in the 2024 application cycle, while changes to linguistic complexity, personalization, and topic diversity were modest tinyurl.com/44fktr7c #MedEd
TEJAS PATEL MD, MBA, MPH retweeted
In a real world analysis of Non Randomized observational data, #Fineranone was associated with a reduction in events vs #spironolactone in the treatment of #HFpEF (hypothesis generating data)
academic.oup.com/eschf/artic…
TEJAS PATEL MD, MBA, MPH retweeted
Apparent resistant hypertension affected about 40% of people with CKD and type 2 dm in CONFIDENCE. Finerenone plus empagliflozin lowered BP more than either drug alone, on par with spironolactone but without its hyperkalemia burden. Now in JACC: Advances: sciencedirect.com/science/ar…
TEJAS PATEL MD, MBA, MPH retweeted
Please for heavens sake DON’T put your patients at risk. I recommend both Daratumumab based therapy and plasma exchange for acute light chain cast nephropathy specially in newly diagnosed myeloma.
These papers which mix up patients cause me more problems. Dara VCd plus plasma exchange is the best therapy for acute light chain cast nephropathy. If you treat patients with some other cause for renal failure with this approach it won’t help. If you have a doubt on the diagnosis of acute light chain cast nephropathy, renal biopsy will be needed.
If you start therapy late when the renal failure has been there for over a month therapy won’t work. If you give suboptimal therapy (Dara alone etc) you cannot hope for the plasma exchange to work. If you give Dara based therapy without plasma exchange you can’t hope for renal recovery quickly because it takes 2-4 weeks for the therapy to work and in that time the kidney is getting damaged. You need BOTH in a timely manner.
Plasma Exchange and Daratumumab for Myeloma Cast Nephropathy
-In a multicenter cohort study, neither PLEX nor daratumumab was associated with kidney recovery at 90 days #mmsm #bmtsm @cshincovich @ShrutiGkidney
onlinelibrary.wiley.com/doi/…
TEJAS PATEL MD, MBA, MPH retweeted
In 2012 I said machines would do 80% of what doctors do. Many were furious. Now AI out-diagnoses doctors in study after study. Is printing organs on demand next? Having your own stem cell repository is next generation "planning".
@cellinobio is building autonomous foundries that make personalized stem cells with AI and lasers. Your cells age every day. Preserve your immune cells with @withreservoir. Excited to back @nabihasaklayen, @madridmarinna & team.
In partnership with Vinod Khosla (@vkhosla), I’m proud to introduce Reservoir.
Billionaires have owned their cells for years. Starting today, you can too.
Sign up today: withreservoir.com
TEJAS PATEL MD, MBA, MPH retweeted
Just published @TheLancet
Global threats to health in the 21st century
an opus, 59 page comprehensive dissection of all the threats we face
thelancet.com/journals/lance… @IHME_UW
TEJAS PATEL MD, MBA, MPH retweeted
A pragmatic poll about pragmatic trials indicates they may not be either pragmatic or informative re decision making ... jamanetwork.com/channels/tri…
TEJAS PATEL MD, MBA, MPH retweeted
No, they can't measure blood pressure accurately.
American Heart Statement: "currently available devices may be inappropriate for clinical use." and "using these devices to guide treatment could lead to inappropriate care and may pose safety risks to patients." @American_Heart
ahajournals.org/doi/10.1161/… open-access
gift link wsj.com/health/wellness/bloo…
TEJAS PATEL MD, MBA, MPH retweeted
Based on solid evidence, all mammograms should include 3 AI algorithms and they should be free to patients: (1) better detection of breast cancer, (2) detecting cancer risk in the next 5 years despite a "normal" mammogram, and (3) risk of heart disease.
erictopol.substack.com/p/why…
Todays' article on future risk (2)
nytimes.com/2026/10/01/well/…
TEJAS PATEL MD, MBA, MPH retweeted
The GRAIL NHS Galleri randomized trial with over 142,000 participants was published today @NEJM
"In this trial, we did not observe a lower incidence rate of stage III or IV cancers [the primary endpoint] across 12 prespecified cancers after three screening rounds with multicancer early-detection testing plus usual care than with usual care alone."
nejm.org/doi/full/10.1056/NE…
TEJAS PATEL MD, MBA, MPH retweeted
The potential to predict breast and prostate cancer up to 8 years before it is diagnosed from blood cell-free DNA methylation patterns
cell.com/cell-genomics/fullt…
TEJAS PATEL MD, MBA, MPH retweeted
Refounding America: The Tax Code Needs to Change in the Age of AI. I’m as certain as I’ve been about anything that AI will do 80% of each job for 80% of jobs or 64% of human labor. Yet we tax labor at higher rates while giving capital preferential tax treatment. Exactly backwards for the AI era! We need to rebalance towards labor & help those impacted.
khoslaventures.com/posts/ref…
TEJAS PATEL MD, MBA, MPH retweeted
I am grateful to the legendary @Bob_Wachter of @UCSF for spending some time with an advance copy of “The Moral Alibi.”
I appreciate his comments:
“We have come to accept a healthcare system that underperforms with stunning regularity. Jain argues, persuasively, that this is less the product of bad people than of good people averting their eyes. In refusing to avert his own, he has produced a masterwork of moral courage.”
Learn more about the book and preorder it at its website:
themoralalibi.com/
TEJAS PATEL MD, MBA, MPH retweeted
Excited to join Roon as a Founding Physician in hematology, and thrilled to bring The Blood Project along with me.
Another place to talk blood, ask questions, and learn from one another. 🩸
We’re excited to welcome Drs. Ariela Marshall (@AMarshallMD), William Aird (@WilliamAird4), Julie Kanter (@jkw4444), and Long Zheng (@DrXLongZheng) as Founding Physicians in hematology on Roon.
Together, they bring perspectives from across the field, from classical hematology and sickle cell disease to vascular biology, transfusion medicine, and TTP. They’re clinicians, researchers, and educators who are advancing the field and shaping how hematology is practiced and taught.
We’re honored to have their voices shaping the conversations on Roon.
If you’re a physician working in hematology, join them: roon.com/doctors?utm_campaig…
TEJAS PATEL MD, MBA, MPH retweeted
The first educational material I made after becoming an attending nephrologist.
One sheet of cardstock. Full color. Two-sided.
Everything you needed to know about CKD.
Before the smartphone. Before apps. Before UpToDate in your pocket.
There was cardstock.
TEJAS PATEL MD, MBA, MPH retweeted
Our latest study, just published in @TheLancet, reports the first successful transition from porcine kidney #xenotransplantation to human kidney transplantation.
A genetically engineered pig kidney provided >9 months (271 days) of dialysis-free kidney function before successful human transplantation, supporting xenotransplantation as a potential bridge while preserving future transplant options.
Beyond the clinical milestone, the study provides new insights into late microvascular inflammation and innate immune activation that will help shape future immunosuppressive strategies and donor genetic engineering.
Link to article: thelancet.com/journals/lance…
@mgh_transplant @MGHSurgery @MGBResearchNews @MGBKidneys @eGenesisBio
TEJAS PATEL MD, MBA, MPH retweeted
In specialties with high application-per-applicant volume, a high-signal approach is associated with reduced application numbers and associated costs tinyurl.com/bddh66y4 #MedEd
TEJAS PATEL MD, MBA, MPH retweeted
1/2
WHAT DOES COPPER HAVE TO DO WITH IRON?
More than I realized.
Copper-dependent ferroxidases help move Fe from cells → transferrin → erythron.
So copper deficiency can impair Fe delivery even when Fe is present.
And that’s only one way copper deficiency causes anemia.






























