Freely Filtered 008 Deep Mind

The Filtrate (minus Matt) gather to talk about the Deep Mind trial on predicting AKI. For the first time the Filtrate invited a guest, Perry Wilson, to help them navigate the trial.


Joel Topf

Jennie Lin

Swapnil Hiremath

Perry Wilson

Samira Farouk

Show Notes:

A clinically applicable approach to continuous prediction of future acute kidney injury.

Deep Mind National Health services scandal

KDIGO AKI guidelines (PDF)  

Frank Harrell on the value of continuous variables

Wilson’s AKI Alert trial published in The Lancet, Automated, electronic alerts for acute kidney injury: a single-blind, parallel-group, randomised controlled trial.

The NINJA trial 

EPICparodyEMR on Explore the Space:

Tweet where Nassim Nicholas Taleb calls Swap an imbecile:

Blood Pressure Medicines for Five Years to Prevent Death, Heart Attacks, and Strokes.

NNT is SPRINT: In participants assigned to intensive BP lowering, major adverse cardiovascular events were reduced by 25% (5.2% v. 6.8%; hazard ratio [HR] 0.75, 95% confidence interval [CI] 0.64–0.89; number needed to treat [NNT] of 62 over 3 yr) and all-cause mortality was reduced by 27% (3.3% v. 4.5%; HR 0.73, 95% CI 0.60–0.90; NNT of 90 over 3 yr).

NNT is highly misleading when assessing chronic disease prevention.

Washington University School of Medicine establishes Division of Physician-Scientists

Physician scientists in the NEJM 

NYT article on Physician Scientists:

brussels.sprout on Instagram  

Freely Filtered 007 MENTOR

The Filtrate (minus Samira) gather to talk about MENTOR the randomized trial of Rituximab versus cyclosporin for the treatment of idiopathic membranous nephropathy.


Joel Topf

Jennie Lin

Matt Sparks

Swapnil Hiremath

Show Notes:

NephJC Coverage of MENTOR: 


KDIGO Membranous recommendations: 

2017 Kidney Week Abstract:


Heymann Nephritis:

Susan Quaggin:

Manasi Bapat on non-inferiority trials:

Prognosis and risk factors for idiopathic membranous nephropathy with nephrotic syndrome in Japan:

Nice review of Membranous by Alfaadhel and Cattrran that purports to say than CNI are the standard therapy for idiopathic membranous. (It doesn’t) 

Pablo Garcia saves the day: 

Larry beck’s land mark study demonstrating antiPLA2r as the antigen in idiopathic membranous. 


Jennie Lin’s How to Be a Nephrology Fellow, Choose Your Own Adventure: 

CJASN How to Review a Paper Podcast: 

Freely Filtered 006 SONAR

The Filtrate (minus Matt) gather to talk about SONAR the randomized, placebo-controlled trial of atrasentan for the treatment of diabetic nephropathy.


Joel Topf

Jennie Lin

Samira Farouk

Swapnil Hiremath

Show Notes:

NephJC coverage of SONAR:

SONAR in PubMed:

Avosentan for overt diabetic nephropathy, the ASCEND trial:

RADAR coverage at NephJC, May 2014:

RADAR in PubMed:

Google Hangout on RADAR:

Vlado Perkovic:


Nephmadness adaptive trial:

KIDNEYcon adaptive trial tweet thread:

Excellent NEJM review on adaptive trials:

Potential role of Adaptive trials in AKI:

BNP levels in CKD:

Generalizability from Wikipedia:

Anemia (and other adverse effects of Endothelin antagonists)

Data safety monitoring boards:

AbbVie Allergen Merger:

Tangri Kidney Failure Risk Equation:

Fragility index paper

LITFL write up

Calculator (many) eg


Rates of Hyperkalemia after Publication of the Randomized Aldactone Evaluation Study by David Juurlink et al.:

Vinay Prasad:

Classic mouse studies looking at endothelin:

Nice reviews:

Review of vascular effects:

Freely Filtered 005 IgA Nephropathy

The Filtrate (minus Samira) gather to talk about predicting the natural (or not so natural history) of IgA nephropathy.


Joel Topf

Jennie Lin

Matt Sparks

Swapnil Hiremath

Show Notes:

Levi Strauss:

Levey MDRD study:

ADPKD Total Kidney Volume:

Halt PKD:

Tempo 3:4 Trial:

Description description of IgA nephropathy by Berger and Hiunglais:

The reprint in JASN in 2000 with commentary as part of the Milestones in Nephrology series: JASN supplies an English translation from the original French.

Nice reference from JASN backing up Matt’s assertion that preeclampsia and not IgA nephropathy is the most common glomerular disease in the world:

Description of the Singapore Army screening recruits from the Oxford Textbook of Clinical Nephrology:

Description of the Japanese glomerulonephritis screening program:

Swapnil’s studies on autopsy studies:



Nephrology Secrets, either one of the best or the best nephrology textbooks ever:

TESTING Trial on NephJC:

Stop-Iga Trial on NephJC:

Testing Trial two: Therapeutic Evaluation of Steroids in IgA Nephropathy Global Study Low Dose Study:

MEST Score versus MEST-C in NephJC:

Nice discussion of the statistical tests during the Tweet Chat by people who know their stats (I.e. not Joel):

Tweet-length description of IDI:

Assessing the performance of prediction models: a framework for traditional and novel measures.

Net Reclassification Indices for Evaluating Risk-Prediction Instruments: A Critical Review

Predicting Progression in CKD: Perspectives and Precautions

The Article by Nancy Cook in Circulation that Jennie was talking about: Use and misuse of the receiver operating characteristic curve in risk prediction.

Discovery of new risk loci for IgA nephropathy implicates genes involved in immunity against intestinal pathogens

Genome-wide polygenic risk predictors for kidney disease

Where does Matt find minutia like the grams of IgA produced a day? Here:

Animal models of IgA nephropathy:

Matt’s Book Originals:

Eric Neilson, Dean of Northwestern University

Brussels sprout Insta-famous dog and future dean of the medical school:

Josh Farkas Rantorial about Contrast Nephropathy:

Swapnil’s Tweetorial about Contrast Nephropathy:

Tukaram’s pic of NEJM’s progression from Contrast Induced Nephropathy to Contrast Associated Nephropathy:

Zero sodium dialysate for heart failure?

Freely Filtered 004 Hypernatremia

The Filtrate (minus Swapnil) gather to talk about the treatment of hypernatremia.

Show Notes:

Joel Topf

Jennie Lin

Matt Sparks

Samira Farouk


The strange story of Jennifer Strange.

Water Poker

 Nintendo Game Consoles

2019 Narins winner, Mitchel Rosner on MDMA induced hyponatremia

And Rosner again on exercise induced hyponatremia.

The Arieff article on the dangers of severe hyponatremia: Hyponatremia, Convulsions, Respiratory Arrest, and Permanent Brain Damage after Elective Surgery in Healthy Women

The Richard Sterns article on the dangers of rapid correction of hyponatremia: Osmotic Demyelination Syndrome Following Correction of Hyponatremia

The editorial by the man himself, Robert Narins: Therapy of Hyponatremia

The infant study showing seizures associated with rapid correction of hypernatremia.

Follow up study with oral rehydration.

The Linder study of adults admitted to the ICU

French study on patients presenting to the ER with hypernatremia.

Study on US veterans showing poorer outcomes with slow correction of hypernatremia.

Cerebral edema during the treatment of DKA.

The MIMIC 3 Database. MIMIC is an openly available dataset developed by the MIT Lab for Computational Physiology, comprising deidentified health data associated with ~40,000 critical care patients. It includes demographics, vital signs, laboratory tests, medications, and more.

Chalrson Comorbidity Index

The paper: A new method of classifying prognostic comorbidity in longitudinal studies: development and validation.

JCI article on organic brain osmnoles in response to hypernatremia

John Booth on the value of MIMIC 3

Sri Lekha on checking labs in hypernatremia

Steve Coca on chunky water administration

Steve Coca musing the Cersei’s sodium level

Steve Coca swearing in High Valarlian:

Steve Coca proving the non-existence of hypernatremia therapy being associated with brain damage through the inability of trial lawyers to find and sue doctors for this issue:

The original paper on the Kardashian Index

Kardashian Index Calculator

Facebook CEO Mark Zuckerberg says the ‘future is private’

Khenar Jhaveri et al on ‘WhatsApp’ening in nephrology training

Mike Morrison’s video on how to rebuild the scientific poster

Mike’s Twitter: with lot’s of examples of his design in the wild.

Make your own QR code:


Ten Worst Drugs for your Kidney:

Drugs that can falsely elevate your creatinine levels:

Dr Orrange, not wishing to engage on Twitter in a meaningful way: