Welcome to NephJC, the Twitter Nephrology Journal Club.
NephJC meets twice a month to discuss the research, guidelines, and editorials that are driving nephrology forward. We use the open, social media platform, Twitter to allow people across medicine to participate. We regularly get doctors, students, fellows, patients and residents participating in our spirited conversations. After the chat the conversations are archived by Symplur and in Storify. You can also follow our posts on Pubmed.
Scintillating chats, very capably moderated by Joel and Francesco. From evidence based medicine full thermonuclear gif war!
In a NephJC first, first author, Laurie Tomlinson wrote up some comments on the implications of her study.
ACEi, ARBs, the increase in creatinine and health outcomes: Now for some retrospective data.
The #NephJC chat on the #Descartes workgroup statement had a thriving conversation. One of the questions that came up was about allowing one's children to donate.
Kevin Fowler shares his thoughts as a transplant recipient on the safety of kidney donation.
Visual Abstract for this weeks NephJC chat. Now updated with NNH.
Chat on Tuesday and Wednesday April 11 and 12. EDTA Descartes Work Group white paper on the risk of kidney donation.
Do APOL1 risk variants lead to a podocytopathy? A basic science #NephJC
“A bear, however hard he tries, grows tubby without exercise.”
CKD Staging: helping or hurting patients and nephrology. Tuesday Sept 26th. #AskASN.
One last patient perspective on the Himmelfarb Editorial.
Fabulous chat - great, though-provoking conversation, with comments from Dr Himmelfarb, and some GFR/CKD staging experts. Thanks again to the staff at CJASN for making the article free for us this month.
Patient awareness of kidney function is the first step to patient engagement.
Precision Medicine & CKD: A Call to Arms or a Howl at the Moon?
Fantastic chat. Lot of participation - though the study didn't seem to move the needle much!
Kevin Fowler talks about his thoughts on Harmony and what they may mean to patients
Rapid steroid withdrawal after transplant. Can it be done safely and can it reduce the risk of diabetes after transplant? Find out in the next exciting edition of NephJC.
The winners of the inaugural NephJC Kidneys
Thanks for voting. On friday November 18th at the #KidneyWk TweetUp we announced the winners in all 5 categories.
Rookie of the year: Silvi Shah
Most Valuable Player: Kevin Fowler
Engaged Scientist of the Year: EXTRiP
Study of the Year: AKIKI
Kidney Week 2016 posts
This week, we will discuss the fresh-off-the-press NEJM paper on the utility of using NAC (vs placebo) or bicarb-based hydration (vs saline) in preventing contrast AKI. A medical reversal that has taken almost 2 decades...
Iodinated contrast is well known to cause acute kidney injury (AKI), mainly from its physico-chemical properties, and is the commonly cited as being the third most common cause of AKI in hospitalized patients. But is this really true? Even the term contrast-induced AKI (CI-AKI) is now being increasingly replaced by contrast-associated AKI (CA-AKI), and could contrast be an 'innocent bystander'?
Stop-IgAN suggested steroids may not be useful in patients with intermediate range proteinuria. Now, in a different population with more proteinuria, TESTING finds a mixed result: some benfit + more adverse events. Should we keep on TESTING?
The #NephJC chat on IgA nephropathy and the significance of crescents was quite exciting, and we were fortunate to have Dr Jonathan Barratt, one of the authors, join us for the EU chat. Thanks again to JASN for providing full text access!
The Oxford pathology classification does not include crescents in its assessment of IgA nephropathy. This was due to the low number of crescents on the initial cohort. This week's NephJC looks at a recent attempt to right this oversight.
Hyperhomocysteinemia was all the rage a few years ago. Sadly, as is often the case, trials to lwoer homocysteine failed to show much clinical benefit. Now comes a trial to test the effect of follic acid, on CKD prevention. With an N > 15,000 - this should make for an interesting NephJC discussion.
Talking to people about donating a kidney is very difficult. This week's NephJC looks at an app that helps recipients talk about their disease and why they need someone to donate a kidney. The app is backed up by a study to support its efficacy.
Hector was quick on the draw and had last night's chat all summarised by sunrise the next morning. Here for your reading pleasure.
Historically nephrology is a specialty that has been criticized for it’s inability to produce high quality randomized controlled clinical trials designed to answer a specific question. So, when the Lancet publishes the results of a clinical trial in the field it is worth taking note.
The NephJC Summer Book Club met at the end of July and discussed Eric Topol's provocative book, The Patient Will See You Now. Explore the book through the following posts:
Despite the summer and vacations, we had two very successful chats. This post has links to the full archive of the discussion as well as two curated Storifys.
In the final chapter Topol discusses what needs to happen in order to get from where we are now to a truly emancipated patient. It is a tall order. Dr. Sparks dissects the chapter.
In the penultimate chapter, Topol turns to the developing world and how digital technologiee have the potential to improve health for the poorest humans.
Special guest Scott Brimble reviews the thirteenth chapter on predicting and preempting disease. Scott adapts the lessons of David Sackett and has a skeptical angle on the chapter.
Topol takes on privacy and security in our digital world. This is the darkest chapter of the book. It is filled with problems and the answers he poses seem thin and inadequate.
Intelligent analysis of all the big data we are on the verge of creating in medicine will be the engine that drives future innovation. In cahpter 11, Dr. Topol outlines how open source organization will allow us to harness the potential of this data.
In chapter ten, Dr. Topol describes the hospital of the future which will be very different than today's hospital. Dr. Daniel Coyne is not convinced.
Eric explores how digital tools will allow virtualization of the entire medical encounter. Hello Tricorder.
In chapter 8 Topol looks at the absurd costs of medical care. He also shines a light on possible solutions. Dr. Burgner takes us through it.
Tool looks at electronic medical records and how they can be the bridge to better care. He discusses the potential for EMRs to allow patients to have real access to their medical information. Also pills with electronic trackers.
In this chapter Topol discusses the future of lab tests. It is a bit dated as he lauds Theranos prior to their implosion, so it is a kind of trip down memory lane.
GPS is so successful at concurring location that getting lost is outdated. Eric discusses The personal GIS, or geographic information system that integrates all the 'omics of a single individual and which could make medicine outdated.
Chapter Four. The intersection of genes, breasts and the power of celebrity. The story of Angelina Jolie's choice and how it changed the conversation on patient empowerment.
Topol goes deep into the revolution that was the printing press and how similar it looks to the current smartphone revolution.
Paternalism has defined the doctor-patient relationship for millennia. However this aspect of medical cultureis collapsing. Dr. Lerma dissects chapter 2, a deep dive into medical paternalism.
Eric Topol begins this book by setting the stage of why patients will become more empowered. Topol argues that patients are not going to settle for the amount of power physicians are comfortable yielding, but rather that forces larger than medicine will fundamentally alter the traditional patient-doctor relationship.
You still have time to buy Eric Topol's The Patient Will See You Now in time to be ready for #NephJC's summer book club. We will be discussing this on July 26 and 27 at the usual @NephJC times.