We had some mindblowing #NephJC chats on CREDENCE over the the last week.

The chats were hosted by Swap, Aakash and Laura with NSMC intern Ted Fitzgerald making his hosting debut. The previous record for NephJC participation had been 234 participants for PIVOTAL. CREDENCE shattered that record.

The overall participation was 2842 tweets from 639 participants. You can see the breakdown by each session below.

Part of that particiation was doubtlessly provided by the lead author, Vlado Perkovic’s participation in all 3 chats. He did this while traveling from Sydney to Calgary. The transcripts of the three sessions are available below

Summary of Discussion

Listen to the Freely Filtered Podcast dropping soon where we discuss CREDENCE and the highlights from the chat.

As can be seen from the sheer statistics, there is an enormous energy and enthusiasm for using these agents. In the twitter poll we ran, 95% of respondents are already using SGLT2is, or plan to start using these drugs.

Aisha Shaikh summarizing why it’s such a big deal for the nephrology community

Charbel Khoury starting early by linking to phlorizin discovery

Katalin Susztak pointing out the GWAS data on role of proximal tubules

Charlie Tomson on possible effect on Na/H exchangers (the whole thread is fantastic)

Jennie Lin and Katalin Susztak on bioenergetics

Aisha Shaikh with an excellent tweetorial on mechanisms

Aisha again with a curation of Vlado Perkovic’s answers

Advice from East London diabetes doc Sarah Finer on using SGLT2i

Some discussion of sick day rules - more useful for avoiding euglycemic DKA (in theory) than AKI

Lot of discussion about cost and coverage. NICE guidance eagerly awaited. Another point made that there are many expensive drugs we currently use which lack evidence - which could (or should) be replaced.

And cap it off with this visual summary from medical student (and future internist, and obviously a budding nephrologist) Caitlyn Vlaesschaert

Wrapup curated by Swapnil Hiremath