#NephJC on AKI timing: some comparisons

Firstly, check out Joel's post here if you haven't already.

A nice comparison from the methods man, Perry Wilson, is available here, with some great points and comparative tables.

Some more comparisons:

The winners of the #JAMAcup

At every #NephJC chat I find myself delighted with the bits of Twitter wisdom that get funneled through the hashtag. We are going to try to do a better job of rewarding the best of these. Some of these awards will even have prizes. This week we are delighted to announce winners of a great looking JAMA coffee mug, named the JAMAcup in this pre-chat banter:

The things I do to win the JAMA cup. Up tweeting even before my morning coffee. Interesting topic #nephjc #TooEarly #India

— Sanjeev Nair (@Nair_Sanj) August 12, 2015

Can we hashtag #JAMAcup? #nephjc

— Joel Topf (@kidney_boy) August 12, 2015

The winner of the #JAMAcup for the Tuesday night chat is Azra Bihorac (@AzraBihorac) who wrote this gem: 

#nephjc yet all we talk about ad nausea is preop cardiac eval YET POSTOP MI is rare and POSTOP AKI IS one of the most common complication

— Azra Bihorac (@AzraBihorac) August 12, 2015

We would also like to give honorable mention (but no mug) to Mike Walsh (@lastwalsh) who was the first to alert us to the negative results for RIPC in other large trials:

T3: @NephJC problem is RIPHEART and ERRICA both negative as were the Korean trials. This trial looks like a chance finding #nephjc

— mike walsh (@lastwalsh) August 12, 2015

The Wednesday chat was great and picking a winner was difficult but we selected this dejavu all over again tweet by Graham Abra (@GrahamAbra):

T3: Don't want N-acetylcysteine all over again... Low risk intervention might save world.. Data muddy for next 20 years... #NephJC

— Graham Abra, MD (@GrahamAbra) August 12, 2015

Honorable mention to Michael Hultström (@mhulstrom) for this:

@kidney_boy Does sleeping on your arm protect you from heart attacks and AKI? #nephjc

— Michael Hultström (@mhultstrom) August 12, 2015

A hearty thanks to JAMA. We love working with them and appreciate their support of post-publication peer review.

#NephJC does #RIPC Tues Aug 11 and Wed Aug 12. And thanks to @jama_current

RIPC = Remote Ischemic PreConditioning

We hope to see many of you in one of these chats. Thanks again to Preeti Malani, and the folks at JAMA for supporting us - both with providing a toll-free access to the article (at this link), and for providing some prizes - cool JAMA swag! 

So for discussion, the topics will be

• T0: Do you use a risk score to stratify patients pre-op for risk of AKI? The authors in this study used the Cleveland Clinic risk score, but there are others. If you use a risk score, which one do you use?
• T1: Do you agree with the inclusion exclusion criteria? especially GFR < 30 as an exclusion? How about the particulars of doing the RIPC? 50 mm Hg > systolic or 200 mm Hg, whichever is lower for 5 minutes X 3. Is the sham acceptable? Lack of blinding the investigators an issue?
• T2: Dive into the results. What do people make of the difference in secondary outcomes (less effect in mild AKI?). The biomarker outcomes are also intriguing, do you agree with the interpretation?
• T3: What happens now? The authors think of this as a phase-2 study. What outcomes would you like to see in the next study? Intervention is simple and cheap - or is it?