Background
Cristina Adriana Popa
Advance-HTN: Return of the systolic order – ...

This week, we will discuss a NEJM trial on uncontrolled hypertension: lorundrostat, an aldosterone synthase inhibitor, aims at the hormonal dark side driving resistance.

Advance-HTN: Return of the systolic order – Lorundrostat’s role in restoring balance
Background
swapnil hiremath
Double Trouble: ddAVP and the Bleeding Biopsy

This week, we will discuss a double header: two single centre ddAVP trials in kidney biopsy from India.

Double Trouble: ddAVP and the Bleeding Biopsy
Background
Cristina Adriana Popa
Kidney Allografts-Play With Fire, Get Burned

This week, we will discuss the prognostic role of microvascular inflammation in kidney transplantation. Can the capillaries whisper their damage in lesions before antibodies speak? Maybe this study compels us to treat the injury we see, not just the disease we can name…

Kidney Allografts-Play With Fire, Get Burned
Background
swapnil hiremath
Metformin- Should I Stay or Should I Go

This week, we will discuss another target trial emulation study. The FDA says to stop metformin at a GFR of 30. Are they right?

Metformin- Should I Stay or Should I Go
Background
Brian Rifkin
KDIGO 2025 ADPKD Guidelines Review

This week, we will discuss the first iteration of KDIGO’s 2025 guidelines on ADPKD.  These guidelines are a result of a decade of global collaboration between physicians, researchers, advocates, and patients. The guidelines incorporate ADPKD-specific care as well as many general CKD management practice points.


KDIGO 2025 ADPKD Guidelines Review

Ted Cruz drops out, the primaries are over!

Thanks everyone for voting for what you want covered in NephJC.

The winner is a prospective RCT to see if this Pip/Tazo+Vanco toxicity is real. The reference is here. Back ground from NephMadness 2015 here and ALiEM discussed it here. We will be discussing this on May 31 and June 1. There is an #AskASN chat on May24 pushing us back a week.

Don't forget Next Tuesday/Wednesday we go all Acid-Base for a discussion of acetazolamide.

 

 

study 

The NephJC Book Club Returns. Vote for your choice.

Last summer we did a book club on Atul Gawande's Being Mortal. The NephJC team blogged its way through every chapter and we did a discussion of the book during one of our Tuesday/Wednesday chats. We think the summer is a great time to slow down from the rapid digestion of medical literature and enjoy a slower paced book. We couldn't decide on a book among ourselves so we are turning to you to pick this Summer's book. Here are the choices:

1. When Breath Becomes Air by Dr. Paul Kalanithi. NYT Review.

2. The Patient will See You Now by Dr. Eric Topol (@erictopol) NYT Review. 

3. How doctors think by Dr. Jerome Groopman. NYT Review

4. On the Move by Dr. Oliver Sacks. NYT Review

5. The Laws of Medicine: Field Notes from an Uncertain Science by Dr. Siddhartha Mukherjee. Los Angeles Times Review

Social Media Workshop website now open

Yesterday Matt Sparks, Kenar Jhaveri, and I ran a social media workshop at the NKF Spring Clinical Meeting. We were given the opportunity to do a workshop rather than a few lectures, so we really focused on making the workshop interactive. As such we did not have a slide deck, but rather created a website with all of the content.

The workshop operated by having Matt and I narrate our experience as we navigated the website from introduction through professionalism. The participants created a blog post and tweeted and debated ethical issues in social media. It was an information dense two hours. We thought it went great.

Take a look at the materials here.

The Twitter4Nephrons, disappeared from the primary navigation bar at the top of the site. It can now be found in the about folder.

Twitter polls redux

A few months ago, we wrote about the nephro-twitterverse discovering twitter polls. Graham Abra and Thomas Hiemstra were early adopters, though response rates were ~ 20-40 at best then. But there are many more, with much better response rates. Check them out:

During #NephMadness, Krishna Penmatsa made a bunch of #PredictaPolls - check some notable ones:

 

Graham, again, on IgA nephropathy and pregnancy

Tomas Rohal on tweeps preference of social networks

Matt on the deprescribing PPI question

And the PPI article we discussed at #NephJC was actually decided on the basis of a twitter poll too!

What RRT modality would nephrons choose for themselves (sparked by a tweet from Scherly at #HDu)

Matt again on how nephrons  refer to themselves

Joel (was he making fun of my #DreamRCT, #MAGIK?) 

#NephJC on desensitization & the winners of the #NEJMCup

This was another great #NephJC. Notable for many firsts:

The transcripts and storifys are also already done - and up on the page, due to uber-fast curation from Hector.

Lastly, we have the pleasure of announcing the winners of the coveted #NEJMCup. There were many great tweets, so it took some time to sift through all the nominees. Here are the winning tweets:

Congratulations, Kevin and Sian! Your #NEJMCups should be on the way soon, courtesy of the New England Journal of Medicine.

Announcing the #NEJMCup for the next #NephJC, courtesy @NEJM

We are discussing an NEJM article next week (on that note check out the summary, written by Matt Graham-Brown). The hurdle? Its behind a subscriber-only wall - and this is an issue that has come up as a barrier for many of us not in academia or with a personal subscription to the Journal. However, the nice people at the Journal have kindly agreed to make it easily accessible for #NephJC readers - use the link on our summary page, and you will get the full text. 

But there is more good news. Like what we have done in the past with JAMA, the best tweet of the night will get a prize. One for each chat. 

The #NEJMCup!

The #NEJMCup!

Lastly, thanks to Lisa Rosenbaum for opening to doors to NEJM for us. 

Therapeutic Hypothermia: Comments on @PubMed Commons

Back in fall 2015, we discussed one of the few positive trials in nephrology on #NephJC, on the use of therapeutic hypothermia for cooling deceased donors and the impact of subsequent graft function. To our pleasant surprise, a few weeks later, the lead author, Claus Niemann, replied in detail to our Pubmed Commons summary comment (see here).

A weeks ago, we noticed another comment on the same article, which pointed out that the record in clinicaltrials.gov had reported a different primary outcome, which indeed it did (primary outcome was terminal graft function in donor). We noted and tweeted out this comment, and the COMPARE group also replied.

But the story is not done yet. Today there is another comment on PubMedCommons, from Melissa Greenwald of the Health Resources and Services Administration, which funded the trial. From her review of documents, delayed graft function does seem to have been one of the primary outcomes, if not the main one. Read it and decide for yourself!

TWiN: The week in Nephrology (March 1 2016)

This week we bring two resources for both physicians and nurses caring for ESRD patients.

  • Starting off with guidelines published in PDI - A syllabus for healthcare professionals for teaching Peritoneal Dialysis to patients and caregivers. Get it here ($wall alert).
  • Dr Schell presents a guide for nephrologists on communicating with the elderly on their choices regarding dialysis.
  • Pediatric kidneys are at risk of worsening function in the setting of non renal transplant patients. This article sets out recommendations on how one should monitor the kidney functions in children with non-renal transplants and guidelines on when to refer the patient to a pediatric nephrologist.
  • We all love to advice about diet and hypertension, and several studies have shown that diet does affect the BP. Coming this week is a systematic review and meta-analysis of studies looking at various kinds of dietary interventions' effect on the BP. The DASH diet still wins with the highest net effect of nearly 7/4 mmHg decrease in BP. This was published in Hypertension.

    Blog posts of note

    We present two brilliant essays by our newly minted interns of #NSMC (Nephrology Social Media Collective)

    • Benjamin Stewart  wrote an essay on the the nephron number and the GFR talking about the "Super-Kidney" or the elite kidneys and what nephron endowment means to the GFR. GIve the blogpost a read on Renal Fellow Network and follow him on twitter.
    • Our next post was by renal transplant fellow Silvi Shah who describes the implications of pregnancy and kidney transplant in a question answer format. Again Renal Fellow Network features this blogpost.
    • Rounding off with my favourite topic - Home Hemodialysis - I came across this excellent essay by a Home Hemodialysis patient in Australia, who describes the econo-socio-political advantages of home hemodialysis and also talks directly to patients (peer-2-peer) about the advantages of HHD. The poem at the end is a touching reminder to all physicians on what a patient really wants for himself. Read it here.

    - Nikhil Shah

    Participate in the #NephJC Caucus

    Vote for the next #NephJC article and help make NephJC great again!

    We are going to be talking about anemia on March 22nd with either some classic articles like Beserab and TREAT or the recent systematic review on ESAs and quality of life, but we have a hole in the schedule on March 8th. So help us figure this out by voting in our twitter poll.

    Proton pump inhibitors cause CKD From JAMA Internal Medicine #PPI2CKD

    Maybe statins really are good in dialysis. Long term follow up of the 4D study. #StatinHD 

    Nephrectomies cause heart damage. Early CKD is sowing the seed for future CV catastrophe even at pedestrian GFRs. #GFRgood.

    Sevelamer versus calcium based binders. A systematic review showing a mortality benefit with sevelamer. #BinderWars

    The winner will be discussed March 8th and the others may be put in the cue to be discussed in April and beyond. The loser will drop out of the race and endorse Rubio.