The #NephJC Pip/Taz + Vancomycin chat wrap up

Storify for both chats

Transcripts

Required reading for This Week's Chat

The introduction by Matt Graham-Brown is excellent but I think the post by Josh Farkas will be a major influence on the discussion. Don't miss it.

Next NephJC: Pip/Tazo + Vanco = AKI

This has been a hot topic that has been gaining momentum. See the discussion in NephMadness 2015 and ALiEM. We should have an official summary up in a day or two. Please join us for the discussion next week.

TWiN (The Week in Nephrology) 4th July 2016

Neesh Pannu (@nipannu) and others published a new risk prediction score for #AKI requiring renal replacement therapy post cardiac surgery using variables available pre-op like - congestive heart failure, Canadian Cardiovascular Society angina class III or higher, diabetes mellitus , baseline estimated glomerular filtration rate , increasing hemoglobin concentration, proteinuria , coronary artery bypass graft (CABG) plus valve surgery (v. CABG only), other cardiac procedure (v. CABG only) and emergent status for surgery booking. This new tool published in CMAJ improves the prediction over the previously available Cleveland Clinic Score.

An excellent review on the pathophysiology and treatment of Lupus Nephritis from Kidney International was just published. And published in NDT is a comparison of all the Lupus Nephritis treatment guidelines. A nice 1-2 for #Lupus Nephritis this week.

In a recent study published in CJASN, a group of investigators studied the outcomes of use of various induction therapies and the use of steroids in deceased donor kidney transplants. The data suggested that rATG may have better outcomes in patients on a steroid avoidance protocol.

A review from Nature Reviews Nephrology - Phil Halloran authors an informative review on the molecules of kidney transplant disease states from transplant biopsies. #mustread

A fascinating review on the role of infectious diseases and its impact on kidney diseases was published by Vivek Jha (@vjha126)  and N.Prasad in AJKD. Though this articles relates to the Asia Pacific region, Veeraish Chauhan(@DrVC_kidney) makes a compelling argument for all nephrologists (incl Western Hemisphere) to pay heed, in his AJKDBlog post.

- Nikhil Shah (@dr_nikhilshah)

The EMPA-REG Renal #NephJC chat wrap-up

What's up with the NephJC signal cityscape

In the last few months we have been scheduling our chats out further and further, however this breaks down when a high impact trial is published. This led to the concept of the emergency NephJC chat. We did it first for AKIKI and ELAIN:

And then most recently for this week's chat on EMPA-REG

#NephJC emergency meeting on empagliflozin for diabetic kidney disease. Next week June 28 and 29. pic.twitter.com/uSc4k5oxne

— Nephrology Jrnl Club (@NephJC) June 24, 2016

Some people have asked about the buildings in the cityscape. They are:

Sears Tower in Chicago for Edgar

Leaning Tower of Pisa for Francesco

The Gherkin in London for Tom and Matt

The Statue of Liberty in New York for Kenar and Scherly

The CN Tower of Toronto for Swapnil (closest I could get to Ottawa)

The Renaissance Center in Detroit for Joel

The AT&T building in Nashville for Anna

The Trans America Pyramid in San Francisco for Graham

That's not the whole team but it is a start.

The #EXTRIP #NephJC wrap up

This chat was really special. We had a lot of new participants - experts from the toxicology world, and many individuals sharing their experience. Many scintillating conversations (with some prominent disagreements!). Should we dialyse someone with asymptomatic high Lithium levels (yes), is rebound of lithium levels after we stop dialysis a bad thing (maybe not) and should we really dialyse in acetaminophen toxicity (ahem...see the storify and make up your mind on that one!).

If you haven't yet, check out all the summaries on UKidney. The full texts of the EXTRIP guidelines are easily available on their website too.

Lastly, remember - we have an emergency session of #NephJC *next week* on June 28 and 29. #NephJC staff is working overtime to cover the EMPAREG-Renal outcomes.

TWiN (The Week in Nephrology) June 20 2016

Mycophenolic acid inhibits the rate limiting enzyme in de novo purine synthesis. Its action is not limited to T and B cells. It has some effects on non-immune cells like mesangial cells and podocytes. This review paper in Pediatric Nephrology sheds light on the molecular mechanisms of the anti proteinuric effect of MMF.

The conundrum of selecting the most appropriate vascular access for elderly patients who choose hemodialysis is explored in this review by Tushar Vachharajani (@tvachh), Kevan Polinghorne (@kevanp2) and others in Nature Reviews.

SGLT2 inhibitors are getting increasing footage in the press with the recently published trials. The FDA has strengthened its kidney injury warning for this group of drugs and as Dr Alice Cheng(@AliceYYCheng), endocrinologist from Toronto reminds us that SGLT2 inhibitors are part of the SADMANS - Sick day medication mnemonic.

Multiple Myeloma - 2016 update on diagnosis, risk stratification and management was recently published in the American Journal of Hematology by Dr Vincent Rajkumar(@VincentRK) from Mayo.

ICYMI - An 2010 Seminars in Dialysis paper from Dr Jula Inrig on antihypertensive agents for the hemodialysis patients was doing the rounds on twitter this week. Good bookmark!

The new classification of donation after circulatory death (DCD) donors (Modified Maastricht Classification) was published recently in Transplant International.

- Nikhil Shah (@dr_nikhilshah)

And now Hector Madariaga(@HecmagsMD)  brings you the best of #ATC2016Boston in a 5 part storify collection.