The Filtrate:Jennie LinJoel TopfJosh WaitzmanSwapnil HiremathWith Special GuestsPedro TeixeiraJay KoynerEditor Sophia AmbrusoShow NotesThe article: A Randomized Trial of Intravenous Amino Acids for Kidney ProtectionNephJC SummaryKDIGO Clinical Practice Guideline for Acute Kidney Injury (PDF)Steve Coca study Evaluation of Short-Term Changes in Serum Creatinine Level as a Meaningful End Point in Randomized Clinical Trials (PubMed)Using Nephrocheck to prevent AKI: Prevention of cardiac surgery-associated AKI by implementing the KDIGO guidelines in high risk patients identified by biomarkers: the PrevAKI randomized controlled trial (PubMed)Brenner’s Review of protein intake and renal hemodynamics: Dietary Protein Intake and the Progressive Nature of Kidney Disease: — The Role of Hemodynamically Mediated Glomerular Injury in the Pathogenesis of Progressive Glomerular Sclerosis in Aging, Renal Ablation, and Intrinsic Renal Disease (NEJM)Husain-Syed a look at preoperative renal functional reserve and risk of AKI: Preoperative Renal Functional Reserve Predicts Risk of Acute Kidney Injury After Cardiac Operation (PubMed)Dana Fuhrman review of renal functional reserve: The Role of Renal Functional Reserve in Predicting Acute Kidney Injury (PubMed)Use of SGLT2i prevented AKI in the placebo controlled trials. Clinical Adverse Events Associated with Sodium-Glucose Cotransporter 2 Inhibitors: A Meta-Analysis Involving 10 Randomized Clinical Trials and 71 553 Individuals (PubMed)Assessment of P values for demographic data in randomized controlled trials (PubMed)Tubular SecretionsSwapnil The Lord of the Rings: Rings of Power Season 2 on Amazon Prime (Wikipedia)Josh Fortnite (Website)Pedro CRRT Academy at University of Alabama Birmingham (Website)Jay Koyner Slow Horses on AppleTV (Wikipedia)Jennie Linn #KidneyWk Run Club Friday 10/25 at 6:15 am PST Meet in front of Sally’s Fish House ~2 miles. Easy pace (10-12 min/mile) (Strava)Joel Topf Your Honor on Netflix (Wikipedia)

The draft order:Sophia AmbrusoNayan AroraSwapnil HiremathAC GomezJoel TopfEditor Nayan AroraShow NotesPrevious drafts:2021 KDIGO Hypertension —Joel, Sophia, Swap, Nayan, Josh2021 ASN Kidney Week Draft—Joel, Sophia, Swap, Nayan, Jennie2022 The ISPD Peritonitis Guideline— Joel, Sophia, Swap, Nayan2022 ASN Kidney Week Draft—Joel, Sophia, Swap, Nayan2023 ASN Kidney Week Draft—Joel, Sophia, Swap, Nayan, AC, Josh2024 KDIGO CKD Clinical Practice Guideline —Joel, Sophia, Swap, Nayan, Josh, ACThe guidelineThe NephJC discussion Part 1 | Part 2First RoundSophia’s Pick 3.7.1 We recommend treating patients with type 2 diabetes (T2D), CKD, and an eGFR ≥20 ml/min per 1.73 m2 with an SGLT2i (1A).Not Nayan’s Pick 3.7.3: We suggest treating adults with eGFR 20 to 45 ml/min per 1.73 m2 with urine ACR <200 mg/g (<20 mg/mmol) with an SGLT2i (2B).Nayan’s Pick 2.2.1: In people with CKD G3–G5, we recommend using an externally validated risk equation to estimate the absolute risk of kidney failure (1A).A birdie told me there will not be a Tangri KFRE vs the World debate at Kidney WeekThe action points based on absolute risk results:Practice Point 2.2.1: A 5-year kidney failure risk of 3%–5% can be used to determine need for nephrology referral in addition to criteria based on eGFR or urine ACR, and other clinical considerations.Practice Point 2.2.2: A 2-year kidney failure risk of >10% can be used to determine the timing of multidisciplinary care in addition to eGFR-based criteria and other clinical considerations.Practice Point 2.2.3: A 2-year kidney failure risk threshold of >40% can be used to determine the modality education, timing of preparation for kidney replacement therapy (KRT) including vascular access planning or referral for transplantation, in addition to eGFR-based criteria and other clinical considerations. Swap’s Pick 3.15.1.1: In adults aged ‡50 years with eGFR <60 ml/min per 1.73 m2 but not treated with chronic dialysis or kidney transplantation (GFR categories G3a–G5), we recommend treatment with a statin or statin/ezetimibe combination (1A).AC’s Pick 3.7.2: We recommend treating adults with CKD with an SGLT2i for the following (1A):eGFR ≥20 ml/min per 1.73 m2 with urine ACR ≥200 mg/g (≥20 mg/mmol), orheart failure, irrespective of level of albuminuria. (1A)Joel’s Pick 3.10.1: In people with CKD, consider use of pharmacological treatment with or without dietary intervention to prevent development of acidosis with potential clinical implications (e.g., serum bicarbonate <18 mmol/l in adults).Practice Point 3.10.2: Monitor treatment for metabolic acidosis to ensure it does not result in serum bicarbonate concentrations exceeding the upper limit of normal and does not adversely affect BP control, serum potassium, or fluid status. Freely Filtered 061: Bicarb in Transplant with Nav TangriSecond RoundJoel’s Pick 3.3.1.1: We suggest maintaining a protein intake of 0.8 g/kg body weight/d in adults with CKD G3–G5 (2C).Practice points related to protein intake:3.3.1.1: Avoid high protein intake (>1.3 g/kg body weight/d) in adults with CKD at risk of progression.3.3.1.2: In adults with CKD who are willing and able, and who are at risk of kidney failure, consider prescribing, under close supervision, a very low–protein diet (0.3–0.4 g/kg body weight/d) supplemented with essential amino acids or ketoacid analogs (up to 0.6 g/kg body weight/d). 3.3.1.3: Do not prescribe low- or very low–protein diets in metabolically unstable people with CKD.AC’s Pick 3.9.1: In adults with T2D and CKD who have not achieved individualized glycemic targets despite use of metformin and SGLT2 inhibitor treatment, or who are unable to use those medications, we recommend a long-acting GLP-1 RA (1B).Swapnil’s Pick Practice Point 5.4.1: Initiate dialysis based on a composite assessment of a person’s symptoms, signs, QoL, preferences, level of GFR, and laboratory abnormalities.IDEAL Trial: A Randomized, Controlled Trial of Early versus Late Initiation of Dialysis NEJMTiming of dialysis initiation to reduce mortality and cardiovascular events in advanced chronic kidney disease: nationwide cohort study NephJCNayan’s Pick Practice Point 1.1.4.2: Use tests to establish a cause based on resources available (Table 6b).Sophia’s Pick Practice Point 1.1.1.2: Following incidental detection of elevated urinary albumin-to-creatinine ratio (ACR), hematuria, or low estimated GFR (eGFR), repeat tests to confirm presence of CKD.Joel’s cystatin C Tweet The cystatin C guideline recommendation 1.1.2.1: In adults at risk for CKD, we recommend using creatinine-based estimated glomerular filtration rate (eGFRcr). If cystatin C is available, the GFR category should be estimated from the combination of creatinine and cystatin C (creatinine and cystatin C– based estimated glomerular filtration rate [eGFRcr-cys]) (1B).Nayan’s additional thoughts. He is not a fan of Practice Points 3.6.4 and 3.6.5Practice Point 3.6.4 Continue ACEi or ARB therapy unless serum creatinine rises by more than 30% within 4 weeks following initiation of treatment or an increase in dose.andPractice Point 3.6.5: Consider reducing the dose or discontinuing ACEi or ARB in the setting of either symptomatic hypotension or uncontrolled hyperkalemia despite medical treatment, or to reduce uremic symptoms while treating kidney failure (estimated glomerular filtration rate [eGFR] <15 ml/min per 1.73 m2).Tubular Secretion Swap The Murderbot Diaries by Martha Wells Nayan Searching for Hobey Baker Narrated by David Duchovny AC Rosie Revere, EngineerSophia BassnectarHow to fix the Apple Music automatically playing when you connect to bluetooth.Joel The Veil with Elizabeth Moss

The Filtrate:Joel TopfJosh WaitzmanWith Special Guest:Brad Rovin (@BradRovin) Chief of nephrology at The Ohio State University Wexner Medical Center, one of the authors of the Nefigard trial. Koyal Jain (@koyaljainMD) Program director of the GN Fellowship at University of North CarolinaRoger Rodby (@NephRodby) Associate program director of the Rush University Nephrology FellowshipEditor Sophia AmbrusoShow NotesThe manuscript (The Lancet | PubMed | NephJC)The Results of Part A (Kidney Int | PubMed)Edmund (Ed) Louis memorium by Steve Korbet in KISteve Korbet Do not miss this tweet TESTING Freely Filtered #48 with Sean BarbourIptapocan at the World Congress of Nephrology: WCN24-1506 Efficacy And Safety Of Iptacopan In Patients With IgA Nephropathy: Interim Results From The Phase 3 APPLAUSE-IgAN StudyFDA and mandatory post-marketing studies. What happens when the study is negative (or not completed) (UNDARK)Who should treat lupus nephritis: rheumatologists or nephrologists? (Nature Reviews Nephrology)Protein and albumin-to-creatinine ratios in random urines accurately predict 24 h protein and albumin loss in patients with kidney disease (PubMed)MEST Scores in NephJC Risk scores in IgAN in NephJCRepeat renal biopsy improves the Oxford classification-based prediction of immunoglobulin A nephropathy outcome (NDT)Tarpeyo pills 4 mg. Four pills once a day. (WellRx has a picture of the pills)IgA nephropathy in African Americans: uncommon but possible (PubMed Central)Aberrantly Glycosylated IgA1 in IgA Nephropathy: What We Know and What We Don’t Know (PubMed Central)Effectiveness of Mycophenolate Mofetil Among Patients With Progressive IgA Nephropathy (JAMA Network Open)Tubular Secretions Joel: Constellation on Apple TV (Wikipedia). Not good. Dune audio books are excellent. (Audible)Josh: Podcasts about donating a kidneyOne Is Enough Podcast (National Kidney Registry)Donor Diaries (National Kidney Donation Organization)Roger Iceland (Wikipedia)Koyal India (Wikipedia)Brad Fishing in Dubai

The Filtrate:Joel TopfSwapnil HiremathJosh WaitzmanNayan AroraSophia AmbrusoWith Special Guest:Brendon Neuen Super smart guy and clinical trialistVlado Perkovic Lead author of FLOW and friend of NephJCEditor Joel TopfShow NotesThe manuscript (NEJM): Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 DiabetesThe acronym FLOW from the title: evaluate renal Function with semagLutide Once Weekly (Twitter)Joel wrote a blog post prior to the FLOW publication to try to set the table: Peeking Inside Schrödinger’s BoxBrendon’s Neuen’s tweet about total versus chronic slope (X | Twitter)Modification of Association of Cystatin C With Kidney and Cardiovascular Outcomes by Obesity (Science Direct)Semaglutide and Diabetic Retinopathy Risk in Patients with Type 2 Diabetes Mellitus: A Meta-Analysis of Randomized Controlled Trials (PubMed)The Efficacy and Safety of the Combination Therapy With GLP-1 Receptor Agonists and SGLT-2 Inhibitors in Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis (Frontiers in Pharmacology)Statistical considerations for testing multiple endpoints in group sequential or adaptive clinical trials (PubMed)Proteinuria Thresholds Are Irrational: A Call for Proteinuria Indexing (Nephron Clinical Practice)Frank Harrel on why the NNT sucks (data methods)Regulation of Na+/H+ exchanger NHE3 by glucagon-like peptide 1 receptor agonist exendin-4 in renal proximal tubule cells (PubMed)Switching Between Glucagon-Like Peptide-1 Receptor Agonists: Rationale and Practical Guidance (PubMed)Safety, tolerability and efficacy of up-titration of guideline-directed medical therapies for acute heart failure (STRONG-HF): a multinational, open-label, randomised, trial (PubMed)Doctors are like the pyromaniac fireman (PBFluids)Suggest topics for NephMadness (Twitter)Design of the COmbinatioN effect of FInerenone anD EmpaglifloziN in participants with chronic kidney disease and type 2 diabetes using a UACR Endpoint study (CONFIDENCE) (PubMed)Albuminuria-Lowering Effect of Dapagliflozin, Eplerenone, and Their Combination in Patients with Chronic Kidney Disease: A Randomized Crossover Clinical Trial (PubMed)Spitzer’s involvement in revolutionizing nephrology is part of this lecture I did at the University of Nebraska Diabetes Symposium. (Dropbox: Start on slide 29)Spitzer Resigns, Citing Personal Failings (New York Times)Tubular Secretions Swap: Dumb Money on NetFlix (Wikipedia)Josh: Hiking Zion National Park (National Park Service)Sophia: Lost in Space 2018 TV series on NetFlix (Wikipedia)Nayan: Pelican Hill resort (Website)Joel: BodkinNephJC Summer Book Club: Covenant of Water by Abraham Verghese (Amazon)

The Filtrate:Joel TopfSwapnil HiremathAC GomezNayan AroraWith Special Guest:Anuja Java, complement god and pre-eclampsia research (Twitter)Shannon M. Clark, MD, FACOG, an honest to god, true, maternal-fetal medicine specialist. (Website | Instagram)Editor Nayan AroraShow NotesCHIP Study from 2015 (NEJM | NephMadness 2015) CHAP study from 2022 (NEJM | NephJC)NephMadness 2024 coverage of the diagnosis of preeclampsia sFlt background: Pathogenesis of Preeclampsia and Therapeutic Approaches Targeting the Placenta (PubMed)PlGF background: Perspectives on the Use of Placental Growth Factor (PlGF) in the Prediction and Diagnosis of Pre-Eclampsia: Recent Insights and Future Steps (PubMed)The PRAECIS trial (NephJC | NEJM Evidence)You may just want to listen to Anna Burgner discuss preeclampsia with Kenar Jhaveri and Koyal Jain (GN in Ten) for the NephMadness PodCrawlBene Gesserit (Wikipedia)Pathogenesis of preeclampsia: the genetic component (PubMed)Tubular SecretionsSwap Slow Horses on Apple TV (Wikipedia)AC Hidden Figures (Amazon)Nayan Baseball, little leagueAnuja Young Sheldon (Wikipedia)Joel Dune audiobook (Amazon)

The Filtrate:Joel TopfSwapnil HiremathPriya Yenebere Nayan AroraWith Special Guest:Brendon Neuen Super smart guy and clinical trialistMichelle Rheault Lead author of DUPLEX and friend of the podShow NotesSparsentan versus Irbesartan in Focal Segmental GlomerulosclerosisNephJC Summary | PubMed | NEJMKDIGO FSGS Guidelines 2021 (PDF)Characterization of the Clinical Evidence Supporting Repository Corticotropin Injection for FDA-Approved Indications, A Scoping Review (JAMA Internal Medicine)DUET: A Phase 2 Study Evaluating the Efficacy and Safety of Sparsentan in Patients with FSGS (PubMed)Vlado Perkovic, mentor and sponsor extradenoire (UNSW Sydney)Shimer Its a floor wax and a desert topping (TikTok)SONAR: Atrasentan and renal events in patients with type 2 diabetes and chronic kidney disease: a double-blind, randomised, placebo-controlled trial. (NephJC)Travere Therapeutics Announces FDA Accelerated Approval of FILSPARIᵀᴹ (sparsentan), the First and Only Non-immunosuppressive Therapy for the Reduction of Proteinuria in IgA Nephropathy (Travere press release)GFR Slope: Chronic vs Total slope: A meta-analysis of GFR slope as a surrogate endpoint for kidney failure (Nature Medicine)There are dozens of us! Dozens! (Know your Meme)Brendon’s Neuen’s tweet about total versus chronic slope (X | Twitter)Julie R. Ingelfinger, deputy editor for the New England Journal of Medicine (Wikipedia)You know nothing, John Snow (YouTube shorts)Tubular SecretionsSwapnil Foundation season two on Apple TV Wheel of Time season two Amazon PrimeBrendon Andor Priya Poverty, by America Mattew DesmondNayan The Armor of Light: A Novel by Ken FollettMichelle Lessons in Chemistry: A Novel by Bonnie Garmus

The Filtrate:Joel TopfSwapnil HiremathJordy CohenAC GomezWith Special Guest:Tim Anderson @TimAndersonMDEditor:Priya Yenebere Show NotesClinical Outcomes of Intensive Inpatient Blood Pressure Management in Hospitalized Older Adults NephJC Summary | PubMed | JAMA Internal MedicineThe Jordy AC collab: An Interactive Ambulatory Nephrology Curriculum for Internal Medicine Interns: Design, Implementation, and Participant Feedback (PubMed)Clinical Outcomes After Intensifying Antihypertensive Medication Regimens Among Older Adults at Hospital Discharge (PubMed)Trends in Blood Pressure Treatment Intensification in Older Adults With Hypertension in the United States, 2008 to 2018 (PubMed)Overlap Weighting: A Propensity Score Method That Mimics Attributes of a Randomized Clinical Trial (JAMA Guide to Statistics and Methods) Tubular secretionsSwap The Dispatcher by John Scalzi (Wikipedia)AC A Heart that Works by Rob Delaney (NYT Review)Tim Demon Copperhead by Barbara Kingsolver (Amazon)Jordy The Anthropocene Reviewed: Essays on a Human-Centered Planet (Amazon)Joel The Dolomites for hiking n Northern Italy

Animal House RegionNephMadness description by Tiffany TruongEditorial by Kelly Hyndman @DrKeeksPhD They May Look Cute, But Are All Animals Sweet?The Filtrate:Joel TopfSwapnil HiremathSophia AmbrusoJosh WaitzmanWith Special Guest:Kelly HyndmanEditor:Sophia AmbrusoShow NotesAnimal House 2018 with Mark Zeidel, MD (AJKDblog)Animal House 2021 with Kelly Hyndman (AJKDBlog)Animal House 2022 with Kelly Hyndman (AJKDBlog)Mount Desert Island Summer Junket (Website)First person account go a Gila Monster bite (YouTube)Looks like Gila Hank, the gun toting mascot of Eastern Arizona College has been replaced by a non-gun toting Gila monster cowboy. Old logo (Reddit) | New logo (Gila Valley Central Newspaper)Discovery, characterization, and clinical development of the glucagon-like peptides (Drucker JCI 2017)The rationale, design and baseline data of FLOW, a kidney outcomes trial with once-weekly semaglutide in people with type 2 diabetes and chronic kidney disease (Rossing NDT 2023)Semaglutide 1.0 mg demonstrates 24% reduction in the risk of kidney disease-related events in people with type 2 diabetes and chronic kidney disease in the FLOW trial (Novo Nordisk)King Gizzard & The Lizard Wizard - Gila Monster (YouTube)Eastern Arizona Campus Store Tubular SecretionsSwap: Three Body Problem (Wikipedia)Josh: Animal Crossing (Nintendo)Sophie: Pyelonephritis in inflammatory bowel disease. Is this a thing?Joel: Maggie Moore(s) (Wikipedia)

How Medicine Works, and When It Doesn’tAmazonThe Filtrate:Joel TopfJosh WaitzmanJennie LinWith Special Guest:Jade TeakellPerry WilsonEditor:Joel TopfShow NotesUnderstanding Medical Research: Your Facebook Friend is Wrong. CourseraIllusory truth effect (Wikipedia)Number needed to treat (Wikipedia)NNT at MedPage Today: NNT on NephJC Deaths of Despair:Suicide (CDC 2001-2021)Drug Overdose (CDC 2001-2021)Steve Jobs delayed therapy for his treatable pancreatic cancer (ABC News)Residents are unionizing at Mass General Brigham. Here's what you need to know (WBUR)Pi and bouncing bricks (YouTube)Doctors in New Zealand—the only non-U.S. country that allows DTC advertising—call for bans (FiercePharma)The Surgisphere Scandal: What Went Wrong? (The Scientist)VITAL SIGNS: FERTILITY; A Study Links Prayer and Pregnancy (The New York Times)Researcher Pulls His Name From Paper on Prayer and Fertility (The New York Times)Tubular SecretionsJosh: Glomerular Nephritis by Thomas Addis (Review in JAMA from 1948)Jennie: The Chicago Marathon Jade: The People’s Hospital (Amazon) Perry: Anathem by Neal Stephenson (Amazon)

The Filtrate:Joel TopfNayan AuroraSophia AmbrusoWith Special Guest:Michael CollinsEditor:Nayan AuroraShow Notes:Twitter is now X (NYT)Michael Collins (the astronaut, not the real one)PlasmaLyte by BaxterNephJC BEST Fluids summaryEarly Goal Directed Therapy for Sepsis NEJM manuscript which changed practice patterns and welcomed in an era of massive fluid resuscitation.PLUS Trial NEJMSPLIT Trial JAMABaSICS NephJC SummarySALTED and SMART NephJC SummaryAdaptive minimization wikipediaBEST Fluids statistical planBEST Fluids in CLinicalTrials.govDelayed Graft Function review in American Journal of TransplantBalanced Crystalloids versus Saline in Critically Ill Adults — A Systematic Review with Meta-Analysis in NEJM EvidenceA pragmatic, open-label, randomized controlled trial of Plasma-Lyte-148 versus standard intravenous fluids in children receiving kidney transplants (PLUTO) in Kidney InternationalTubular SecretionNayan finally getting around to Succession on HBOSophia autoimmune protocol dietHawthorne EffectMichael Stephen Fry reading Harry Potter

The Filtrate:Joel TopfSwapnil HiremathSophia AmbrusoAC GomezJosh WaitzmanJennie LinNayan AroraThe CurbsidersMatt F. Watto (@DoctorWatto)Paul Nelson Williams, America’s primary care physician (@PaulNWilliamz)With Special Guest:JD Foster (@KidneyVet)Sayed Tabatabai (@TheRealDoctorT) Nephrologist in Austin and the author of These Vital SignsMichelle Rheault (@rheault_m) Chief of Pediatric Nephrology at the University of Minnesota and lead author of the DUPLEX TrialEditor:Joel TopfShow Notes:Lily toxicity in the cat (PubMed)Surgeons perform kidney transplants in cats amid rising demand for advanced pet care (ABC News)Treatment of ibuprofen toxicity with serial charcoal hemoperfusion and hemodialysis in a dog (PubMed)Nephrology in Veterinary Medicine (Kidney 360)Star Wars Society of San Antonio (FaceBook)These Vital Signs (Amazon)Dr Tabatabai read a short story called The Handholder, here is the original tweet thread for that story (ThreadReader)The pearl not the patient (PubMed)Late Braking and High Impact Clinical Trial press releaseMENTOR, Rituximab or Cyclosporine in the Treatment of Membranous Nephropathy, was in 2019 not 2017 (NEJM)KALM-1, A Phase 3 Trial of Difelikefalin in Hemodialysis Patients with Pruritus, was in 2019 not 2017 (NEJM)Sophie’s number one pick: Efficacy and safety of sparsentan versus irbesartan in patients with IgA nephropathy (PROTECT): 2-year results from a randomised, active-controlled, phase 3 trial (Lancet)Patients in the sparsentan group had a slower rate of eGFR decline than those in the irbesartan group. eGFR chronic 2-year slope (weeks 6–110) was −2·7 mL/min per 1·73 m2 per year versus −3·8 mL/min per 1·73 m2 per year (difference 1·1 mL/min per 1·73 m2per year, 95% CI 0·1 to 2·1; p=0·037); total 2-year slope (day 1–week 110) was −2·9 mL/min per 1·73 m2 per year versus −3·9 mL/min per 1·73 m2 per year (difference 1·0 mL/min per 1·73 m2 per year, 95% CI −0·03 to 1·94; p=0·058).Clinical Trial Considerations in Developing Treatments for Early Stages of Common, Chronic Kidney Diseases: A Scientific Workshop Cosponsored by the National Kidney Foundation and the US Food and Drug Administration (AJKD)AC Gomez’s Pick: MDR-101-MLK Update: Operational Immune Tolerance Achieved in Living Related HLA-Matched Kidney Transplant Recipients (ASN-Online.org) Josh’s Pick: A Phase 2 Trial of Sibeprenlimab in Patients with IgA Nephropathy (NEJM)Nayan’s Pick: The EnAKT LKD Cluster Randomized Clinical Trial (JAMA Internal Medicine) The Freely Filtered simultaneous release (NephJC)Freely Filtered is now a verb. Swap’s Pick: Strategies for the Management of Atrial Fibrillation in PatiEnts Receiving Dialysis (SAFE-D) (ASN-Online.org)Joel’s Pick: AYAME Study: Randomized, Double-Blind, Placebo-Controlled Phase 3 Study of Bardoxolone Methyl in Diabetic Kidney Disease (DKD) Patients (ASN-Online.org)Reata is a no-show to the 2012 ASN Kidney Week (PBFluids)Michelle’s Pick: Sparsentan versus Irbesartan in Focal Segmental Glomerulosclerosis. The DUPLEX Study (NEJM)DUET: A Phase 2 Study Evaluating the Efficacy and Safety of Sparsentan in Patients with FSGS (PubMed)

The Filtrate:Joel TopfSwapnil HiremathSophia AmbrusoAC GomezWith Special Guest:Amit Garg (@AmitXGarg) Nephrologist at Western University, London, and lead PI of the EnAKT LKD trial. Susan Q. McKenzie (LinkedIn) Co-Founder & Chair, Transplant Ambassador Program. President of the Kidney Patient and Donor Alliance of Canada.Editor:Joel TopfShow Notes:Late Braking and High Impact Clinical Trial press releaseJAMA Internal MedicineMyTEMP trial Personalised cooler dialysate for patients receiving maintenance haemodialysis (MyTEMP): a pragmatic, cluster-randomised trial (PubMed | NephJC | Freely Filtered)Transplant is cheaper! An economic assessment of contemporary kidney transplant practice (PDF)Transplant is better! Survival for waitlisted kidney failure patients receiving transplantation versus remaining on waiting list: systematic review and meta-analysis (PubMed)Transplant disparities Association of Race and Ethnicity With Live Donor Kidney Transplantation in the United States From 1995 to 2014 (PubMed)MUC1 Kidney Disease Autosomal Dominant Tubulointerstitial Kidney Disease: An Emerging Cause of Genetic CKD (Kidney International Reports)This study has all the adjectives: “We conducted a pragmatic, two-arm, parallel-group, open-label, registry-based, superiority, cluster- randomized clinical trial.”Explore Transplant by Amy Waterman, PhDTransplant Ambassador ProgramKidney Failure Risk Equation A Predictive Model for Progression of Chronic Kidney Disease to Kidney Failure (JAMA | Calculator)The complete protocol A Quality Improvement Intervention to Enhance Access to Kidney Transplantation and Living Kidney Donation (EnAKT LKD) in Patients With Chronic Kidney Disease: Clinical Research Protocol of a Cluster-Randomized Clinical Trial (PDF)Pre-published statistical plan Enhance Access to Kidney Transplantation and Living Kidney Donation (EnAKT LKD): Statistical Analysis Plan of a Registry-Based, Cluster-Randomized Clinical Trial (PubMed)Hawthorne effect (Wikipedia)The Advancing American Kidney Health Initiative “Aim for 80% of new American ESRD patients in 2025 receiving either home dialysis or a transplant” (NKF)Tubular SecretionsSwapnil The Time Travelers Wife by Audrey Niffenegger (Wikipedia) and HBO movie of the same name (Wikipedia).Sophia The Wheel of Time streaming on Amazon (Wikipedia) based on the series of books of the same name by Robert Jordan and Brandon Sanderson.Susan The Woman Who Loved Giraffes movie (Website)Amit Canadians cannot get Visas to visit India (Reuters)AC Eagles are good at Football (Fox Sports) and Alport Connect Meeting in San Diego (Alport Syndrome Foundation Website)Joel Live podcast recording at Kidney Week (NephJC)

Bicarbonate did not slow the loss of GFR in this well done Swiss, single-blind study of transplant patients.The Filtrate:Joel TopfNayan AroraSwapnil HiremathPirya YenebereWith Special Guest:Nav Tangri nephrologist and epidemiology at the University of ManitobaEditor:Nayan AroraShow Notes:Arsenal FCThe London study that kicked it all off!de Brito-Ashurst, I., Varagunam, M., Raftery, M. J., & Yaqoob, M. M. (2009). Bicarbonate supplementation slows progression of CKD and improves nutritional status. Journal of the American Society of Nephrology: JASN, 20(9), 2075–2084.The multi center (but unblinded) UBI Study with mortality benefit!Di Iorio, B. R., Bellasi, A., Raphael, K. L., Santoro, D., Aucella, F., Garofano, L., Ceccarelli, M., Di Lullo, L., Capolongo, G., Di Iorio, M., Guastaferro, P., Capasso, G., & UBI Study Group. (2019). Treatment of metabolic acidosis with sodium bicarbonate delays progression of chronic kidney disease: the UBI Study. Journal of Nephrology, 32(6), 989–1001.The BiCARB Study: Double blinded and negativeBiCARB study group. (2020). Clinical and cost-effectiveness of oral sodium bicarbonate therapy for older patients with chronic kidney disease and low-grade acidosis (BiCARB): a pragmatic randomised, double-blind, placebo-controlled trial. BMC Medicine, 18(1), 91.The initial Veverimer StudyWesson, D. E., Mathur, V., Tangri, N., Stasiv, Y., Parsell, D., Li, E., Klaerner, G., & Bushinsky, D. A. (2019). Long-term safety and efficacy of veverimer in patients with metabolic acidosis in chronic kidney disease: a multicentre, randomised, blinded, placebo-controlled, 40-week extension. In The Lancet (Vol. 394, Issue 10196, pp. 396–406). doi.org/10.1016/s0140-6736(19)31388-1The Valor CKD trial is still unpublished. But here is the press release. VALOR-CKD design manuscriptThe study of the night: Sodium bicarbonate for kidney transplant recipients with metabolic acidosis in Switzerland: a multicentre, randomized, single-blind, placebo-controlled, phase 3 trialNephJC | PubMed | LancetAlkali with normal bicarb? Sure, take a look at: Goraya, N., Simoni, J., Jo, C., & Wesson, D. E. (2012). Dietary acid reduction with fruits and vegetables or bicarbonate attenuates kidney injury in patients with a moderately reduced glomerular filtration rate due to hypertensive nephropathy. Kidney International, 81(1), 86–93.Metforminator!The BASE Trial: Raphael, K. L., Isakova, T., Ix, J. H., Raj, D. S., Wolf, M., Fried, L. F., Gassman, J. J., Kendrick, C., Larive, B., Flessner, M. F., Mendley, S. R., Hostetter, T. H., Block, G. A., Li, P., Middleton, J. P., Sprague, S. M., Wesson, D. E., & Cheung, A. K. (2020). A Randomized Trial Comparing the Safety, Adherence, and Pharmacodynamics Profiles of Two Doses of Sodium Bicarbonate in CKD: the BASE Pilot Trial. Journal of the American Society of Nephrology: JASN, 31(1), 161–174.Tubular SecretionsSwap The Three-Body Problem (novel) | NetflixNayan Women’s World CupTangri English Premier Soccer and InflationPriya Silo on Apple TVJoel Live Podcast recording at ASN Kidney

The Filtrate:Joel TopfNayan AroraSwapnil HiremathPirya YenebereWith Special Guest:Nav Tangri nephrologist and epidemiology at the University of ManitobaEditor:Nayan AroraShow Notes:Arsenal FCThe London study that kicked it all off!de Brito-Ashurst, I., Varagunam, M., Raftery, M. J., & Yaqoob, M. M. (2009). Bicarbonate supplementation slows progression of CKD and improves nutritional status. Journal of the American Society of Nephrology: JASN, 20(9), 2075–2084.The multi center (but unblinded) UBI Study with mortality benefit!Di Iorio, B. R., Bellasi, A., Raphael, K. L., Santoro, D., Aucella, F., Garofano, L., Ceccarelli, M., Di Lullo, L., Capolongo, G., Di Iorio, M., Guastaferro, P., Capasso, G., & UBI Study Group. (2019). Treatment of metabolic acidosis with sodium bicarbonate delays progression of chronic kidney disease: the UBI Study. Journal of Nephrology, 32(6), 989–1001.The BiCARB Study: Double blinded and negativeBiCARB study group. (2020). Clinical and cost-effectiveness of oral sodium bicarbonate therapy for older patients with chronic kidney disease and low-grade acidosis (BiCARB): a pragmatic randomised, double-blind, placebo-controlled trial. BMC Medicine, 18(1), 91.The initial Veverimer StudyWesson, D. E., Mathur, V., Tangri, N., Stasiv, Y., Parsell, D., Li, E., Klaerner, G., & Bushinsky, D. A. (2019). Long-term safety and efficacy of veverimer in patients with metabolic acidosis in chronic kidney disease: a multicentre, randomised, blinded, placebo-controlled, 40-week extension. In The Lancet (Vol. 394, Issue 10196, pp. 396–406). https://doi.org/10.1016/s0140-6736(19)31388-1The Valor CKD trial is still unpublished. But here is the press release. VALOR-CKD design manuscript The study of the night: Sodium bicarbonate for kidney transplant recipients with metabolic acidosis in Switzerland: a multicentre, randomized, single-blind, placebo-controlled, phase 3 trialNephJC | PubMed | Lancet Alkali with normal bicarb? Sure, take a look at: Goraya, N., Simoni, J., Jo, C., & Wesson, D. E. (2012). Dietary acid reduction with fruits and vegetables or bicarbonate attenuates kidney injury in patients with a moderately reduced glomerular filtration rate due to hypertensive nephropathy. Kidney International, 81(1), 86–93.Metforminator!The BASE Trial: Raphael, K. L., Isakova, T., Ix, J. H., Raj, D. S., Wolf, M., Fried, L. F., Gassman, J. J., Kendrick, C., Larive, B., Flessner, M. F., Mendley, S. R., Hostetter, T. H., Block, G. A., Li, P., Middleton, J. P., Sprague, S. M., Wesson, D. E., & Cheung, A. K. (2020). A Randomized Trial Comparing the Safety, Adherence, and Pharmacodynamics Profiles of Two Doses of Sodium Bicarbonate in CKD: the BASE Pilot Trial. Journal of the American Society of Nephrology: JASN, 31(1), 161–174.Tubular SecretionsSwap The Three-Body Problem (novel) | Netflix Nayan Women’s World CupTangri English Premier Soccer and InflationPriya Silo on Apple TVJoel Live Podcast recording at ASN Kidney

The Filtrate:Joel TopfNayan AroraSophia AmbrusoWith Special Guest:Boback Ziaeian @boback Assistant Professor of Medicine David Geffen School of Medicine at UCLA. His Google Schoolar page is better than yours. And returning for her fourth time (why do we keep inviting her back?)Sadiya Khan @heartDocSadiya Assistant Professor of Medicine (Cardiology) and Preventative Medicine at Northwestern Feinberg School of Medicine. LinkEditor:Priya YenebereShow Notes:Diuretic Therapy review by. Craig Brater NEJMThe manuscript in JAMA | NephJCMetoprolol vs Carvedilol: Comparison of carvedilol and metoprolol on clinical outcomes in patients with chronic heart failure in the Carvedilol Or Metoprolol European Trial (COMET): randomised controlled trial (Lancet)EMPULSE: The SGLT2 inhibitor empagliflozin in patients hospitalized for acute heart failure: a multinational randomized trial (Nature Medicine)Effect of Aliskiren on Postdischarge Mortality and Heart Failure Readmissions Among Patients Hospitalized for Heart Failure The ASTRONAUT Randomized TrialEffects of Oral Tolvaptan in Patients Hospitalized for Worsening Heart Failure The EVEREST Outcome TrialSophia ended up placing fifth in NephMadness 2023. (Link)Joel finished 697thAfter winning in the opening round, Northwestern lost to UCLA, in the second round of the March Madness tournament, 68-63.Torsemide to furosemide equivalents CardioMems positive trial: Sustained efficacy of pulmonary artery pressure to guide adjustment of chronic heart failure therapy: complete follow-up results from the CHAMPION randomised trial (The Lancet)CardioMems negative trial: Haemodynamic-guided management of heart failure (GUIDE-HF): a randomised controlled trial (The Lancet)Estimation of the Absolute Risk of Cardiovascular Disease and Other Events: Issues With the Use of Multiple Fine-Gray Subdistribution Hazard Models (Circulation)Torasemide in chronic heart failure: results of the TORIC study (PubMed)Tubular SecretionsNayan: Louise Penny A World of Curiosities: A Novel (Amazon)Sadiya: Ted Lasso season threeSophia:The Last of Us on HBO and SNL skit Mario Cart as Prestige DramaBoback: Duolingo for Japanese

The Filtrate:Joel TopfSwapnil HiremathJosh WaitzmanNayan AroraSophia AmbrusoWith Special Guest:Megan Prochaska Assistant professor of medicine at University of Chicago John Asplin Medical Director Consultant LithoLink (Twitter)Editor:Joel TopfShow Notes:The LithoLink websiteStone Camp tweetPrevention of Repeated Episodes of Kidney Stones in Adults: A Clinical Practice Guideline From the American College of Physicians (link)NOSTONE in the NEJM and NephJCFred Coe Google Scholar | YouTube | BlogHypercalcuria. Curhan et al. 24-h uric acid excretion and the risk of kidney stones PubMedEQUIL2 software to evaluate urinary super saturation Anna Zisman Racial Differences in Risk Factors for Kidney Stone Formation (CJASN)Potassium Citrate on GoodRxMoonstone NutritionPotassium and citrate by Fred Coe (blog)Thiazide Diuretics and Fracture Risk: A Systematic Review and Meta‐Analysis of Randomized Clinical Trials (PubMed)Chlorthalidone promotes mineral retention in patients with idiopathic hypercalciuria by Coe et al (PubMed)NHANES 24-hour urine Na (Abstract) Kidney Stone risk is reduced with empagliflozin (PubMed)Prospective trial to determine the effect of SGLT2i on urinary supersaturation (BMJ Open)GLP agonists and kidney stone risk Tubular SecretionsSwap: Star Wars: Thrawn Series by Timothy Zahn (Penguin Random House)Josh: Little League Megan: Renal related podcastsSophia Renal Stone Camp and ABCKidney.comNayan: Ted Lasso Robert Galbraithand The Comoran Strike Novels (home page)John: Fred Coe’s BlogJoel: Spiderman across the Spider-Verse (Wikipedia)

The Filtrate:Joel TopfSwapnil HiremathJosh WaitzmanJordy CohenWith Special Guest:Areef ishani lead author and Chief of Medicine VA MinneapolisEditor:Nayan AroraShow Notes:MRFIT switches diuretics and finds better outcomes. Swapnil shows how many studies he is familiar with by spewing out a string of them.Chlorthalidone wins: ALLHAT, MRFIT, SPRINT, HYVET, CLICK (not mentioned by Swap but by Jordy later)HCTZ loses: HOPE3, ACCOMPLISHDiuretic half-lifes NEJM reviewEdarbyclor: Azilsartan and Chlorthalidone $240/month as per GoodRxNice mention of late study originator Frank Lederle. Please see his article in Annals about his diagnosis of pancreatic cancer. Moving. Network analysis of HCTZ vs chlorthalidoneAntihypertensive efficacy of hydrochlorothiazide vs chlorthalidone combined with azilsartan medoxomil by George BakrisSynopsis of the 2020 U.S. Department of Veterans Affairs/U.S. Department of Defense Clinical Practice Guideline: The Diagnosis and Management of Hypertension in the Primary Care Setting (Annals of Internal Medicine)Testing for Primary Aldosteronism and Mineralocorticoid Receptor Antagonist Use Among U.S. Veterans: A Retrospective Cohort Study by Jordy CohenStudy showing better risk reward ratio of low dose than high dose thiazide diuretics. Treatment of hypertension in the elderly: I. Blood pressure and clinical changes. Results of a Department of Veterans Affairs Cooperative Study.Tubular SecretionsSwapnil Louise Penny author of book upon which the Amazon Prime series, Three Pines is based on.Jordy Last of Us series on HBOJosh Channel Your Enthusiasm A Very Special Episode: Meet the GlaucomfleckensAreef The Body: A Guide for OccupantsJoel NephMadness (this did not age well)

The Filtrate:Joel TopfSwapnil HiremathJosh WaitzmanSophia AmbrusoWith Special Guest:Anna Vinakova Associate Professor of Medicine at Virginia Commonwealth University. NephMadness Executive. Vanuja Java is a transplant nephrologist at Washington University in St. Louis, MO. Her research involves functional characterization of genetic variants in complement-mediated diseases. She co-chairs the ClinGen complement gene curation expert panel.Editor:Sophia AmbrusoShow Notes:#NephMadness 2023: Thrombotic Microangiopathy RegionTMA Review article in the NEJM from 2014: Syndromes of Thrombotic MicroangiopathyDr. Anuja Java Co-chairs Working Group in an International Committee for Revising aHUS NomenclatureNephrology Secrets 4th Edition at AmazonUniversity of Iowa Genetic testing for aHUSEarly Eculizumab Withdrawal in Patients With Atypical Hemolytic Uremic Syndrome in Native Kidneys Is Safe and Cost-Effective: Results of the CUREiHUS Study. KI reports. This is the Netherlands study. They used home urine dipsticks to monitor for relapses. Clinical promise of next-generation complement therapeutics Nature reviews. Drug DiscoveryNephMadness PodcrawlTubular SecretionsSwap: Neuromancer and the works of William Gibson (@GreatDismal)Sophia: The Magicians on NetflixAnna: Recommends nephrology. Says it is awesome. Anuja: Dope Sick on Hulu and Women in Nephrology mentor programJosh: Mobituaries with Mo Rocca. Specifically “Death of a Banana”Joel: Ivory by TapBot

Welcome to the NephMadness PodCrawlThe idea behind a podcrawl is for a variety of podcasts to coordinate on timing and topic to push a theme and get each other’s listeners to explore all of the podcasts. One of the first goals behind NephMadness was to build a community and in the early years of Twitter, NephMadness was central to the formation of #NephTwitter and defining the ethos that makes our online community kind, intelligent, vibrant, and interesting. The NephMadness Podcrawl hopes to inspire and grow the nephrology podcast community in the same way. For 2023, our second year,  the PodCrawl has assembled the Avengers of Medical Pods!Go to NephMadness.com/podcrawl for more information and links to all of the podcasts!The Curbsiders gets the skinny on mineralcorticoid receptor antagonistsCore IM will be covering Kidney Transplant in their classic Five Pearl formatThe CardioNerds will be covering the effect of Heart Failure Devices on Kidney HealthFreely Filtered will try to understand thrombotic microangiopathyISN Global Kidney Care goes deep on IgA nephropathyThe Cribsiders look at transitions, first the Peditrics to Adult nephrology transition and then from living to death with palliative nephrology Fellow on Call will be covering OnconephrologyAnd finally, The Nephron Segment looks at Transgender Health and CKD

The Filtrate:Joel TopfSwapnil HiremathNayan AroraSophia AmbrusoWith Special Guest:Amit Garg @AmitXGarg, Nephrologist at Western University, London, and lead PI of the MYTEMP trial. Editor:Joel TopfShow Notes:MyTEMP in pubmed: Personalised cooler dialysate for patients receiving maintenance haemodialysis (MyTEMP): a pragmatic, cluster-randomised trialMyTEMP Summary on NephJC It’s really cold in OntarioThe NephTrials blog summary on Pragmatic TrialsThe pragmatic TiME trial on longer time on dialysis (ahem, sabotaged by site investigators like Joel who cut dialysate time) Dember et al in JASNPoor quality of trial data preceding MyTEMP, a systematic review from Mustafa et al in JASN The 2007 European Best Practice Guideline (EBPG) from 2007, recommending “Cool dialysate temperature dialysis (35–36°C) or isothermic treatments by blood temperature controlled feedback should be prescribed in patients with frequent episodes of IDH (Evidence level I).” in NDT47% of centres from a DOPPS study of 273 centers routinely use of lower dialysate temperature, Dasgupta et al in JASNHow do you convert from C to F? Almanac.com (35.5 C is 96.9 F; 37 C is 98.6 F)More on the rationale and design of MyTEMP: Al-Jaishi et al in CJKHDHow big is 4.3 million (the number of hemodialysis treatments in MyTEMP)? Very big indeed.NephJC discussion of another cluster RCT and granular data only on a subset SSASS Participants in dialysis clinical trials are not representative of the real world dialysis cohorts, Smyth et al in JAMA Int MedPeritoneal dialysis numbers in Ontario are high, Blake et al in PDI, though with ~ 60% CVC rates, Blake et al in Kidney360Dialysate Magnesium #DreamRCT from Swap, NephTrials discussion of DialMagStatistical analysis plan of MyTEMP, Dixon et al in CJKHDTubular SecretionsSwap: Watch Everything, Everywhere All At Once on PrimeNayan: Read The Midnight Ride from Ben Mezrich (brother of Josh Mezrich from the NephJC Summer Book Club 2021)Sophia: Making nephrology education fun at the UC DenverAmit: The wrestling team at Western U from 1990-91Joel: House of the Dragon on HBO Max

The Filtrate:Joel TopfSwapnil HiremathJordy Cohen With Special Guest:Laurie Tomlinson. @Roxytonin Nephrologist at University Hospitals Sussex and research hero of Jordy. Editor: Priya Yenebere Show Notes:STOP-ACE in pubmed: Renin-Angiotensin System Inhibition in Advanced Chronic Kidney DiseaseSTOP-ACE Summary in NephJC Prior data showing preservation of renal function by stopping ACEi: The impact of stopping inhibitors of the renin-angiotensin system in patients with advanced chronic kidney diseaseEfficacy and Safety of Benazepril for Advanced Chronic Renal Insufficiency: NEJMDr. Tomlinson’s article on creatinine changes in RASi from 2017: Serum creatinine elevation after renin-angiotensin system blockade and long term cardiorenal risks: cohort study NephJC | PubMed Accuracy of eGFR at low GFR: A new equation to estimate glomerular filtration rateStrong opinions, loosely held. “Permissive AKI” with treatment of heart failure. Editorial by Chirag Parish and Steven CocaThe rational for NICE avoiding RASi in black patients: Hypertension and ethnic groupAASK trial showing superiority of RASi in African Americans. JAMAALLHAT post-hoc analysis of outcomes by self-reported race. JAMA | PubMedSophisticated Swedish observational study that Swap loved. Stopping Renin-Angiotensin System Inhibitors in Patients with Advanced CKD and Risk of Adverse Outcomes: A Nationwide StudyTarget Trials in Nephrology Dr Edouard Fu grand rounds at Ottawa Nephrology, YouTubeTarget Trial EmulationA Framework for Causal Inference From Observational Data by Miguel Hernán in JAMATubular SecretionsJordy: Third season of His Dark Materials on HBOSwap: Movies by Wes Anderson on Disney PlusLaurie: The Book, “Nearly All the Men in Lagos are Mad”Jordy: How Medicine Works and When It Doesn't: Learning Who to Trust to Get and Stay Healthy | AmazonJoel EO | NYT Review

The Filtrate:Joel TopfSwapnil HiremathJosh WaitzmanSophia AmbrusoPriya Yenebere With Special Guest:Brendon Neuen, Secretariat of the SGLT2 Trialists Consortium and cool guy on Twitter. Editor: Sophia AmbrusoShow Notes:Joel’s Conflict of Interest Statement. Sophia is also conflicted with Astra Zeneca and Brendon with everybody in the SGLT2i space.Joel starts off with a history of SGLT2iEMPA-REG Outcomes. First!CANVAS. OMG this signal is reproducible!CREDENCE (🎧). It works in a dedicated population at high risk of kidney disease. And in a study designed for renal end-points.DAPA-CKD (🎧). It’s not just for diabetics!EMPA-Kidney. It works at really low GFR. And without albuminuria. And again in non-diabetics.SGLT Inhibitors for Type 1 Diabetes: Proceed With Extreme CautionClick to find the supplement (requires a subscription)Differences in definition in the decreased renal function component of the composite primary outcomes.EMPA-Kidney 40%DAPA-Kidney 50%CREDENCE doubling of serum CrUsability Testing of a Sick-Day Protocol in CKD (Pubmed)New Guidelines for Statistical Reporting in the Journal (link, commentary on said guidelines by Frank Harrell)CKD outcomes and the FDA: Change in Albuminuria and GFR as End Points for Clinical Trials in Early Stages of CKD: A Scientific Workshop Sponsored by the National Kidney Foundation in Collaboration With the US Food and Drug Administration and European Medicines AgencyThe Peripheral on Amazon PrimeUnsealed the Tylenol Murders PodcastProject Hail Mary by Andrew WeirLizzy McAlpine Singer Song WriterRachel Maddow Presents: UltraTwitter chaos continues. Get your Med-Mastodon handle

The Filtrate:Joel TopfSwapnil HiremathNayan AroraSophia AmbrusoEditor: Nayan AroraShow Notes:Joel’s Conflict of Interest StatementThe Draft Board EMPA-Kidney is “off the board”Lunch Symposium on Current and Future Approaches to the Diagnostic Assessment and Management of AKI in Patients with Cirrhosis provided by an educational grant from Mallinckrodt PharmaceuticalsThe CONFIRM Trial Terlipressin plus Albumin for the Treatment of Type 1 Hepatorenal Syndrome in NephJCClinical Practice Session Leveraging Social Media to Create, Learn, Teach, Advocate, and Dispel MisinformationThe BEST-Fluids Trial: A Randomized Controlled Trial of Balanced Crystalloid Solution vs. Saline to Prevent Delayed Graft Function in Deceased Donor Kidney Transplantation - Michael G. Collins, Magid Fahim, Elaine Pascoe, Carmel Hawley, David W. Johnson, Philip A. Clayton, Steven J. Chadban (ClinicalTrials.gov)The Late Breaking and High Impact Trials Session line upStop ACEiCLARITY Angiotensin receptor blockers for the treatment of covid-19: pragmatic, adaptive, multicentre, phase 3, randomised controlled trialEffects of Pantoprazole on Kidney Outcomes: Post Hoc Analyses From the COMPASS Randomized Controlled Trial by Lonnie Pyne, et alNo Stone: Hydrochlorothiazide for the Prevention of Kidney Stone Recurrence by Daniel Foster, et alMyTEMP: Personalised cooler dialysate for patients receiving maintenance haemodialysis (MyTEMP): a pragmatic, cluster-randomised trialClinical Practice Session Best of NephJC“We'd Now Like To Open The Floor To Shorter speeches disguised as questions.”ASN Task Force on the Future of NephrologyAttracting Osteopathic Medical Students Into NephrologyHasan Minhaj’s joke at the expense of DOsTRANSFORM-HF: Torsemide vs. Furosemide in Treating Patients With HFPoint-of-Care Ultrasound in Nephrology specifically VExUS

The Filtrate:Joel TopfJordy CohenNayan AroraSophia AmbrusoSpecial Guests:Boback Ziaeian @boback Assistant Professor of Medicine David Geffen School of Medicine at UCLA returns for his second episode (SODIUM-HF). His Google Schoolar page is better than yours. David Ellison @dhekidney is professor of medicine at Oregon Health Science University and head of the Oregon Clinical & Translational Institute. Show Notes:Ultrafiltration in Decompensated Heart Failure with Cardiorenal Syndrome (The CARESS Trial)Ultrafiltration versus intravenous diuretics for patients hospitalized for acute decompensated heart failure (The UNLOAD trial)Diuretic Strategies in Patients with Acute Decompensated Heart Failure (The DOSE Trial)Diuretic Strategies for Loop Diuretic Resistance in Acute Heart Failure (The 3T Trial)Sequential nephron blockade with a thiazide diuretic has a 1 B-NR (non-radomized) grade in the AHA/ACC Heart Failure Guidelines (7.2)Three important acute decompensated heart failure with SGLT2i:1. Sotagliflozin in Patients with Diabetes and Recent Worsening Heart Failure (SOLOIST-WHF Trial)2. The SGLT2 inhibitor empagliflozin in patients hospitalized for acute heart failure: a multinational randomized trial (The EMPULSE Trial)3. Effects of Early Empagliflozin Initiation on Diuresis and Kidney Function in Patients With Acute Decompensated Heart Failure (EMPAG-HF)Interpreting the Kansas City Cardiomyopathy Questionnaire in Clinical Trials and Clinical Care: JACC State-of-the-Art ReviewCardiologist Sues Epic Over Copyright InfringementOutcomes associated with a strategy of adjuvant metolazone or high-dose loop diuretics in acute decompensated heart failure: a propensity analysis.Acetazolamide to increase natriuresis in congestive heart failure at high risk for diuretic resistance (PubMed)Efficacy and Safety of Spironolactone in Acute Heart Failure (ATHENA Trial)Joel with a video on acetazolamide for altitude sickness. The Butchering Art: Joseph Lister's Quest to Transform the Grisly World of Victorian Medicine(Amazon)

The Filtrate:Joel TopfSwapnil HiremathNayan AroraPriya YenebereSpecial Guests:Todd Miano, PharmD, PhD @Miano81 Assistant Professor of Epidemiology, Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine.Show Notes:Early Pip/Tazo article showing nephrotoxicity. Covered by NephJCLinazolid vs Vanco RCT showing excess AKI with Vanco. Yes Vance is a lot less toxic than it was in the Mississippi mud days but your attending telling you it is no longer nephrotoxic is wrong. Linezolid in methicillin-resistant Staphylococcus aureus nosocomial pneumonia: a randomized, controlled study and Vancomycin and the Risk of AKI: A Systematic Review and Meta-Analysis.Vancomycin-Associated Acute Kidney Injury with a Steep Rise in Serum CreatinineVancomycin-Associated Cast Nephropathy: Reality or Fantasy?Molecular Epidemiology of SepsiS in the ICU (MESSI) prospective cohort. Learn about it her: A multibiomarker-based outcome risk stratification model for adult septic shock*Cystatin C in acute kidney injury Changing Definitions of SepsisProposed new definitions of AKI incorporating biomarkers: Recommendations on Acute Kidney Injury Biomarkers From the Acute Disease Quality Initiative Consensus Conference. A Consensus Statement in JAMA Network OpenApplications of propensity score methods in observational comparative effectiveness and safety research: where have we come and where should we go?The effect of glucocorticoids on serum cystatin C in identifying acute kidney injury: a propensity-matched cohort studyProtective effect of piperacillin against nephrotoxicity of cephaloridine and gentamicin in animalsPulmCrit – Myth-busting the conditional nephrotoxicity of piperacillin-tazobactam by Josh FarkasSharp Objects on Good ReadsBandon Dunes The Ocean Course at Kiawah Island Golf ResortBe Real follow me: BeRe.al/kidney_boySNL spoof of BeReal

The Filtrate:Joel TopfSwapnil HiremathJennie LinSpecial Guests:Priya Yenebere @PriRenalAKI Transplant nephrologist at Indiana University School of Medicine. She is a current NSMC Intern. J Pedro Teixeira @NephCrit_NM ICU Nephrologist at the University of New Mexico.Editor: Priya YenebereShow Notes:Critical Care Nephrology Critical Care Nephrology: Core Curriculum 2020 by Benjamin R Griffin, Kathleen D Liu, and J Pedro Teixeira.Critical Care Rheumatology Dual-Trained Rheumatologists Take Multidisciplinary Approach to Their PatientsMed-Peds to NephrologyEarly Goal-Directed Therapy in the Treatment of Severe Sepsis and Septic Shock by Emanuel RiversProMISe: Trial of Early, Goal-Directed Resuscitation for Septic Shock ARISE: Goal-Directed Resuscitation for Patients with Early Septic ShockProCESS: A Randomized Trial of Protocol-Based Care for Early Septic ShockThe Filtrate:Rinaldo Bellomo and micro circulatory disorders as cause of AKI in sepsis. Septic acute kidney injury: new conceptsComparison of Two Fluid-Management Strategies in Acute Lung Injury (FACTT) The negative trial we accept as a positive trial because of the secondary outcomes. The prime minister of Finland was caught on the dance floor. This is a bad thing? (NY Times)Deferred Consent: A New Approach for Resuscitation Research on Comatose PatientsLactate conversion MediCalcThe Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)Mottling score is a strong predictor of 14-day mortality in septic patients whatever vasopressor doses and other tissue perfusion parametersCritical Care Reviews Podcast: CLASSIC Trial Results PresentationWhat is the most George Constanza-esque reason you broke up with someone? (reddit)Bonferroni correctionThe Importance of Fluid Management in Acute Lung Injury Secondary to Septic ShockRestrictive versus Liberal Fluid Therapy for Major Abdominal Surgery in the NEJM. RELIEF, NephJC discussionEffect of an Early Resuscitation Protocol on In-hospital Mortality Among Adults With Sepsis and Hypotension: A Randomized Clinical Trial in JAMAFEAST Trial: Mortality after Fluid Bolus in African Children with Severe InfectionRings of Power on Amazon PrimeWhy the Hobbit trilogy suckedIndustry on HBOSandman 2022 on NetflixWhere did Liverpool FC go wrong with the 2021/2022 Premier League? (Quora)CRRT Academy at University of Alabama with 2020 Robert G. Narins Award Recipient: Ashita Tolwani, MD, MS (YouTube)Life as a Nephrologist podcast on CritCare NephrologyContinuous KRT: A Contemporary Review by J. Pedro Teixeira, Javier A. Neyra and Ashita TolwaniUniversity of New Mexico Nephrology Program. Apply to their fellowship.The Pledge Drive is over, but you can always support NephJC. NephJC is a 501(3)c registered non-profit and all donations are tax deductible in the US.

The Filtrate:Joel TopfSwapnil HiremathJosh WaitzmanSophia AmbrusoSpecial Guests:Boback Ziaeian @boback Assistant Professor of Medicine David Geffen School of Medicine at UCLA. His Google Schoolar page is better than yours. And returning for her third time (why sdo we keep inviting her back?)Sadiya Khan @heartDocSadiya Assistant Professor of Medicine (Cardiology) and Preventative Medicine at Northwestern Feinberg School of Medicine. LinkEditor: Sophia AmbrusoDonate to NephJCGet your Freely Filtered Mug by becoming a Freely Filtered Fan, all proceeds go to NephJC. All donations are tax deductible in the U.S.http://www.nephjc.com/new-products/freely-filtered-fanIf you want to support NephJC to a different tune than $200, take a look at the NephJC September Pledge Drive page. Show Notes:2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure says:Restricting dietary sodium is a common nonpharmacological treatment for patients with HF symptomatic with congestion, but specific recommendations have been based on low-quality evidence. Concerns about the quality of data regarding clinical benefits or harm of sodium restriction in patients with HF include the lack of current pharmacological therapy, small samples without sufficient racial and ethnic diversity, questions about the correct threshold for clinical benefit, uncertainty about which subgroups benefit most from sodium restriction, and serious questions about the validity of several RCTs in this area. However, there are promising pilot trials of sodium restriction in patients with HF. The AHA currently recommends a reduction of sodium intake to <2300 mg/d for general cardiovascular health promotion; however, there are no trials to support this level of restriction in patients with HF. Sodium restriction can result in poor dietary quality with inadequate macronutrient and micronutrient intake. Nutritional inadequacies have been associated with clinical instability, but routine supplementation of oral iron, thiamine, zinc, vitamin D, or multivitamins has not proven beneficial. The DASH diet is rich in antioxidants and potassium, can achieve sodium restriction without compromising nutritional adequacy when accompanied by dietary counseling, and may be associated with reduced hospitalizations for HF.This is 2a Class of Recommendation (moderate strength) with a C-LoD level of evidence (Limited data).Study acronym: the Study Of Dietary Intervention Under 100 Milimoles in Heart Failure. 100 mmol of sodium is 2300 mgMeta analysis of high versus low sodium diet pulled from Heart due to duplicated and missing data. Retraction Watch.65 mmol of sodium is 1500 mgThe trial design papers: Design and Region-Specific Adaptation of the Dietary Intervention Used in the SODIUM-HF Trial: A Multicentre Study and Rationale and design of the Study of Dietary Intervention Under 100 MMOL in Heart Failure (SODIUM-HF)3-day food diaries underestimate sodium intake vs 24 hour urine - and this is worse for patients on loop diuretics: Evaluation of 2 methods for sodium intake assessment in cardiac patients with and without heart failure: the confounding effect of loop diureticsPREDIMED trial of Mediterranean diet: retracted, republished, still trusted? DASH Diet trial where they gave food to the participants Effects on Blood Pressure of Reduced Dietary Sodium and the Dietary Approaches to Stop Hypertension (DASH) DietMedical Therapy for Heart Failure With Reduced Ejection Fraction: The CHAMP-HF RegistryInterpreting the Kansas City Cardiomyopathy Questionnaire in Clinical Trials and Clinical Care: JACC State-of-the-Art Review Development and evaluation of the Seattle Angina questionnaire: A new functional status measure for coronary artery diseaseCardiologist Sues Epic Over Copyright Infringement6-minute walking test: a useful tool in the management of heart failure patientsFrank Harrell on Statistical Errors in the Medical LiteratureANCOVA versus change from baseline: more power in randomized studies, more bias in nonrandomized studiesA-HeFT: Combination of Isosorbide Dinitrate and Hydralazine in Blacks with Heart FailureTOPCAT: Spironolactone for Heart Failure with Preserved Ejection FractionSSaSS: Effect of Salt Substitution on Cardiovascular Events and DeathMini Cooper SE Electric hardtop 2 door Taylor Swift can't stop emitting CO2 with her private plane. The Captain (miniseries)Nope.The Mystery of Why Some People Don’t Get CovidFor All Mankind (TV series)

The Filtrate:Joel TopfSwapnil HiremathJosh WaitzmanJordy CohenSpecial Guest:Sean Barbour. Clinical Associate Professor, Division of Nephrology, University of British Columbia Chair, BC Glomerulonephritis Committee and Network, BC RenalEditor:Joel TopfShow Notes:NephJC Summary of TESTING: Re-TESTING Steroids for IgA Nephropathy (have you ever noticed how good the titles for the NephJC summaries are?)TESTING in JAMASTOP-IgA NephJC Summary: Don't just do something, stand there. Another great title, this one from from a long time ago.The British Columbia GN network really owes its existence to TESTING: An overview of the British Columbia Glomerulonephritis network and registry: integrating knowledge generation and translation within a single framework (PubMed)Dunning–Kruger effect WikipediaPrior Art for steroids in IgA nephropathy:Italian study: Randomized controlled clinical trial of corticosteroids plus ACE-inhibitors with long-term follow-up in proteinuric IgA nephropathyAnother, earlier, Italian study: Corticosteroids in IgA nephropathy: a randomised controlled trialChinese study: Combination therapy of prednisone and ACE inhibitor versus ACE-inhibitor therapy alone in patients with IgA nephropathy: a randomized controlled trialOriginal TESTING publication from 2017, also in JAMA. Oh, and we covered that in NephJC too, IgA Nephropathy: Testing Steroids Again.NephJC also talked about Sean Barbour’s risk score for IgA Nephropathy: Summary | Freely Filtered Podcast episode 5A Controlled Trial of Fish Oil in IgA Nephropathy in the NEJM!Stevens-Johnson Syndrome. “When to see a doctor Stevens-Johnson syndrome requires immediate medical attention. Seek emergency medical care if you experience signs and symptoms of this condition.” Change in Albuminuria and GFR as End Points for Clinical Trials in Early Stages of CKD: A Scientific Workshop Sponsored by the National Kidney Foundation in Collaboration With the US Food and Drug Administration and European Medicines Agency (PubMed)Adaptive Trials in NephMadness 2016 with Selection Committee Member, Perry Wilson!TreifGeographic Differences in Genetic Susceptibility to IgA Nephropathy: GWAS Replication Study and Geospatial Risk AnalysisThe MEST score provides earlier risk prediction in lgA nephropathyDAPA-IgA: A pre-specified analysis of the DAPA-CKD trial demonstrates the effects of dapagliflozin on major adverse kidney events in patients with IgA nephropathySwap and Josh fight about SGLT2i in IgA NephropathySignificance of serum galactose deficient IgA1 as a potential biomarker for IgA nephropathy: A case control study (PubMed)FDA approves first drug to decrease urine protein in IgA nephropathy, a rare kidney disease. FDA has granted accelerated approval for  budesonide delayed release capsules to reduce proteinuria in adults with primary IgA nephropathy at risk of rapid disease progression. It has not been established whether budesonide delayed release capsules slow kidney function decline in patients with IgA nephropathy. Targeted-release budesonide versus placebo in patients with IgA nephropathy (NEFIGAN): a double-blind, randomised, placebo-controlled phase 2b trial (Lancet)Omicron in Ontario.Prescribing Nirmatrelvir/Ritonavir for COVID-19 in Advanced CKD by SwapStar Trek: Strange New WorldsOrigins of Renal Physiology: Fellows 2022 Medical Students: Kidney TREKSApplication of the International IgA Nephropathy Prediction Tool one or two years post-biopsy (Kidney International)The Triple Crown in Virginia

The Filtrate:Joel TopfNayan AroraSophia AmbrusoSwapnil HiremathJosh WaitzmanSpecial Guest:Natalie Bello Director of Hypertension Research at Cedars SinaiEditor:Nayan AroraShow Notes:NephJC summary of CHAPCHiPS TV showCHIPS study: Less-Tight versus Tight Control of Hypertension in PregnancyPrevention, Diagnosis, and Management of Hypertensive Disorders of Pregnancy: a Comparison of International Guidelines (Pubmed)SFLT in preeclampsia from where else but NephMadness and here.Aspirin Use to Prevent Preeclampsia and Related Morbidity and MortalityUS Preventive Services Task Force Recommendation Statement (JAMA)The NNT for aspirin in pregnancy is like a relationship on Facebook, it’s complicated. Astrologic signs as predictor of aspirin effectiveness in Randomised trial of intravenous streptokinase, oral aspirin, both, or neither among 17,187 cases of suspected acute myocardial infarction: ISIS-2. ISIS-2 (Second International Study of Infarct Survival) Collaborative Group (Pubmed) ACOG revises the guidelines on hypertension: Clinical Guidance for the Integration of the Findings of the Chronic Hypertension and Pregnancy (CHAP) StudyMeta-analysis showing treating blood pressure in pregnancy didn’t help. Antihypertensive drug therapy for mild to moderate hypertension during pregnancy.

The Filtrate:Joel TopfNayan AroraSophia AmbrusoSwapnil HiremathSpecial Guest:Jade TeakallJeff Perl, Great Twitter handle, PD_PerlsEditor:Joel TopfShow Notes:ISPD 2022 Peritonitis GuidelinesNephJC DiscussionDimitrios Oreopoulos obituary in JASN. Peritoneal Dialysis International: Journal of the International Society for Peritoneal DialysisThe draft board: Google DocThe PROMPT Study showing delayed peritonitis treatment increases the risk of treatment failure: The Relationship Between Presentation and the Time of Initial Administration of Antibiotics With Outcomes of Peritonitis in Peritoneal Dialysis Patients: The PROMPT StudyEmbedded PD catheters: Complications and catheter survival with prolonged embedding of peritoneal dialysis cathetersNikhil Shah asking questions about fungal prophylaxisQuestion 1Question 2Icodextrin antibiotic compatibility: Stability and compatibility of antibiotics in peritoneal dialysis solutions or in Tweet Form.Nikhil Shah on having antibiotics at homeTweet thread about the things we do for little reason regarding getting people listed for transplant.Regarding the trend in duration of antibiotics: Duration of Antibiotic Therapy: Shorter Is Better‘Spelling the Dream’ Review: Netflix’s Inspiring Spelling Bee Doc Is an Unexpected Rallying CryABC KidneyHome Dialysis University was May 1, 2The Grand Canyon, second largest hole in the ground.

The Filtrate:Joel TopfJoshua WaitzmanNayan AroraJennie LinSophia AmbrusoSpecial Guest:Paul A Welling Editor:Sophia AmbrusoShow Notes:NephJC Summary on SSaSSPaul Welling’s tweetorial on the potassium switchThe 2016 Canadian Hypertension guidelines were the first to suggest adding potassium: Hypertension Canada's 2016 Canadian Hypertension Education Program Guidelines for Blood Pressure Measurement, Diagnosis, Assessment of Risk, Prevention, and Treatment of HypertensionSwapnil’s Potassium Trial: Diet or additional supplement to increase potassium intake: protocol for an adaptive clinical trialWhen Food Firms Cut The Salt, What Do They Put In Instead? From NPR.Effect of increased potassium 🍌 intake on cardiovascular risk factors and disease: systematic review and meta-analysesEffect of lower sodium🧂 intake on health: systematic review and meta-analysesEstimated population wide benefits and risks in China of lowering sodium through potassium enriched salt substitution: modelling studyFDA Issues Final Guidance Regarding Use of an Alternate Name for Potassium Chloride in Food LabelingDavid Ellison and Paul Welling’s reviewing the NEJM: Insights into Salt Handling and Blood PressureNephTrials on Cluster Randomized Trials: http://www.nephjc.com/news/clusterct Nu-Salt (KCl) 3 oz for $4.97 at Amazon (no afiliate link because we don’t have our act together) Salt for Life looks like it is 75% KCl 25% NaCl and it is 11.99 for 10.5 oz at Amazon (see above disclaimer)Bridgerton, only 8 episodes for Season 2Inhibition of nonalcoholic fatty liver disease in mice by selective inhibition of mTORC1: The Paper | The TweetKansas wins March MadnessWork in Josh’s lab. Get in touch: [email protected] Educational Resources (OER)NKF Spring Clinical Meeting 2022Little Podocye

The Filtrate:Joel TopfJoshua WaitzmanNayan AroraJordy CohenSpecial Guest:Josh Mezrich Editor:Nayan AroraShow Notes:When Death Becomes Life: Notes from a Transplant Surgeon. AmazonAm J Transplant 2022 Jan 20. doi: 10.1111/ajt.16930. PMID: 35049121Coverage on NephJCFirst transplant of a pig into a human. NYU transplant. Keith Reemtsma’s experience with chimpanzees transplantation: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1408776/?page=1 Infection of human cells by an endogenous retrovirus of pigsUnited Therapeutics page on xenokidney.Article by Starzl on the early days of kidney transplant, including David Humes experiment grafting kidneys to the arms and grafts of patients. The Early Days of TransplantationPatient in Groundbreaking Heart Transplant DiesHeterotopic heart transplantation: where do we stand?Denton Cooley and the first artificial heart transplantFor the First Time in North America, a Woman Gives Birth After Uterus Transplant From a Deceased DonorBlacksburg company raised genetically modified pig for first heart transplant into humanChristiaan Barnard and the first human-to-human heart transplantMaking The Impossible Possible: A Conversation With Martine Rothblatt. The founder of United Therapeutics and SiriusXMPaige Porrett, M.D., Ph.D. first authorJayme Locke, M.D., MPH senior authorLouise Penny author pageThe Four QuestionsChutzpod!Joshua Malina, not the new cantor at Temple Israel.Primitive Technology YouTube Channel

The Filtrate:Joel TopfJoshua WaitzmanNayan AroraSophia AmbrusoJordy CohenSpecial Guest:Kelly HyndmanEditor:Joel TopfPodCrawlMonday, March 14: The Curbsiders An Internal Medicine Podcast…for the Internist. This episode will focus on the Cardiorenal region with Game Maker, Joel Topf @Kidney_Boy, and Selection Committee Member, Sadiya Khan @HeartDocSadiya. Listen on Apple or SpotifyTuesday, March 15: The Drs. WashingtonThe Drs. Washington are three sister physicians who discuss their story and the stories of minority physicians, tips for students interested in careers in medicine, and health-related topics. In this episode, Katie Rizzolo @katierizzolo and Dinushika Mohottige @DMohottige discuss social and physical determinants of health as well as governmental and institutional initiatives that affect health inequities in nephrology.Listen on Apple or SpotifyWednesday, March 16: The CribsidersOn this pediatric podcast, go deep into the Neonatal AKI bracket with the writer, Michelle Starr @mcstarr1. Listen on Apple or SpotifyThursday, March 17: Up My Nursing GameUp My Nursing Game is an educational nursing podcast that uses expert interviews to address common nursing questions and pitfalls. It offers free CE credits through VCU Health. This episode featuring Bourne Auguste @bourneauguste and Daniel Weiner @DanTheKidneyMan will focus on blood pressure and Dialysis. Listen on Apple or SpotifyFriday, March 18: Best Science (BS) MedicineThe Best Science Medicine podcast is all about helping primary care clinicians incorporate the best available evidence into their practice in order to help facilitate shared decision-making. In this episode, Game Makers Samira Farouk @ssfarouk and Matthew Sparks @Nephro_Sparks discuss the tricky issue of albuminuria – who to monitor, what to monitor, and who to treat. They spend a lot of time dribbling and end up deciding that nothing is a slam dunk, so stay until the end for a real buzzer beater.Listen on Apple or SpotifySaturday, March 19: Freely FilteredThe Filtrate break down the Animal House region with Selection Committee Member Kelly Hyndman @DrKeeksPhD.Listen on Apple or SpotifyShow Notes:Kelly Hyndman is an Assistant Professor of Medicine in the Section of Cardio-Renal Physiology and Medicine, Division of Nephrology, at the University of Alabama at Birmingham. She has trained both in comparative physiology and kidney physiology labs and is currently a principal investigator of a basic science lab with research interests in novel mechanisms of fluid-electrolyte balance.From Fish to Philosopher by Homer Smith. Review from 1954 in JAMA.#BlueRibbonFailMarine Iguana Visual Abstract by SophieThe OctonautsThe Oregon TrailCRIC StudyAnimal House 2022 blog post by Tiffany TruongGiraffes sleep 4.6 hours a day. Behavioural sleep in the giraffe (Giraffa camelopardalis) in a zoological gardenTobias WangPeter BieGimli the Corgi GiraffeManBearPig from South ParkMike TysonEmus, not mammelsClimate Change Threats on Black Bears in CaliforniaAs Winter Warms, Bears Can’t Sleep. And They’re Getting Into Trouble.Fat Bear Week has a champion: All hail 480 OtisStillsuit in DuneFreely Filtered 042: Nephrin Antibodies Cause Minimal Change Disease. Wait...What?A molecular mechanism explaining albuminuria in kidney diseaseAmerican Heart Association Hypertension Podcast with Swapnil Hiremath and Carolyn ThomasLink to all the AHA podcastsThe Trojan horse Affair podcastCurbsiders #321 Hypertension FAQ with Jordy CohenThe Alpinist

The Filtrate:Joel TopfJennie LinJoshua WaitzmanNayan AroraSophia AmbrusoSpecial Guest:Astrid Weins (@AstridWeins) renal pathologist at the Brigham and Woman’s Hospital and Harvard Medical SchoolEditor:Nayan AuroraShow Notes:Summary of minimal change disease according to the orthodoxy: Light microscopy of renal biopsy specimens from patients with MCD shows minimal to no change; however, electron microscopy reveals the effacement of podocyte foot processes. To add to the conundrum, immunofluorescent staining of biopsy specimens is negative, and no immune complexes are evident.Minimal change disease and idiopathic FSGS: manifestations of the same diseaseNew Views of the Glomerulus: Advanced Microscopy for Advanced DiagnosisImaging of the Porous Ultrastructure of the Glomerular Epithelial Filtration SlitAutoantibodies against podocytic UCHL1 are associated with idiopathic nephrotic syndrome relapses and induce proteinuria in miceFishing ExpeditionKoch's postulatesMeasles in the Nephrotic SyndromeNEPTUNE: NEPhrotic syndrome sTUdy NEtworkCongenital nephrotic syndrome and recurrence of proteinuria after renal transplantationMost of these patients have a homozygous truncating mutation (Fin-major mutation) in the nephrin gene (NPHS1), leading to total absence of the major podocyte protein, nephrin. After RTx, these patients develop anti-nephrin antibodies resulting in nephrotic range proteinuria.Nephrotic syndrome relapse in a boy with COVID-19Minimal Change Disease After First Dose of Pfizer-BioNTech COVID-19 Vaccine: A Case Report and Review of Minimal Change Disease Related to COVID-19 VaccineDr. Laurence Beck and the discovery of Phospholipase A2 Receptor as Target Antigen in Idiopathic Membranous Nephropathy as published in the NEJM.Cheer Season 2 now on NetflixCloud Cuckoo Land: A Novel by Anthony DoerrWinter Surfing in Massachusetts?!

The Filtrate:Joel TopfSwapnil HiremathMatt SparksEditor:Joel TopfShow Notes:The 2010 RFN Top Nephrology StoriesThe 2021 NephJC Top Nephrology StoriesNumber 10: AKIKI AKIKI 2 in The LancetAKIKI 2 in NephJC AKIKI 2 on Freely FilteredNumber 9: Effect of Salt Substitution on Cardiovascular Events and DeathThe Salt Substitute and Stroke Study (SSaSS) in the NEJM The Salt Substitute and Stroke Study (SSaSS) in NephJC FDA Issues Final Guidance Regarding Use of an Alternate Name for Potassium Chloride in Food LabelingNumber 8: AURORA, voclosporin for Lupus NephritisEfficacy and safety of voclosporin versus placebo for lupus nephritis (AURORA 1) in the LancetAURORA 1 on NephJCAURORA 1 on Freely FilteredNumber 7: FIGARO trial of finerenone for CV outcomesCardiovascular Events with Finerenone in Kidney Disease and Type 2 Diabetes in the NEJMRates of Hyperkalemia after Publication of the Randomized Aldactone Evaluation Study by David JuurlinkJoel’s intermissionFDA RejectionsTricida’s VeverimerRoxadustatBardoxoloneTenapanorNumber 6: Pig Kidney Transplant.As covered in the New York TimesClinical Pig Kidney Xenotransplantation: How Close Are We? from JASNNumber 5: KDIGO Blood Pressure GuidelinesKDIGO GuidelinesAs discussed in NephJCAnd on Freely FilteredMatt’s article on ACCORD he wrote for RFN as a fellowNumber 4: Chlorthalidone for Hypertension in Advanced Chronic Kidney Disease (CLICK)CLICK in the NEJMCLICK on NephJCCLICK on Freely FilteredNumber 3: Dapagliflozin helps IgA nephropathyThe LancetFDA OKs First Proteinuria Drug for IgA Nephropathy: delayed released budesonideNumber 2: New eGFR formulas, now race free.New Creatinine- and Cystatin C–Based Equations to Estimate GFR without Race in the NEJMNumber 16: Fixing ADPKD in miceRenal plasticity revealed through reversal of polycystic kidney disease in mice in Nature GeneticsPress release from YaleNumber 1: KDIGO GN GuidelinesPDF in Kidney InternationalNephJC DiscussionLast Month in Nephrology skeptical of all the Rituximab Tubular SecretionsOvercooked! All You Can EatLego Porsche 911Lego Baby Yoda (Grogu)Beyblades

The Filtrate:Joel TopfSwapnil HiremathJennie Lin (who was only there because her plans got boxed by covid)Jordy CohenJosh WaitzmanSpecial Guest:Rajiv Agarwal (@AgarwalRajivMD)Editor:Joel TopfShow Notes:NephJC discussion of CLICK: http://www.nephjc.com/news/click4chlorthalidone CLICK Visual abstract: http://www.nephjc.com/news/2021/12/7/the-click-visual-abstract Hawthorne effect: https://en.wikipedia.org/wiki/Hawthorne_effect A nice discussion run in periods in clinical trials: http://www.nephjc.com/news/run-in-period The ABCD trial Agarwal used to describe the need for a beta blocker to enroll in the trial, but it looks like a review article https://pubmed.ncbi.nlm.nih.gov/12574784/ Canadian trial showing that atenolol did as well as evidence based beta blockers: https://pubmed.ncbi.nlm.nih.gov/31495887/ Associated editorial by Agarwal: https://pubmed.ncbi.nlm.nih.gov/31578572/ Meta-analysis of dose-response relationships for hydrochlorothiazide, chlorthalidone, and bendroflumethiazide on blood pressure, serum potassium, and urate by Mark A Peterzan https://pubmed.ncbi.nlm.nih.gov/22547443/ HCTZ vs Chlorthalidone compete to the death: VA CSP Study No. 597: Diuretic Comparison Project https://www.research.va.gov/programs/csp/597/default.cfm Effectiveness versus Efficacy Trials: https://www.ncbi.nlm.nih.gov/books/NBK44024/ Foundation on Apple TV+: https://www.indiewire.com/2021/09/foundation-review-apple-tv-plus-sci-fi-adaptation-1234666972/ The Expanse on Amazon Prime: https://en.wikipedia.org/wiki/The_Expanse_(TV_series) The Beatles: Get Back on Disney+: https://en.wikipedia.org/wiki/The_Beatles:_Get_Back School of chocolate on Netflix: https://www.themarysue.com/school-of-chocolate/ And Just Like That... on Disney+: https://en.wikipedia.org/wiki/And_Just_Like_That... Past-president of AHA forced to make a statement about the Sex and the City episode: https://twitter.com/NMCardioVasc/status/1471627453885997068 https://twitter.com/NMCardioVasc/status/1471817955344371717 Chris Noth is a bad guy and how Peloton dealt with this. https://variety.com/2021/digital/news/peloton-deletes-chris-noth-ad-sexual-assault-allegations-1235135264/ Apply for the NSMC Social Media Internship: https://www.nsmc.blog

The Filtrate:Joel TopfSwapnil HiremathNayan AroraJennie LinSophie AmbrusoEditorJoel TopfShow Notes:Sign Up for NephSim Nephrons. Deadline 11/30. https://nephsim.com/nephsim-nephrons/ The Draft Board except for Swapnil’s picks because…Calvin Ball: https://docs.google.com/document/d/1Unk_27uqTpMGXrOyrxbI-2csKg2W_qnbbN7IE3wZY_Y/edit?usp=sharing Calvinball per the Calvin and Hobbes Wiki: Calvinball is a game invented by Calvin and Hobbes. Calvinball has no rules; the players make up their own rules as they go along, so that no Calvinball game is like another. https://www.polygon.com/comics/2020/5/13/21254476/calvin-and-hobbes-comic-strips-books-quarantine Swap’s Twitter Moment after he Tweeted all 28 Late Breaking and High Impact Clinical Trial Posters:https://twitter.com/i/events/1456347526936809480 Selena Gomez’s Kidney Transplant: https://www.youtube.com/watch?v=cMgfp0hu5lw and Kidney Transplant drama due to…Justin Bieber! https://www.koimoi.com/hollywood-news/selena-gomez-cut-ties-with-her-kidney-donor-francia-raisa-in-2018-the-reason-was-allegedly-related-to-justin-bieber/

The Filtrate:Joel TopfSwapnil HiremathNayan AroraJennie LinJoshua WaitzmanSpecial GuestsAlfred Kim assistant Professor at Washington University, director of the lupus clinic. Receives support from Arena Pharmaceuticals, manufacturer of volcloosporin, or at least he did before this episode aired.Dawn Castor assistant professor at The University of Louisville School of Medicine. She is on the speaker bureau for Arena Pharmaceuticals, manufacturer of volcloosporin. She was a site principle investigator (PI) as well as an author of the trial.EditorNayan AroraShow Notes:NIH Cyclophosphamide trial, long term follow-up: Combination therapy with pulse cyclophosphamide plus pulse methylprednisolone improves long-term renal outcome without adding toxicity in patients with lupus nephritis. Other important publications on this trial include:Therapy of lupus nephritis. Controlled trial of prednisone and cytotoxic drugs NEJM 1986Controlled trial of pulse methylprednisolone versus two regimens of pulse cyclophosphamide in severe lupus nephritis Lancet 1992Euro-Lupus Nephritis Trial, a randomized trial of low-dose versus high-dose intravenous cyclophosphamideVoclosporin is approved by FDA in January 2021Previous Lupus Nephritis podcast with Dawn and Alfred: Freely Filtered 029: Belimumab for lupus nephritisRituximab în Lupus. The LUNAR Trial (Spoiler, it didn’t work): Efficacy and safety of rituximab in patients with active proliferative lupus nephritis: the Lupus Nephritis Assessment with Rituximab studySystematic review of the literature on reproducibility of the interpretation of renal biopsy in lupus nephritisConclusion The interpretation of renal biopsy in lupus nephritis is poorly reproducible, causing serious doubts about its validity and its clinical application. As it can lead to serious diagnosis, treatment and prognosis errors, it is necessary to intensify research in this field.The ALMS trials of mycohenolate mofetil (MMF) trials in lupus nephritisInduction: Mycophenolate Mofetil versus Cyclophosphamide for Induction Treatment of Lupus Nephritis (JASN 2009)Maintenance: Mycophenolate versus Azathioprine as Maintenance Therapy for Lupus Nephritis (NEJM 2011)Jacob deGrom on the mound. Baseball Reference. DeGrom is a two time Cy Young award winner, a 4-time All-Star and former Rookie of the Year winner.AURORA2: Aurinia Renal Assessments 2: Aurinia Renal Response in Lupus With Voclosporin (ClinicalTrials.gov)Aurinia Pharmaceuticals.KDIGO 2021 Glomerulonephritis Guidelines Daily aspirin vs placebo for suspected acute myocardial infarction is highly protective except for patients born under Libra or Gemini. Current misconception 3: that subgroup-specific trial mortality results often provide a good basis for individualising patient careMultitarget therapy for induction treatment of lupus nephritis: a randomized trial.Patient Benefits Justify Price of New Lupus Nephritis Drugs“The estimated annual price of belimumab is approximately $43,000 per patient; the estimated annual price for voclosporin is approximately $92,000 per patient.”2019 update of the EULAR recommendations for the management of systemic lupus erythematosus GuidelineDr. Glaucomflecken on TwitterCardiology vs Nephrology Round 1Nephrology vs Cardiology Round 2In the Heights (Wikipedia)The Mitchells vs. the Machines (Wikipedia)Paws in PrisonFlozinator pin

The Filtrate:Joel TopfSwapnil HiremathNayan AroraSophie AmbrusoJoshua WeismanEditorJoel TopfShow Notes:Soccer star Christian Eriksen 'was gone' after on-field cardiac arrest, doctor says (NBC News)120-sided Die. This was covered in Wired Magazine. Respect. https://www.wired.com/2016/05/mathematical-challenge-of-designing-the-worlds-most-complex-120-sided-dice/ Nephrologists that played D&D: https://twitter.com/kidney_boy/status/1398660927680036865?s=20 Doctors that played D&D (i.e. control group): https://twitter.com/kidney_boy/status/1398661170328899586?s=20 Average sodium intake among Americans is 3,400 mg (147 mEq of Na per day). Sodium and the Dietary Guideline Factsheet (PDF)DASH Sodium Diet Trial https://www.nejm.org/doi/10.1056/NEJM200101043440101 The PURE Trial as discussed by NephJC and as seen in the NEJMFormulas to Estimate Dietary Sodium Intake From Spot Urine Alter Sodium-Mortality Relationship https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.119.13117 The Taiwan Nursing Home study: https://pubmed.ncbi.nlm.nih.gov/16762939/ Peruvian Cluster RCT of sodium reduction in Nature (oooh!) https://www.nature.com/articles/s41591-020-0754-2 DASH Diet in CKD https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4957723/ A comparison of treating metabolic acidosis in CKD stage 4 hypertensive kidney disease with fruits and vegetables or sodium bicarbonate https://pubmed.ncbi.nlm.nih.gov/23393104/ ACCORD https://www.nejm.org/doi/full/10.1056/nejmoa1001286 Kidney Damage Biomarkers and Incident CKD During Blood Pressure Reduction: A Case-Control Study within SPRINT https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6953744/ Association of Urinary Biomarkers of Inflammation, Injury, and Fibrosis with Renal Function Decline: The ACCORD Trial https://pubmed.ncbi.nlm.nih.gov/27189318/ Lake Wobegon https://en.wikipedia.org/wiki/Lake_Wobegon SPRINT https://www.nejm.org/doi/full/10.1056/nejmoa1511939 Effect of Intensive vs Standard Blood Pressure Control on Probable Dementia https://jamanetwork.com/journals/jama/fullarticle/2723256 Characterizing Frailty Status in the Systolic Blood Pressure Intervention Trial https://pubmed.ncbi.nlm.nih.gov/26755682/ Syncope, Hypotension, and Falls in the Treatment of Hypertension: Results from the SPRINT Randomized Clinical Trial https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8045467/ The USPSTF recommends screening for hypertension in adults 18 years or older with office blood pressure measurement (OBPM). The USPSTF recommends obtaining blood pressure measurements outside of the clinical setting for diagnostic confirmation before starting treatment. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/hypertension-in-adults-screening Concordance Between Blood Pressure in the Systolic Blood Pressure Intervention Trial and in Routine Clinical Practice https://pubmed.ncbi.nlm.nih.gov/33044494/

The Filtrate:Joel TopfSwapnil HiremathNayan AroraSophie AmbrusoAnd special guests:Jay L Koyner, Professor of Medicine, University of ChicagoSarah Faubel, Professor of Medicine, University of Colorado EditorNayan AroraShow Notes:It was Kidney 360, not Kidney Medicine. Here is the study I was thinking of: https://kidney360.asnjournals.org/content/2/1/33 SNL Five-Timers Club: https://www.youtube.com/watch?v=6bWGoWFMwKE The Fluid and Electrolyte Companion. Download The Whole EnchiladaAbout the Authors from Topf and Faubel’s first book, The Microbiology Companion.Ted Post: The Sarah Faubel of The Clinical Physiology of Acid Base and Electrolyte Disorders.Meta analysis of early dialysis in AKI by Victor Seabra: https://pubmed.ncbi.nlm.nih.gov/18562058/ Meta analysis of early dialysis in AKI by Morgan Grimes: https://www.ajkd.org/article/S0272-6386(15)00530-2/abstract H-index: https://en.wikipedia.org/wiki/H-index Mortality in ARDS: ACURASYS study. The hazard ratio for death at 90 days in the cisatracurium group, as compared with the placebo group, was 0.68 https://www.nejm.org/doi/full/10.1056/nejmoa1005372 Has Mortality from Acute Respiratory Distress Syndrome Decreased over Time? A Systematic Review It is commonly stated and assumed that mortality from acute respiratory distress syndrome (ARDS) is decreasing.We found that mortality from ARDS has not decreased substantially since the publication of a consensus definition in 1994. Based on our findings, a baseline mortality risk from ARDS of 40 to 45% for observational studies and 35 to 40% for randomized control trials should be expected. These results highlight the need for future effective therapeutic interventions for this highly lethal syndrome.https://www.atsjournals.org/doi/full/10.1164/rccm.200805-722oc From Up To Date:Numerous studies suggest that survival has improved over time [2,9,10,11]. As an example, an observational study of 2451 patients who had enrolled in ARDSNet randomized trials found a fall in mortality from 35 to 26 percent between 1996 and 2005 [10]. To the extent that mortality may be decreasing with time, several issues should be considered:● It is not known if mortality has decreased among patients who received their care outside of a specialized center or a clinical trial.● The improved mortality may be attributable to patients who have ARDS related to risk factors other than sepsis, such as trauma [9].● To the extent that mortality has decreased, the reasons are uncertain. Likely causes include better supportive care and improved ventilatory strategies, such as low tidal volume ventilation [10,12,13]Early Goal-Directed Therapy in the Treatment of Severe Sepsis and Septic Shock by Emanuel Rivers https://www.nejm.org/doi/full/10.1056/nejmoa010307 Early Goal Directed Therapy from NephMadness 2015 https://ajkdblog.org/2015/03/01/nephmadness-2015-critical-care-nephrology-region/#Early Counter point by NSMC graduate Kamran Boka https://ajkdblog.org/2015/03/18/nephmadness-2015-process-arise-promise-and-the-promise-of-early-goal-directed-therapy/ Furosemide stress test https://jasn.asnjournals.org/content/26/8/2023 EM Crit looks at the furosemide stress test: https://emcrit.org/pulmcrit/furosemide-stress-test/ ASN Kidney Week Biomarker debate between Faubel and Koyner. https://www.asn-online.org/education/kidneyweek/2020/program-session-details.aspx?sessId=371699&sessPar=371678 NAD therapy Samir Parikh Don Seldin Young Investigator Award winner 2019.Sarah Faubel’s Dream RCT https://ukidney.com/nephrology-resources/dream-rct-initiative/dream-rct-entries/item/nephrologist-driven-rrt-usual-late-or-early-start-for-acute-kidney-injury Perry Wilson’s DreamRCT https://www.medpagetoday.com/Nephrology/DreamRCT/53876 Steve Coca on “Permissive AKI” with treatment of heart failure https://www.kidney-international.org/article/S0085-2538(19)30708-2/pdf Edward Clark on HIRRT: Mechanisms for hemodynamic instability related to renal replacement therapy: a narrative review https://pubmed.ncbi.nlm.nih.gov/31407042/ Cytokine adsorption in patients with severe COVID-19 pneumonia requiring extracorporeal membrane oxygenation (CYCOV): a single centre, open-label, randomised, controlled trial https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(21)00177-6/fulltext The Handbook of Critical Care Nephrology Amazon | Target (actually not available 😩)Sophia and Sarah Tweetorial on her Lung metabolomics in AKI study: https://twitter.com/sophia_kidney/status/1390394006366994432 AKIKI NephJC coverage | NEJM manuscript

The Filtrate:Matt SparksJennie LinSamira FaroukJoel TopfSwapnil HiremathAnd two special guests:Dawn J. Caster, Assistant Professor at University of LouisvilleAlfred Kim, Assistant Professor of Medicine at Washington University (Twitter)Show Notes:NephJC coverage of the trial: The Bliss trialIn the NEJM: https://www.nejm.org/doi/full/10.1056/NEJMoa2001180 Turtles all the way down: https://en.wikipedia.org/wiki/Turtles_all_the_way_down Nature previews Nephrology on BAFF: https://www.nature.com/articles/nri844 Phase III trial results with blisibimod, a selective inhibitor of B-cell activating factor, in subjects with systemic lupus erythematosus (SLE): results from a randomised, double-blind, placebo-controlled trial: https://pubmed.ncbi.nlm.nih.gov/29563108/ BRIGHT-SC: Blisibimod Response in IgA Nephropathy Following At-Home Treatment by Subcutaneous Administration: https://clinicaltrials.gov/ct2/show/NCT02062684 Guideline for naming monoclonal drugs: https://www.antibodysociety.org/wordpress/wp-content/uploads/2017/07/INN-2017-Reference-20.pdf A long-term study of hydroxychloroquine withdrawal on exacerbations in systemic lupus erythematosus. The Canadian Hydroxychloroquine Study Group: https://pubmed.ncbi.nlm.nih.gov/9541091/ Long-term follow-up of the MAINTAIN Nephritis Trial, comparing azathioprine and mycophenolate mofetil as maintenance therapy of lupus nephritis https://pubmed.ncbi.nlm.nih.gov/25757867/ A Day In The Life Of Dr. Anthony Fauci: https://www.huffpost.com/entry/anthony-fauci-fighting-covid-19_n_5fc7fed7c5b61bea2b14e3eeMC Arbatin MD FPCP FPSN @mcamd: the glomerulus tree: https://twitter.com/mcamd/status/1337744822543605760 finished product: https://twitter.com/mcamd/status/1338429211963322371

The Filtrate:Swapnil HiremathSamira FaroukMatt SparksJoel TopfJennie LinAnd two special guests:Katherine Tuttle Clinical Professor Division of Nephrology, Medical & Scientific Director, Providence Medical Research Center/Sacred Heart Center, Professor of Basic Medical Sciences, WWAMI Program Washington State Universityendocrinologist and nephrologist at the University of Washington Ian de Boer Professor in the Division of Nephrology, Adjunct Professor, Epidemiology and Associate Director, Kidney Research InstituteShow Notes:The GuidelineNephJC’s summaryAccord study showing harm from tight glycemic controlAdvance Trial the other trial showing harm from tight glycemic control2007 KDOQI diabetes guidelines2012 KDOQI diabetes guidelinesADA guidelinesRob Nelson, diabetes legendClassic pathology of diabetic nephropathyShould all patients with diabetes have a kidney biopsy?Flow trial: A Research Study to See How Semaglutide Works Compared to Placebo in People With Type 2 Diabetes and Chronic Kidney DiseaseThe Grading of Recommendations Assessment, Development and Evaluation (short GRADE) working group. Don’t you love it when the first word in an acronym is the acronym itself.Continuous Glucose Monitoring and Use of Alternative Markers To Assess Glycemia in Chronic Kidney DiseaseContinuous glucose monitoring and icodextrin. Keto diets have 1.2 to 1.7 g protein/kgUrinary Sodium and Potassium Excretion, Mortality, and Cardiovascular Events by the PURE investigatorsThe Association Between Kidney Disease and Diabetes Remission in Bariatric Surgery Patients With Type 2 DiabetesJordy Cohen and Bariatric surgery in CKD at Kidney WeekMetformin knocking out of the park in UKPDSKidneys at the Zoo: What Can We Learn from Comparative Renal Physiology? at Kidney Week

The Filtrate:Swapnil HiremathSamira FaroukMatt SparksJoel TopfJennie LinAnd two special guests:Katherine Tuttle Clinical Professor Division of Nephrology, Medical & Scientific Director, Providence Medical Research Center/Sacred Heart Center, Professor of Basic Medical Sciences, WWAMI Program Washington State Universityendocrinologist and nephrologist at the University of Washington Ian de Boer Professor in the Division of Nephrology, Adjunct Professor, Epidemiology and Associate Director, Kidney Research InstituteShow Notes:The GuidelineNephJC’s summaryAccord study showing harm from tight glycemic controlAdvance Trial the other trial showing harm from tight glycemic control2007 KDOQI diabetes guidelines2012 KDOQI diabetes guidelinesADA guidelinesRob Nelson, diabetes legendClassic pathology of diabetic nephropathyShould all patients with diabetes have a kidney biopsy?Flow trial: A Research Study to See How Semaglutide Works Compared to Placebo in People With Type 2 Diabetes and Chronic Kidney DiseaseThe Grading of Recommendations Assessment, Development and Evaluation (short GRADE) working group. Don’t you love it when the first word in an acronym is the acronym itself.Continuous Glucose Monitoring and Use of Alternative Markers To Assess Glycemia in Chronic Kidney DiseaseContinuous glucose monitoring and icodextrin. Keto diets have 1.2 to 1.7 g protein/kgUrinary Sodium and Potassium Excretion, Mortality, and Cardiovascular Events by the PURE investigatorsThe Association Between Kidney Disease and Diabetes Remission in Bariatric Surgery Patients With Type 2 DiabetesJordy Cohen and Bariatric surgery in CKD at Kidney WeekMetformin knocking out of the park in UKPDSKidneys at the Zoo: What Can We Learn from Comparative Renal Physiology? at Kidney Week

The Filtrate:Swapnil HiremathSamira FaroukMatt SparksJoel TopfAnd two special guests:Vandana Dua Niyyar, Professor of Medicine at Emory University and the president elect of American Society of Diagnostic and Interventional Nephrology. Wears lead.Sophia Ambruso, assistant professor and nephrologist at the University of Colorado.Show Notes:Drug-Coated Balloons for Dysfunctional Dialysis Arteriovenous FistulasThe NephJC summaryThe article in the NEJMThe Haskal study, Stent Graft versus Balloon Angioplasty for Failing Dialysis-Access Grafts in the NEJM from 2010Accuracy of physical examination in the detection of arteriovenous fistula stenosisThe Big Three was a trio of Major League Baseball starting pitchers for the Atlanta Braves from 1993-2002 which consisted of Greg Maddux, Tom Glavine, and John Smoltz. The Big Three combined to win seven National League Cy Young Awards in the 1990s and helped lead the Atlanta Braves to a 1995 World Series win. Each member of the Big Three has had their jersey retired by the Atlanta Braves and has been inducted into the Baseball Hall of Fame. (From Wikipedia)The Trerotola study, Drug Coated Balloon Angioplasty in Failing AV FistulaeScathing anti-interventional nephrologist editorial by TrerotolaRebuttal though data by Beathard, Effectiveness and safety of dialysis vascular access procedures performed by interventional nephrologistsAnd then a walk back and update by Tretola…What is the current and future status of interventional nephrology?Paclitaxel mechanism of action video with awesome musicThe role of fungus in the paclitaxel story Twitter comment on the half life of balloon delivered paclitaxelThe meta analysis of peripheral revasculaization having a mortality signal with paclitaxel: Risk of Death Following Application of Paclitaxel-Coated Balloons and Stents in the Femoropopliteal Artery of the Leg: A Systematic Review and Meta-Analysis of Randomized Controlled TrialsFDA warning about paclitaxel balloons: Treatment of Peripheral Arterial Disease with Paclitaxel-Coated Balloons and Paclitaxel-Eluting Stents Potentially Associated with Increased MortalityThe NephJC primer on non-inferiority trials: Understanding the vortex of non-inferiority trialsASN Distinguished Clinical Service Award 2020 goes to Vandana Dua Niyyar! (and Derek Fine, who is also a great guy)ASN Kidney Week Sessions:Samira: Embracing Technology: Nephrology 2.0Swapnil: Hard-to-Control Hypertension: What to Do Next?Vandana: A Look Inside: Noninvasive Imaging of Kidney Diseases

The Filtrate:Matt SparksJoel TopfSwapnil HiremathJennie LinJordy CohenAnd two special guests:Morgan Grams, study author.Talar Kharadjian, nephrology fellow UC San DiegoShow Notes:History of albuminuria from Matt’s opening monolog: https://academic.oup.com/ndt/article/18/7/1281/1809803Microalbuminuria As A Predictor Of Clinical Nephropathy In Insulin-Dependent Diabetes Mellitus in the Lancet 1982.Microalbuminuria Predicts Clinical Proteinuria and Early Mortality in Maturity-Onset Diabetes in the NEJM 1984Episode of Freely Filtered with Dr. Feldman, the big guy at the top of the CRIC trial: NSAIDs vs Opioids.The Aldo study where they didn’t do a meta-analysis but they should have: Aldosteronism is everywhere.Estimating Urine Albumin-to-Creatinine Ratio from Protein-to-Creatinine Ratio: Development of Equations using Same-Day Measurements. Canadian data. CJASNThe kidney failure risk equation has a dotcom: https://kidneyfailurerisk.comKDIGO Controversies Conference on Early Identification & Intervention in CKDChoose Your Own Adventure: Cave of Time.Witte et al. in 2009 JASN on first morning urine vs 24 hour collection: First Morning Voids Are More Reliable Than Spot Urine Samples to Assess MicroalbuminuriaSensitivity and specificity for Joel to studyYour Manuscript On Peer ReviewNephrology Business Leaders University (NBLU)Cloth Masks May Prevent Transmission of COVID-19: An Evidence-Based, Risk-Based Approach with lead author Catherine Clasehttps://www.clothmasks.caElimination or Prolongation of ACE Inhibitors and ARB in Coronavirus Disease 2019 (REPLACECOVID)Fast Grant. Apparently they are not just for Brian ByrdNephJC ACE2 Stuff as Jordy calls it: http://www.nephjc.com/news/covidace2The BRACE-CORONA trial a 700 person RCT of ACEi and ARB in Covid-19. No effect. Tweet stream by Swapnil.MC Hammer is a science nerd: https://cen.acs.org/education/science-communication/Hammer-time-Science-Twitter-drummers/98/i31Hammerman origin story for the MC Hammer cartoon.Bowman Society Lecture - Race & Renal Function CalculationsBasic Research Forum for Emerging Kidney Scientists: A Partnership Between APS and ASN

The Filtrate:Matt SparksJoel TopfSwapnil Hiremath COI: he was a sub-investigator on STARRTJennie LinAnd two special guests:Dr. Jay Koyner of the University of Chicago and #NephBBQ fame.Anitha Vijayan, professor of medicine at Wash U in St LouisShow Notes:The STARRT-AKI trial acronym is: Standard versus Accelerated Initiation of Renal-Replacement Therapy in Acute Kidney InjuryMatt suggests STAKRT-AKI Standard versus Accelerated Initiation of Kikdney-Replacement Therapy in Acute Kidney InjuryCoverage at NephJC: Time to Stop Starting RRT Early in AKIHouse of God by Samuel Shem. Contemporary Review in the New Yorker. AmazonRonco’s legendary dose of CRRT study. Lancet 2000.AJKD Meta analysis on initiation of dialysis in AKI by VF Seabra.Lead time biasTiming of Initiation of Dialysis in Critically Ill Patients with Acute Kidney Injury Initiation of dialysis by BUN in the Picard trial by Dr. Kathleen Liu.Jean-Luc PicardImmortal time biasAKIKI and ELAIN trials as covered by NephJCIssues surrounding informed consent in the ICUThe Chicago WayDr Palevsky’s ATN Study, AKA Intensity of Renal Support in Critically Ill Patients with Acute Kidney InjuryIs Irregardless A Word?Debate at Kidney Week: Intensivist vs Nephrologist for Renal Replacement Therapy (RRT) in the ICUInternal and External Validation of a Machine Learning Risk Score for Acute Kidney InjuryThat sweet sweet NephJC pot of goldFurosemide Stress Test and Biomarkers for the Prediction of AKI SeverityThai study that used FST to randomize patients for early versus late start KRT: Early versus standard initiation of renal replacement therapy in furosemide stress test non-responsive acute kidney injury patients (the FST trial)AKIKI 2 at clinical trials.govSwapnil’s Tubular secretion, the Twitter timeline of Oded RechaviMatt’s Tubular Secretion: #kidneydietchallengeAnitha comes from the land of coconuts. Lots of potassium in coconut water.The Skeleton Key Group on The Renal Fellow Network

The Filtrate:Matt SparksJoel TopfSwapnil HiremathSamira FaroukJennie LinAnd three special guests:Carina Seah a second year MD PhD student Mt Sinai who led the initiative to remove race from the eGFR formulasPoyan Mehr, founder of GlomCon and author of this post on the use of race in eGFR estimating formulas.Deidra Crews Professor of Medicine and researcher in health disparities.Show Notes:Petition for Removal of “Race Correction” in eGFR at Mount Sinai https://docs.google.com/document/d/1vJCwVndyzemWCx8RXZLvLm6JLuFN7NdgEFVCFaDnSOk/editDr Murphy, Dean For Clinical Integration And Population Health. Professor And System Chair. https://icahn.mssm.edu/profiles/barbara-murphyThe Bowman Society at the University of Chicago. I can not find a recording of the webinar https://pritzker.uchicago.edu/resources/bowman-societySocial Determinants of Racial Disparities in CKD https://jasn.asnjournals.org/content/27/9/2576Socioeconomic Disparities in Chronic Kidney Disease https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4291541/Shortcomings of the current GFR estimating equations https://pubs.glomcon.org/archives/1491Alan S Go’s work on eGFR, hospitalization and death: https://www.nejm.org/doi/full/10.1056/nejmoa041031Tangri Kidney Failure Risk Calculation https://kidneyfailurerisk.comDe-adjusting for body surface area: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2756662/2018 Nature Reviews Nephrology Porrini Estimated GFR: time for a critical appraisal https://www.nature.com/articles/s41581-018-0080-9Estimating Glomerular Filtration Rate from Serum Creatinine and Cystatin C https://www.nejm.org/doi/full/10.1056/nejmoa1114248Transdermal Measurement of Glomerular Filtration Rate in Mice https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6235579/Worldwide Frequencies of Apolipoprotein L1 Renal Risk Variants https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6482949/Health Affairs Blog about when and how to measure race in research: https://www.healthaffairs.org/do/10.1377/hblog20200630.939347/full/ASN Kidney Stars https://www.asn-online.org/grants/travel/details.aspx?app=MSR

The Filtrate:Joel TopfSwapnil HiremathSamira FaroukAnd special guests:Katalin Susztak, Professor of Medicine Perlman School of Medicine, University of Pennsylvania. @KSusztakShow Notes:CKD-FIX: Effects of Allopurinol on the Progression of Chronic Kidney DiseasePERL: Serum Urate Lowering with Allopurinol and Kidney Function in Type 1 DiabetesCoverage at NephJC: Effects of Allopurinol on the Progression of Chronic Kidney DiseaseRichard Johnson’s theory in pay-walled Nature Reviews Nephrology: Hypothesis: fructose-induced hyperuricemia as a causal mechanism for the epidemic of the metabolic syndromeRichard Johnson’s theory in open access Nehrology Dialysis and Transplantation: Uric acid and chronic kidney disease: which is chasing which?PERL: Preventing early renal lossIohexol, good for measuring GFR as well as causing contrast associated nephropathy?Uric acid versus urate: The Crystallization of Monosodium UrateAssociation of HLA-B*5801 allele and allopurinol-induced Stevens Johnson syndrome and toxic epidermal necrolysis: a systematic review and meta-analysisWHO list of essential medicationsFixing the numbers, specifically phosphorousGFR Decline as an End Point for Clinical Trials in CKD: A Scientific Workshop Sponsored by the National Kidney Foundation and the US Food and Drug AdministrationCost of allopurinol: $7/month but it is only $9 for 3 monthsFebuxostat Therapy for Patients With Stage 3 CKD and Asymptomatic Hyperuricemia: A Randomized TrialTipping point analysis - multiple imputation for stress test under missing not at random (MNAR) or a YouTube video if that’s your speed (sorry, I couldn’t find a TikTok on imputation stress tests).Mendelian randomization study of urate and CKD by Ron Do and teamDad jokesFake systematic review by Johnson’s group showing Urate lowering prevented CKDHyperuricemia As a trigger of Immune Response in Hypertension and Chronic Kidney Disease by Claudio Ponticelli published the week after these two RCTs were published.NEJM Editorial: Urate-Lowering Therapy and Chronic Kidney Disease Progression by Daniel FeigCOVID and PPI manuscriptHashtag the cowboy‘WhatsApp®’ening in nephrology trainingArkana LIVE Pathology SessionsNephJC Summer Book Club. Read Rana Awdish’s In Shock

The Filtrate:Joel TopfSwapnil HiremathSamira FaroukMatt SparksJordy CohenAnd special guests:Brian Byrd, a cardiologist investigating aldosteronism at the University of MichiganandSusan Steigerwalt, a nephrologist and hypertension specialist who unfortunately due to technical problems largely was cut out of this episode 😢.The Study: The Unrecognized Prevalence of Primary AldosteronismCoverage at NephJC: http://www.nephjc.com/news/aldosterone“What gets measured, gets managed.” Peter Drucker, or notHow much sodium comes from the food processing? 71%. Fourteen percent comes from the food itself, with 5% coming from food prep at home and another 5% from the salt shaker at the table. https://www.ahajournals.org/doi/epub/10.1161/CIRCULATIONAHA.116.024446Surgical versus medical therapy for primary hyperaldosteronism: https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.117.10596 .And the editorial by David Calhoun: https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.118.10759I could find no empiric data to support Swap’s supposition that the French and Italian people are more courageous than people in Canada. Citation needed.ENAC inhibitors as treatment for primary hyperaldosteronism: https://onlinelibrary.wiley.com/doi/full/10.1111/jch.13566Pathway 3 Trial: https://www.thelancet.com/journals/landia/article/PIIS2213-8587(15)00377-0/fulltextRennin in cow stomachs: http://www.vivo.colostate.edu/hbooks/pathphys/digestion/stomach/rennin.htmlSodium content of muffins: https://www.fatsecret.com/calories-nutrition/food/muffins/sodiumThe MICE Package in R: MICE: Multivariate Imputation via Chained Equations) https://www.analyticsvidhya.com/blog/2016/03/tutorial-powerful-packages-imputing-missing-values/Gender-Affirming Hormone Therapy, Vascular Health and Cardiovascular Disease in Transgender Adults https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.119.13080False-positive aldosterone renin ratios in patients on combined estrogen progesterone treatment (only with direct renin concentration, the plasma renin activity is not fooled) https://academic.oup.com/jcem/article/102/7/2329/3093639John Funder video commentary on the study: https://www.acpjournals.org/doi/abs/10.7326/M20-1758ACD blood pressure guidelines (note the absence of B): https://pubmed.ncbi.nlm.nih.gov/17083059/Pathway 2 study: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)00257-3/fulltextALLHAT trial: https://pubmed.ncbi.nlm.nih.gov/12479763/international.org/article/S0085-2538(20)30552-4/abstract

The Filtrate:Joel TopfSwapnil HiremathSamira FaroukMatt SparksAnd special guests:Sadiya Kahn a heart failure specialist at Northwestern University. @HeartDocSadiyaandPaul Welling a professor of medicine and nephrology at Johns Hopkins. @PAWellingMDShow Notes:The Study: https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.120.045691Coverage at NephJC: http://www.nephjc.com/news/sglt2mechanismDiuretics for heart failure NEJM Review article: https://www.nejm.org/doi/full/10.1056/nejmra1703100Don’t say renal: https://www.kidney-international.org/article/S0085-2538(20)30233-7/fulltext?mobileUi=0Sanjiv “We pronounce HFpEF huff-puff” Shah, MD https://www.feinberg.northwestern.edu/faculty-profiles/az/profile.html?xid=16814 and https://asecho.org/wp-content/uploads/2016/02/Shah-HFpEF.pdfHuff Puff is like fetch. It is not going to happen. https://www.youtube.com/watch?v=Pubd-spHN-0Did he have buttons? https://ajkdblog.org/2019/06/17/muscle-relaxant-use-in-dialysis/Rate My Room: https://twitter.com/ratemyskyperoom?lang=enReview on Renal Glucosuria from CJASN: https://cjasn.asnjournals.org/content/5/1/133 and another from the National Organizations of Rare Disorders: https://rarediseases.org/rare-diseases/renal-glycosuria/Mechanism of Impaired Natriuretic Response to Furosemide during Prolonged Therapy: https://pubmed.ncbi.nlm.nih.gov/2811065/Two studies that showed drops in BNP with SGLT2iDAPA HF: https://www.nejm.org/doi/full/10.1056/NEJMoa1911303DEFINE HF showing nice reduction BNP with dapagliflozen: https://pubmed.ncbi.nlm.nih.gov/31524498/?dopt=AbstractCopeptin, what is it? https://pubmed.ncbi.nlm.nih.gov/18291667/?dopt=AbstractSIADH treatment with empagliflozen: https://jasn.asnjournals.org/content/31/3/615.abstract and it is JASN not CJASN. My bad.EVEREST. Tolvaptan for heart failure: https://jamanetwork.com/journals/jama/fullarticle/206251Remdesivir placebo controlled RCT: https://www.nejm.org/doi/full/10.1056/NEJMoa2007764Joel’s Remdesivir study: https://www.nejm.org/doi/full/10.1056/NEJMoa2007016Remdesivir for 5 or 10 Days in Patients with Severe Covid-19: https://www.nejm.org/doi/full/10.1056/NEJMoa2015301Swap showing a lot of skepticism to the Lancet HCQ data even before the retraction (which happened after this recording) https://www.the-scientist.com/news-opinion/lancet-retracts-surgispheres-study-on-hydroxychloroquine-67613Baclofen is dangerous https://www.kidney-international.org/article/S0085-2538(20)30552-4/abstract

The Filtrate:Joel TopfSwapnil HiremathMatt SparksAnd special guests:Joshua Waitzman, third year nephrology fellow at Beth IsraelHarold “Harv” Feldman. Editor in Chief at AJKD and national study chair of CRIC and principal investigator of the Scientific and Data Coordinating Center of the CRIC Study. https://www.dbei.med.upenn.edu/bio/harold-i-feldman-md-msceShow Notes:CRIC: Chronic Renal Insufficiency Cohort http://www.cristudy.org/NSAID Studies at NephJC:Precision: http://www.nephjc.com/news/2017/1/20/hwgrko70d3z88djtjcmzvwpzlirm6c?rq=precisionArmy of NSAIDs: http://www.nephjc.com/news/nsaids and the podcast (from before the name Freely Filtered, http://www.nephjc.com/freelyfiltered/2019/3/24/nephjc-drive-time-001-an-army-of-nsaids)And this week’s study: CRIC: http://www.nephjc.com/news/nsaids-vs-opioidsMethods at 16:55Matt had to get a mouse study 🐁 in, so here it is: Renal Abnormalities And An Altered Inflammatory Response In Mice Lacking Cyclooxygenase Ii https://www.nature.com/articles/378406a0The Beth Israel Flex, “The first time I read the paper…”Results at 32:46Discussion 48:13Josh King on opioids being nephrotoxic: https://twitter.com/nephrotox/status/1260400636253921281?s=20This Week in CovidThe fight over round spikey things.German autopsy study showing SARS-CoV2 in the kidney: https://www.nejm.org/doi/full/10.1056/NEJMc2011400Kidney International walking back some previous declarations of what they are seeing on EM: https://twitter.com/Kidney_Int/status/1263641195416150018?s=20MedRxIV on AKI with COVID-19 at Mount Sinai Medical Center: https://www.medrxiv.org/content/10.1101/2020.05.04.20090944v1Juan Carlos discussing etiologies of AKI in COVID-19 outbreak in New Orleans.https://kidney360.asnjournals.org/content/early/2020/05/13/KID.0002652020Triple combination of interferon beta-1b, lopinavir–ritonavir, and ribavirin in the treatment of patients admitted to hospital with COVID-19: an open-label, randomised, phase 2 trial https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31042-4/fulltextFriend of the Podcast, Kenar Jhaveri and his data on COVID19 and AKI in Kidney International. https://www.kidney-international.org/article/S0085-2538(20)30532-9/fulltext

The Filtrate:Joel TopfSwapnil HiremathSamira FaroukJennie LinMatt SparksAnd special guests:David J. Cohen: Professor of Medicine at the University of Missouri-Kansas City and Director of Cardiovascular Research at Saint Luke’s Mid America Heart Institute. In addition, he is Medical Director of the Medical Economics and Technology Assessment Group at Mid America Heart Institute. He was previously Associate Director of Interventional Cardiology at Beth Israel Deaconess Medical Center where he was also Associate Professor of Medicine at Harvard Medical School and Director of Economics and Quality of Life Research at the Harvard Clinical Research Institute. He is on Twitter at @djc795Keith Bellovich: Chief Medical Officer Ascension St John. He is also on the board of directors of the renal physician association where he currently the treasurer/secretary.Show Notes:Ischemia CKD trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1915925The most famous figure in nephrology: https://jasn.asnjournals.org/content/10/7/1606(This figure was originally published in AJKD, but is now behind a paywall, hence the JASN link https://www.ajkd.org/article/S0272-6386(98)00339-4/pdf)Should Statins Be Banned from Dialysis? https://jasn.asnjournals.org/content/28/6/1675Ischemia trial (not CKD) https://www.nejm.org/doi/full/10.1056/NEJMoa1915922Courage trial from 2007: https://www.nejm.org/doi/full/10.1056/NEJMoa070829Drug eluting stents approved in 2003: https://en.wikipedia.org/wiki/Drug-eluting_stentCéline Dion, Courage: https://www.youtube.com/watch?v=WN-ZHOHmvcwDr. Farouk hanging with her close personal friend Ms. Dion: https://twitter.com/ssfarouk/status/1246448332039471107https://twitter.com/ssfarouk/status/1235935956152311808A lot of the enrollment of CKD-Ischemia was from Asia, 25%Methods: 19:40Avoiding the Oculostenotic Reflex: https://www.acc.org/membership/sections-and-councils/fellows-in-training-section/section-updates/2016/02/12/16/29/avoiding-the-oculostenotic-reflexBeta blockers in dialysis patients: https://www.ncbi.nlm.nih.gov/pubmed/10201019Mehran Score: https://www.mdcalc.com/mehran-score-post-pci-contrast-nephropathyUltra-low contrast coronary angiography and zero-contrast percutaneous coronary intervention for prevention of contrast-induced nephropathy: step-by-step approach and review: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6727230/Capsulology 32:30Antiplatelet treatment of STEMI with P2Y12 inhibitors https://en.wikipedia.org/wiki/P2Y12#Antiplatelet_treatment_of_STEMIImpact of concomitant use of proton pump inhibitors and clopidogrel or ticagrelor on clinical outcomes in patients with acute coronary syndrome https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4826890/Jennie is an intermediate metabolizer so she will be sluggish to activate P2Y12 inhibitor pro-drugs (which is just about all of them) https://www.mdmag.com/conference-coverage/acc-2018/realtime-genetic-data-impacts-physician-prescribing-behavior-following-stent-proceduresSt John's Wort Supplements Endanger the Success of Organ Transplantation: https://jamanetwork.com/journals/jamasurgery/fullarticle/212243Results 37:10Frank Harrell https://twitter.com/f2harrellHis blog: https://www.fharrell.comDiscussion 46:56Samira does not work at NYU.The Argument for Abolishing Cardiac Screening of Asymptomatic Kidney Transplant Candidates https://pubmed.ncbi.nlm.nih.gov/31492488/Coronary-Artery Revascularization before Elective Major Vascular Surgery. The CARP study https://www.nejm.org/doi/full/10.1056/NEJMoa041905A Single Ventilator for Multiple Simulated Patients to Meet Disaster Surge https://onlinelibrary.wiley.com/doi/pdf/10.1197/j.aem.2006.05.009Joel’s enthusiasm for Remdesivir: The COVID Diaries 3: Ladies and Gentleman, I think this tweet is going to get me in trouble… http://pbfluids.com/2020/05/the-covid-diaries-3-the-tweet-heard-round-the-world/Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31022-9/fulltextNIH Clinical Trial Shows Remdesivir Accelerates Recovery from Advanced COVID-19 https://www.niaid.nih.gov/news-events/nih-clinical-trial-shows-remdesivir-accelerates-recovery-advanced-covid-19

The Filtrate:Joel TopfSwapnil HiremathSamira FaroukJennie LinMatt SparksAnd special guests:Agnes Fozo: John L. Shapiro Chair of Pathology at Vanderbilt University and on Twitter: https://twitter.com/AgnesFogoHua Su: Professor of Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaOsama El Shamy: Home Therapy Fellow at Mount Sinai and on Twitter: https://twitter.com/osamaelshamy88Chirag Parikh: Director of Nephrology Johns Hopkins and on Twitter: https://twitter.com/KidneydrChiragShow Notes:Mark Denison, Corona virus expert. https://www.vumc.org/viiii/person/mark-r-denison-md and on Twitter: https://twitter.com/DenisonLabDiscussion on Twitter that the 3electron microgrpahs may show clathrin coated pits rather than Conorna virus. https://twitter.com/vighnesh_w/status/1250880961463513088?s=20Chris Larsen’s case of collapsing glomerulopathy in a patient with COVID-19 https://www.kireports.org/article/S2468-0249(20)31172-4/abstractOsler's rule: States that a neurological defect has to be related to a specific lesion, in contrast to Hickam's dictum, which states that the neurological defect can be due to several lesions.Altered Lipid Metabolism in Recovered SARS Patients Twelve Years after Infection. https://www.ncbi.nlm.nih.gov/pubmed/28831119We don’t record (or roll) on the sabath https://www.youtube.com/watch?v=GPo9OBrIOi4Using a dialysis machine to make CRRT dialysate, the Tweet: https://twitter.com/KidneydrChirag/status/1249867795602583554Derek Fine, Parikh’s partner in crime: https://www.hopkinsmedicine.org/profiles/results/directory/profile/0007605/derek-fine and on Twitter: https://twitter.com/DerekFineMDTablo Machine makes its own dialysate. It does not look like a cooler. https://www.outsetmedical.com/tablo/Is Canada a communist country? https://www.quora.com/Is-Canada-a-communist-countryLokelma is not a sponsor of Freely FilteredComplications and Catheter Survival With Prolonged Embedding of Peritoneal Dialysis Catheters https://pubmed.ncbi.nlm.nih.gov/18281722/Ontario Nursing Homes,”It felt like a war zone” https://www.pri.org/stories/2020-04-24/it-felt-war-zone-coronavirus-tears-through-canada-nursing-homes

Cast:Joel TopfSwapnil HiremathSamira FaroukJennie LinMatt SparksAnd special guest Joshua WaitzMartin Pollak: http://www.nasonline.org/member-directory/members/20033579.htmlJosh Waitz @jwaitz100 Days of COVID-19: https://www.voanews.com/episode/100-days-covid-19-4236811MinTac: http://www.nephjc.com/news/mintacMy magical experience with minimal change disease. This is not the actual tweet, but a dramatization: http://pbfluids.com/2020/04/the-magic-of-treating-minimal-change-disease/Non-inferiority, NephJC: http://www.nephjc.com/news/2019/7/8/understanding-the-vortex-of-non-inferiority-trialsNon-inferiority, through the looking glass: https://pubmed.ncbi.nlm.nih.gov/21539749/Kevin Fowler on Tacrolimus side effects: https://twitter.com/gratefull080504/status/1247697780736512000?s=20Mt Sinai is converting some transplant patients from tacrolimus to belatecept: https://www.nejm.org/doi/full/10.1056/nejmoa1506027CAPSULOLOGY: Open the “Images” tab https://www.webmd.com/drugs/2/drug-10097-6108/tacrolimus-oral/tacrolimus-oral/detailsTacrolimus for your cat and dog dry eye needs: https://vcahospitals.com/know-your-pet/tacrolimus-ophthalmic-in-dogsWHO, NSAIDs, and double negatives: https://twitter.com/kidney_boy/status/1240452941187821570?s=20CJASN stands for the Clinical Journal of the American Society of Nephrology. The C does not stand for Canada. Sorry Swap.Conversion calculator from old world (SI) units, mg/mole Cr, to freedom units (gram protein / gram creatinine): http://www.scymed.com/en/smnxps/psdjf223.htmMichelle Rheault about starting the clock to relapse tweet: https://twitter.com/rheault_m/status/1247703322200596483?s=20Marvin Gonzalez calls for larger studies: https://twitter.com/MarvinGonzlez16/status/1247701186972733442?s=20Acute PD for COVID-19 is discussed in this article from CJASN: https://cjasn.asnjournals.org/content/early/2020/04/03/CJN.03750320PD for AKI, the experience from Brazil https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3525422/The lead author, Daniela Ponce is really the world authority on PD and AKI: https://www.ncbi.nlm.nih.gov/pubmed/?term=Ponce%20D%5BAuthor%5D&cauthor=true&cauthor_uid=22641732Nursing home outbreaks in Durham: https://www.newsobserver.com/news/coronavirus/article241975401.htmlPrison outbreak: https://www.npr.org/2020/04/06/827922287/inmates-staff-on-edge-as-covid-19-spreads-through-federal-prisonsOttawa COVID-19: https://ottawacitizen.com/news/local-news/covid-19-long-term-care-outbreaks-continue-devastating-spread-across-ontario/West Coast herd immunity: https://www.ksbw.com/article/new-study-investigates-californias-possible-herd-immunity-to-covid-19/32073873#The History of HIV associated Nephropathy: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3494840/Racial breakdown of NYC coronavirus deaths reveals ‘disparities,’ de Blasio says https://nypost.com/2020/04/08/de-blasio-releases-racial-breakdown-data-of-coronavirus-deaths/Michelle Rheault is tired: https://twitter.com/rheault_m/status/1248371721356402689?s=20KidneyCon Lite! Saturday April 18 from 9-11. Kidney Pathology workshop.Lunch Doodles with Mo Willems: https://youtu.be/7KBkUyE6MOwDr Glaucomflecken and Telehealth: https://twitter.com/DGlaucomflecken/status/1247709538322657282?s=20NephSim for kindergartner’s https://nephsim.comNephSim live: https://twitter.com/Neph_SIM/status/1247637727048327170?s=20

Loeb’s Laws of Medicine or Loeb’s Rules of TherapeuticsRobert Frederick Loeb (March 14, 1895-October 21, 1973) was a famous American Physician who provided some very simple common sense approach to treating patients know as:1. If what you are doing is doing good, keep doing it.2. If what you are doing is not doing good, stop doing it.3. If you do not know what to do, do nothing.4. Never make the treatment worse than the disease.The last ‘law’ in present times is often replaced with:“If at all possible, keep your patient out of the operating room.”Or“Above all, never let a surgeon get your patient.”This is a decent reference for this: https://www.ncbi.nlm.nih.gov/books/NBK13258/Dr. Glaucomflecken gives some tips for attending trying to go back to the ICU: https://twitter.com/DGlaucomflecken/status/1238954558140772354?s=20Francis Deng and going back to become an internist: https://twitter.com/francisdeng/status/1245475268158009349?s=20JCI article on using convalescent serum for treating disease: https://www.jci.org/articles/view/138003Human trial of convalescent serum from JAMA: https://jamanetwork.com/journals/jama/fullarticle/2763983 It works! (in uncontrolled, observational trials)Monkeys develop protective antibodies: https://www.biorxiv.org/content/10.1101/2020.03.13.990226v1Time course for antibodies and viral clearance in SARS-CoV2 from Nature: https://www.nature.com/articles/s41586-020-2196-xPeripheral blood monocyte proeonomics: https://www.biorxiv.org/content/10.1101/2020.03.31.019216v1.full.pdfCytokine storm in the New York Times. Check mate Rheumatologists: https://www.nytimes.com/2020/04/01/health/coronavirus-cytokine-storm-immune-system.htmlDr. Anthony Chang and Thrombi on COVID biopsies: https://twitter.com/ChangUCanSpare/status/1240686922332160001?s=20ASN April 2 Webinar on dialysis and COVID-19 with Anitha Vijayan (among others): https://www.asn-online.org/ntds/resources/Webcast_2020_04_02_COVID-19.mp4UK data on length of ventilatory support (ICNARC): https://t.co/WB1ZnODRFF?amp=1Swap forgot Michele Mokrzycki’s name. Her name is Michele.Samira’s elementary school shampoo: https://www.influenster.com/reviews/pert-plus-classic-clean-2-in-1-shampoo-conditionerProlonged Intermittent Renal Replacement Therapy (PIRRT): https://www.ncbi.nlm.nih.gov/pubmed/27113696MDCalc COVID-Resource Center: https://www.mdcalc.com/covid-19Acute PD for COVID-19 is discussed in this article from CJASN: https://cjasn.asnjournals.org/content/early/2020/04/03/CJN.03750320PD for AKI, the experience from Brazil https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3525422/The lead author, Daniela Ponce is really the world authority on PD and AKI: https://www.ncbi.nlm.nih.gov/pubmed/?term=Ponce%20D%5BAuthor%5D&cauthor=true&cauthor_uid=22641732NEJM ACE2 review article that Matt didn’t read or peer review: https://www.nejm.org/doi/full/10.1056/NEJMsr2005760NephJC COVID site: http://www.nephjc.com/covid19

NephJC’s COVID-19 and the Kidney PatientCast:Joel TopfSwapnil HiremathSamira FaroukJennie LinMatt SparksShow Notes:The NephJC Page on ACE2 and COVID-19Nature Letter showing AER2’s central role in lung injury (in mice). This was SARS from 2005.Losartan RCT in COVID-19; University of Minnesota:Outpatient NCT04311177Inpatient NCT04312009France's health ministry says NSAIDs may be bad in COVID-19 coverage by CNNWHO Tweets its position on NSAIDs.Early case report on COVID-19 and (heart) transplantMatt’s question to Twitter about cytokine stormASN Webinar on dialysis and COVID-19NephJC page on dialysis and COVID-19Dimitrios G. Oreopoulos, one of the giants of peritoneal dialysisTwitter Self Care BotTweetorial on Zoom by SamiraChristos Argyropoulos the Nostradamus of COVID-19

Plasma Exchange and Glucocorticoids in Severe ANCA-Associated VasculitisSummary on NephJCCast:Joel TopfSwapnil HiremathSamira FaroukJennie LinJordy CohenShow Notes:55th ERS-EDTA Congress, late breaking and high impact trials. June 2018The CJASN Review recommended by JennieMEPEX studyC5a antagonist, Avacopan in ANCA-Associated VasculitisThe fragility index as described in JAMA SurgeryMichael Walsh looks at the Fragility Index in 399 trials in medical literatureThe EVOLVE trial of Cinacalcet. Age-adjusted HR results in statistically significant results for primary outcome, but was not defined as the primary endpoint. Patients were one year older in the cinacalcet group; older age known to increase mortality in dialysis patients. Wiki Journal Club.Ron Falk and his irresponsible editorial.Cochrane Systematic Review and Meta-analysis of Anti‐cytokine targeted therapies for ANCA‐associated vasculitisNephMadness is now in full swing at the AJKDblog!

Just the dudes gathered to talk about the JAMA Internal Medicine Meta Analysis on Gadolinium in CKD stage 4 and 5.Risk of Nephrogenic Systemic Fibrosis in Patients With Stage 4 or 5 Chronic Kidney Disease Receiving a Group II Gadolinium-Based Contrast AgentA Systematic Review and Meta-analysis.Summary on NephJCCast:Joel TopfSwapnil HiremathMatt SparksShow Notes:Swap has a disclosure!He was an author on the Canadian Association of Radiology guidelines on use of Gad in CKD.Grobner’s original paper reporting the association between gadolinium and NSF.Matt’s article on alternatives to gadolinium in MRI:Diagnostic value of alternative techniques to gadolinium-based contrast agents in MR neuroimaging—a comprehensive overviewUsing Ferumoxytol as an MRI contrast agent.Saurabh Jha’s editorial (@RogueRad) for NephMadness when Gadolinium in CKD 4 was a team in 2018.PEXIVAS was an abstract in 2018 and was not published until 2020.A Cultural History of Rock-Paper-ScissorsMichelle’s recent case of NSF in a child (in case you thought this disease was gone)Removing Gad with dialysis.Matt’s tubular secretion: Biorender.comJohn Mandrola Expert or not an expert?JACC Case Reports on the Kardashian IndexRobert Cardiff’s editorial on the Kardashian Index in JACC Case Reports.Bryan Vartabedian blog post on Robert Cardiff’s editorialAnd NephMadness is coming! Friday March 13, 2020!

Cast:Joel TopfJennie LinSwapnil HiremathMatt SparksShow Notes:The NephJC discussion can be found here.The study was published in the NEJM.NephJC summary of the AJKD systematic review of uremic pruritusAtul Gawande on itching.Pinnacle MountainComprehensive review on toxicodendron dermatitis: poison ivy, oak, and sumac.KIDNEYconTom Oates 12 days of Poems on Twitter

Cast:Joel TopfJennie LinSwapnil HiremathMatt SparksSamira FaroukShow Notes:Pathway 2 Trialhttps://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)00257-3/fulltextNephJC discussion of Pathway2http://www.nephjc.com/pathwayThe DIAMOND Trial. Much more ambitious than I described in the podcast.https://clinicaltrials.gov/ct2/show/NCT03888066SPRINThttps://www.nejm.org/doi/full/10.1056/NEJMoa1511939Omron 907 BP cuffonly $678 from Amazon: https://www.amazon.com/Omron-HEM-907XL-IntelliSense-Professional/dp/B000FENZPSEvaluation of the Potential for Drug Interactions With Patiromer in Healthy Volunteers:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5555446/The TOPCAT Trial story: A Clinical Trial Torpedoed By Fraud and Incompetencehttps://blogs.sciencemag.org/pipeline/archives/2017/04/27/a-clinical-trial-torpedoed-by-fraud-and-incompetenceCJSAN article looking at 24-hour urine for calcium and phos with patiromerhttps://cjasn.asnjournals.org/content/14/1/103Swap’s best tweeters of #Kidney Wkaldorodrigo https://twitter.com/aldorodrigoAlex Meraz https://twitter.com/nephroguyJoshua Waitzman https://twitter.com/JwaitzKIDNEYconkidneycon.org

Cast:Joel TopfSamira FaroukJennie LinSwapnil Hiremathand special guest, Perry WilsonA clinically applicable approach to continuous prediction of future acute kidney injury. https://www.ncbi.nlm.nih.gov/pubmed/?term=A+clinically+applicable+approach+to+continuous+prediction+of+future+acute+kidney+injury#Deep Mind National Health services scandal https://www.telegraph.co.uk/technology/2017/07/03/googles-deepmind-nhs-misused-patient-data-trial-watchdog-says/KDIGO AKI guidelines (PDF) https://kdigo.org/wp-content/uploads/2016/10/KDIGO-2012-AKI-Guideline-English.pdfFrank Harrell on the value of continuous variables http://biostat.mc.vanderbilt.edu/wiki/Main/CatContinuoushttps://twitter.com/f2harrell/status/1176908371464794113?s=20Wilson’s AKI Alert trial published in The Lancet, Automated, electronic alerts for acute kidney injury: a single-blind, parallel-group, randomised controlled trial. http://www.nephjc.com/aki-alertThe NINJA trial http://www.nephjc.com/news/2016/8/3/ninja-using-technology-to-prevent-acute-kidney-injury?rq=ninjaThe end of EPICparodyEMR: https://twitter.com/EPICEMRparody/status/1178788488881299457?s=20EPICparodyEMR on Explore the Space: https://www.explorethespaceshow.com/podcasting/epicparodyemr-on-electronic-medical-records/Tweet where Nassim Nicholas Taleb calls Swap an imbecile: https://twitter.com/nntaleb/status/1178252052453089281?s=20Blood Pressure Medicines for Five Years to Prevent Death, Heart Attacks, and Strokes. https://www.thennt.com/nnt/anti-hypertensives-to-prevent-death-heart-attacks-and-strokes/NNT is SPRINT: In participants assigned to intensive BP lowering, major adverse cardiovascular events were reduced by 25% (5.2% v. 6.8%; hazard ratio [HR] 0.75, 95% confidence interval [CI] 0.64–0.89; number needed to treat [NNT] of 62 over 3 yr) and all-cause mortality was reduced by 27% (3.3% v. 4.5%; HR 0.73, 95% CI 0.60–0.90; NNT of 90 over 3 yr).NNT is highly misleading when assessing chronic disease prevention. https://www.ncbi.nlm.nih.gov/pubmed/25027390Washington University School of Medicine establishes Division of Physician-Scientists https://medicine.wustl.edu/news/school-of-medicine-establishes-division-of-physician-scientists/Physician scientists in the NEJM https://www.nejm.org/doi/full/10.1056/NEJMp1904482NYT article on Physician Scientists: https://www.nytimes.com/2019/09/23/opinion/doctor-scientist-medical-research.htmlbrussels.sprout on Instagram https://www.instagram.com/brussels.sprout/?hl=enSuperintelligence by Nick Bostrom https://www.amazon.com/Superintelligence-Dangers-Strategies-Nick-Bostrom/dp/1501227742Amazon bulk powdered cheese: https://www.amazon.com/s?k=powdered+cheese&ref=nb_sb_noss

Cast:Joel TopfJennie LinSwapnil HiremathMatt SparksShow Notes:NephJC Coverage of MENTOR: http://www.nephjc.com/news/mentorMENTOR: https://www.nejm.org/doi/full/10.1056/NEJMoa1814427KDIGO Membranous recommendations: https://kdigo.org/wp-content/uploads/2017/02/KDIGO-2012-GN-Guideline-English.pdf2017 Kidney Week Abstract: https://www.asn-online.org/education/kidneyweek/2017/program-abstract.aspx?controlId=2831149PEXIVAS: http://www.nephjc.com/news/pexivasearlyHeymann Nephritis: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3042693/Susan Quaggin: https://www.feinberg.northwestern.edu/faculty-profiles/az/profile.html?xid=26269Manasi Bapat on non-inferiority trials: http://www.nephjc.com/news/2019/7/8/understanding-the-vortex-of-non-inferiority-trialsPrognosis and risk factors for idiopathic membranous nephropathy with nephrotic syndrome in Japan: https://www.sciencedirect.com/science/article/pii/S0085253815498503Nice review of Membranous by Alfaadhel and Cattrran that purports to say than CNI are the standard therapy for idiopathic membranous. (It doesn’t) https://www.ncbi.nlm.nih.gov/pubmed/27536673?dopt=AbstractPablo Garcia saves the day: https://twitter.com/PabloGarciaMD/status/1148767319323099136?s=20Larry beck’s land mark study demonstrating antiPLA2r as the antigen in idiopathic membranous. https://www.nejm.org/doi/full/10.1056/NEJMoa0810457GEMRITUX Study: https://www.ncbi.nlm.nih.gov/pubmed/27352623Jennie Lin’s How to Be a Nephrology Fellow, Choose Your Own Adventure: https://twitter.com/jenniejlin/status/1156329711057981442?s=20CJASN How to Review a Paper Podcast: https://www.asn-online.org/media/podcast/CJASN/2019_07_23_How_to_Write_a_Cons.mp3

Cast:Joel TopfJennie LinSamira FaroukSwapnil HiremathShow Notes:NephJC coverage of SONAR: http://www.nephjc.com/news/sonarSONAR in PubMed: https://www.ncbi.nlm.nih.gov/pubmed/30995972Avosentan for overt diabetic nephropathy, the ASCEND trial: https://www.ncbi.nlm.nih.gov/pubmed/20167702RADAR coverage at NephJC, May 2014: http://www.nephjc.com/atrasentanRADAR in PubMed: https://www.ncbi.nlm.nih.gov/pubmed/24722445/Google Hangout on RADAR: https://www.youtube.com/watch?v=pkkQbb-isog&feature=youtu.beVlado Perkovic: https://twitter.com/VladoPerkovicSONAR: https://en.wikipedia.org/wiki/SonarNephmadness adaptive trial: https://ajkdblog.org/2016/03/10/nephmadness-2016-statistics-in-nephrology-region/#adaptiveKIDNEYcon adaptive trial tweet thread: https://twitter.com/hswapnil/status/1117194018331471873?s=21Excellent NEJM review on adaptive trials: https://www.nejm.org/doi/10.1056/NEJMra1510061Potential role of Adaptive trials in AKI: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4869991/BNP levels in CKD: https://cjasn.asnjournals.org/content/3/6/1644Generalizability from Wikipedia: https://en.wikipedia.org/wiki/Generalizability_theoryAnemia (and other adverse effects) of Endothelin antagonists: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5210319/Data safety monitoring boards: https://www.nidcr.nih.gov/research/human-subjects-research/interventional-studies/data-and-safety-monitoring-board-guidelinesAbbVie Allergen Merger: https://www.barrons.com/articles/abbvie-allergan-merger-pharma-deals-takeda-celgene-bristol-myers-squibb-51563890831Tangri Kidney Failure Risk Equation: https://qxmd.com/calculate/calculator_308/kidney-failure-risk-equation-4-variableFragility index paper: https://www.ncbi.nlm.nih.gov/m/pubmed/24508144/LITFL write up: https://litfl.com/fragility-index/Calculator: https://clincalc.com/Stats/FragilityIndex.aspxCANVAS Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1811744Rates of Hyperkalemia after Publication of the Randomized Aldactone Evaluation Study by David Juurlink et al.: https://www.nejm.org/doi/full/10.1056/NEJMoa040135Vinay Prasad: https://en.wikipedia.org/wiki/Vinay_PrasadClassic mouse studies looking at endothelin: https://www.jci.org/articles/view/119297/pdfhttps://www.ncbi.nlm.nih.gov/pubmed/8377387/https://diabetes.diabetesjournals.org/content/65/8/2429Nice reviews:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4698004/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4216619/Review of vascular effects:https://www.ncbi.nlm.nih.gov/pubmed/28223322

Joel TopfJennie LinMatt SparksSwapnil HiremathShow Notes: IgA Nephropathy ScoreLevi Strauss: https://www.biography.com/fashion-designer/levi-straussLevey MDRD study: https://www.ncbi.nlm.nih.gov/pubmed/10075613ADPKD Total Kidney Volume: https://www.nejm.org/doi/10.1056/NEJMoa054341Halt PKD: https://www.nejm.org/doi/full/10.1056/nejmoa1402685Tempo 3:4 Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1205511Description description of IgA nephropathy by Berger and Hiunglais: https://www.ncbi.nlm.nih.gov/pubmed/4180586The reprint in JASN in 2000 with commentary as part of the Milestones in Nephrology series: https://jasn.asnjournals.org/content/jnephrol/11/10/1957.full.pdf JASN supplies an English translation from the original French.Nice reference from JASN backing up Matt’s assertion that preeclampsia and not IgA nephropathy is the most common glomerular disease in the world: https://jasn.asnjournals.org/content/18/8/2281Description of the Singapore Army screening recruits from the Oxford Textbook of Clinical Nephrology: https://books.google.com/books?id=fVItBQAAQBAJ&lpg=PA485&ots=JRoOnUnleT&dq=singapore%20kidney%20biopsy%20army&pg=PA485#v=onepage&q&f=falseDescription of the Japanese glomerulonephritis screening program: https://cjasn.asnjournals.org/content/2/6/1360Swapnil’s studies on autopsy studies:Finland: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC501386/Japan: https://www.ncbi.nlm.nih.gov/pubmed/12753320/Nephrology Secrets, either one of the best or the best nephrology textbooks ever: https://www.amazon.com/Nephrology-Secrets-Book-Edgar-Lerma-ebook/dp/B079TSYNQW/ref=sr_1_1TESTING Trial on NephJC: http://www.nephjc.com/news/2017/8/28/testingStop-Iga Trial on NephJC: http://www.nephjc.com/iga-nephropathyTesting Trial two: Therapeutic Evaluation of Steroids in IgA Nephropathy Global Study Low Dose Study: https://clinicaltrials.gov/ct2/show/NCT01560052MEST Score versus MEST-C in NephJC: http://www.nephjc.com/news/2016/10/16/do-crescents-matter-for-iga-nephropathyNice discussion of the statistical tests during the Tweet Chat by people who know their stats (I.e. not Joel): https://twitter.com/NephJC/status/1133546750814367746Tweet-length description of IDI: https://twitter.com/kiwiskiNZ/status/1133595698929098752Assessing the performance of prediction models: a framework for traditional and novel measures. https://www.ncbi.nlm.nih.gov/pubmed/20010215/Net Reclassification Indices for Evaluating Risk-Prediction Instruments: A Critical Review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3918180/Predicting Progression in CKD: Perspectives and Precautions https://www.ajkd.org/article/S0272-6386(15)01413-4/abstractThe Article by Nancy Cook in Circulation that Jennie was talking about: Use and misuse of the receiver operating characteristic curve in risk prediction. https://www.ncbi.nlm.nih.gov/pubmed/17309939Discovery of new risk loci for IgA nephropathy implicates genes involved in immunity against intestinal pathogens https://www.nature.com/articles/ng.3118Genome-wide polygenic risk predictors for kidney disease https://www.nature.com/articles/s41581-018-0067-6Where does Matt find minutia like the grams of IgA produced a day? Here: https://www.annualreviews.org/doi/abs/10.1146/annurev-pathol-011110-130216Animal models of IgA nephropathy: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4337240/Matt’s Book Originals: https://www.amazon.com/gp/product/014312885X/ref=dbs_a_def_rwt_bibl_vppi_i1Eric Neilson, Dean of Northwestern University https://www.feinberg.northwestern.edu/faculty-profiles/az/profile.html?xid=23239Brussels sprout Insta-famous dog and future dean of the medical school: https://www.instagram.com/brussels.sprout/?hl=enJosh Farkas Rantorial about Contrast Nephropathy: https://twitter.com/PulmCrit/status/1134922050794139648Swapnil’s Tweetorial about Contrast Nephropathy: https://twitter.com/hswapnil/status/1133906398096609280Tukaram’s pic of NEJM’s progression from Contrast Induced Nephropathy to Contrast Associated Nephropathy: https://twitter.com/tukaramj/status/1135214980985266178Zero sodium dialysate for heart failure? https://twitter.com/i/moments/1134811009217155072

Joel TopfJennie LinMatt SparksSamira FaroukThe strange story of Jennifer Strange.https://insiderexclusive.com/radios-deadly-stunts-the-jennifer-strange-story/Water Pokerhttps://www.thelocal.se/20120706/41878Nintendo Game Consoleshttps://en.wikipedia.org/wiki/Nintendo_video_game_consoles2019 Narins winner, Mitchel Rosner on MDMA induced hyponatremiahttps://www.ncbi.nlm.nih.gov/pubmed/18684895And Rosner again on exercise induced hyponatremia.https://cjasn.asnjournals.org/content/2/1/151The Arieff article on the dangers of severe hyponatremia: Hyponatremia, Convulsions, Respiratory Arrest, and Permanent Brain Damage after Elective Surgery in Healthy Womenhttps://www.nejm.org/doi/full/10.1056/NEJM198606123142401The Richard Sterns article on the dangers of rapid correction of hyponatremia: Osmotic Demyelination Syndrome Following Correction of Hyponatremiahttps://www.nejm.org/doi/10.1056/NEJM198606123142402The editorial by the man himself, Robert Narins: Therapy of Hyponatremiahttps://www.nejm.org/doi/full/10.1056/NEJM198606123142409The infant study showing seizures associated with rapid correction of hypernatremia.https://www.ncbi.nlm.nih.gov/pubmed/35558?dopt=AbstractFollow up study with oral rehydration.https://www.ncbi.nlm.nih.gov/pubmed/3958850?dopt=AbstractThe Linder study of adults admitted to the ICUhttps://www.ncbi.nlm.nih.gov/pubmed/18037096French study on patients presenting to the ER with hypernatremia.https://bmcnephrol.biomedcentral.com/articles/10.1186/1471-2369-15-37Study on US veterans showing poorer outcomes with slow correction of hypernatremia.https://www.ncbi.nlm.nih.gov/pubmed/21358313Cerebral edema during the treatment of DKA.https://emj.bmj.com/content/21/2/141The MIMIC 3 Database. MIMIC is an openly available dataset developed by the MIT Lab for Computational Physiology, comprising deidentified health data associated with ~40,000 critical care patients. It includes demographics, vital signs, laboratory tests, medications, and more.https://mimic.physionet.orgChalrson Comorbidity Indexhttps://www.mdcalc.com/charlson-comorbidity-index-cci#creator-insightsThe paper: A new method of classifying prognostic comorbidity in longitudinal studies: development and validation.https://www.ncbi.nlm.nih.gov/pubmed/3558716JCI article on organic brain osmnoles in response to hypernatremiahttps://www.ncbi.nlm.nih.gov/pubmed/2332498?dopt=AbstractJohn Booth on the value of MIMIC 3https://twitter.com/ThePeanutKidney/status/1128742219471642624Sri Lekha on checking labs in hypernatremiahttps://twitter.com/LTummalapalli/status/1128479041634226176Steve Coca on chunky water administrationhttps://twitter.com/scoca1/status/1128744643422769152Steve Coca musing the Cersei’s sodium levelhttps://twitter.com/scoca1/status/1128698514026975232Steve Coca swearing in High Valarlian:https://twitter.com/scoca1/status/1128629713826721792Steve Coca proving the non-existence of hypernatremia therapy being associated with brain damage through the inability of trial lawyers to find and sue doctors for this issue:https://twitter.com/scoca1/status/1128652586612080642The original paper on the Kardashian Indexhttps://genomebiology.biomedcentral.com/articles/10.1186/s13059-014-0424-0Kardashian Index Calculatorhttp://theinformationalturn.net/kardashian-index/Facebook CEO Mark Zuckerberg says the ‘future is private’https://www.theverge.com/2019/4/30/18524188/facebook-f8-keynote-mark-zuckerberg-privacy-future-2019Khenar Jhaveri et al on ‘WhatsApp’ening in nephrology traininghttps://academic.oup.com/ckj/advance-article/doi/10.1093/ckj/sfz045/5482109Mike Morrison’s video on how to rebuild the scientific posterhttps://www.youtube.com/watch?v=1RwJbhkCA58Mike’s Twitter: https://twitter.com/mikemorrison?lang=en with lot’s of examples of his design in the wild.Make your own QR code: https://www.qr-code-generator.comGoodRx: https://www.goodrx.comTen Worst Drugs for your Kidney: https://www.goodrx.com/blog/10-worst-medications-for-your-kidneys/Drugs that can falsely elevate your creatinine levels: https://www.goodrx.com/blog/drugs-cause-false-high-creatinine-levels-blood-test/Dr Orrange, not wishing to engage on Twitter in a meaningful way: https://twitter.com/Orrangemd/status/1129165083194511361

This week we discussed the CREDENCE trial published in the NEJM, on the effect of Canaglifozin on diabetic nephropathy. There was lots to discuss so it may be a long podcast.The article is available here.The NephJC summary can be read here, with links to the visual abstract, and the wrapup.Links from the show:Swapnil’s first post at AJKDblog on SGLT2i in 2014! SGLT-2 Inhibitors: Can They Prevent Diabetic Nephropathy?Lonnie Pyne’s brilliant tweetorial on proteinuria as a proposed end-point in CKD trials.Combined RAAS blockade (don’t do it)Combining ACEI and direct renin inhibitorsCombining ACEi and ARBWe repeatedly compare CREDENCE to IDNT by Ed Lewis and RENAAL by Barry BrennerYou will need to be familiar with EMPA-REG and CANVAS (links to summaries on NephJC)Why run-in periods are bad for clinical trials: Run-in Periods in Randomized TrialsImplications for the Application of Results in Clinical PracticeHispanics in the study: https://twitter.com/VladoPerkovic/status/1121078118029103105Lot of discussion on mechanisms: • The original description of phlorizin by Josef von Mering in 1800• Podocyte effects in JCI• Effect on Hyperfiltration by SGlT2i in humans• Emerging role of proximal tubule in CKD via GWAS studies• SGLT2i effect on Na/H exchangers in heart and kidney• SGLT2i interact with heart NHE1 (mouse model)• SGLT2i as the ‘betablockers’ of the kidney?Jordan Weinstein on the clinical scientists’ mechanism of SHGLT2i:https://twitter.com/drjjw/status/1121577808164159491Why subgroups should be interpreted very carefullyHost: Joel TopfDiscussants: Samira Farouk, Swapnil Hiremath, Jennie Lin and Matt Sparks.

This week we discussed the ASCEND trial published in Annals of Internal Medicine, on the comparative effectiveness of cognitive behavioural therapy and Sertraline in patients on dialysis with depression.The article is available here.The NephJC summary can be read here, with links to the visual abstract.Links from the show:In the background section, we mentioned the data from a recent JASN study on cardiovascular safety of different antidepressants. The contrast with the CAST trial came up as well. PDF links to the BDI, QIDS-SR and QIDS-C scores.KIDNEYCon 2020 will be in April. Follow @KIDNEYCon to stay updated, as well for the links to the recorded sessions from #KIDNEYCon 2019.Host: Joel TopfDiscussants: Swapnil Hiremath, Jennie Lin and Matt Sparks. We missed Samira Farouk who was travelling.

This is the audio commentary of the NephJC Chats on March 19 and 20, 2019.This week we discussed the study published in JAMA Network Open, on the kidney outcomes in NSAID users from the US military.The article (open access) is available here.The NephJC summary can be read here, with links to the visual abstract.Links from the show:In the background section, we mentioned the data from the Physicians Health Study (two reports) and the Nurses Health Study. There was also discussion about this high quality study from Switzerland in patients with rheumatoid arthritis.The NephMadness pain region scouting report, from Sam GelfandThe PRECISION trial published in NEJM, and the NephJC summary by Scherly LeonHigh risk of GI bleeding in CKD patientsA study from Taiwan reporting high risk of stroke with NSAIDs even in anuric patientsHost: Joel TopfCo-hosts: Samira Farouk, Swapnil Hiremath, Jennie Lin and Matt Sparks