Freely Filtered, a NephJC Podcast: Recent Episodes
NephJC Team
The Filtrate
Joel Topf kidneyboy.bsky.social
Swapnil Hiremath @hswapnil.medsky.social
Natalie Freidin Program director at Medical University of South Carolina
Sophia Ambruso @sophia_kidney
AC @medpeedskidneys.bsky.social
Special Guests
Carla Nester, Professor of Medicine, Professor of Pediatrics, University of Iowa. Senior author of Valiant
Editing
Natalie Freidin
The Kidney Connection written and performed by Timothy Yau
Show Notes
Trial of Pegcetacoplan in C3 Glomerulopathy and Immune-Complex MPGN NEJM | NephJC
Tubular Secretions
Swapnil: City of Last Chances by Adrian Tchaikovsky (Amazon)
Natalie:Heated Rivalry, the books by Rachel Reid
Carla: Rowing and gold fiber embroidery
AC: Audiobooks, that are appropriate for children: The Giver and Tuck Everlasting
Sophia: Greeking Out podcast and the Wheel of Time by Robert Jordan (Wikipedia)
Joel: This is How You Lose The War by Amal El-Mohtar and Max Gladstone (Amazon)
The Filtrate
Joel Topf kidneyboy.bsky.social
Swapnil Hiremath @hswapnil.medsky.social
Pedro Teixeira @nephcrit.bsky.social
Special Guests
Ewout J. Hoorn, Professor of Medicine Erasmus MC, Netherlands. One of the primary authors.
Harish Seethapathy, Assistant physician at Massachusetts General Hospital
Editing
Vipin Verghese
The Kidney Connection written and performed by Timothy Yau
Show Notes
A Randomized Trial of Targeted Hyponatremia Correction in Hospitalized Patients in NEJM Evidence, in PubMed, in NephJC
Seethapathy: Severe Hyponatremia Correction, Mortality, and Central Pontine Myelinolysis in NEJM Evidence
MacMillan: Osmotic Demyelination Syndrome in Patients Hospitalized with Hyponatremia in NEJM Evidence
SALSA: Risk of Overcorrection in Rapid Intermittent Bolus vs Slow Continuous Infusion Therapies of Hypertonic Saline for Patients With Symptomatic Hyponatremia: The SALSA Randomized Clinical Trial in JAMA Internal Medicine
SALT 1 and 2: Tolvaptan, a Selective Oral Vasopressin V2-Receptor Antagonist, for Hyponatremia in NEJM
Hyponatremia registry: Current treatment practice and outcomes. Report of the hyponatremia registry in Kidney International
The Richard Sterns’ article on the lower mortality with more severe hyponatremia: Mortality and Serum Sodium: Do Patients Die from or with Hyponatremia? in CJASN
The European Hyponatremia Guidelines: Clinical practice guideline on diagnosis and treatment of hyponatraemia inThe European Journal of Endocrinology
The American Hyponatremia Guidelines: Diagnosis, Evaluation, and Treatment of Hyponatremia: Expert Panel Recommendations in American Journal of Medicine
Treating hyponatremia: damned if we do and damned if we don't by Tom Berl in Kidney International
Prospective (clamp) versus reactive (rescue) DDAVP in hyponatremia: Safety and efficacy of proactive versus reactive administration of desmopressin in severe symptomatic hyponatremia: a randomized controlled trial in Nature Scientific Reports and as covered in PBFluids
Helbert Rondon’s RCT of urea Urea for Chronic Hyponatremia on ClinicalTrials.gov
Tubular Secretions
Swapnil: Catfishing on CatNet: A Novel by Naomi Kritzer (Amazon)
Harish:Disney Cruise
Edward: Flesh: A Novel (Booker Prize Winner) by David Szalay (Amazon)
Pedro: Scrubs reboot (IMDB)
Joel: KIDNEYcon
The Filtrate
Joel Topf kidneyboy.bsky.social
Special Guests
Dr. Samir Parikh, President of the American Society of Nephrology
Prof. Donal Reddan, President, Irish Nephrology Society
Prof. Catherine Godson
Editing
Joel Topf
The Kidney Connection written and performed by Timothy Yau
Show Notes
Tubular Secretions
Joel Topf, the Dublin Port Greenway Link
Catherine Godson: never heard ofthe Dublin Port Greenway
Samir Parikh: Trinity College Dublin and specifically the Eavan Boland Library, named after the Irish poet.
Donal Reddan: Something about rugby
The Filtrate
Joel Topf kidneyboy.bsky.social
Pedro Teixeira @nephcrit.bsky.social
Nayan Arora @captainchloride.bsky.social
Anna Gaddy @annagaddy.bsky.social
Swapnil Hiremath @hswapnil.medsky.social and on LinkedIn
Special Guests
Ian McCoy, MD @NephroNinja study author and UCSF
Chi-yuan Hsu Senior author and Chief of the Division of Nephrology at UCSF
Samuel Silver Associate Professor at Queens University in Canada
Editing
Vipin Verghese and Joel Topf
Show Notes
NephJC Discusion: Dialyze Less, Recover More? AKI’s Chance to Get LIBERATE-D
Manuscript: A Conservative Dialysis Strategy and Kidney Function Recovery in Dialysis-Requiring Acute Kidney InjuryThe Liberation From Acute Dialysis (LIBERATE-D) Randomized Clinical Trial JAMA | PubMed
Ben’s pilot study: RAD-AKI Pilot study: Recovery After Dialysis-Requiring Acute Kidney Injury (RAD-AKI) (ClinicalTrials.gov)
STARRT-AKI NephJC
Editorial in JAMA: A-E-I-O-U and Sometimes Why—Dialysis in Acute Kidney Injury (JAMA)
What Is Dialytrauma? (Nephrology Times)
How Fragile Are the Results of a Trial? The Fragility Index (PubMedCentral)
Shiffl Trial: Daily Hemodialysis and the Outcome of Acute Renal Failure (NEJM)
AKIKI: Initiation Strategies for Renal-Replacement Therapy in the Intensive Care Unit (NEJM)
AKIKI2: How Late it was, How Late! (NephJC)
Sam Silver’s study: Promoting Kidney Recovery After Acute Kidney Injury Receiving Dialysis (Recover-AKI) (ClinicalTrial.Gov)
Marie Kondo (Wikipedia)
Tubular Secretions
Swap: The smutty dragon novels of novels of Rebecca Yarros (Wikipedia) Specifically The Empyrean series
Anna: Brisket recipes
Pedro: The Naked Gun (Wikipedia) with Liam Neeson
Ian: ASN Kidney Health Guidance on the Outpatient Management of Patients with Dialysis-Requiring Acute Kidney Injury (PubMed) he really doesn’t get Tubular Secretions.
Nayan: Tilt: A Novel by Emma Pattee (Amazon)
Chi: The Year of Magical Thinking by Joan Didion (Wikipedia) and Innovations in Nephrology (Springer Nature)
Sam: Monopoly Super Electronic Banking Board Game (Amazon)
Joel: Song Sung Blue (Wikipedia)
The Filtrate
Joel Topf (kidneyboy.bsky.social)
AC (@medpeedskidneys.bsky.social)NephMadness
Anna Gaddy (@AnnaGaddy)
Vipin Verghese (@vipvargh.bsky.social)
Natalie Freidin Program director at Medical University of South Carolina
Special Guests
Anna Vinnikova (@kidneywars.bsky.social) Long time game maker for NephMadness and Associate Professor at Virginia Commonwealth University
Autumn Harris Associate Professor of Veterinary Medicine at NC State
Sarah Street MD PhD Assistant Professor of Medicine at Virginia Commonwealth University
Editing
Joel Topf
Show Notes
Animal House scouting report
Autumn Harris on Team Cat
Cheese!
I know 2026 feels like it ihas been here for months, but only a few weeks ago we were celebrating the nephrology accomplishments of 2025. The New Filtrate came together to review the year.
The Filtrate
Joel Topf @kidneyboy.bsky.social (COI)
Swapnil Hiremath @hswapnil.medsky.social and on LinkedIn Editor in Chief of Kidney International Case Reports
Anna Gaddy (@AnnaGaddy) Winner of NephJC Rookie of the Year 2020
Nayan Arora (@CaptainChloride.bsky.social)
AC (@medpeedskidneys.bsky.social)
Vipin Verghese (@vipvargh.bsky.social) co-winner of NephJC Engaged Scientist of the Year in 2021
Brian Rifkin (@brianrifkin.bsky.social) Co-Editor in Chief NephJC. Winner of NephJC Rookie of the Year 2021
Cristina Popa (@NephroSeeker) Co-Editor in Chief NephJC. Wwinner of NephJC Rookie of the Year 2022 and MVP 2023
Editing and Show Notes by
Anna Gaddy and Joel Topf
The Kidney Connection written and performed by Tim Yau
Show Notes
Top Stories in Nephrology 2025 (NephJC)
First Top sories in Nephrology 2010! (Renal Fellow Network)
Links to all of the Top Stories in Nephrology, hosted on NephJC since 2017 (NephJC)
1. IgA Nephropathy
VISIONARY: Sibeprenlimab in IgA Nephropathy — Interim Analysis of a Phase 3 Trial (NEJM)
ORIGIN 3: A Phase 3 Trial of Atacicept in Patients with IgA Nephropathy (NEJM)
APPLAUSE-IgA Alternative Complement Pathway Inhibition with Iptacopan in IgA Nephropathy (NEJM)
Aliza M. Thompson, MD, MS (ASN)
2. Lupus Nephritis
REGENCY: Efficacy and Safety of Obinutuzumab in Active Lupus Nephritis (NEJM)
3. Nobel prize winner and peripheral immune tolerance
4. Xenotransplantation
5. GLP1ra Revolution
Remodel REMODELing mechanistic trials for kidney disease: a multimodal, tissue-centered approach to understand the renal mechanism of action of semaglutide (Kidney International)
SURPASS-CVOT Tirzepatide vs. Dulaglutide Is Associated with Reduced Major Kidney Events in Patients with Type 2 Diabetes, CVD, and Very High-Risk Kidney Diseases (Kidney Week abstract in JASN)
Poll: 1 in 8 Adults Say They Are Currently Taking a GLP-1 Drug for Weight Loss, Diabetes or Another Condition, Even as Half Say the Drugs Are Difficult to Afford (KFF survey)
6. GDMT implementation in CKD: lessons learnt from CONFIDENCE and MIRO-CKD
Confidence Finerenone with Empagliflozin in Chronic Kidney Disease and Type 2 Diabetes (NEJM)
MIRO-CKD Balcinrenone in combination with dapagliflozin compared with dapagliflozin alone in patients with chronic kidney disease and albuminuria: a randomised, active-controlled double-blind, phase 2b clinical trial (The Lancet)
7. Flozin Meta analysis
SMART-C. SGLT2 Inhibitors and Kidney Outcomes by Glomerular Filtration Rate and Albuminuria.A Meta-Analysis (JAMA)
SMART-C. Effects of Sodium Glucose Cotransporter 2 Inhibitors by Diabetes Status and Level of Albuminuria.A Meta-Analysis(JAMA)
8. Paradigm Shift: Aiming for CKD Remission
9. Fish Oil and Dialysis
PISCES Fish-Oil Supplementation and Cardiovascular Events in Patients Receiving Hemodialysis (NEJM)
10. Decline in Dialysis Patients in the United States
USRD 2025 Annual Data Report (USRDS)
Tubular Secretion
Swapnil Hiremath Alien Earth on FX Hulu (Wikipedia)
AC A Christmas Carol by Charles Dickens (Wikipedia) and The Muppet Christmas Carol (Wikipedia)
Anna Monty Don (Wikipedia)
Nayan Back Street Boys at The Sphere (Wikipedia)
Brian Marty Supreme (Wikipedia)
Cristina The Yellow Tie (Wikipedia)
Vipin Stranger Things, good for a four year old? (Wikipedia)
Joel Crash Course: The Universe with Katie Mack and John Green (Apple PodCasts)
The Filtrate
Joel Topf @kidneyboy.bsky.social (COI)
Sophia Ambruso @sophia-kidney.bsky.social
Swapnil Hiremath @hswapnil.medsky.social and on LinkedIn
Special Guests
Jonathan Barratt Professor of Renal Medicine, University of Leicester Google Scholar (COI: all the companies)
Editing and Show Notes by
Nayan Arora @captainchloride.bsky.social
The Kidney Connection written and performed by Tim Yau
Show Notes
Proteinuria Reduction as a Surrogate End Point in Trials of IgA Nephropathy (Aliza Thompson, 2019 PubMed)
The number, quality, and coverage of randomized controlled trials in nephrology (PubMed 2004)
A Randomized, Controlled Trial of Rituximab in IgA Nephropathy with Proteinuria and Renal Dysfunction (PubMed 2017)
BLISS Belimumab in lupus nephritis (NephJC | PubMed)
The Phase 2 trial of atacicept A phase 2b, randomized, double-blind, placebo-controlled, clinical trial of atacicept for treatment of IgA nephropathy (PubMed)
The phase 3 trial of atacicept, the subject of this podcast A Phase 3 Trial of Atacicept in Patients with IgA Nephropathy (PubMed | NephJC)
The use of Gd-IgA1 in the Testing Trial Role of Systemic Glucocorticoids in Reducing IgA and Galactose-Deficient IgA1 Levels in IgA Nephropathy (PubMed)
If you can’t get enough Jon Barratt, take a look at his grand rounds at The University of Ottawa. Updates to the KDIGO Guidelines for the treatment of IgA nephropathy, with Prof Jonathan Barratt (YouTube)
Tubular Secretion
Swapnil Hiremath Pluribus on Apple TV (Wikipedia)
Jon Barratt Lynyrd Skynyrd (Wikipedia) Slow Horses (Wikipedia) on AppleTV
Joel Topf the new ASN
The Filtrate
Joel Topf @kidneyboy.bsky.social (COI)
Pedro Teixeira @nephcrit.bsky.social
Ana Gaddy @AnnaGaddy
Nayan Arora @captainchloride.bsky.social
Special Guests
David Goldfarb Professor of Medicene, NYU (COI)
Editing by
Pedro Teixeira
The Kidney Connection written and performed by Tim Yau
Show Notes
BICARBICU 2018 (Lancet)
BICARBICU-2 2025 (JAMA)
SOFA score (Wikipedia)
Sodium bicarbonate administration for metabolic acidosis in the intensive care unit: a target trial emulation (PubMed)
Effect of sodium bicarbonate on intracellular pH under different buffering conditions (PubMed)
Evaluating the clinical and cost-effectiveness of Sodium Bicarbonate administration for critically ill patients with Acute Kidney Injury (MOSAICC) (ICNARC Site)
SODium BICarbonate for Metabolic Acidosis in the ICU (SODa-BIC) (ClinicalTrials.gov)
Surviving Sepsis Campaign Guidelines 2021 (Website)
Tubular Secretions
Nayan: Louise Penny, The Black Wolf (Amazon)
Anna: Broom Gate: A Curling Scandle (CBC)
Pedro: One Battle After Another! (Wikipedia)
David: Patti Smith (Wikipedia)
Bonus pick: Kids Rarely Read Whole Books Anymore. Even in English Class. (NYT)
Joel: Boys in the Boat by Daniel James Brown (Film Wikipedia | Book Wikipedia)
The Filtrate
Joel Topf @kidneyboy.bsky.social (COI)
Swapnil Hiremath @hswapnil.medsky.social and on LinkedIn
Pedro Teixeira @nephcrit.bsky.social
Special Guests
Charmaine E Lok, MD Professor of Medicine at the Faculty of Medicine, University of Toronto
Editing and Show Notes by
Joel Topf
The Kidney Connection written and performed by Tim Yau
Show Notes
Fish-Oil Supplementation and Cardiovascular Events in Patients Receiving Hemodialysis NEJM | NephJC
What works in hemodialysis?
Iron: PIVOTAL Trial (NEJM)
Hemodiafiltration: CONVINCE (NEJM)
That’s the whole list
Earlier work on vascular access, The FISH Trial: Effect of fish oil supplementation on graft patency and cardiovascular events among patients with new synthetic arteriovenous hemodialysis grafts: a randomized controlled trial JAMA
Eskimo myth: "Fishing" for the origins of the "Eskimos and heart disease" story: facts or wishful thinking? (PubMed)
Dialysis patients have low levels of fish oil in their body (PubMedCentral)
Positive trial in non-dialysis patients: REDUCE-IT
Negative trial of fish oil in non-dialysis patients: STRENGTH
ACC does not recommend FISH Oil for primary or secondary prevention of CV events (ACC)
Poisson distribution (Wikipedia)
Ocean Nutrition Canada (Wikipedia)
Ocean Nutrition was bought by DSM (Press Release)
DSM merged with Firmenich (Press Release)
Vanguard feasibility trials (PubMed)
Freezing fish oil caps will eliminate the fishy aftertaste (Pharmacists Letter)
The study also received a philanthropic donation from Mr. Alexander Epstein (UHN Research)
Selection Bias, Interventions and Outcomes for Survivors of Cardiac Arrest (PubMedCentral)
Effectiveness of fish oil in controlling inflammation in adult patients undergoing hemodialysis: A systematic review and meta-analysis (PubMed)
Tubular Secretions
Swapnil Hiremath: Michael Clayton (IMDB)
Pedro: Fifa World Cup Soccer coming to North America with Portugal! (FIFA)
Charmaine: New Puppy, Rose. It’s a Barbet (Wikipedia)
Joel Topf: The Dark Forrest by Liu Cixin (Wikipedia)
The Filtrate
Joel Topf @kidneyboy.bsky.social (COI)
Sophia Ambruso @sophia-kidney.bsky.social
Swapnil Hiremath @hswapnil.medsky.social and on LinkedIn
Special Guests
Jonathan Barratt Professor of Renal Medicine, University of Leicester Google Scholar (COI: all the companies)
Editing and Show Notes by
Nayan Arora @captainchloride.bsky.social
The Kidney Connection written and performed by Tim Yau
Show Notes
Proteinuria Reduction as a Surrogate End Point in Trials of IgA Nephropathy (Aliza Thompson, 2019 PubMed)
The number, quality, and coverage of randomized controlled trials in nephrology (PubMed 2004)
Updated here (PubMed | NephJC discussion)
A Randomized, Controlled Trial of Rituximab in IgA Nephropathy with Proteinuria and Renal Dysfunction (PubMed 2017)
BLISS Belimumab in lupus nephritis (NephJC | PubMed)
The Phase 2 trial of atacicept A phase 2b, randomized, double-blind, placebo-controlled, clinical trial of atacicept for treatment of IgA nephropathy (PubMed)
The phase 3 trial of atacicept, the subject of this podcast A Phase 3 Trial of Atacicept in Patients with IgA Nephropathy (PubMed | NephJC)
Christos’ Bluesky post:
https://bsky.app/profile/christosargyrop.bsky.social/post/3m5bsujwg3s2q
The use of Gd-IgA1 in the Testing Trial Role of Systemic Glucocorticoids in Reducing IgA and Galactose-Deficient IgA1 Levels in IgA Nephropathy (PubMed)
If you can’t get enough Jon Barratt, take a look at his grand rounds at The University of Ottawa. Updates to the KDIGO Guidelines for the treatment of IgA nephropathy, with Prof Jonathan Barratt (YouTube)
Tubular Secretion
Swapnil Hiremath Pluribus on Apple TV (Wikipedia)
Jon Barratt Lynyrd Skynyrd (Wikipedia) Slow Horses (Wikipedia) on AppleTV
Joel Topf the new ASN
The Filtrate
Joel Topf @kidneyboy.bsky.social
Sophia Ambruso @sophia-kidney.bsky.social
Nayan Arora @captainchloride.bsky.social
Special Guests
Brian Rifkin @brianrifkin.bsky.social
Anna Gaddy @AnnaGaddy
Editing and Show Notes by
Joel Topf
The Kidney Connection written and performed by Tim Yau
Show Notes
Brian Rifkin and Cristina Popa ascend to co-editors in chief of NephJC.
Paresh Jadav receives the first NephJC Champion award. Dr. Jadav hosted the NephJC night and saved NephJC thousands of dollars. It makes a huge difference in our fund raising. Thank you.
Also a big thank-you to Jade Teakell for buying the cowboy hats!
The first pick of the draft, by Sophia is Fish oil for dialysis: Fish-Oil Supplementation and Cardiovascular Events in Patients Receiving Hemodialysis (NEJM)
The second pick, by Brian is FINE-ONE (Bayer Press release)
Rajiv Agarwal’s mediation analysis to show how much of finerenone’s beneficial renal effects are captured by the reduction proteinuria: Impact of Finerenone-Induced Albuminuria Reduction on Chronic Kidney Disease Outcomes in Type 2 Diabetes : A Mediation Analysis (PubMed)
Anna has the third pick and it goes to Katherine Tuttle and the REM0DEL Trial: REMODELing mechanistic trials for kidney disease: a multimodal, tissue-centered approach to understand the renal mechanism of action of semaglutide (Science Direct)
Nayan goes off-board and picks a poster by a med student (backed by Testani)
Mechanism and Effects of Manipulating Chloride Homeostasis in Stable Heart Failure (ClinicalTrials.gov)
For the final pick in the draft Joel went with a little Lilly on Lilly violence: Tirzepatide vs. Dulaglutide Is Associated with Reduced Major Kidney Events in Patients with Type 2 Diabetes, CVD, and Very High-Risk Kidney Diseases (JASN)
Bring out your dead…What’s left on the draft board.
Liberate-D A Conservative Dialysis Strategy and Kidney Function Recovery in Dialysis-Requiring Acute Kidney Injury: The Liberation From Acute Dialysis (LIBERATE-D) Randomized Clinical Trial (JAMA)
Atacicept for IgAN A Phase 3 Trial of Atacicept in Patients with IgA Nephropathy (NEJM)
Lilia Cervantes crushed it with Community Health Worker Support for Hispanic and Latino Individuals Receiving Hemodialysis: The Navigate-Kidney Randomized Clinical Trial (JAMA)
Tubular Secretion
Brian: Late Breaking and High Impact Clinical Trials. Including Sibe! REGENCY Biopsy Data.
Sophia: Flying Home. No, really it’s the Electrolyte Quiz
Joel: The Poster Session, the Quiz Session, and
Nayan: Flying to AHA to talk about dual-heart-kidney-transplant
Anna: Kidney STARS! and Melanie Hoenig’s session on potassium
The Filtrate
Joel Topf @kidneyboy.bsky.social
Swapnil Hiremath@hswapnil.medsky.social
AC @medpeedskidneys.bsky.social
Special Guest
Mike Walsh Associate Professor in the Departments of Medicine and Health Research Methods, Evidence, and Impact, McMaster University as well as a Scientist at the Population Health Research Institute and a nephrologist at St. Joseph’s Healthcare Hamilton where he is the Chair of the Clinical Nephrology Research Group.
Editing and Show Notes by
Sophia Ambruso
The Kidney Connection written and performed by Tim Yau
Show Notes
ALCHEMIST (NephJC Shorts, Rossignol et al Lancet 2025)
AC is in her 83rd year of med-peds fellowship.
Joel’s monologue brings us all down.
Prophylactic ICD therapy doesn’t improve sudden cardiac death or all-cause mortality in HD patients in the ICD2 trial (Jukema JW et al. Circulation 2019)
Initiation with statins do not impact MACE endpoints or atherosclerotic events (4D AURORA trial Fellstrom BC et al. NEJM 2009 & SHARP trial Baigent C et al. Lancet 2011)
Mike tries to liven up the mood by mentioning positive outcomes with iron therapy in heart failure with the PIVOTAL trial (Macdougall IC et al. NEJM 2018)
TOPHAT trial revealed treatment with spironolactone in HFpEF did not affect MACE outcomes. (Pitt B et al. NEJM 2014)
NephTrials ‘Run-in periods in clinical trials: What can we ACHIEVE?’
SPIN D trial - spironolactone dose finding trial in ESRD (Charytan DM et al. Kidney Int 2018)
Mike shares the human experience of the trial after being instructed to end the trial prematurely and being told they have “answered their question”
Study in Japan - spironolactone predominantly benefits male over females (cannot find this)
Male vs female benefit not observed in ACHIEVE despite Mike’s initial hypothesis
Swap compares and contrasts ACHIEVE, ALCHEMIST & Meta-analysis (Pyne L et al. Lancet 2025)
Mike discusses how nonadherence to spironolactone impacted the intention to treat outcomes in the trial.
What is a high risk of bias for dummies?
Mike, Swap & Joel ponder future nsMRA or ASI trials hemodialysis?
Tubular secretions
Swap is probably stalking Martha Wells by now, has moved on from Witch King, now onto Queen Demon on Good Reads
AC is adding to her brood, 2 dogs (Snickers & Harper), 1 child
Dungeon Crawler Call - a science fantasy book series by Matt Dinniman (on goodreads), which he lovingly referred to as complete nerd trash.
Joel is binging on the series Task on HBO max, featuring Mark Ruffalo as FBI agent.
NephJC is having its annual fundraiser (get your tickets here) at ASN. Providing a party shuttle that is leaving every 30 minutes from the conference center. As always, it will feature a live podcast recording covering the ASN late breaking, high impact clinical trials.
Swap describes the high impact model at ASN this year - go big or go home.
The Filtrate
Joel Topf @kidneyboy.bsky.social
Swapnil Hiremath @hswapnil.medsky.social
Nayan Arora captainchloride.bsky.social
Sopia Ambruso @sophia-kidney.bsky.social
Special Guests
Brendon Neuen @brendonneuen.bsky.social Associate Professor and Program Lead, Renal and Metabolic at The George Institute for Global Health. Nephrologist and Director of Kidney Trials at Royal North Shore Hospital.
Neuen has had three prior appearances on Freely Filtered: EMPA Kidney, DUPLEX and Sparsentan in FSGS, FLOW and Semaglutide
Muthiah Vaduganathan @mvaduganathan on X. Cardiologist at Brigham and Women's Hospital and Harvard Medical School. Assistant Professor of Medicine.
Editing by
Joel Topf
The Kidney Connection written and performed by Tim Yau
Show Notes
DONATE to NephJC!
Finerenone with Empagliflozin in Chronic Kidney Disease and Type 2 Diabetes NEJM | NephJC Summary
FIDELIO Bakris et al, NEJM 2020 | NephJC Summary; subgroup throws doubt on efficacy of finerenone in patients on flozins
FIGARO Pitt et al, NEJM 2021; subgroups clearly shows finerenone works, flozins or not
NEJM editorial (wrongly) saying do not use Flozins unless on RASi
Don’t use dual RAS blockade ONTARGET Yusuf et al, NEJM 2008; VA NEPHRON-D Fried et al NEJM 2013
Why we cannot study finerenone in HFrEF (RALES Pitt et al NEJM 1999)
Muthu is jealous of GFR slope and albuminuria surrogate endpoints and wants to borrow them for HFpEF (Inker et al EHJ 2025)
Combination therapy and CV outcomes in hypertension (Wang et al JAMA Card 2024 on low dose combinations and BP; Egan et al Blood Pressure 2022 review of topic)
CONFIRMATION HF trial registry entry (Finerenone and Empagliflozin in hospitalized patients with HF)
23:20: Nayan and Swap miss a chance to say ‘de-flozination’ to discuss stopping a flozin which would allow a patient to be included in the trial
Finerenone is a CYP3A4 substrate (Heinig et al Clin Pharmacokinetics 2023); Useful list of CYP3A4 inducers and inhibitors
Everyone should get an ABPM (Bugeja et al CMAJ 2022)
EASiKIDNEY study design
Albuminuria mediates CKD benefits with Finerenone (Agarwal et al Ann Intern Med 2023)
GFR slope and Albuminuria and the FDA (Taylor et al eClin Med 2025)
Dapagliflozin and Eplerenone combination crossover trial (Provenzano et al JASN 2022)
Joel gets promoted! (PBFluids reflection)
Bluesky NephJC Chat discussion on ‘renal remission’
Withdrawal of Finerenone and worse outcomes from FINEARTS (Vaduganathan et al JACC 2025)
Combination therapies Analysis from Brendan and Muthu (Neuen et al Circulation 2024)
Do not use KFRE when GFR > 60 (KDIGO Practice Point 2.2.4: Note that risk prediction equations developed for use in people with CKD G3–G5, may not be valid for use in those with CKD G1–G2)
Finerenone vs Spironolactone trial in Primary Aldosteronism (Hu et al Circulation 2025)
FIND CKD trial design (Heerspink et al NDT 2025)
FINE-ONE trial design (Heerspink et al Diab Res Practice 2023)
Tubular Secretions
Nayan keeping his chin up as Yankees lose and Mariners follow (MLB Playoffs)
Sophia’s adventures with Beekeeping (Royal Jelly?)
Brendon loves listening to ‘Susan’ by Raye
Muthu is back into Taekwondo
Swap is still reading Martha Wells (Witch King on GoodReads)
Joel will be hiking the Laugavegur trail in Iceland
The Filtrate
Joel Topf Bluesky: @kidneyboy.bsky.social
AC @medpeedskidneys.bsky.social
Nayan Arora @captainchloride.bsky.social
Special Guest
Vandana Niyyar Professor of Medicine at Emory School of Medicine
Editing by
Nayan Arora
The Kidney Connection written and performed by by Tim Yau
Show Notes
American Society of Diagnostic and Interventional Nephrology (Website)
ASDIN List of training sites
Placement, performance and complications of the Ash Split Cath hemodialysis catheter (PubMed)
Platelet Function Assay FAQ (PDF)
Saint Clair’s Vascular Access Center where we do outpatient biopsies (Website)
The studies:
NephJC Summary
Prasad Study KI Reports
Chakrabarti in Kidney 360
Thromboelastogram (TEG) (Life in the Fastline)
Elastigirl (Wikipedia)
Association of Kidney Biopsy Needle Gauge with Post-Procedure Complications and Biopsy Adequacy (PubMed)
Complications of Percutaneous Renal Biopsy (PubMed)
Tubular Secretions
Nayan Quarterback on Netflix (Wikipedia)
AC The Rehearsal on HBO (Wikipedia)
Joel The Detroit Tigers (MLB)
The Filtrate
Joel Topf Bluesky: @kidneyboy.bsky.social
Jordy Cohen Bluesky: @jordybc.bsky.social
Swapnil Hiremath Bluesky: @hswapnil.medsky.social
Special Guest
Edouard “call me Ed” Fu Assistant Professor and Medical Student, and second author of his second paper covered on NephJC. LinkedIn | Leiden University Medical Center
Editing by
Simon Topf and Sophia Ambruso
The Kidney Connection written and performed by by Tim Yau
Show Notes
Ed’s first paper on NephJC: Timing of dialysis initiation to reduce mortality and cardiovascular events in advanced chronic kidney disease: nationwide cohort study (NephJC | BMJ)
Phenformin Wikipedia | Boca Raton News
The metformin black box (as part of the FDA Label)
WARNING: LACTIC ACIDOSIS
Postmarketing cases of metformin-associated lactic acidosis have resulted in death, hypothermia, hypotension, and resistant bradyarrhythmias. The onset of metforminassociated lactic acidosis is often subtle, accompanied only by nonspecific symptoms such as malaise, myalgias, respiratory distress, somnolence, and abdominal pain. Metforminassociated lactic acidosis was characterized by elevated blood lactate levels (>5 mmol/Liter), anion gap acidosis (without evidence of ketonuria or ketonemia), an increased lactate/pyruvate ratio; and metformin plasma levels generally >5 mcg/mL (see PRECAUTIONS).
Risk factors for metformin-associated lactic acidosis include renal impairment, concomitant use of certain drugs (e.g. carbonic anhydrase inhibitors such as topiramate), age 65 years old or greater, having a radiological study with contrast, surgery and other procedures, hypoxic states (e.g., acute congestive heart failure), excessive alcohol intake, and hepatic impairment.
Steps to reduce the risk of and manage metformin-associated lactic acidosis in these high risk groups are provided (see DOSAGE AND ADMINISTRATION, CONTRAINDICATIONS, and PRECAUTIONS).
If metformin-associated lactic acidosis is suspected, immediately discontinue metformin and institute general supportive measures in a hospital setting. Prompt hemodialysis is recommended (see PRECAUTIONS).
Target Trial Emulation A Framework for Causal Inference From Observational Data. Miguel A. Hernán, MD, DrPH; Wei Wang, PhD; David E. Leaf, MD JAMA 2022
Stopping Versus Continuing Metformin in Patients With Advanced CKD: A Nationwide Scottish Target Trial Emulation Study (NephJC | PubMed)
Toxicokinetics of Metformin During Hemodialysis (KI Reports)
Metformin in People With Diabetes and Advanced CKD: Should We Dare? Editorial that ran in AJKD along side the Lambourg manuscript (AJKD)
Immortal Time Bias in Cohort Studies of Kidney Transplant Recipients (Kim SJ Amer J Trans 2010)
Ed’s Target trial review in JASN which Jordy mentioned and includes an explanation of the obesity paradox by depletion of the susceptibles. (Fu JASN 2023)
Ed’s Grand Rounds at Ottawa on YouTube. Very good.
Response by Cohen et al to Letter Regarding Article, “Association of Inpatient Use of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers With Mortality Among Patients With Hypertension Hospitalized With COVID-19” by Jordy and the crew Circ Res 2000
Review article on the issue: Evaluating sources of bias in observational studies of angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker use during COVID-19: beyond confounding Jordy and a different crew J Hyperten 2021
Figure S5: Weighted cumulative incidence curves for MACE, by treatment strategy
The S4 image that Swap loved
Tubular Secretions
Jordy Andor Season 2 on Disney+ (Wikipedia)
Swapnil Murderbot on Apple TV+ (Wikipedia)
Eduoard: New house and grant Grant Grant (Wikipedia)
Joel Topf Three Body Problem Audio book (Audible)
One of NephJC signature moves has been to adapt new technologies and communication techniques to delivering state of the art nephrology education. Podcasts, Visual Abstracts, Tweetorials. NephJC has been on the front of these waves. Clearly one of the most exciting and controversial new technologies is artificial intelligence and it is unclear what role it may play in the NephJC educational package. Our blogs and tweets are written entirely by human minds but it is inevitable that as AI becomes the spellcheck of the 2020s, that it will leach into all of our writing.
One AI tool that intrigues us is Google’s NotebookLM. This product can create podcasts from source documentation. We have done a couple of dry runs converting our blogs into novel, low-effort, podcasts with impressive results. So, at least for now, we plan on publishing a podcast before each chat. We are fact checking them before publication, but some mistakes may slip through. Please send you feedback, we want to know what you think of this. As always, the email is Captopril@NephJC.com
This will supplement and not replace Freely Filtered. One possible future move is to separate out both podcasts to individual feeds, but for now they will piggyback on each other.
The Filtrate
Joel Topf
AC Gomez
Sophia Ambruso
Nayan Arora
Special Guest
Charles Edelstein, MD, PhD Professor, Medicine-Renal Med Diseases/Hypertension
Extra-Special Guest
Michelle Rheault, MD Professor of Pediatrics, University of Minnesota
Editing by
Simon and Joel Topf
The Kidney Connection written and performed by by Tim Yau
Show Notes
KDIGO ADPKD Guidelines:
Website
Guideline PDF
Executive Summary PDF
NephJC coverage
Consortium for Radiologic Imaging Studies of Polycystic Kidney Disease (CRISP)
Hy’s Law (Wikipedia) has three components:
ALT or AST by 3-fold or greater above the upper limit of normal
And total serum bilirubin of greater than 2× the upper limit of normal, without findings of cholestasis (defined as serum alkaline phosphatase activity less than 2× the upper limit of normal)
And no other reason can be found to explain the combination of increased aminotransferase and serum total bilirubin, such as viral hepatitis, alcohol abuse, ischemia, preexisting liver disease, or another drug capable of causing the observed injury
Meeting this definition yields a very high risk of fulminant kidney failure (76% in one series)
Clinical Pattern of Tolvaptan-Associated Liver Injury in Subjects with Autosomal Dominant Polycystic Kidney Disease: Analysis of Clinical Trials Database (PubMed) Two of 957 patients on tolvaptan met Hy’s law criteria. None had fulminant kidney failure.
Effects of Hydrochlorothiazide and Metformin on Aquaresis and Nephroprotection by a Vasopressin V2 Receptor Antagonist in ADPKD: A Randomized Crossover Trial (PubMed) Patients had a baseline urine volume on tolvaptan of 6.9 L/24 h. Urine volume decreased to 5.1 L/24 h with hydrochlorothiazide and to 5.4 L/24 h on metformin.
TEMPO 3:4 Tolvaptan in Patients with Autosomal Dominant Polycystic Kidney Disease (NEJM)
Reprise Trial Tolvaptan in Later-Stage Autosomal Dominant Polycystic Kidney Disease ( NEJM | NephJC )
Unified ultrasonographic diagnostic criteria for polycystic kidney disease by Edelstein in JASN (PubMed)
Tolvaptan and Kidney Function Decline in Older Individuals With Autosomal Dominant Polycystic Kidney Disease: A Pooled Analysis of Randomized Clinical Trials and Observational Studies (PubMed)
Charles’ draft choice Recommendation 4.1.1.1: We recommend initiating tolvaptan treatment in adults with ADPKD with an estimated glomerular filtration rate (eGFR) ‡25 ml/min per 1.73 m2 who are at risk for rapidly progressive disease (1B).
Sophia’s draft choice Recommendation 1.4.2.1: We recommend employing the Mayo Imaging Classi cation (MIC) to predict future decline in kidney function and the timing of kidney failure (1B).
Progression to kidney failure in ADPKD: the PROPKD score underestimates the risk assessed by the Mayo imaging classification (Frontiers of Science)
AC’s draft choice Recommendation 9.2.1: We recommend targeting BP to ≤ 50th percentile for age, sex, and height or ≤ 110/70 mm Hg in adolescents in the setting of ADPKD and high BP (1D).
HALT-PKD Blood Pressure in Early Autosomal Dominant Polycystic Kidney Disease (NEJM)
Nayan’s draft choice Recommendation 6.1.2: We recommend screening for ICA in people with ADPKD and a personal history of SAH or a positive family history of ICA, SAH, or unexplained sudden death in those eligible for treatment and who have a reasonable life expectancy (1D).
Screening for Intracranial Aneurysms in Patients with Autosomal Dominant Polycystic Kidney Disease (CJASN)
Surgical Clipping Versus Endovascular Coiling in the Management of Intracranial Aneurysms (PubMed) Clipping is associated with a higher rate of occlusion of the aneurysm and lower rates of residual and recurrent aneurysms, whereas coiling is associated with lower morbidity and mortality and a better postoperative course.
Joel’s editorial pick Recommendation 6.1.1: We recommend informing adults with ADPKD about the increased risk for intracranial aneurysms (ICAs) and subarachnoid hemorrhage (1C).
Joel’s first draft pick The bring out your dead pick:
Recommendation 4.3.1: We recommend not using mammalian target of rapamycin (mTOR) inhibitors to slow kidney disease progression in people with ADPKD (1C).
Recommendation 4.4.1: We suggest not using statins specfiically to slow kidney disease progression in people with ADPKD (2D).
Recommendation 4.5.1: We recommend not using metformin specifically to slow the rate of disease progression in people with ADPKD who do not have diabetes (1B).
Recommendation 4.6.1: We suggest that somatostatin analogues should not be prescribed for the sole purpose of decreasing eGFR decline in people with ADPKD (2B).
Perfect match: mTOR inhibitors and tuberous sclerosis complex (Orphanet Journal of Rare Diseases)
Navitor Pharmaceuticals Announces Janssen Has Acquired Anakuria Therapeutics, Inc. (BioSpace) This is press release about acquiring the mTor1 inhibitor.
Joel’s second draft pick Recommendation 4.2.1.1: We suggest adapting water intake, spread throughout the day, to achieve at least 2–3 liters of water intake per day in people with ADPKD and an eGFR ≥ 30 ml/min per 1.73 m2 without contraindications to excreting a solute load (2D).
Nayan’s bonus draft Practice Point 4.7.1: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) should not be used to slow eGFR decline in people with ADPKD.
Open-Label, Randomized, Controlled, Crossover Trial on the Effect of Dapagliflozin in Patients With ADPKD Receiving Tolvaptan (KIReports)
SMART Trial of GLP-1ra in non-diabetics: Semaglutide in patients with overweight or obesity and chronic kidney disease without diabetes: a randomized double-blind placebo-controlled clinical trial (PubMed)
Tubular Secretions
Nayan: Landman on Paramount Plus (IMDB)
Sophia: Pass
Nayan: steps in with The Pitt on HBO (Wikipedia)
Charles: The White Lotus, Yellowstone 1923, Poirot (IMDB)
AC: The Pitt
Michael Crichton’s Estate Sends The Pitt to the Courtroom (Vulture)
Joel: I Must Betray you by Ruta Sepetys (Amazon)
The Filtered Fragments (OG Filtrate)
Joel Topf
Jennie Lin
Swapnil Hiremath
Special Guest
Brad Rovin GN God and second author from The Ohio State
Koyal Jain GN Specialist from UNC
Alfred Kim Rheumatologist from Washington University
Editing by
Simon Topf and Nayan Arora
The Kidney Connection written and performed by by Tim Yau
Show Notes
Joel’s monologue One of the most surprising facts of nephrology is that despite conventional wisdom that lupus nephritis is an antibody mediated disease, that over a decade ago, the LUNAR investigtors were unable to find a significant benefit when rituximab was added to conventional therapy. And this was after the equally negative phase 2 trial of rituximab, EXPLORER.
In fact, despite this finding rituximab has been able to burough its way into treatment of many nephrologists and rheumatologists as well as the KDIGO guidelines where it is suggested for patients with persistent disease activity or inadequate response to initial standard-of-care therapy.
This long conflict is now coming to an end. Obinutuzumab, a newer, better monoclonal antibody targeting the same CD20 that we grew to love with rituximab, but it has a number of advantages.
One. It is humanized antibody rather than a chimeric mouse-human antibody
Two. It’s cytotoxicity is not complement dependent an particular advantage if you want to deploy it ina disease where hypocomplementemia is a disease characteristic
Three, and most importantly, it causes stronger and deeper b-cell depletion than rituximab. Better B-cell depletion in the blood and tissue.
And this brings us to tonight’s topic, we had already seen the phase two results of obinutuzumab which, unlike EXPLORER, were positive, we will look at the phase three regency trial. This makes the third novel lupus nephritis drug in the last 4 years. We continue to remake glomerular nephritis.
LUNAR: Efficacy and safety of rituximab in patients with active proliferative lupus nephritis: the Lupus Nephritis Assessment with Rituximab study Pubmed
EXPLORER: Efficacy and safety of rituximab in moderately-to-severely active systemic lupus erythematosus: the randomized, double-blind, phase II/III systemic lupus erythematosus evaluation of rituximab trial Pubmed
REGENCY: Efficacy and Safety of Obinutuzumab in Active Lupus Nephritis NEJM | NephJC
NOBILITY: B-cell depletion with obinutuzumab for the treatment of proliferative lupus nephritis: a randomised, double-blind, placebo-controlled trial Annals of Rheumatic Disease
Comparison of intravenous and subcutaneous exposure supporting dose selection of subcutaneous belimumab systemic lupus erythematosus Phase 3 program PubMed Central
Class 5 lupus nephritis is slow to respond Long-term Use of Voclosporin in Patients with Class V Lupus Nephritis: Results from the AURORA 2 Continuation Study ACR Meeting abstract
Tubular Secretions
Swap: Young Adult novel I Must Betray You by Ruta Sepetys (Amazon)
Koyal: Taekwondo (Wikipedia)
Jennie: these unprecedented times Trump NYT: Administration Freezes $1 Billion for Cornell and $790 Million for Northwestern, Officials Say
Al: Acquired Podcast
Brad: The Feather Thief by Kirk Wallace Johnson (Amazon)
Joel: Paradise on Hulu (Wikipedia)
The Filtrate
Joel Topf
Jordy Cohen
Nayan Arora
Special Guest
Katie Kwon @katiekwonmd.bsky.social
Mariana Murea @MarianaMurea
Editing by
Simon Topf and Joel Topf
Show Notes
NephMadness at AJKDblog.org
The Hemodialysis Region
Vote for your favorites
The Filtrate
Joel Topf
Swapnil Hiremath
AC Gomez
Sopia Ambruso
Nayan Arora
Special Guests
Michelle Rheault, Director, Division of Pediatric Nephrology, Professor of Medicine
Tiffany Caza, Nephropathologist, Scientist and self-described Freely Filtered fan girl
Editing by
Simon Topf and Sophia Ambruso
Show Notes
-
Healthcare Cyberattacks
-
ApoE in C3 glomerulonephropathy
-
Workforce woes in Adult and Pediatric Nephrology
-
Hyponatremia correction meta-analysis
-
Microvascular inflammation increases risk of graft loss - in all of its forms
-
Xenotransplantation
-
KDIGO CKD Guidelines
-
Hypertension control trials (ESPRIT, BPROAD)
-
The Renaissance of IgAN: IgAN treatment trials
-
FLOW: GLP-1 RAs in CKD
The Filtrate
Joel Topf
Swapnil Hiremath
AC Gomez
Jordy Cohen
Nayan Arora
Special Guest
Brendon Nuen
Editing by
Simon Topf and Nayan Arora
Show Notes
FINEARTS-HF in NEJM
FINEARTS Kidney outcomes in JACC
FINE-HEART pooled analysis of cardiovascular, kidney and mortality outcomes in Nature Medicine discussion in NephJC
BARACH-D: Low-dose spironolactone and cardiovascular outcomes in moderate stage chronic kidney disease: a randomized controlled trial (Nature Medicine)
Live Freely Filtered at KidneyWk
Swapnil comes out as a SpiroStan post to NephJC
TOPCAT
TOPCAT primary publication
TOPCAT North American results
TOPCAT funny business explained
AHA/ACC/HFSA Heart Failure Guidelines (PDF)
SGLT2i are 2a
MRA are a 2b
ARBs are a 2b
ARNI are a 2b
Clinical Phenogroups in Heart Failure With Preserved Ejection Fraction: Detailed Phenotypes, Prognosis, and Response to Spironolactone
Kansas city cardiomyopathy questionnaire in patients with CKD without a diagnosis of heart failure: https://pubmed.ncbi.nlm.nih.gov/21187260/
GFR slope with steroidal MRAs in HF: https://onlinelibrary.wiley.com/doi/10.1002/ejhf.2635
Why Has it Been Challenging to Modify Kidney Disease Progression in Patients With Heart Failure? (JACC)
Tubular Secretions
Swap: Disclaimer on Apple TV
AC: Duo Lingo Plushy (Amazon)
Nayan: The Puzzle Box
Jordy: Project Hail Mary
Brendon has a podcast, The Kidney Compass with Shikha Wadhwani. And he recommends singer-songwriter, Maggie Rogers (YouTube)
Joel: The Singularity Is Nearer: When We Merge with AI by Ray Kurzweil
Closing music, Tim Yau with The Kidney Connection
The Filtrate:
Joel Topf
Swapnil Hiremath
With Special Guest:
Michelle Hladunewich, Nephrologist at the University of Toronto
Mir Melamed, Maternal-Fetal Medicine at the University of Toronto
Editor
Simon Topf
Show Notes
Priscilla Smith’s letter:
Dear Joel and the Freely Filtered team,
I am a long-time fan of your podcast and was looking forward to hearing your recently aired discussion of the Praecis study of sflt1:PlGF use in preeclampsia. Preeclampsia and renal disease in pregnancy are areas that many nephrologists report a lack of knowledge or confidence in discussing and managing. I am a nephrologist who has been co-leading a renal pregnancy clinic in London while writing a PhD on progression of renal disease in pregnancy. I have had the immense privilege of working with experts and key opinion leaders in preeclampsia research both in the UK and internationally. As you know, preeclampsia is a serious and significant condition contributing to global maternal mortality and is also associated with future CKD and CVD risk so is both relevant and important within our professional group.
Sadly, I found myself disappointed by the episode and felt it was a missed opportunity. I appreciate that you had difficulties obtaining appropriate experts to join the discussion, but perhaps it would have been better to delay production. While you all valiantly proceeded to discuss this important study, the topic is complex and there appeared to be a lack of understanding of the surrounding literature and pathogenesis of preeclampsia. Sadly, the maternal medicine expert’s comments at the end of the podcast added little as she seemed determine to negate any benefit from the results despite declaring she had no experience or expertise in the use of these biomarkers.
There are many people who understand the clinical aspects of preeclampsia as well as having direct experience of the use and utility of these biomarkers who would have been able to contribute much to your conversation. I look forward to future discussions of renal disease in pregnancy on your podcast and would be happy to suggest some expert panellists if you ever find yourself stuck.
Kind regards,
Priscilla
Excess placental soluble fms-like tyrosine kinase 1 (sFlt1) may contribute to endothelial dysfunction, hypertension, and proteinuria in preeclampsia (JCI 2003)
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)
We had a great NephJC get together. We recorded the whole event and packaged it into a podcast.
Musical entertainment
Tim Yau (@Maximal_Change)
Too Sweet by Hozier
Fairy Tale of New York by written Jem Finer and Shane MacGowan. Hear it performed by the Pogues.
Interview of Tom Mueller
Tom Mueller author of How to Make a Killing
Jade Teakall@jmteakell
Graham Abra@GrahamAbra
Interview of Tom Mueller
Tom Mueller author of How to Make a Killing
Jade Teakall @jmteakell
Graham Abra @GrahamAbra
NephMadness logo reveal
NephJC Kidneys
NephJC blog post
NephJC Manuscript of the Year: Flow accepted by Meg Jardine
Manjula Kurella Tamura, winner of the 2015 NephMadness, oh and author of NEJM manuscripts and subject of a NYT article.
NephJC Visual Abstract of the Year: Corina Teodusiu, creator of the Flozinator logo
NephJC Social Justice Award: ISN petition to the WHO on Kidney Health
Most Engaged Scientist Award: Michelle Rheault
Rookie of the Year: Milagros Flores
MVP: Christina Popa
NephJC Founders Award: Joshua Waitzman
Nathan Hellman Social Media Project of the Year: Edgar Lerma and the ASN Visual Abstract Team
More Music with Tim
Saginaw, Michigan as performed by Johny Cash
Betty, written by Taylor Swift
The Kidney Connection
Freely Filtered Kidney Week Draft
Previous drafts
2021 ASN Kidney Week Draft
2022 ASN Kidney Week Draft
2023 ASN Kidney Week Draft
List of all the simultaneous publications from Kidney Week 2024
Sophia: SMART Trial (Link goes to the new KidneyCompass podcast that interview lead author Hiddo Heerspink
Jordy’s editorial in the European Heart Journal. Link
Josh: APPLAUSE Alternative Complement Pathway Inhibition with Iptacopan in IgA Nephropathy in the NEJM
APPLAUSE results announcement at The World Congress of Neophrology in Buenos Aries
Iptapocan is a factor B inhibition
Jordy: POISE-3 with simultaneous publication in KI
Mentions she wanted to pick KAT-AKI because she worked with Perry Wilson.
Per Nayan, Amit Garg is the Beyonce of Nephrology
Accord Trial (NEJM)
Joel: HSK21541 for Pruritus
Correction link to source (graph)
Nayan: FINEARTS-HF with simultaneous publication in JACC
BARACH-D: Low-dose spironolactone and cardiovascular outcomes in moderate stage chronic kidney disease: a randomized controlled trial (Nature Medicine)
Swapnil comes out as a SpiroStan
TOPCAT funny business
PATHWAY-2 Trial (NephJC coverage)
Swap: K Bath and cardiac arrhythmia with simultaneous publication in Kidney International
CAST: A study that rocked the cardiology world and became the poster child for evidence-based medicine (Link)
Tubular Secretions
Swap: Late breaking and high impact sessions
Nayan: Intro to…
Joel: Student poster on blood pressure technique
Jordy: The Penguin. A couple of mentee posters
Sophie: Tracks her sessions on paper.
Josh: Quiz and Questionaire session with JC Velez, Bea Concepcione, Anna Burgner, Roger Rodby.
The Filtrate:
Jennie Lin
Joel Topf
Josh Waitzman
Swapnil Hiremath
With Special Guests
Pedro Teixeira
Jay Koyner
Editor
Sophia Ambruso
Show Notes
The article: A Randomized Trial of Intravenous Amino Acids for Kidney Protection
NephJC Summary
KDIGO 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 Secretions
Swapnil 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 Ambruso
Nayan Arora
Swapnil Hiremath
AC Gomez
Joel Topf
Editor
Nayan Arora
Show Notes
Previous drafts:
2021 KDIGO Hypertension —Joel, Sophia, Swap, Nayan, Josh
2021 ASN Kidney Week Draft—Joel, Sophia, Swap, Nayan, Jennie
2022 The ISPD Peritonitis Guideline— Joel, Sophia, Swap, Nayan
2022 ASN Kidney Week Draft—Joel, Sophia, Swap, Nayan
2023 ASN Kidney Week Draft—Joel, Sophia, Swap, Nayan, AC, Josh
2024 KDIGO CKD Clinical Practice Guideline —Joel, Sophia, Swap, Nayan, Josh, AC
The guideline
The NephJC discussion Part 1 | Part 2
First Round
Sophia’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 Week
The 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), or
heart 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 Tangri
Second Round
Joel’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 NEJM
Timing of dialysis initiation to reduce mortality and cardiovascular events in advanced chronic kidney disease: nationwide cohort study NephJC
Nayan’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 3.6.5
Practice 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.
and
Practice 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 BakerNarrated by David Duchovny
AC Rosie Revere, Engineer
Sophia Bassnectar
How to fix the Apple Music automatically playing when you connect to bluetooth.
Joel The Veil with Elizabeth Moss
The Filtrate:
Joel Topf
Josh Waitzman
With 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 Carolina
Roger Rodby (@NephRodby) Associate program director of the Rush University Nephrology Fellowship
Editor
Sophia Ambruso
Show Notes
The manuscript (The Lancet | PubMed | NephJC)
The Results of Part A (Kidney Int | PubMed)
Edmund (Ed) Louis memorium by Steve Korbet in KI
Steve Korbet Do not miss this tweet
TESTING Freely Filtered #48 with Sean Barbour
Iptapocan 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 Study
FDA 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 NephJC
Repeat 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 kidney
One 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 Topf
Swapnil Hiremath
Josh Waitzman
Nayan Arora
Sophia Ambruso
With Special Guest:
Brendon Neuen Super smart guy and clinical trialist
Vlado Perkovic Lead author of FLOW and friend of NephJC
Editor
Joel Topf
Show Notes
The manuscript (NEJM): Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes
The 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 Box
Brendon’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: Bodkin
NephJC Summer Book Club: Covenant of Water by Abraham Verghese (Amazon)
The Filtrate:
Joel Topf
Swapnil Hiremath
AC Gomez
Nayan Arora
With 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 Arora
Show Notes
CHIP 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 PodCrawl
Bene Gesserit (Wikipedia)
Pathogenesis of preeclampsia: the genetic component (PubMed)
Tubular Secretions
Swap Slow Horses on Apple TV (Wikipedia)
AC Hidden Figures (Amazon)
Nayan Baseball, little league
Anuja Young Sheldon (Wikipedia)
Joel Dune audiobook (Amazon)
The Filtrate:
Joel Topf
Swapnil Hiremath
Priya Yenebere
Nayan Arora
With Special Guest:
Brendon Neuen Super smart guy and clinical trialist
Michelle Rheault Lead author of DUPLEX and friend of the pod
Show Notes
Sparsentan versus Irbesartan in Focal Segmental Glomerulosclerosis
NephJC Summary | PubMed | NEJM
KDIGO 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 Secretions
Swapnil Foundation season two on Apple TV Wheel of Time season two Amazon Prime
Brendon Andor
Priya Poverty, by America Mattew Desmond
Nayan The Armor of Light: A Novel by Ken Follett
Michelle Lessons in Chemistry: A Novel by Bonnie Garmus
The Filtrate:
Joel Topf
Swapnil Hiremath
Jordy Cohen
AC Gomez
With Special Guest:
Tim Anderson @TimAndersonMD
Editor:
Priya Yenebere
Show Notes
Clinical Outcomes of Intensive Inpatient Blood Pressure Management in Hospitalized Older Adults
NephJC Summary | PubMed | JAMA Internal Medicine
The 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 secretions
Swap 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 Region
NephMadness description by Tiffany Truong
Editorial by Kelly Hyndman @DrKeeksPhD They May Look Cute, But Are All Animals Sweet?
The Filtrate:
Joel Topf
Swapnil Hiremath
Sophia Ambruso
Josh Waitzman
With Special Guest:
Kelly Hyndman
Editor:
Sophia Ambruso
Show Notes
Animal 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 Secretions
Swap: 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’t
Amazon
The Filtrate:
Joel Topf
Josh Waitzman
Jennie Lin
With Special Guest:
Jade Teakell
Perry Wilson
Editor:
Joel Topf
Show Notes
Understanding Medical Research: Your Facebook Friend is Wrong. Coursera
Illusory 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 Secretions
Josh: 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 Topf
Nayan Aurora
Sophia Ambruso
With Special Guest:
Michael Collins
Editor:
Nayan Aurora
Show Notes:
Twitter is now X (NYT)
Michael Collins (the astronaut, not the real one)
PlasmaLyte by Baxter
NephJC BEST Fluids summary
Early Goal Directed Therapy for Sepsis NEJM manuscript which changed practice patterns and welcomed in an era of massive fluid resuscitation.
PLUS Trial NEJM
SPLIT Trial JAMA
BaSICS NephJC Summary
SALTED and SMART NephJC Summary
Adaptive minimization wikipedia
BEST Fluids statistical plan
BEST Fluids in CLinicalTrials.gov
Delayed Graft Function review in American Journal of Transplant
Balanced Crystalloids versus Saline in Critically Ill Adults — A Systematic Review with Meta-Analysis in NEJM Evidence
A pragmatic, open-label, randomized controlled trial of Plasma-Lyte-148 versus standard intravenous fluids in children receiving kidney transplants (PLUTO) in Kidney International
Tubular Secretion
Nayan finally getting around to Succession on HBO
Sophia autoimmune protocol diet
Hawthorne Effect
Michael Stephen Fry reading Harry Potter
The Filtrate:
Joel Topf
Swapnil Hiremath
Sophia Ambruso
AC Gomez
Josh Waitzman
Jennie Lin
Nayan Arora
The Curbsiders
Matt 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 Signs
Michelle Rheault (@rheault_m) Chief of Pediatric Nephrology at the University of Minnesota and lead author of the DUPLEX Trial
Editor:
Joel Topf
Show 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 release
MENTOR, 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 Topf
Swapnil Hiremath
Sophia Ambruso
AC Gomez
With 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 Topf
Show Notes:
Late Braking and High Impact Clinical Trial press release
JAMA Internal Medicine
MyTEMP 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, PhD
Transplant Ambassador Program
Kidney 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 Secretions
Swapnil 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)
The Filtrate:
Joel Topf
Jennie Lin
Josh Waitzman
With Special Guest:
AC Gomez MedPeds nephrology fellow at Mass General/Brigham and Boston Children’s | Twitter
Gentian Hall Assistant Professor of Medicine Duke Department of Medicine
Editor:
Sophia Ambruso
Show Notes:
APOL1 review by the OG Scientists APOL1 Nephropathy: From Genetics to Clinical Applications
MYH9 and APOL1 connection: The population genetics of chronic kidney disease: insights from the MYH9–APOL1 locus
Martin Pollack Lab
Vertex Lab
Worldwide Frequencies of APOL1 Renal Risk Variants (NEJM)
Kidney Disease-Associated APOL1 Variants Have Dose-Dependent, Dominant Toxic Gain-of-Function
End-Stage Renal Disease in African Americans With Lupus Nephritis Is Associated With APOL1
Apolipoprotein L1 Risk Variants Associate with Systemic Lupus Erythematosus-Associated Collapsing Glomerulopathy
HEK293 Cells Wikipedia
Tubular Secretions
Josh: From Serial and the New York Times: The Retrievals
Jennie: Marathon induced hyponatremia (NEJM)
Donate to the NKF of Illinoise in honor of Jennie’s really long run
Donate to New England Donor Services in honor of Josh’s much shorter ruin
Gentian: Vivien Thomas wikipedia. HBO Movie: Something the Lord Made
AC: Talking to the FDA about SGLT2i Tweet
Joel: NephJC 2023 Fund drive
Bicarbonate did not slow the loss of GFR in this well done Swiss, single-blind study of transplant patients.
The Filtrate:
Joel Topf
Nayan Arora
Swapnil Hiremath
Pirya Yenebere
With Special Guest:
Nav Tangri nephrologist and epidemiology at the University of Manitoba
Editor:
Nayan Arora
Show Notes:
Arsenal FC
The 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 negative
BiCARB 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 Study
Wesson, 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)31388-1
The 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 trial
NephJC | 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 Secretions
Swap The Three-Body Problem (novel) | Netflix
Nayan Women’s World Cup
Tangri English Premier Soccer and Inflation
Priya Silo on Apple TV
Joel Live Podcast recording at ASN Kidney
The Filtrate:
Joel Topf
Nayan Arora
Sophia Ambruso
With 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. Link
Editor:
Priya Yenebere
Show Notes:
Diuretic Therapy review by. Craig Brater NEJM
The manuscript in JAMA | NephJC
Metoprolol 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 Trial
Effects of Oral Tolvaptan in Patients Hospitalized for Worsening Heart Failure The EVEREST Outcome Trial
Sophia ended up placing fifth in NephMadness 2023. (Link)
Joel finished 697th
After 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 Secretions
Nayan: Louise Penny A World of Curiosities: A Novel (Amazon)
Sadiya: Ted Lasso season three
Sophia:The Last of Us on HBO and SNL skit Mario Cart as Prestige Drama
Boback: Duolingo for Japanese
The Filtrate:
Joel Topf
Swapnil Hiremath
Josh Waitzman
Nayan Arora
Sophia Ambruso
With Special Guest:
Megan Prochaska Assistant professor of medicine at University of Chicago
John Asplin Medical Director Consultant LithoLink (Twitter)
Editor:
Joel Topf
Show Notes:
The LithoLink website
Stone Camp tweet
Prevention of Repeated Episodes of Kidney Stones in Adults: A Clinical Practice Guideline From the American College of Physicians (link)
NOSTONE in the NEJM and NephJC
Fred Coe Google Scholar | YouTube | Blog
Hypercalcuria. Curhan et al. 24-h uric acid excretion and the risk of kidney stones PubMed
EQUIL2 software to evaluate urinary super saturation
Anna Zisman Racial Differences in Risk Factors for Kidney Stone Formation (CJASN)
Potassium Citrate on GoodRx
Moonstone Nutrition
Potassium 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 Secretions
Swap: Star Wars: Thrawn Series by Timothy Zahn (Penguin Random House)
Josh: Little League
Megan: Renal related podcasts
Sophia Renal Stone Camp and ABCKidney.com
Nayan: Ted Lasso Robert Galbraithand The Comoran Strike Novels (home page)
John: Fred Coe’s Blog
Joel: Spiderman across the Spider-Verse (Wikipedia)
The Filtrate:
Joel Topf
Swapnil Hiremath
Josh Waitzman
Jordy Cohen
With Special Guest:
Areef ishani lead author and Chief of Medicine VA Minneapolis
Editor:
Nayan Arora
Show 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, ACCOMPLISH
Diuretic half-lifes NEJM review
Edarbyclor: Azilsartan and Chlorthalidone $240/month as per GoodRx
Nice 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 chlorthalidone
Antihypertensive efficacy of hydrochlorothiazide vs chlorthalidone combined with azilsartan medoxomil by George Bakris
Synopsis 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 Cohen
Study 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 Secretions
Swapnil Louise Penny author of book upon which the Amazon Prime series, Three Pines is based on.
Jordy Last of Us series on HBO
Josh Channel Your Enthusiasm A Very Special Episode: Meet the Glaucomfleckens
Areef The Body: A Guide for Occupants
Joel NephMadness (this did not age well)
The Filtrate:
Joel Topf
Swapnil Hiremath
Josh Waitzman
Sophia Ambruso
With 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 Ambruso
Show Notes:
NephMadness 2023: Thrombotic Microangiopathy Region
TMA Review article in the NEJM from 2014: Syndromes of Thrombotic Microangiopathy
Dr. Anuja Java Co-chairs Working Group in an International Committee for Revising aHUS Nomenclature
Nephrology Secrets 4th Edition at Amazon
University of Iowa Genetic testing for aHUS
Early 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 Discovery
NephMadness Podcrawl
Tubular Secretions
Swap: Neuromancer and the works of William Gibson (@GreatDismal)
Sophia: The Magicians on Netflix
Anna: Recommends nephrology. Says it is awesome.
Anuja: Dope Sick on Hulu and Women in Nephrology mentor program
Josh: Mobituaries with Mo Rocca. Specifically “Death of a Banana”
Joel: Ivory by TapBot
Welcome to the NephMadness PodCrawl
The 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 antagonists
Core IM will be covering Kidney Transplant in their classic Five Pearl format
The CardioNerds will be covering the effect of Heart Failure Devices on Kidney Health
Freely Filtered will try to understand thrombotic microangiopathy
ISN Global Kidney Care goes deep on IgA nephropathy
The 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 Onconephrology
And finally, The Nephron Segment looks at Transgender Health and CKD
The Filtrate:
Joel Topf
Swapnil Hiremath
Nayan Arora
Sophia Ambruso
With Special Guest:
Amit Garg @AmitXGarg, Nephrologist at Western University, London, and lead PI of the MYTEMP trial.
Editor:
Joel Topf
Show Notes:
MyTEMP in pubmed: Personalised cooler dialysate for patients receiving maintenance haemodialysis (MyTEMP): a pragmatic, cluster-randomised trial
MyTEMP Summary on NephJC
It’s really cold in Ontario
The NephTrials blog summary on Pragmatic Trials
The pragmatic TiME trial on longer time on dialysis (ahem, sabotaged by site investigators like Joel who cut dialysate time) Dember et al in JASN
Poor 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 NDT
47% of centres from a DOPPS study of 273 centers routinely use of lower dialysate temperature, Dasgupta et al in JASN
How 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 CJKHD
How 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 Med
Peritoneal dialysis numbers in Ontario are high, Blake et al in PDI, though with ~ 60% CVC rates, Blake et al in Kidney360
Dialysate Magnesium #DreamRCT from Swap, NephTrials discussion of DialMag
Statistical analysis plan of MyTEMP, Dixon et al in CJKHD
Tubular Secretions
Swap: Watch Everything, Everywhere All At Once on Prime
Nayan: 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 Denver
Amit: The wrestling team at Western U from 1990-91
Joel: House of the Dragon on HBO Max
The Filtrate:
Joel Topf
Swapnil Hiremath
Jordy 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 Disease
STOP-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 disease
Efficacy and Safety of Benazepril for Advanced Chronic Renal Insufficiency: NEJM
Dr. 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 rate
Strong opinions, loosely held.
“Permissive AKI” with treatment of heart failure. Editorial by Chirag Parish and Steven Coca
The rational for NICE avoiding RASi in black patients: Hypertension and ethnic group
AASK trial showing superiority of RASi in African Americans. JAMA
ALLHAT post-hoc analysis of outcomes by self-reported race. JAMA | PubMed
Sophisticated Swedish observational study that Swap loved. Stopping Renin-Angiotensin System Inhibitors in Patients with Advanced CKD and Risk of Adverse Outcomes: A Nationwide Study
Target Trials in Nephrology Dr Edouard Fu grand rounds at Ottawa Nephrology, YouTube
Target Trial EmulationA Framework for Causal Inference From Observational Data by Miguel Hernán in JAMA
Tubular Secretions
Jordy: Third season of His Dark Materials on HBO
Swap: Movies by Wes Anderson on Disney Plus
Laurie: 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 | Amazon
Joel EO | NYT Review
The Filtrate:
Joel Topf
Swapnil Hiremath
Josh Waitzman
Sophia Ambruso
Priya Yenebere
With Special Guest:
Brendon Neuen, Secretariat of the SGLT2 Trialists Consortium and cool guy on Twitter.
Editor:
Sophia Ambruso
Show 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 SGLT2i
EMPA-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 Caution
Click 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 Cr
Usability 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 Agency
The Peripheral on Amazon Prime
Unsealed the Tylenol Murders Podcast
Project Hail Mary by Andrew Weir
Lizzy McAlpine Singer Song Writer
Rachel Maddow Presents: Ultra
Twitter chaos continues. Get your Med-Mastodon handle
The Filtrate:
Joel Topf
Swapnil Hiremath
Nayan Arora
Sophia Ambruso
Editor:
Nayan Arora
Show Notes:
Joel’s Conflict of Interest Statement
The 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 Pharmaceuticals
The CONFIRM Trial Terlipressin plus Albumin for the Treatment of Type 1 Hepatorenal Syndrome in NephJC
Clinical Practice Session Leveraging Social Media to Create, Learn, Teach, Advocate, and Dispel Misinformation
The 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 up
Stop ACEi
CLARITY Angiotensin receptor blockers for the treatment of covid-19: pragmatic, adaptive, multicentre, phase 3, randomised controlled trial
Effects of Pantoprazole on Kidney Outcomes: Post Hoc Analyses From the COMPASS Randomized Controlled Trial by Lonnie Pyne, et al
No Stone: Hydrochlorothiazide for the Prevention of Kidney Stone Recurrence by Daniel Foster, et al
MyTEMP: Personalised cooler dialysate for patients receiving maintenance haemodialysis (MyTEMP): a pragmatic, cluster-randomised trial
Clinical 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 Nephrology
Attracting Osteopathic Medical Students Into Nephrology
Hasan Minhaj’s joke at the expense of DOs
TRANSFORM-HF: Torsemide vs. Furosemide in Treating Patients With HF
Point-of-Care Ultrasound in Nephrology specifically VExUS
The Filtrate:
Joel Topf
Jordy Cohen
Nayan Arora
Sophia Ambruso
Special 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:
-
Sotagliflozin in Patients with Diabetes and Recent Worsening Heart Failure (SOLOIST-WHF Trial)
-
The SGLT2 inhibitor empagliflozin in patients hospitalized for acute heart failure: a multinational randomized trial (The EMPULSE Trial)
-
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 Review
Cardiologist Sues Epic Over Copyright Infringement
Outcomes 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 Topf
Swapnil Hiremath
Nayan Arora
Priya Yenebere
Special 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 NephJC
Linazolid 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 Creatinine
Vancomycin-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 Sepsis
Proposed 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 Open
Applications 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 study
Protective effect of piperacillin against nephrotoxicity of cephaloridine and gentamicin in animals
PulmCrit – Myth-busting the conditional nephrotoxicity of piperacillin-tazobactam by Josh Farkas
Sharp Objects on Good Reads
Bandon Dunes
The Ocean Course at Kiawah Island Golf Resort
Be Real follow me: BeRe.al/kidney_boy
SNL spoof of BeReal
The Filtrate:
Joel Topf
Swapnil Hiremath
Jennie Lin
Special 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 Yenebere
Show 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 Patients
Med-Peds to Nephrology
Early Goal-Directed Therapy in the Treatment of Severe Sepsis and Septic Shock by Emanuel Rivers
ProMISe: Trial of Early, Goal-Directed Resuscitation for Septic Shock
ARISE: Goal-Directed Resuscitation for Patients with Early Septic Shock
ProCESS: 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 concepts
Comparison 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 Patients
Lactate conversion MediCalc
The 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 parameters
Critical Care Reviews Podcast: CLASSIC Trial Results Presentation
What is the most George Constanza-esque reason you broke up with someone? (reddit)
Bonferroni correction
The Importance of Fluid Management in Acute Lung Injury Secondary to Septic Shock
Restrictive versus Liberal Fluid Therapy for Major Abdominal Surgery in the NEJM. RELIEF, NephJC discussion
Effect of an Early Resuscitation Protocol on In-hospital Mortality Among Adults With Sepsis and Hypotension: A Randomized Clinical Trial in JAMA
FEAST Trial: Mortality after Fluid Bolus in African Children with Severe Infection
Rings of Power on Amazon Prime
Why the Hobbit trilogy sucked
Industry on HBO
Sandman 2022 on Netflix
Where 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 Nephrology
Continuous KRT: A Contemporary Review by J. Pedro Teixeira, Javier A. Neyra and Ashita Tolwani
University 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 Topf
Swapnil Hiremath
Josh Waitzman
Sophia Ambruso
Special 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. Link
Editor: Sophia Ambruso
Donate to NephJC
Get 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-fan
If 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 mg
Meta analysis of high versus low sodium diet pulled from Heart due to duplicated and missing data. Retraction Watch.
65 mmol of sodium is 1500 mg
The 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 diuretics
PREDIMED 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) Diet
Medical Therapy for Heart Failure With Reduced Ejection Fraction: The CHAMP-HF Registry
Interpreting 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 disease
Cardiologist Sues Epic Over Copyright Infringement
6-minute walking test: a useful tool in the management of heart failure patients
Frank Harrell on Statistical Errors in the Medical Literature
ANCOVA versus change from baseline: more power in randomized studies, more bias in nonrandomized studies
A-HeFT: Combination of Isosorbide Dinitrate and Hydralazine in Blacks with Heart Failure
TOPCAT: Spironolactone for Heart Failure with Preserved Ejection Fraction
SSaSS: Effect of Salt Substitution on Cardiovascular Events and Death
Mini 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 Covid
For All Mankind (TV series)
The Filtrate:
Joel Topf
Swapnil Hiremath
Josh Waitzman
Jordy Cohen
Special Guest:
Sean Barbour. Clinical Associate Professor, Division of Nephrology, University of British Columbia Chair, BC Glomerulonephritis Committee and Network, BC Renal
Editor:
Joel Topf
Show 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 JAMA
STOP-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 Wikipedia
Prior 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 nephropathy
Another, earlier, Italian study: Corticosteroids in IgA nephropathy: a randomised controlled trial
Chinese study: Combination therapy of prednisone and ACE inhibitor versus ACE-inhibitor therapy alone in patients with IgA nephropathy: a randomized controlled trial
Original 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 5
A 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!
Treif
Geographic Differences in Genetic Susceptibility to IgA Nephropathy: GWAS Replication Study and Geospatial Risk Analysis
The MEST score provides earlier risk prediction in lgA nephropathy
DAPA-IgA: A pre-specified analysis of the DAPA-CKD trial demonstrates the effects of dapagliflozin on major adverse kidney events in patients with IgA nephropathy
Swap and Josh fight about SGLT2i in IgA Nephropathy
Significance 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 Swap
Star Trek: Strange New Worlds
Origins of Renal Physiology: Fellows 2022
Medical Students: Kidney TREKS
Application of the International IgA Nephropathy Prediction Tool one or two years post-biopsy (Kidney International)
The Triple Crown in Virginia
The Filtrate:
Joel Topf
Nayan Arora
Sophia Ambruso
Swapnil Hiremath
Josh Waitzman
Special Guest:
Natalie BelloDirector of Hypertension Research at Cedars Sinai
Editor:
Nayan Arora
Show Notes:
NephJC summary of CHAP
CHiPS TV show
CHIPS study: Less-Tight versus Tight Control of Hypertension in Pregnancy
Prevention, 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) Study
Meta-analysis showing treating blood pressure in pregnancy didn’t help. Antihypertensive drug therapy for mild to moderate hypertension during pregnancy.
The Filtrate:
Joel Topf
Nayan Arora
Sophia Ambruso
Swapnil Hiremath
Special Guest:
Jade Teakall
Jeff Perl, Great Twitter handle, PD_Perls
Editor:
Joel Topf
Show Notes:
ISPD 2022 Peritonitis Guidelines
NephJC Discussion
Dimitrios Oreopoulos obituary in JASN.
Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
The draft board: Google Doc
The 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 Study
Embedded PD catheters: Complications and catheter survival with prolonged embedding of peritoneal dialysis catheters
Nikhil Shah asking questions about fungal prophylaxis
Question 1
Question 2
Icodextrin antibiotic compatibility: Stability and compatibility of antibiotics in peritoneal dialysis solutions or in Tweet Form.
Nikhil Shah on having antibiotics at home
Tweet 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 Cry
ABC Kidney
Home Dialysis University was May 1, 2
The Grand Canyon, second largest hole in the ground.
The Filtrate:
Joel Topf
Joshua Waitzman
Nayan Arora
Jennie Lin
Sophia Ambruso
Special Guest:
Paul A Welling
Editor:
Sophia Ambruso
Show Notes:
NephJC Summary on SSaSS
Paul Welling’s tweetorial on the potassium switch
The 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 Hypertension
Swapnil’s Potassium Trial: Diet or additional supplement to increase potassium intake: protocol for an adaptive clinical trial
When 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-analyses
Effect of lower sodium🧂 intake on health: systematic review and meta-analyses
Estimated population wide benefits and risks in China of lowering sodium through potassium enriched salt substitution: modelling study
FDA Issues Final Guidance Regarding Use of an Alternate Name for Potassium Chloride in Food Labeling
David Ellison and Paul Welling’s reviewing the NEJM: Insights into Salt Handling and Blood Pressure
NephTrials 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 2
Inhibition of nonalcoholic fatty liver disease in mice by selective inhibition of mTORC1: The Paper | The Tweet
Kansas wins March Madness
Work in Josh’s lab. Get in touch: jswaitzm@bidmc.harvard.edu
Open Educational Resources (OER)
NKF Spring Clinical Meeting 2022
Little Podocye
The Filtrate:
Joel Topf
Joshua Waitzman
Nayan Arora
Jordy Cohen
Special Guest:
Josh Mezrich
Editor:
Nayan Arora
Show Notes:
When Death Becomes Life: Notes from a Transplant Surgeon. Amazon
Am J Transplant 2022 Jan 20. doi: 10.1111/ajt.16930. PMID: 35049121
Coverage on NephJC
First 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 pigs
United 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 Transplantation
Patient in Groundbreaking Heart Transplant Dies
Heterotopic heart transplantation: where do we stand?
Denton Cooley and the first artificial heart transplant
For the First Time in North America, a Woman Gives Birth After Uterus Transplant From a Deceased Donor
Blacksburg company raised genetically modified pig for first heart transplant into human
Christiaan Barnard and the first human-to-human heart transplant
Making The Impossible Possible: A Conversation With Martine Rothblatt. The founder of United Therapeutics and SiriusXM
Paige Porrett, M.D., Ph.D. first author
Jayme Locke, M.D., MPH senior author
Louise Penny author page
The Four Questions
Chutzpod!
Joshua Malina, not the new cantor at Temple Israel.
Primitive Technology YouTube Channel
The Filtrate:
Joel Topf
Joshua Waitzman
Nayan Arora
Sophia Ambruso
Jordy Cohen
Special Guest:
Kelly Hyndman
Editor:
Joel Topf
PodCrawl
Monday, 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 Spotify
Tuesday, March 15: The Drs. Washington
The 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 Spotify
Wednesday, March 16: The Cribsiders
On this pediatric podcast, go deep into the Neonatal AKI bracket with the writer, Michelle Starr @mcstarr1.
Listen on Apple or Spotify
Thursday, March 17: Up My Nursing Game
Up 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 Spotify
Friday, March 18: Best Science (BS) Medicine
The 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 Spotify
Saturday, March 19: Freely Filtered
The Filtrate break down the Animal House region with Selection Committee Member Kelly Hyndman @DrKeeksPhD.
Listen on Apple or Spotify
Show 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.
BlueRibbonFail
Marine Iguana Visual Abstract by Sophie
The Octonauts
The Oregon Trail
CRIC Study
Animal House 2022 blog post by Tiffany Truong
Giraffes sleep 4.6 hours a day. Behavioural sleep in the giraffe (Giraffa camelopardalis) in a zoological garden
Tobias Wang
Peter Bie
Gimli the Corgi Giraffe
ManBearPig from South Park
Mike Tyson
Emus, not mammels
Climate Change Threats on Black Bears in California
As Winter Warms, Bears Can’t Sleep. And They’re Getting Into Trouble.
Fat Bear Week has a champion: All hail 480 Otis
Stillsuit in Dune
Freely Filtered 042: Nephrin Antibodies Cause Minimal Change Disease. Wait...What?
A molecular mechanism explaining albuminuria in kidney disease
American Heart Association Hypertension Podcast with Swapnil Hiremath and Carolyn Thomas
Link to all the AHA podcasts
The Trojan horse Affair podcast
Curbsiders #321 Hypertension FAQ with Jordy Cohen
The Alpinist
The Filtrate:
Joel Topf
Jennie Lin
Joshua Waitzman
Nayan Arora
Sophia Ambruso
Special Guest:
Astrid Weins (@AstridWeins) renal pathologist at the Brigham and Woman’s Hospital and Harvard Medical School
Editor:
Nayan Aurora
Show 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 disease
New Views of the Glomerulus: Advanced Microscopy for Advanced Diagnosis
Imaging of the Porous Ultrastructure of the Glomerular Epithelial Filtration Slit
Autoantibodies against podocytic UCHL1 are associated with idiopathic nephrotic syndrome relapses and induce proteinuria in mice
Fishing Expedition
Koch's postulates
Measles in the Nephrotic Syndrome
NEPTUNE: NEPhrotic syndrome sTUdy NEtwork
Congenital nephrotic syndrome and recurrence of proteinuria after renal transplantation
Most 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-19
Minimal Change Disease After First Dose of Pfizer-BioNTech COVID-19 Vaccine: A Case Report and Review of Minimal Change Disease Related to COVID-19 Vaccine
Dr. 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 Netflix
Cloud Cuckoo Land: A Novel by Anthony Doerr
Winter Surfing in Massachusetts?!
The Filtrate:
Joel Topf
Swapnil Hiremath
Matt Sparks
Editor:
Joel Topf
Show Notes:
The 2010 RFN Top Nephrology Stories
The 2021 NephJC Top Nephrology Stories
Number 10: AKIKI
AKIKI 2 in The Lancet
AKIKI 2 in NephJC
AKIKI 2 on Freely Filtered
Number 9: Effect of Salt Substitution on Cardiovascular Events and Death
The 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 Labeling
Number 8: AURORA, voclosporin for Lupus Nephritis
Efficacy and safety of voclosporin versus placebo for lupus nephritis (AURORA 1) in the Lancet
AURORA 1 on NephJC
AURORA 1 on Freely Filtered
Number 7: FIGARO trial of finerenone for CV outcomes
Cardiovascular Events with Finerenone in Kidney Disease and Type 2 Diabetes in the NEJM
Rates of Hyperkalemia after Publication of the Randomized Aldactone Evaluation Study by David Juurlink
Joel’s intermission
FDA Rejections
Tricida’s Veverimer
Roxadustat
Bardoxolone
Tenapanor
Number 6: Pig Kidney Transplant.
As covered in the New York Times
Clinical Pig Kidney Xenotransplantation: How Close Are We? from JASN
Number 5: KDIGO Blood Pressure Guidelines
KDIGO Guidelines
As discussed in NephJC
And on Freely Filtered
Matt’s article on ACCORD he wrote for RFN as a fellow
Number 4: Chlorthalidone for Hypertension in Advanced Chronic Kidney Disease (CLICK)
CLICK in the NEJM
CLICK on NephJC
CLICK on Freely Filtered
Number 3: Dapagliflozin helps IgA nephropathy
The Lancet
FDA OKs First Proteinuria Drug for IgA Nephropathy: delayed released budesonide
Number 2: New eGFR formulas, now race free.
New Creatinine- and Cystatin C–Based Equations to Estimate GFR without Race in the NEJM
Number 16: Fixing ADPKD in mice
Renal plasticity revealed through reversal of polycystic kidney disease in mice in Nature Genetics
Press release from Yale
Number 1: KDIGO GN Guidelines
PDF in Kidney International
NephJC Discussion
Last Month in Nephrology skeptical of all the Rituximab
Tubular Secretions
Overcooked! All You Can Eat
Lego Porsche 911
Lego Baby Yoda (Grogu)
Beyblades
The Filtrate:
Joel Topf
Swapnil Hiremath
Jennie Lin (who was only there because her plans got boxed by covid)
Jordy Cohen
Josh Waitzman
Special Guest:
Rajiv Agarwal (@AgarwalRajivMD)
Editor:
Joel Topf
Show 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 Topf
Swapnil Hiremath
Nayan Arora
Jennie Lin
Sophie Ambruso
Editor
Joel Topf
Show 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 Topf
Swapnil Hiremath
Nayan Arora
Jennie Lin
Joshua Waitzman
Special Guests
Alfred 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.
Editor
Nayan Arora
Show 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 1986
Controlled trial of pulse methylprednisolone versus two regimens of pulse cyclophosphamide in severe lupus nephritis Lancet 1992
Euro-Lupus Nephritis Trial, a randomized trial of low-dose versus high-dose intravenous cyclophosphamide
Voclosporin is approved by FDA in January 2021
Previous Lupus Nephritis podcast with Dawn and Alfred: Freely Filtered 029: Belimumab for lupus nephritis
Rituximab 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 study
Systematic review of the literature on reproducibility of the interpretation of renal biopsy in lupus nephritis
Conclusion 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 nephritis
Induction: 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 care
Multitarget 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 Guideline
Dr. Glaucomflecken on Twitter
Cardiology vs Nephrology Round 1
Nephrology vs Cardiology Round 2
In the Heights (Wikipedia)
The Mitchells vs. the Machines (Wikipedia)
Paws in Prison
Flozinator pin
The Filtrate:
Joel Topf
Swapnil Hiremath
Nayan Arora
Sophie Ambruso
Joshua Weisman
Editor
Joel Topf
Show 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 NEJM
Formulas 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 Topf
Swapnil Hiremath
Nayan Arora
Sophie Ambruso
And special guests:
Jay L Koyner, Professor of Medicine, University of Chicago
Sarah Faubel, Professor of Medicine, University of Colorado
Editor
Nayan Arora
Show 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 Enchilada
About 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 Sparks
Jennie Lin
Samira Farouk
Joel Topf
Swapnil Hiremath
And two special guests:
Dawn J. Caster, Assistant Professor at University of Louisville
Alfred Kim, Assistant Professor of Medicine at Washington University (Twitter)
Show Notes:
NephJC coverage of the trial: The Bliss trial
In 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_5fc7fed7c5b61bea2b14e3ee
MC 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 Hiremath
Samira Farouk
Matt Sparks
Joel Topf
Jennie Lin
And 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 BoerProfessor in the Division of Nephrology, Adjunct Professor, Epidemiology and Associate Director, Kidney Research Institute
Show Notes:
The Guideline
NephJC’s summary
Accord study showing harm from tight glycemic control
Advance Trial the other trial showing harm from tight glycemic control
2007 KDOQI diabetes guidelines
2012 KDOQI diabetes guidelines
ADA guidelines
Rob Nelson, diabetes legend
Classic pathology of diabetic nephropathy
Should 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 Disease
The 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 Disease
Continuous glucose monitoring and icodextrin.
Keto diets have 1.2 to 1.7 g protein/kg
Urinary Sodium and Potassium Excretion, Mortality, and Cardiovascular Events by the PURE investigators
The Association Between Kidney Disease and Diabetes Remission in Bariatric Surgery Patients With Type 2 Diabetes
Jordy Cohen and Bariatric surgery in CKD at Kidney Week
Metformin knocking out of the park in UKPDS
Kidneys at the Zoo: What Can We Learn from Comparative Renal Physiology? at Kidney Week
The Filtrate:
Swapnil Hiremath
Samira Farouk
Matt Sparks
Joel Topf
Jennie Lin
And 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 BoerProfessor in the Division of Nephrology, Adjunct Professor, Epidemiology and Associate Director, Kidney Research Institute
Show Notes:
The Guideline
NephJC’s summary
Accord study showing harm from tight glycemic control
Advance Trial the other trial showing harm from tight glycemic control
2007 KDOQI diabetes guidelines
2012 KDOQI diabetes guidelines
ADA guidelines
Rob Nelson, diabetes legend
Classic pathology of diabetic nephropathy
Should 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 Disease
The 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 Disease
Continuous glucose monitoring and icodextrin.
Keto diets have 1.2 to 1.7 g protein/kg
Urinary Sodium and Potassium Excretion, Mortality, and Cardiovascular Events by the PURE investigators
The Association Between Kidney Disease and Diabetes Remission in Bariatric Surgery Patients With Type 2 Diabetes
Jordy Cohen and Bariatric surgery in CKD at Kidney Week
Metformin knocking out of the park in UKPDS
Kidneys at the Zoo: What Can We Learn from Comparative Renal Physiology? at Kidney Week
The Filtrate:
Swapnil Hiremath
Samira Farouk
Matt Sparks
Joel Topf
And 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 Fistulas
The NephJC summary
The article in the NEJM
The Haskal study, Stent Graft versus Balloon Angioplasty for Failing Dialysis-Access Grafts in the NEJM from 2010
Accuracy of physical examination in the detection of arteriovenous fistula stenosis
The 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 Fistulae
Scathing anti-interventional nephrologist editorial by Trerotola
Rebuttal though data by Beathard, Effectiveness and safety of dialysis vascular access procedures performed by interventional nephrologists
And 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 music
The role of fungus in the paclitaxel story
Twitter comment on the half life of balloon delivered paclitaxel
The 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 Trials
FDA warning about paclitaxel balloons: Treatment of Peripheral Arterial Disease with Paclitaxel-Coated Balloons and Paclitaxel-Eluting Stents Potentially Associated with Increased Mortality
The NephJC primer on non-inferiority trials: Understanding the vortex of non-inferiority trials
ASN 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 2.0
Swapnil: Hard-to-Control Hypertension: What to Do Next?
Vandana: A Look Inside: Noninvasive Imaging of Kidney Diseases
The Filtrate:
Matt Sparks
Joel Topf
Swapnil Hiremath
Jennie Lin
Jordy Cohen
And two special guests:
Morgan Grams, study author.
Talar Kharadjian, nephrology fellow UC San Diego
Show Notes:
History of albuminuria from Matt’s opening monolog: https://academic.oup.com/ndt/article/18/7/1281/1809803
Microalbuminuria 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 1984
Episode 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. CJASN
The kidney failure risk equation has a dotcom: https://kidneyfailurerisk.com
KDIGO Controversies Conference on Early Identification & Intervention in CKD
Choose 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 Microalbuminuria
Sensitivity and specificity for Joel to study
Your Manuscript On Peer Review
Nephrology Business Leaders University (NBLU)
Cloth Masks May Prevent Transmission of COVID-19: An Evidence-Based, Risk-Based Approach with lead author Catherine Clase
https://www.clothmasks.ca
Elimination or Prolongation of ACE Inhibitors and ARB in Coronavirus Disease 2019 (REPLACECOVID)
Fast Grant. Apparently they are not just for Brian Byrd
NephJC ACE2 Stuff as Jordy calls it: http://www.nephjc.com/news/covidace2
The 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/i31
Hammerman origin story for the MC Hammer cartoon.
Bowman Society Lecture - Race & Renal Function Calculations
Basic Research Forum for Emerging Kidney Scientists: A Partnership Between APS and ASN
The Filtrate:
Matt Sparks
Joel Topf
Swapnil Hiremath COI: he was a sub-investigator on STARRT
Jennie Lin
And two special guests:
Dr. Jay Koyner of the University of Chicago and #NephBBQ fame.
Anitha Vijayan, professor of medicine at Wash U in St Louis
Show Notes:
The STARRT-AKI trial acronym is: Standard versus Accelerated Initiation of Renal-Replacement Therapy in Acute Kidney Injury
Matt suggests STAKRT-AKI Standard versus Accelerated Initiation of Kikdney-Replacement Therapy in Acute Kidney Injury
Coverage at NephJC: Time to Stop Starting RRT Early in AKI
House of God by Samuel Shem. Contemporary Review in the New Yorker. Amazon
Ronco’s legendary dose of CRRT study. Lancet 2000.
AJKD Meta analysis on initiation of dialysis in AKI by VF Seabra.
Lead time bias
Timing 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 Picard
Immortal time bias
AKIKI and ELAIN trials as covered by NephJC
Issues surrounding informed consent in the ICU
The Chicago Way
Dr Palevsky’s ATN Study, AKA Intensity of Renal Support in Critically Ill Patients with Acute Kidney Injury
Is Irregardless A Word?
Debate at Kidney Week: Intensivist vs Nephrologist for Renal Replacement Therapy (RRT) in the ICU
Internal and External Validation of a Machine Learning Risk Score for Acute Kidney Injury
That sweet sweet NephJC pot of gold
Furosemide Stress Test and Biomarkers for the Prediction of AKI Severity
Thai 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.gov
Swapnil’s Tubular secretion, the Twitter timeline of Oded Rechavi
Matt’s Tubular Secretion: #kidneydietchallenge
Anitha comes from the land of coconuts. Lots of potassium in coconut water.
The Skeleton Key Group on The Renal Fellow Network
The Filtrate:
Matt Sparks
Joel Topf
Swapnil Hiremath
Samira Farouk
Jennie Lin
And three special guests:
Carina Seah a second year MD PhD student Mt Sinai who led the initiative to remove race from the eGFR formulas
Poyan 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/edit
Dr Murphy, Dean For Clinical Integration And Population Health. Professor And System Chair. https://icahn.mssm.edu/profiles/barbara-murphy
The Bowman Society at the University of Chicago. I can not find a recording of the webinar https://pritzker.uchicago.edu/resources/bowman-society
Social Determinants of Racial Disparities in CKD https://jasn.asnjournals.org/content/27/9/2576
Socioeconomic 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/1491
Alan S Go’s work on eGFR, hospitalization and death: https://www.nejm.org/doi/full/10.1056/nejmoa041031
Tangri Kidney Failure Risk Calculation https://kidneyfailurerisk.com
De-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/s41581-018-0080-9
Estimating Glomerular Filtration Rate from Serum Creatinine and Cystatin C https://www.nejm.org/doi/full/10.1056/nejmoa1114248
Transdermal 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 Topf
Swapnil Hiremath
Samira Farouk
And special guests:
Katalin Susztak, Professor of Medicine Perlman School of Medicine, University of Pennsylvania. @KSusztak
Show Notes:
CKD-FIX: Effects of Allopurinol on the Progression of Chronic Kidney Disease
PERL: Serum Urate Lowering with Allopurinol and Kidney Function in Type 1 Diabetes
Coverage at NephJC: Effects of Allopurinol on the Progression of Chronic Kidney Disease
Richard Johnson’s theory in pay-walled Nature Reviews Nephrology: Hypothesis: fructose-induced hyperuricemia as a causal mechanism for the epidemic of the metabolic syndrome
Richard Johnson’s theory in open access Nehrology Dialysis and Transplantation: Uric acid and chronic kidney disease: which is chasing which?
PERL: Preventing early renal loss
Iohexol, good for measuring GFR as well as causing contrast associated nephropathy?
Uric acid versus urate: The Crystallization of Monosodium Urate
Association of HLA-B*5801 allele and allopurinol-induced Stevens Johnson syndrome and toxic epidermal necrolysis: a systematic review and meta-analysis
WHO list of essential medications
Fixing the numbers, specifically phosphorous
GFR 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 Administration
Cost of allopurinol: $7/month but it is only $9 for 3 months
Febuxostat Therapy for Patients With Stage 3 CKD and Asymptomatic Hyperuricemia: A Randomized Trial
Tipping 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 team
Dad jokes
Fake systematic review by Johnson’s group showing Urate lowering prevented CKD
Hyperuricemia 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 Feig
COVID and PPI manuscript
Hashtag the cowboy
‘WhatsApp®’ening in nephrology training
Arkana LIVE Pathology Sessions
NephJC Summer Book Club. Read Rana Awdish’s In Shock
The Filtrate:
Joel Topf
Swapnil Hiremath
Samira Farouk
Matt Sparks
Jordy Cohen
And special guests:
Brian Byrd, a cardiologist investigating aldosteronism at the University of Michigan
and
Susan 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 Aldosteronism
Coverage at NephJC: http://www.nephjc.com/news/aldosterone
“What gets measured, gets managed.” Peter Drucker, or not
How 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.116.024446
Surgical 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.118.10759
I 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.13566
Pathway 3 Trial: https://www.thelancet.com/journals/landia/article/PIIS2213-8587(15)00377-0/fulltext
Rennin in cow stomachs: http://www.vivo.colostate.edu/hbooks/pathphys/digestion/stomach/rennin.html
Sodium content of muffins: https://www.fatsecret.com/calories-nutrition/food/muffins/sodium
The 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.119.13080
False-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/102/7/2329/3093639
John Funder video commentary on the study: https://www.acpjournals.org/doi/abs/10.7326/M20-1758
ACD 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/fulltext
ALLHAT trial: https://pubmed.ncbi.nlm.nih.gov/12479763/international.org/article/S0085-2538(20)30552-4/abstract
The Filtrate:
Joel Topf
Swapnil Hiremath
Samira Farouk
Matt Sparks
And special guests:
Sadiya Kahn a heart failure specialist at Northwestern University. @HeartDocSadiya
and
Paul Welling a professor of medicine and nephrology at Johns Hopkins. @PAWellingMD
Show Notes:
The Study: https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.120.045691
Coverage at NephJC: http://www.nephjc.com/news/sglt2mechanism
Diuretics for heart failure NEJM Review article: https://www.nejm.org/doi/full/10.1056/nejmra1703100
Don’t say renal: https://www.kidney-international.org/article/S0085-2538(20)30233-7/fulltext?mobileUi=0
Sanjiv “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.pdf
Huff Puff is like fetch. It is not going to happen. https://www.youtube.com/watch?v=Pubd-spHN-0
Did he have buttons? https://ajkdblog.org/2019/06/17/muscle-relaxant-use-in-dialysis/
Rate My Room: https://twitter.com/ratemyskyperoom?lang=en
Review 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 SGLT2i
DAPA HF: https://www.nejm.org/doi/full/10.1056/NEJMoa1911303
DEFINE HF showing nice reduction BNP with dapagliflozen: https://pubmed.ncbi.nlm.nih.gov/31524498/?dopt=Abstract
Copeptin, what is it? https://pubmed.ncbi.nlm.nih.gov/18291667/?dopt=Abstract
SIADH 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/206251
Remdesivir placebo controlled RCT: https://www.nejm.org/doi/full/10.1056/NEJMoa2007764
Joel’s Remdesivir study: https://www.nejm.org/doi/full/10.1056/NEJMoa2007016
Remdesivir for 5 or 10 Days in Patients with Severe Covid-19: https://www.nejm.org/doi/full/10.1056/NEJMoa2015301
Swap 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-67613
Baclofen is dangerous https://www.kidney-international.org/article/S0085-2538(20)30552-4/abstract
The Filtrate:
Joel Topf
Swapnil Hiremath
Matt Sparks
And special guests:
Joshua Waitzman, third year nephrology fellow at Beth Israel
Harold “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-msce
Show 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=precision
Army 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-opioids
Methods at 16:55
Matt 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/378406a0
The Beth Israel Flex, “The first time I read the paper…”
Results at 32:46
Discussion 48:13
Josh King on opioids being nephrotoxic: https://twitter.com/nephrotox/status/1260400636253921281?s=20
This Week in Covid
The fight over round spikey things.
German autopsy study showing SARS-CoV2 in the kidney: https://www.nejm.org/doi/full/10.1056/NEJMc2011400
Kidney International walking back some previous declarations of what they are seeing on EM: https://twitter.com/Kidney_Int/status/1263641195416150018?s=20
MedRxIV on AKI with COVID-19 at Mount Sinai Medical Center: https://www.medrxiv.org/content/10.1101/2020.05.04.20090944v1
Juan Carlos discussing etiologies of AKI in COVID-19 outbreak in New Orleans.
https://kidney360.asnjournals.org/content/early/2020/05/13/KID.0002652020
Triple 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/fulltext
Friend 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 Topf
Swapnil Hiremath
Samira Farouk
Jennie Lin
Matt Sparks
And 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 @djc795
Keith 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/NEJMoa1915925
The 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/28/6/1675
Ischemia trial (not CKD) https://www.nejm.org/doi/full/10.1056/NEJMoa1915922
Courage trial from 2007: https://www.nejm.org/doi/full/10.1056/NEJMoa070829
Drug eluting stents approved in 2003: https://en.wikipedia.org/wiki/Drug-eluting_stent
Céline Dion, Courage: https://www.youtube.com/watch?v=WN-ZHOHmvcw
Dr. Farouk hanging with her close personal friend Ms. Dion: https://twitter.com/ssfarouk/status/1246448332039471107
https://twitter.com/ssfarouk/status/1235935956152311808
A lot of the enrollment of CKD-Ischemia was from Asia, 25%
Methods: 19:40
Avoiding 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-reflex
Beta blockers in dialysis patients: https://www.ncbi.nlm.nih.gov/pubmed/10201019
Mehran Score: https://www.mdcalc.com/mehran-score-post-pci-contrast-nephropathy
Ultra-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 32:30
Antiplatelet treatment of STEMI with P2Y12 inhibitors https://en.wikipedia.org/wiki/P2Y12#Antiplatelet_treatment_of_STEMI
Impact 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-procedures
St John's Wort Supplements Endanger the Success of Organ Transplantation: https://jamanetwork.com/journals/jamasurgery/fullarticle/212243
Results 37:10
Frank Harrell https://twitter.com/f2harrell
His blog: https://www.fharrell.com
Discussion 46:56
Samira 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 studyhttps://www.nejm.org/doi/full/10.1056/NEJMoa041905
A Single Ventilator for Multiple Simulated Patients to Meet Disaster Surge https://onlinelibrary.wiley.com/doi/pdf/10.1197/j.aem.2006.05.009
Joel’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/fulltext
NIH 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 Topf
Swapnil Hiremath
Samira Farouk
Jennie Lin
Matt Sparks
And special guests:
Agnes Fozo: John L. Shapiro Chair of Pathology at Vanderbilt University and on Twitter: https://twitter.com/AgnesFogo
Hua Su: Professor of Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Osama El Shamy: Home Therapy Fellow at Mount Sinai and on Twitter: https://twitter.com/osamaelshamy88
Chirag Parikh: Director of Nephrology Johns Hopkins and on Twitter: https://twitter.com/KidneydrChirag
Show Notes:
Mark Denison, Corona virus expert. https://www.vumc.org/viiii/person/mark-r-denison-md and on Twitter: https://twitter.com/DenisonLab
Discussion on Twitter that the 3electron microgrpahs may show clathrin coated pits rather than Conorna virus. https://twitter.com/vighnesh_w/status/1250880961463513088?s=20
Chris Larsen’s case of collapsing glomerulopathy in a patient with COVID-19 https://www.kireports.org/article/S2468-0249(20)31172-4/abstract
Osler'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/28831119
We don’t record (or roll) on the sabath https://www.youtube.com/watch?v=GPo9OBrIOi4
Using a dialysis machine to make CRRT dialysate, the Tweet: https://twitter.com/KidneydrChirag/status/1249867795602583554
Derek Fine, Parikh’s partner in crime: https://www.hopkinsmedicine.org/profiles/results/directory/profile/0007605/derek-fine and on Twitter: https://twitter.com/DerekFineMD
Tablo 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-country
Lokelma is not a sponsor of Freely Filtered
Complications 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 Topf
Swapnil Hiremath
Samira Farouk
Jennie Lin
Matt Sparks
And special guest Joshua Waitz
Martin Pollak: http://www.nasonline.org/member-directory/members/20033579.html
Josh Waitz @jwaitz
100 Days of COVID-19: https://www.voanews.com/episode/100-days-covid-19-4236811
MinTac: http://www.nephjc.com/news/mintac
My 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-trials
Non-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=20
Mt Sinai is converting some transplant patients from tacrolimus to belatecept: https://www.nejm.org/doi/full/10.1056/nejmoa1506027
CAPSULOLOGY: Open the “Images” tab https://www.webmd.com/drugs/2/drug-10097-6108/tacrolimus-oral/tacrolimus-oral/details
Tacrolimus for your cat and dog dry eye needs: https://vcahospitals.com/know-your-pet/tacrolimus-ophthalmic-in-dogs
WHO, NSAIDs, and double negatives: https://twitter.com/kidney_boy/status/1240452941187821570?s=20
CJASN 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.htm
Michelle Rheault about starting the clock to relapse tweet: https://twitter.com/rheault_m/status/1247703322200596483?s=20
Marvin Gonzalez calls for larger studies: https://twitter.com/MarvinGonzlez16/status/1247701186972733442?s=20
Acute PD for COVID-19 is discussed in this article from CJASN: https://cjasn.asnjournals.org/content/early/2020/04/03/CJN.03750320
PD 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=22641732
Nursing home outbreaks in Durham: https://www.newsobserver.com/news/coronavirus/article241975401.html
Prison outbreak: https://www.npr.org/2020/04/06/827922287/inmates-staff-on-edge-as-covid-19-spreads-through-federal-prisons
Ottawa 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=20
KidneyCon Lite! Saturday April 18 from 9-11. Kidney Pathology workshop.
Lunch Doodles with Mo Willems: https://youtu.be/7KBkUyE6MOw
Dr Glaucomflecken and Telehealth: https://twitter.com/DGlaucomflecken/status/1247709538322657282?s=20
NephSim for kindergartner’s https://nephsim.com
NephSim live: https://twitter.com/Neph_SIM/status/1247637727048327170?s=20
Loeb’s Laws of Medicine or Loeb’s Rules of Therapeutics
Robert 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:
-
If what you are doing is doing good, keep doing it.
-
If what you are doing is not doing good, stop doing it.
-
If you do not know what to do, do nothing.
-
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=20
Francis Deng and going back to become an internist: https://twitter.com/francisdeng/status/1245475268158009349?s=20
JCI article on using convalescent serum for treating disease: https://www.jci.org/articles/view/138003
Human 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/10.1101/2020.03.13.990226v1
Time course for antibodies and viral clearance in SARS-CoV2 from Nature: https://www.nature.com/articles/s41586-020-2196-x
Peripheral blood monocyte proeonomics: https://www.biorxiv.org/content/10.1101/2020.03.31.019216v1.full.pdf
Cytokine storm in the New York Times. Check mate Rheumatologists: https://www.nytimes.com/2020/04/01/health/coronavirus-cytokine-storm-immune-system.html
Dr. Anthony Chang and Thrombi on COVID biopsies: https://twitter.com/ChangUCanSpare/status/1240686922332160001?s=20
ASN 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.mp4
UK data on length of ventilatory support (ICNARC): https://t.co/WB1ZnODRFF?amp=1
Swap 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-conditioner
Prolonged Intermittent Renal Replacement Therapy (PIRRT): https://www.ncbi.nlm.nih.gov/pubmed/27113696
MDCalc COVID-Resource Center: https://www.mdcalc.com/covid-19
Acute PD for COVID-19 is discussed in this article from CJASN: https://cjasn.asnjournals.org/content/early/2020/04/03/CJN.03750320
PD 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=22641732
NEJM ACE2 review article that Matt didn’t read or peer review: https://www.nejm.org/doi/full/10.1056/NEJMsr2005760
NephJC COVID site: http://www.nephjc.com/covid19
NephJC’s COVID-19 and the Kidney Patient
Cast:
Joel Topf
Swapnil Hiremath
Samira Farouk
Jennie Lin
Matt Sparks
Show Notes:
The NephJC Page on ACE2 and COVID-19
Nature 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 NCT04311177
Inpatient NCT04312009
France's health ministry says NSAIDs may be bad in COVID-19 coverage by CNN
WHO Tweets its position on NSAIDs.
Early case report on COVID-19 and (heart) transplant
Matt’s question to Twitter about cytokine storm
ASN Webinar on dialysis and COVID-19
NephJC page on dialysis and COVID-19
Dimitrios G. Oreopoulos, one of the giants of peritoneal dialysis
Twitter Self Care Bot
Tweetorial on Zoom by Samira
Christos Argyropoulos the Nostradamus of COVID-19
Plasma Exchange and Glucocorticoids in Severe ANCA-Associated Vasculitis
Summary on NephJC
Cast:
Joel Topf
Swapnil Hiremath
Samira Farouk
Jennie Lin
Jordy Cohen
Show Notes:
55th ERS-EDTA Congress, late breaking and high impact trials. June 2018
The CJASN Review recommended by Jennie
MEPEX study
C5a antagonist, Avacopan in ANCA-Associated Vasculitis
The fragility index as described in JAMA Surgery
Michael Walsh looks at the Fragility Index in 399 trials in medical literature
The 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 vasculitis
NephMadness 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 NephJC
Cast:
Joel Topf
Swapnil Hiremath
Matt Sparks
Show 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 overview
Using 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-Scissors
Michelle’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.com
John Mandrola Expert or not an expert?
JACC Case Reports on the Kardashian Index
Robert Cardiff’s editorial on the Kardashian Index in JACC Case Reports.
Bryan Vartabedian blog post on Robert Cardiff’s editorial
And NephMadness is coming! Friday March 13, 2020!
Cast:
Joel Topf
Jennie Lin
Swapnil Hiremath
Matt Sparks
Show Notes:
The NephJC discussion can be found here.
The study was published in the NEJM.
NephJC summary of the AJKD systematic review of uremic pruritus
Atul Gawande on itching.
Pinnacle Mountain
Comprehensive review on toxicodendron dermatitis: poison ivy, oak, and sumac.
KIDNEYcon
Tom Oates 12 days of Poems on Twitter
Cast:
Joel Topf
Jennie Lin
Swapnil Hiremath
Matt Sparks
Samira Farouk
Show Notes:
Pathway 2 Trial
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)00257-3/fulltext
NephJC discussion of Pathway2
http://www.nephjc.com/pathway
The DIAMOND Trial. Much more ambitious than I described in the podcast.
https://clinicaltrials.gov/ct2/show/NCT03888066
SPRINT
https://www.nejm.org/doi/full/10.1056/NEJMoa1511939
Omron 907 BP cuff
only $678 from Amazon: https://www.amazon.com/Omron-HEM-907XL-IntelliSense-Professional/dp/B000FENZPS
Evaluation 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 Incompetence
https://blogs.sciencemag.org/pipeline/archives/2017/04/27/a-clinical-trial-torpedoed-by-fraud-and-incompetence
CJSAN article looking at 24-hour urine for calcium and phos with patiromer
https://cjasn.asnjournals.org/content/14/1/103
Swap’s best tweeters of #Kidney Wk
aldorodrigo https://twitter.com/aldorodrigo
Alex Meraz https://twitter.com/nephroguy
Joshua Waitzman https://twitter.com/Jwaitz
KIDNEYcon
kidneycon.org
Cast:
Joel Topf
Samira Farouk
Jennie Lin
Swapnil Hiremath
and special guest, Perry Wilson
A 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.pdf
Frank Harrell on the value of continuous variables http://biostat.mc.vanderbilt.edu/wiki/Main/CatContinuous
https://twitter.com/f2harrell/status/1176908371464794113?s=20
Wilson’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-alert
The NINJA trial http://www.nephjc.com/news/2016/8/3/ninja-using-technology-to-prevent-acute-kidney-injury?rq=ninja
The end of EPICparodyEMR: https://twitter.com/EPICEMRparody/status/1178788488881299457?s=20
EPICparodyEMR 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=20
Blood 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/25027390
Washington 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/NEJMp1904482
NYT article on Physician Scientists: https://www.nytimes.com/2019/09/23/opinion/doctor-scientist-medical-research.html
brussels.sprout on Instagram https://www.instagram.com/brussels.sprout/?hl=en
Superintelligence by Nick Bostrom https://www.amazon.com/Superintelligence-Dangers-Strategies-Nick-Bostrom/dp/1501227742
Amazon bulk powdered cheese: https://www.amazon.com/s?k=powdered+cheese&ref=nb_sb_noss
Cast:
Joel Topf
Jennie Lin
Swapnil Hiremath
Matt Sparks
Show Notes:
NephJC Coverage of MENTOR: http://www.nephjc.com/news/mentor
MENTOR: https://www.nejm.org/doi/full/10.1056/NEJMoa1814427
KDIGO Membranous recommendations: https://kdigo.org/wp-content/uploads/2017/02/KDIGO-2012-GN-Guideline-English.pdf
2017 Kidney Week Abstract: https://www.asn-online.org/education/kidneyweek/2017/program-abstract.aspx?controlId=2831149
PEXIVAS: http://www.nephjc.com/news/pexivasearly
Heymann Nephritis: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3042693/
Susan Quaggin: https://www.feinberg.northwestern.edu/faculty-profiles/az/profile.html?xid=26269
Manasi Bapat on non-inferiority trials: http://www.nephjc.com/news/2019/7/8/understanding-the-vortex-of-non-inferiority-trials
Prognosis and risk factors for idiopathic membranous nephropathy with nephrotic syndrome in Japan: https://www.sciencedirect.com/science/article/pii/S0085253815498503
Nice 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=Abstract
Pablo Garcia saves the day: https://twitter.com/PabloGarciaMD/status/1148767319323099136?s=20
Larry beck’s land mark study demonstrating antiPLA2r as the antigen in idiopathic membranous. https://www.nejm.org/doi/full/10.1056/NEJMoa0810457
GEMRITUX Study: https://www.ncbi.nlm.nih.gov/pubmed/27352623
Jennie Lin’s How to Be a Nephrology Fellow, Choose Your Own Adventure: https://twitter.com/jenniejlin/status/1156329711057981442?s=20
CJASN 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 Topf
Jennie Lin
Samira Farouk
Swapnil Hiremath
Show Notes:
NephJC coverage of SONAR: http://www.nephjc.com/news/sonar
SONAR in PubMed: https://www.ncbi.nlm.nih.gov/pubmed/30995972
Avosentan for overt diabetic nephropathy, the ASCEND trial: https://www.ncbi.nlm.nih.gov/pubmed/20167702
RADAR coverage at NephJC, May 2014: http://www.nephjc.com/atrasentan
RADAR in PubMed: https://www.ncbi.nlm.nih.gov/pubmed/24722445/
Google Hangout on RADAR: https://www.youtube.com/watch?v=pkkQbb-isog&feature=youtu.be
Vlado Perkovic: https://twitter.com/VladoPerkovic
SONAR: https://en.wikipedia.org/wiki/Sonar
Nephmadness adaptive trial: https://ajkdblog.org/2016/03/10/nephmadness-2016-statistics-in-nephrology-region/#adaptive
KIDNEYcon adaptive trial tweet thread: https://twitter.com/hswapnil/status/1117194018331471873?s=21
Excellent NEJM review on adaptive trials: https://www.nejm.org/doi/10.1056/NEJMra1510061
Potential role of Adaptive trials in AKI: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4869991/
BNP levels in CKD: https://cjasn.asnjournals.org/content/3/6/1644
Generalizability from Wikipedia: https://en.wikipedia.org/wiki/Generalizability_theory
Anemia (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-guidelines
AbbVie Allergen Merger: https://www.barrons.com/articles/abbvie-allergan-merger-pharma-deals-takeda-celgene-bristol-myers-squibb-51563890831
Tangri Kidney Failure Risk Equation: https://qxmd.com/calculate/calculator_308/kidney-failure-risk-equation-4-variable
Fragility 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.aspx
CANVAS Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1811744
Rates of Hyperkalemia after Publication of the Randomized Aldactone Evaluation Study by David Juurlink et al.: https://www.nejm.org/doi/full/10.1056/NEJMoa040135
Vinay Prasad: https://en.wikipedia.org/wiki/Vinay_Prasad
Classic mouse studies looking at endothelin: https://www.jci.org/articles/view/119297/pdf
https://www.ncbi.nlm.nih.gov/pubmed/8377387/
https://diabetes.diabetesjournals.org/content/65/8/2429
Nice 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 Topf
Jennie Lin
Matt Sparks
Swapnil Hiremath
Show Notes: IgA Nephropathy Score
Levi Strauss: https://www.biography.com/fashion-designer/levi-strauss
Levey MDRD study: https://www.ncbi.nlm.nih.gov/pubmed/10075613
ADPKD Total Kidney Volume: https://www.nejm.org/doi/10.1056/NEJMoa054341
Halt PKD: https://www.nejm.org/doi/full/10.1056/nejmoa1402685
Tempo 3:4 Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1205511
Description description of IgA nephropathy by Berger and Hiunglais: https://www.ncbi.nlm.nih.gov/pubmed/4180586
The 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/18/8/2281
Description 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=false
Description of the Japanese glomerulonephritis screening program: https://cjasn.asnjournals.org/content/2/6/1360
Swapnil’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_1
TESTING Trial on NephJC: http://www.nephjc.com/news/2017/8/28/testing
Stop-Iga Trial on NephJC: http://www.nephjc.com/iga-nephropathy
Testing Trial two: Therapeutic Evaluation of Steroids in IgA Nephropathy Global Study Low Dose Study: https://clinicaltrials.gov/ct2/show/NCT01560052
MEST Score versus MEST-C in NephJC: http://www.nephjc.com/news/2016/10/16/do-crescents-matter-for-iga-nephropathy
Nice discussion of the statistical tests during the Tweet Chat by people who know their stats (I.e. not Joel): https://twitter.com/NephJC/status/1133546750814367746
Tweet-length description of IDI: https://twitter.com/kiwiskiNZ/status/1133595698929098752
Assessing 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/abstract
The 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/17309939
Discovery of new risk loci for IgA nephropathy implicates genes involved in immunity against intestinal pathogens https://www.nature.com/articles/ng.3118
Genome-wide polygenic risk predictors for kidney disease https://www.nature.com/articles/s41581-018-0067-6
Where does Matt find minutia like the grams of IgA produced a day? Here: https://www.annualreviews.org/doi/abs/10.1146/annurev-pathol-011110-130216
Animal 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_i1
Eric Neilson, Dean of Northwestern University https://www.feinberg.northwestern.edu/faculty-profiles/az/profile.html?xid=23239
Brussels sprout Insta-famous dog and future dean of the medical school: https://www.instagram.com/brussels.sprout/?hl=en
Josh Farkas Rantorial about Contrast Nephropathy: https://twitter.com/PulmCrit/status/1134922050794139648
Swapnil’s Tweetorial about Contrast Nephropathy: https://twitter.com/hswapnil/status/1133906398096609280
Tukaram’s pic of NEJM’s progression from Contrast Induced Nephropathy to Contrast Associated Nephropathy: https://twitter.com/tukaramj/status/1135214980985266178
Zero sodium dialysate for heart failure? https://twitter.com/i/moments/1134811009217155072
Joel Topf
Jennie Lin
Matt Sparks
Samira Farouk
The strange story of Jennifer Strange.
https://insiderexclusive.com/radios-deadly-stunts-the-jennifer-strange-story/
Water Poker
https://www.thelocal.se/20120706/41878
Nintendo Game Consoles
https://en.wikipedia.org/wiki/Nintendo_video_game_consoles
2019 Narins winner, Mitchel Rosner on MDMA induced hyponatremia
https://www.ncbi.nlm.nih.gov/pubmed/18684895
And Rosner again on exercise induced hyponatremia.
https://cjasn.asnjournals.org/content/2/1/151
The Arieff article on the dangers of severe hyponatremia: Hyponatremia, Convulsions, Respiratory Arrest, and Permanent Brain Damage after Elective Surgery in Healthy Women
https://www.nejm.org/doi/full/10.1056/NEJM198606123142401
The Richard Sterns article on the dangers of rapid correction of hyponatremia: Osmotic Demyelination Syndrome Following Correction of Hyponatremia
https://www.nejm.org/doi/10.1056/NEJM198606123142402
The editorial by the man himself, Robert Narins: Therapy of Hyponatremia
https://www.nejm.org/doi/full/10.1056/NEJM198606123142409
The infant study showing seizures associated with rapid correction of hypernatremia.
https://www.ncbi.nlm.nih.gov/pubmed/35558?dopt=Abstract
Follow up study with oral rehydration.
https://www.ncbi.nlm.nih.gov/pubmed/3958850?dopt=Abstract
The Linder study of adults admitted to the ICU
https://www.ncbi.nlm.nih.gov/pubmed/18037096
French study on patients presenting to the ER with hypernatremia.
https://bmcnephrol.biomedcentral.com/articles/10.1186/1471-2369-15-37
Study on US veterans showing poorer outcomes with slow correction of hypernatremia.
https://www.ncbi.nlm.nih.gov/pubmed/21358313
Cerebral edema during the treatment of DKA.
https://emj.bmj.com/content/21/2/141
The 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.org
Chalrson Comorbidity Index
https://www.mdcalc.com/charlson-comorbidity-index-cci#creator-insights
The paper: A new method of classifying prognostic comorbidity in longitudinal studies: development and validation.
https://www.ncbi.nlm.nih.gov/pubmed/3558716
JCI article on organic brain osmnoles in response to hypernatremia
https://www.ncbi.nlm.nih.gov/pubmed/2332498?dopt=Abstract
John Booth on the value of MIMIC 3
https://twitter.com/ThePeanutKidney/status/1128742219471642624
Sri Lekha on checking labs in hypernatremia
https://twitter.com/LTummalapalli/status/1128479041634226176
Steve Coca on chunky water administration
https://twitter.com/scoca1/status/1128744643422769152
Steve Coca musing the Cersei’s sodium level
https://twitter.com/scoca1/status/1128698514026975232
Steve Coca swearing in High Valarlian:
https://twitter.com/scoca1/status/1128629713826721792
Steve 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/1128652586612080642
The original paper on the Kardashian Index
https://genomebiology.biomedcentral.com/articles/10.1186/s13059-014-0424-0
Kardashian Index Calculator
http://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-2019
Khenar Jhaveri et al on ‘WhatsApp’ening in nephrology training
https://academic.oup.com/ckj/advance-article/doi/10.1093/ckj/sfz045/5482109
Mike Morrison’s video on how to rebuild the scientific poster
https://www.youtube.com/watch?v=1RwJbhkCA58
Mike’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.com
GoodRx: https://www.goodrx.com
Ten 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 inhibitors
Combining ACEi and ARB
We repeatedly compare CREDENCE to IDNT by Ed Lewis and RENAAL by Barry Brenner
You 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 Trials
Implications for the Application of Results in Clinical Practice
Hispanics in the study: https://twitter.com/VladoPerkovic/status/1121078118029103105
Lot 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/1121577808164159491
Why subgroups should be interpreted very carefully
Host: Joel Topf
Discussants: 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 Topf
Discussants: 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 Gelfand
The PRECISION trial published in NEJM, and the NephJC summary by Scherly Leon
High risk of GI bleeding in CKD patients
A study from Taiwan reporting high risk of stroke with NSAIDs even in anuric patients
Host: Joel Topf
Co-hosts: Samira Farouk, Swapnil Hiremath, Jennie Lin and Matt Sparks