Freely Filtered, a NephJC Podcast

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

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

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

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

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

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

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

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

Episode 035: The COVID-19 Pandemic changed everything and last fall the ASN set out to document how it affected our nephrology fellows. The ASN Workforce Committee adapted the Annual Fellow Survey to assess how the pandemic affected nephrology fellows in terms of burn out, education, and enthusiasm for the specialty.

Episode 034: A newly expanded filtrate assembled to discuss the tricky CONFIRM Trial recently published in the NEJM. We are assisted by Elliot Tapper, noted hematologist and member of #LiverTwitter.

On April 6, 2021 Fibrogen announced that the analysis of the cardiovascular outcomes was adjusted after the data was unblinded. When the data was reanalyzed without this adjustment roxadustat is less impactful. Importantly for this NephJC discussion, the previously impressive MACE and MACE+ advantage for incident dialysis is no longer found. Roxadustat remains non-inferior in all outcomes, though the confidence intervals have widened.

Animal House was one of the most exciting regions of NephMadness. We explore this region with the Selection Committee Member as well as the author to unlock the secrets of Animal House.

Roxadustat is the first HIF stabilizer up for FDA approval. There have been a number of roxa publications and today we took at the two most recent. One is a pooled analysis of incident dialysis patients: roxa versus epoetin alpha. And The second is a pre-dialysis CKD study of roxa versus placebo. Roxa represents well, but devils in the details. Join the filtrate as we go deep on roxa!

The DAPA program busted SGLT2i out of the diabetes paradigm by showing that dapagliflozen improved heart failure and CKD outcomes in a patients with or without diabetes.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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