Avsnitt

  • 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    Looks like Gila Hank, the gun toting mascot of Eastern Arizona College has been replaced by a non-gun toting Gila monster cowboy.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)

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  • 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:

    1. Sotagliflozin in Patients with Diabetes and Recent Worsening Heart Failure (SOLOIST-WHF Trial)

    2. The SGLT2 inhibitor empagliflozin in patients hospitalized for acute heart failure: a multinational randomized trial (The EMPULSE Trial)

    3. Effects of Early Empagliflozin Initiation on Diuresis and Kidney Function in Patients With Acute Decompensated Heart Failure (EMPAG-HF)

    Interpreting the Kansas City Cardiomyopathy Questionnaire in Clinical Trials and Clinical Care: JACC State-of-the-Art 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.