In the latest episode we chill out and discuss why it may not be necessary to make patients uncomfortably cool to prevent cardiovascular badness.
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; Register here for the 2023 Gardener’s Grove conference
Joel: House of the Dragon on HBO Max