Blog — NephJC

The next #NephJC, diving into CJASNs Renal Physiology Series

CJASN is doing an exemplary series on renal physiology. We will be examining the latest article in the series, the distal convoluted tubule, on January 6 and7 for NephJC. The editors wrote a great introduction to the series discussing both the mission and its means last July. The final few sentences from the editorial.

The reviews will be brief but comprehensive, and, therefore, they will be accessible to practicing nephrologists, clinician educators, and trainees, but of sufficient heft to provide a focused review for renal physiologists. To enhance clarity, we will try to use a single visual vocabulary for diagrams of tubules and glomerular cells to make sure that the illustrations are consistent across the different review articles in the series. We hope that these reviews will be helpful to practitioners and trainees and useful as they teach physiology to the next generation of residents and medical students.
— Zeidel, Hoenig, and Palvesky
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Introducing the first nephrology social media internship

Social media is becoming a force in medical education the threatens to disrupt the establishment. Free open access medical education (#FOAMed) resources are changing the way doctors learn and keep up to date. Nephrology has been near the front of this revolution with a handful of blogs, innovative crowd-sourced contests like NephMadness and DreamRCT, and a vibrant online journal club (if I do say so myself).

Looking to the future, while the audience for FOAMed is growing, it is clear that nephrology needs more people producing this content. To that end, NephJC is proud to be a founding member of the Nephrology Social Media Collective (NSMC), a loose federation of leaders in social media, that are creating a social media internship for nephrology. The internship is unpaid (like the rest of social media) and open to all doctors and med students interested in the intersection of social media and nephrology. The internship is one year long with much of the learning self directed. However interns will get unique access to some of the leading social media projects in nephrology.

For more information and to apply check out the home page.

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NephJC GMT just concluded...

Tom Oates did an excellent job taking the helm for our inaugural Old World NephJC. Tom did an excellent job with solid turnout. 

A lot of the Nephrons we see on Twitter but don't typically make it to NephJC showed up. Shout outs to:

And we were honored to have social media super star Ronan Kavanagh join in.

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PubMed launches Journal Clubs

PubMed has been quite active recently - in surprisingly innovative ways. A few months ago they launched PubMed Commons, allowing comments on citations in PubMed. Recently, they have also added social media - sharing buttons, allowing you to tweet, like, and +1 directly from the PubMed page.

Overall, the grand vision is to encourage a platform for scientific discourse and post-publication peer review. Check out their blog - the posts are infrequent, but they summarize the strategy. There are other websites (PubPeer is a notable one, but also F1000, and the new kid on the block, Winnower), but PubMed is the 500 pound gorilla in this space.

The latest step is the launch of Journal Clubs on PubMed Commons. And guess what, #NephJC was one of three journal clubs to be part of the launch cohort! Check out the press release, and the NephJC home on PubMed Journal Clubs. This is an exciting development - and we are sure more journal clubs will eventually be added, but we got bragging rights for this one!

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The Rheum Guys show up at #NephJC 17

Tonight we had the first leg of the #NephJC 17 - on Maintenance therapy in ANCA Vasculitis. Not only did Paul Sufka do a great job of the summary write up, he and his Rheum buddies showed up (Al and Sam in particular) and made for a fascinating discussion. Look forward to the #RheumJC starting sometime early next year, that will be a heckuva journal club, for sure. 

And of course, we will be having a second 'leg' - on Thursday at 8 PM GMT, Tom Oates (@toates_19 and winner of the best tweeter #NephJC award at #Kidneywk14) will host another #NephJC on the same article, giving an opportunity for our transatlantic brethren to join in. Look forward to another update in a couple of days!

Curated Transcript

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Storifys of the Awesome Hyperkalemia #NephJC

The #NephJC tweetchat on the two hyperkalemia papers was truly astounding. Broke all previous #NephJC stats. So putting out the storifys was also quite the gargantuan task - and Joel admirably stepped up to it, but by breaking it up into two parts. Part 1 deals with the Bactrim/Septra causing sudden death paper from BMJ:

And then Part 2, which also contains a link to another storify by Tejas (does that make it a meta-storify?).

 

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Sometimes in the heat of the moment you tweet something a little fast

So in the middle of the potassium tweet fest this tweet caught my attention:

Just what we need, a modern trial that confirms or refutes this data showing the futility of Kayexalate:

That figure is from this 1998 Study by the great Michael Emmett. A modern study could confirm or refute the concerns about the safety signal regarding kayexalate:

From Gastrointestinal Adverse Events with Sodium Polystyrene Sulfonate (Kayexalate) Use: A Systematic Review The American Journal of Medicine Vol 126, Issue 3, Pages 264.e9–264.e24, March 2013.

So I was a little disappointed to see that the study had been halted

Then came the part that was too juicy for me to resist:

It was stopped due to a safety signal! I immediately thought it must be the previously known GI problems. Kayexalate was so dangerous that modern researchers couldn't even study the thing! I tweeted a little victory lap:

This has been retweeted 16 times at this moment. It is the tweet that has received the most engagement of any done by NephJC in the last week. It was the number 1 tweet!

But I think it is a bit misleading for a number of reasons:

  1. the study was being done by ZS Pharma the manufacturer of ZS9, not exactly an unbiased observer
  2. there were only two adverse reactions and they don't seem related to the study drug, they were A-fib and long QT

Seems a little fishy. The cynic could imagine that the early data showed ZS-9 to be no better than Kayexalate so the company started looking for a reason to cancel the project. They saw the unbalanced adverse events, 2 with SPS versus 0 with ZS-9 and spiked the study. Luckily, I'm not cynical.  

I posted a retraction with the new data:

Predictably the retraction has not gotten the same social media traction

A lie will go round the world while truth is pulling its boots on.
— Charles Spurgeon
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NephJC goes crazy.

We just completed our most popular NephJC ever. We broke both the number of tweets record and the number of participants record. We also had the most authors ever participating, I think it was 4, two from each study.

Sixty people (previous record was 39) and lots of new faces

Here's how the potassium discussion looks compared to our other discussions:

Look for the Storify tomorrow.

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