Should we call 2024 the Renaissance of nephrology? It was probably the richest year in RCTs in the nephrology world, reflected in the higher number of Late-Breaking Clinical Trials sessions at every big nephrology congress. Probably 1st place won’t surprise anyone; it was the anticipated FLOW of the year, but this Top 10 Nephrology Stories definitely includes some unexpected titles
This week we come to meta-analyse, strikingly late, the cornerstone of all CKD treatments. Are you still in doubt? We need ACEing CKD to the end of GFR, and beyond
This week, we will discuss hopefully the final story of intensive BP lowering. BPROAD is a larger version of ACCORD without the glycemic control arm. Dive in.
Its that time of year again! Jade Teakell is leading team #UrineItToWinIt for #HCWvsHunger 2024. Read more.
This month eJC is talking about Nephrology Fellowship. The article they are using is here and was written by Jeffrey Barns, Stuart Linas and Mitchell Rosner.
As part of the discussion eJC did their first TweetChat on September 10th. It was great, with an excellent turn-out and spirited discussion. Nephrology fellow Amar Bansal lead the discussion. NephJC produced a curated transcript with Storify. Here it is:
We will be discussing the 3 articles on sodium excretion, hypertension and mortality that were published in the NEJM on August 14 at 9pm. PBFluids has an early summary. Look for more background and links in the coming days.
Tejas Desai of Nephrology On-Demand curated the chat into a tight Storify.
Great tweet chat tonight. Here are the analytics and the transcript. Look for a curated (Storify) transcript in a day or two.
Every so often a single tweet neatly encompasses the entire discussion. This happened at last week's aPLA2R TweetChat. This is the tweet that won:
@NephJC #nephjc We've got our viral load for IMN methinks
— ChristosArgyropoulos (@ChristosArgyrop) August 13, 2014
But to properly set it up you need to additional tweets:
@NephJC @ChristosArgyrop Clinical response delayed for months after Ab decline.Not sure when to stop unless following a protocol. #nephjc
— Ross Morton (@signindoc) August 13, 2014
@signindoc @NephJC Exactly #nephjc Would need protocol similar to what the HIV guys did: PLA2R is viral load, proteinuria=CD4+immune fx
— ChristosArgyropoulos (@ChristosArgyrop) August 13, 2014
I love the idea of aPLA2R as a viral load, a leading indicator of idiopathic membranous nephropathy. Nice work Christos. For your effort we will be sending you a #NephJC coffee mug.
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Tweet better!
Next opportunity is tonight 9pm Eastern.
Once again we have two curated archives of the discussion. Joel Topf just published his version for NephJC:
And Tejas of Nephrology On-Demand once again published his curation:
aPLA2R is the first blood test specifically for nephrotic syndrome. It has recently been licensed by the FDA and we want to have an open and frank discussion on how this test may be used in clinical medicine. To aid in this discussion we will be looking at two papers.
The first was highlighted by CJASN's eJC and was covered summarized by Joel Topf and his Fellow, Bilal Saleem:
The second article was published this past Spring in NDT. It is an industry sponsored trial of ACTH for the treatment of membranous nephropathy. Swapnil Hiremath summarized it for #NephJC
And additionally here is a link to the KDIGO Glomerulonephritis Recommendations.
Please join us on Twitter at 9pm Eastern Daylight. Use the hashtag #NephJC.
A bit belatedly, the pubmed comment is up from the great discussion from July 8th on MesoAmerican Nephropathy here.
FOAM Reduction bills itself as a Twitter-free means of receiving FOAM (free open access medical education). The July 25th edition touched on the recent hyponatremia guidelines and included a shout out to our TweetChat. We are honored.
“Hyponatremia
Rumor has it that hyponatremia is near the top of UpToDate’s most searched list. Probably because it is so damn common (15-20% of hospital admissions) and the algorithm is a pain. Enter the Hyponatremia Guideline Development Group (I want to party with these guys), who recently published a new clinical practice guideline for diagnosis and treatment of hyponatremia. It is surprisingly easy to follow, by eliminating volume status guesses and depending on urine osmolality, urine sodium to determine the etiology of water excess.
The guideline can be found here and if you want a more expert take on the guidelines, a group of nephrologists performed a Twitter-based journal club (#NephJC, @nephjc) dissection on the guideline here.
I included the diagnosis algorithm from the new guideline below, along with the algorithm I see used most often.”
Did we mention we had a news letter? (please sign up)
If you were on the mailing list, you can see the letter here. The e-mail covers three important pieces of NephJC news
Our next TweetChat is next Tuesday at 9 PM. We are looking at the NEJM article about VUR prophylaxis. Interesting paper. Pascal Lane did a wonderful summary of the study.
We are changing the way we do video interviews. These will no longer be scheduled events but, instead will get done when we can arrange a time with the most interesting scientists willing to talk to us.
We are exploring the possibility of doing a Live NephJC during Kidney Week in Philadelphia. We have a four question Survey Monkey to try to gauge how much interest there is in this idea.
I have been a dedicated Mac user since 1991 and the turn around that Apple has pulled off never ceases to amaze me. Look at the OS distribution of readers of NephJC.com. Apple has 59% of visitors between iPhone and MacOSX. Incredible.
But I don't think all of the credit can be given to Stevie J and his merry band of Nexters. Look at the twin debacles of Vista and Win8. Together, those two OS's can't smell the OS share of XP whose latest update was over 6 years ago!
Tejas continues to be a great supporter of the NephJC effort. He provides curated transcript to our latest Tweet Chat.
The comment for the tweetchat of #NephJC 5, on the POSEIDON trial is belatedly up on PubMed Commons here.
The investigators focused on how the disease emerged in the last 30 years and have tried to match chemical exposures to this time line and have come up with Monsanto's herbicide, Round-Up.
Here is the pubmed listing for the investigation
An RCT in Hemodialysis patients that is positive? Where do I sign up!
Spironolactone Reduces Cardiovascular and Cerebrovascular Morbidity and Mortality in HD Patients http://t.co/VgPvhrLcS7 potential 4 #NephJC
— Matt Sparks (@Nephro_Sparks) July 10, 2014
Think JACC would make this open access?
