news
Cristina Adriana Popa
Top Stories in Nephrology 2024

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

Top Stories in Nephrology 2024
Background
Cristina Adriana Popa
ACEing the management of advanced CKD

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

ACEing the management of advanced CKD
Background
swapnil hiremath
BPROAD: Sprinting down the BP Road in Diabetes

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.

BPROAD: Sprinting down the BP Road in Diabetes
news, Meta
joel topf
#HCWvsHunger 2024

Its that time of year again! Jade Teakell is leading team #UrineItToWinIt for #HCWvsHunger 2024. Read more.

#HCWvsHunger 2024
Background
Brian Rifkin
Potassium Rollercoaster Heartbreak

This week, we will discuss the use of 3K dialysis bath with sodium zirconium cyclosilicate versus 2K bath and no potassium lowering medications in dialysis patients and the associated risk of arrhythmia.

Potassium Rollercoaster Heartbreak

NSMC Internship application deadline

The internship has garnered more response than we expected and we have a number of qualified applicants. This is going to be fun. We are going to close applications next Wed, January 7th, so if you were thinking of applying, now is the time.

While the applications have been coming in, we have been busy developing the curriculum and it should be great. We have added two more social media stars to the faculty, we are excited to welcome Joshua Schwimmer and Joe Weatherly. Each brings unique expertise to our team.

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

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.

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.

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!

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

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?).

 

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

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.

#NephJC live was a great success

On Saturday at Kidney Week, just after the Late Breaking/High-Impact trials, NephJC held its first, in-real-life, journal club. Over 30 people trudged the mile from the convention center to the Double Tree where we did two short scientific presentations with discussions. Our first speaker, Dr. Wilson (@Nephrolalia) said it best when he said it was the first time he had given a talk where the ratio of presentation time to question and discussion time was 1:4.

This was important because we did not want NephJC live to be just another symposium where you listen to experts for the full hour. There is enough of that at the primary conference. The topics were hot, the speakers sharp and the discussion spirited.

Turn out was good with over 30 people coming to the event. Note that our best twitter discussion had 30 people.

Storify forthcoming.

#KidneyWk14 Social Media Awards The #TNOTs

As part of NephJC live we will be awarding social media awards. We will be giving recognition and prizes for:

  • Best use of Twitter during Kidney Week
  • Best Storify on Kidney Week
  • Best Blog post on Kidney Week
  • Best Fresh Face for a person new to the social media scene making an impact at Kidney Week

If the use of social media has not rocketed you up the academic ranks, it is probably because you have no awards to show for it. Come to NephJC Live and get the recognition you deserve! Remember NephJC founders are not eligible for prizes.

The awards for social media will be decided by a blue ribbon panel made up by, our two speakers, Drs. Sawinsky and Wilson; our two founders, Drs. Topf and Swapnil; and Ivan Oransky and Kristina Fiore of MedPage Today.

We need submissions for best use of social media. So tweet links to examples with the hashtag #TNOT (Top nephrologist of twitter).

,

Humble beginnings

,

I had thought of starting a Nephrology Journal club ever since I wrote about eJC on PBFluids. In fact if you look at my suggestions for how to improve CJASN eJC, you will see the skeleton for the current #NephJC. But ideas are cheap and I never did anything about it.

In the middle of NephMadness last year I received a tweet from from Swapnil suggesting that someone do a Nephrology Twitter Journal Club. I told him it was a great idea but that I had my hands full with NephMadness and that he should write me after the contest ended.

Literally moments after we announced the winner of NephMadness, Swapnil e-mails me about the journal club. I told him to do some research on how twitter journal clubs work and write a post on Medium. I half hoped he would drop the ball and go away but he published it on April 17. A week later we collaborated on a tighter introduction, also published on Medium (we didn't yet have our SquareSpace sight) And five days after that we held our first NephJC.

Last call for #NephJC Live

We are closing registration for NephJC Live this Sunday so register today if you want to be a part of the first NephJC Live event. We have two young investigators who will be sharing their data. We will be awarding the Social Media Awards for the best contributors to the conversation around Kidney Week and we will have lunch!

All the details are available here.

Register before it is too late!

#NephJC goes again tomorrow November 4 with Steigerwalt and @Nephro_Sparks

We have covered a lot of subjects in our first half year but tomorrows study is unique. For the first time NephJC is going to tackle a basic science paper. In order to make this work we are bringing in a couple of ringers.

  • First, we got Dr Susan Steigerwalt, a renowned hypertension specialist who has had a ringside seat for every significant hypertension study of the past two decades. While we were reading about these studies in our pajamas, Dr Steigerwalt was in the trenches calibrating mercury sphygnomamoters. She wrote an in-depth summary of the article that is available at NephJC.com. Don't miss it.
  • The other ringer is Matt Sparks. You may know him from his high profile roles at the Renal Fellow Network, where he played a critical role in saving this institution after the tragic death of Nathan Hellman and or his role as a founder of AJKDblog. But what you probably don't know is that in addition to being a blogger he is a basic science researcher and has sophisticated knowledge about this very paper. We are delighted that he has agreed to step up to the table to spin those wheels of steel and host the @NephJC twitter account tomorrow as we do a deep dive on Harrison's land mark article on T cells and the genesis of hypertension.

The article is a doozy, so make sure you do your homework. Help us make this very special basic-science episode of NephJC a success.