A lot of Storify from ERA-EDTA
Acute kidney injury, when to dialyze
NephJC Summer Book Club Selection
Thanks everyone for voting. The results are in and Eric Topol's The Patient Will See You Now won.
The voting looked like this:
But the reason we asked how likely you are to read the book was so we could weight the votes. The weighting worked like this:
- 0.2 for I'll read it if I have time
- 0.4 for I'll read it if it is the book I want
- 0.6 for 50-50
- 0.8 for I will buy and start
- 1.0 for scout's honor
This turned out to not really affect the results
So Topol's book it is. The Patient Will See You Now examines how changes in technology are forcing a democratization of medicine and empowering patients in an unprecedented way. This seems like an important theme for today medical climate. The exact date of the chat has not been fixed but it will likely be mid to late July, so start reading. Watch the blog for summaries of all the chapters, similar to how we covered Being Mortal.
TWIN for 23 May 2016
General
- Annals of Internal Medicine brings a Nephrology Update - 11 of the most important trials in Nephrology and Hypertension in 2015 - All served on a platter!!
- Blast from the past, a 2013 Nature Reviews Immunology paper on the interaction of kidney with the immune system. It discusses the mechanisms of immune mediated kidney disease and, conversely, how kidney disease affects the immune system.
Acid Base Electrolytes
Pathophysiology of Renal Tubular Acidosis: Core Curriculum 2016 - from AJKD
- Hyperkalemia treatement - Harel and Kamel from St Mike's in Toronto published a systematic review in PLOS on the emergent management of hyperkalemia - 10 units of regular insulin bolus with 50 gms glucose or 20 units of regular insulin with 60 gms glucose - does the job!!
AKI
- #AKIKI RCT re: Initiation Strategies for Renal-Replacement Therapy in the Intensive Care Unit - showed no difference in 60 day mortality between early or late start. Published in NEJM this month. . "Breaking News" NephJC coming soon.
- A double whammy - Also published in JAMA this week and presented at the #ERAEDTA16 were the results of #ELAIN RCT which showed that early RRT initiation (Stage 2 AKI) significantly reduced 90 day mortality, duration of RRT and length of ICU stay. The " Breaking News" NephJC will discuss both these trials and promises to be a thriller!!
Dialysis
- An excellent one page editorial summary of the role of statins in dialysis patients following the long term followup data from the 4D RCT. From Kidney International.
Hypertension
- Swapnil Hiremath summarizes the Canadian Hypertension Guidelines 2016 (CHEP) incorporating the SPRINT data in an AJKD Blog post.
Transplant
- CTS Data published in NDT this month shows the benefit of induction therapy in high risk kidney transplant recipients and no significant effect in low risk recipients.
- Dr Haas presents the Banff Classification 2013 A minireview published in AJT on the nuances of the Banff 2013 update and the studies attempting to validate the classification.
Next #NephJC: Timing of renal replacement therapy in AKI
Next week, on May 31 in American and June 1 in Europe, we will be discussing the two major AKI studies looking at the timing of renal replacement therapy:
Look for a formal background post later this week.
Stop the presses!
Landmark trial dropped in the NEJM yesterday. We will be covering AKIKI on May 31 and June 1 instead of the Pip/Tazo trial. Sorry for the change in plans. We will reschedule Pip/Tazo and AKI, probably for the first week in July, but with ERA-EDTA approaching who knows?
The DIABOLO #NephJC chat wrap up
Additional acetazolamide data
Ted Cruz drops out, the primaries are over!
Thanks everyone for voting for what you want covered in NephJC.
The winner is a prospective RCT to see if this Pip/Tazo+Vanco toxicity is real. The reference is here. Back ground from NephMadness 2015 here and ALiEM discussed it here. We will be discussing this on May 31 and June 1. There is an #AskASN chat on May24 pushing us back a week.
Don't forget Next Tuesday/Wednesday we go all Acid-Base for a discussion of acetazolamide.
study
The NephJC Book Club Returns. Vote for your choice.
Last summer we did a book club on Atul Gawande's Being Mortal. The NephJC team blogged its way through every chapter and we did a discussion of the book during one of our Tuesday/Wednesday chats. We think the summer is a great time to slow down from the rapid digestion of medical literature and enjoy a slower paced book. We couldn't decide on a book among ourselves so we are turning to you to pick this Summer's book. Here are the choices:
1. When Breath Becomes Air by Dr. Paul Kalanithi. NYT Review.
2. The Patient will See You Now by Dr. Eric Topol (@erictopol) NYT Review.
3. How doctors think by Dr. Jerome Groopman. NYT Review
4. On the Move by Dr. Oliver Sacks. NYT Review
5. The Laws of Medicine: Field Notes from an Uncertain Science by Dr. Siddhartha Mukherjee. Los Angeles Times Review
Next NephJC is May 10th and 11th
We will be discussing the DIABOLO trial of acetazolamide to shorten mechanical ventilation. The Tuesday chat will be at 9PM EDT and the Wednesday chat will be at 8PM London, Noon PDT.
The article can be found at the JAMA website or via Pubmed.
Take a look at Joel's summary of the article.
See this summary by The Bottom Line
Coverage by MedPage Today
Acetazolamide for metabolic alkalosis in ventilated patients
Social Media Workshop website now open
Yesterday Matt Sparks, Kenar Jhaveri, and I ran a social media workshop at the NKF Spring Clinical Meeting. We were given the opportunity to do a workshop rather than a few lectures, so we really focused on making the workshop interactive. As such we did not have a slide deck, but rather created a website with all of the content.
The workshop operated by having Matt and I narrate our experience as we navigated the website from introduction through professionalism. The participants created a blog post and tweeted and debated ethical issues in social media. It was an information dense two hours. We thought it went great.
Take a look at the materials here.
The Twitter4Nephrons, disappeared from the primary navigation bar at the top of the site. It can now be found in the about folder.
The #NephJC primaries
CV Risk scores: homework for #NephJC
#NephJC summary for HOPE-3 is Up
Check out the home page - great job by Peter Gallacher putting it together. See you all on April 26th or 27th. We hope to have an author online at the chat too. More soon!
Twitter polls redux
A few months ago, we wrote about the nephro-twitterverse discovering twitter polls. Graham Abra and Thomas Hiemstra were early adopters, though response rates were ~ 20-40 at best then. But there are many more, with much better response rates. Check them out:
During #NephMadness, Krishna Penmatsa made a bunch of #PredictaPolls - check some notable ones:
Graham, again, on IgA nephropathy and pregnancy
Tomas Rohal on tweeps preference of social networks
Matt on the deprescribing PPI question
And the PPI article we discussed at #NephJC was actually decided on the basis of a twitter poll too!
What RRT modality would nephrons choose for themselves (sparked by a tweet from Scherly at #HDu)
Matt again on how nephrons refer to themselves
Joel (was he making fun of my #DreamRCT, #MAGIK?)
#NephJC on desensitization & the winners of the #NEJMCup
This was another great #NephJC. Notable for many firsts:
- Hosting debuts by #NSMC intern, Silvi Shah, and RenalMed founder, Matt Graham-Brown (the latter also wrote the pre-chat summary)
- Lot of fresh faces (hello Pawan, Todd and Sian) and over 700 tweets from more than 60 tweeps
The transcripts and storifys are also already done - and up on the page, due to uber-fast curation from Hector.
Lastly, we have the pleasure of announcing the winners of the coveted #NEJMCup. There were many great tweets, so it took some time to sift through all the nominees. Here are the winning tweets:
Congratulations, Kevin and Sian! Your #NEJMCups should be on the way soon, courtesy of the New England Journal of Medicine.
Announcing the #NEJMCup for the next #NephJC, courtesy @NEJM
We are discussing an NEJM article next week (on that note check out the summary, written by Matt Graham-Brown). The hurdle? Its behind a subscriber-only wall - and this is an issue that has come up as a barrier for many of us not in academia or with a personal subscription to the Journal. However, the nice people at the Journal have kindly agreed to make it easily accessible for #NephJC readers - use the link on our summary page, and you will get the full text.
But there is more good news. Like what we have done in the past with JAMA, the best tweet of the night will get a prize. One for each chat.
The #NEJMCup!
Lastly, thanks to Lisa Rosenbaum for opening to doors to NEJM for us.
Storify from last night's #NephJC on PPI and CKD
Hector was right out of the gate with a 131 tweet Storify of the chat.