Blog — NephJC

from NephJC live to the Lancet

You might remember Perry Wilson, the young dapper nephrologist from Yale who presented his trial on AKI alerts at NephJC live a few months ago. He was tweeting as @nephrolalia - and has now renamed and rebranded himself as @methodsmanmd, which is quite apt given his recent blog posts and succinct and snappy videos up at MedPage Today. 

More notably, the data he presented at #NephJC live has been published today - with some great additional analyses, in the Lancet. We sure know how to pick winners - so the next time we come calling, pick up the phone!

Share

Tweet of the Week: Urine Eosinophils and NephroCheck

Dr. Faubel nailed the best comment about NephroCheck by reminding us while we pick apart the particulars of NephroCheck that we have some other dragons to slay:

And then Edgar slides in with the appropriate #NephPearl (How does he do that so fast?)

Tagged:

Share

#NephJC 20: Who checks the checkers? Storify Part 1: EST chat

Last night we were off to a rollicking start with a great #NephJC chat - in great part due to the participation of Azra, Jay and Sarah! Joel took no time - burning the candle at both ends to do some storifys. 

Here is the entire unedited archive with all the tweets from both chats:


Topic 0: Introduction, and How we do diagnose AKI?

Topic 1: Discussing DISCOVERY, SAPPHIRE and TOPAZ

 

Topic 2: ROC Curves and Diagnosing Aki with Nephrocheck

 

Topic 3: What happens now?

 

The GMT chat today was also very intense - Storify will follow shortly!

Share

KDIGO AKI staging

Tonight's journal club requires knowledge of the KDIGO acute kidney injury stages. These are nearly direct translations from the previous AKI staging systems.

  • RIFLE: the first system. KDIGO 1, 2, 3 roughly corresponds to R, I, F. The primary difference is KDIGO categorizes people with just a 0.3mg/dL rise in Cr as AKI, RIFLE does not.
  • AKIN: As far as I can see AKIN 1, 2, 3 is identical to KDIGO 1, 2, 3.
Share

New for NephJC tonight: Topics

In case you haven't signed up for our mailing list (really - why not? go there and do it now!)  - We are going deep on the FDA approved NephroCheck™, a new test for the early diagnosis of AKI. This is not industry sponsored BS, just honest, crowd-sourced, EBM.

For this #NephJC we have three topics we want to discuss:
 

*please preface your tweets with the topic: i.e. T0, T1 and so on*


Topic Zero: How are you currently diagnosing AKI?

  • Is it all FENa and a microscope slide? 
  • What do you think of the KDIGO AKI stages?
  • How do you use oliguria?

Topic 1: Evaluate their strategy for developing a novel test for AKI.

Three studies in 2 papers:

  1. Discovery: the scientists tested 340 biomarkers and came up with a pair that performed best. N=522.

  2. Sapphire: validated the biomarker from Discovery in a unique cohort. N=744.

  3. Topaz: A separate study just to validate the results of Sapphire. N=420.

Is this a compelling story line? Is this a fair way to discover and validate a test? Do you agree with the conclusions?

Topic 2: Evaluating a test.

  • On ROC the area under the curve was 0.82. Good enough?
  • Two cutoffs are provided, one is sensitive (92%) and the other is specific (95%). How will you use that?

Topic 3: So what?

  • How will having a 12 hour lead time change your management?
  • Should we expect trials designed to change the course of AKI to use NephroCheck™?
Share

GMT NephJC gaining steam

Tom Oates and his merry gang of GMT chatters shattered previous records for the Euro/Afro chat. Great work guys!

Not quite up to the pace of the western hemisphere, but gaining fast.

In a related note, NephJC.com reached 4,000 page views in a month for the first time in January. 

Follow-up from the Meso-American Nephropathy NephJC

From the International Journal of Occupational and Environmental Health comes this article looking at Changes in kidney function among Nicaraguan sugarcane workers. The article is behind a paywall but according to the NPR article it exonerates the fertilizers and pesticides and adds to the data on chronic and recurrent dehydration as the culprit:

“But this new study casts doubt on that theory. It found that field workers whose primary jobs were spraying for weeds and pests (and who thus had the most contact with agricultural chemicals) had the least decline in kidney function over the course of the harvest.

The researchers also found that dehydration among workers with the most physically demanding job — cutting cane — could contribute to the illness.”

I found this bit interesting:

“Cutters who drank more of a generic energy drink while on the job had less of a drop in kidney function than co-workers who drank less of the beverage.”

If the energy drink is protective that seems to counter the fructose/uric acid hypothesis that Dr. Johnson was proposing in his article. This continues to be one of the most interesting stories in nephrology.

Share

Tweet of the night

We had a great NephJC last night. We had a new contributor who was excellent, Eric Weinhandl of Minnesota.

Dr. Weinhandl works with the new PEER Kidney Care Initiative. It looks like a cool project. Here is some press from Nephrology News and Issues.

Tagged:

Share

Noteworthy in Nephrology Social Media

The latest NephJC newsletter was just pushed out. For the second week there is a section that calls out what is new or noteworthy in the nephrology social media sphere.

This week's letter calls out Nikhil Shah's new nephrology blog, Nephrology Tweetbook and Fred Coe's kidney stone blog. We started identifying highlights last week. In the inaugural edition we identified the work being done by  Tejas Desai and one of the latest nephrologist on Twitter, Dr. Ratna Samanta.

If you see or hear of anything that should be promoted on Noteworthy in Nephrology, drop us a tweet.

Share