Blog — NephJC

Participate in the #NephJC Caucus

Vote for the next #NephJC article and help make NephJC great again!

We are going to be talking about anemia on March 22nd with either some classic articles like Beserab and TREAT or the recent systematic review on ESAs and quality of life, but we have a hole in the schedule on March 8th. So help us figure this out by voting in our twitter poll.

Proton pump inhibitors cause CKD From JAMA Internal Medicine #PPI2CKD

Maybe statins really are good in dialysis. Long term follow up of the 4D study. #StatinHD 

Nephrectomies cause heart damage. Early CKD is sowing the seed for future CV catastrophe even at pedestrian GFRs. #GFRgood.

Sevelamer versus calcium based binders. A systematic review showing a mortality benefit with sevelamer. #BinderWars

The winner will be discussed March 8th and the others may be put in the cue to be discussed in April and beyond. The loser will drop out of the race and endorse Rubio.

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TWiN (This Week in Nephrology 22 Feb 2016)

  • AVOID-HF - another one bites the dust. The largest trial of ultrafiltration in acute decompensated heart failure was teminated early for poor recruitment. It was also a trial designed to overcome the deficiencies of previous HF studies. Of the 224 patients recruited (<30% of planned) there were not differences in the outcome and no worsening in the renal function. However there was more hypotension and more infections. The article is here ($wall) and the editorial is here. 
  • This BMJ Sytematic Review and meta analysis generated a lot of chatter on twittersphere. It looked into outcomes with use of RAASi versus other anti hypertensive medications in patients with DM. There was no difference in mortality, cardiac or renal outcomes in either group. 
  • In keeping with the Transplant topic of this week's NephJC  here is a collection of Transplant themed tweets
    • This one published in Transplant International explores the economic and clinical consequences of UTI, sepsis and pneumonia in the first year. 
    • Retransplantation with a previously mismatched HLA antigen can be a trigger for a memory immune response. In this registry analysis published in JASN there was no effect of repeated HLA mismatches on all cause or death censored graft loss. However there was increased hazard ratio in patients with class 2 repeated mismatches or if they had previous graft nephrectomy. 
    • Hector Madariaga rocks again with this fantastic storify of a twitter conversation about treatment strategies of Antibody mediated rejection. 
    • C1q+/C3d+ denovo allograft antibodies were shown to have poorer 10 year graft survival in a pediatric transplant population. Check it out here.
  • Another Systematic review and meta analysis showed that correction of anemia using ESA did not improve the health related QoL in patients with CKD. This was published in the Annals. 
  • This cJASN article explores the outcomes of a cohort of patients with primary FSGS treated with steroids/CNIs or conservatively. The response to immunosuppression was better than conservative management, however there were no differences between steroids or CNIs as first line immunosuppression 

 

Blogs of Note

  • Dr Fred Coe comes up with a superb  blog post on interpretation of the stone work up, equally useful for patients and physicians. Must see. 
  • For the lighter side of Nephrology but no easier!! Check out a collection of crossword puzzles in nephrology on Dr Jhaveri's blog. 
  • And finally a blog post on peer to peer conversation in living transplant donation. Makes interesting reading when the donor also happens to be a nephrologist. 

 

 

TWiN - The Week In Nephrology (15 Feb 2016)

  • Starting this week comes a provocative study published in AJKD by Kam Kalantar-Zadeh regarding the use of incremental HD/Twice weekly HD in patients with substantial residual kidney function. Read it here. Also read the counter argument in an AJKD editorial.
  • How the evolution of dialysis and related technologies guided the ethics of "how resources should be used and who should have access to them" . Dr Butler and colleagues explore the healthcare delivery system through the history of dialysis in a recent CJASN article.
  • Retweeted and liked this week was a January article published by Dr Kenar Jhaveri in CJASN "Nephrologists as Educators: Clarifying Roles, Seizing Opportunities" . It identifies eight attending roles of the nephrologist which can be converted into educational opportunities.
  • A new drug and a new target for TTP ? This NEJMeditorial discusses the Von Willebrand Factor as the new target and Caplacizumab as the drug. The Phase 2 results of the TITAN trial were published in the same issue.
  • Dr Bargman and Dr Lee discuss the utility or futility of studies exploring the survival of patients by dialysis modality in this CJASN article. The quality of life and not the length of life maybe the deciding factor for the individual patient.
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BLING - BLogs In NephroloGy (15 Feb 2016)

BLING (BLogs In NephroloGy) 8 Feb 2016

 

 

 

TWiN (The Week In Nephrology 8 Feb2016)

  • The ASN Innovations in Kidney Education Contest results were revealed this week. Check out their creations here.
    • Water Homeostasis by John Danziger, MD Nephrologist, Harvard Medical School
    • Urine Trouble Board Game by Dorey A. Glenn, MD Fellow, University of North Carolina Kidney Center
    • CRRT Simulator ppt by Kamalanathan K. Sambandam, MD Nephrologist, University of Texas Southwestern Medical School
  • Renewing the discussion on organ trafficking in kidney transplantation are 6 Open Access (Organ Donation and Procurement) articles from Transplantation Direct. You can get them here.
  • Tweeted out this week were the ERA EDTA guidelines on the use of Tolvaptan in ADPKD. Follow this link (Open Access)
  • Ketoanalogues - Should do we still think about them? This latest article from JASN explores a vegetarian diet with ketoanalogue supplementation which showed retardation of CKD progression.
  • From our Pediatric Nephrology friends comes 2 articles of interest
  • One more Belatacept story this week. Published in AJT were results of a new trial which looked into immune manipulation post transplant. They studied the lymphocyte reconstitution after Alemtuzumab induction followed by Belatacept and Rapamycin therapy and showed a reduced rate of acute rejection commonly seen with nondepleting induction with belatacept maintenance.
  • NEJM article on Kidney-Failure Risk Projection for the Living Kidney-Donor Candidate. Get it here.

The #NephJC survey closes soon

Thank you for all of you who have responded and filled out the #NephJC survey - over 300 respondents so far! We wanted to give a heads up to the rest of you - the survey will be closing soon. Wednesday 12 midnight Eastern is the deadline. We would love to hear from any of you who haven't had a chance to voice your opinion. So please go ahead and let us know what you think and how we can improve. 


The #NephJC survey

The #NephJC team has designed a survey - to get to know more about you and your opinions. It's a simple, short survey, that will not take more than a few minutes (we promise) to complete. We would really like you to complete all the questions, though the ones where we ask more about you are optional. The overall purpose of doing this survey is two-fold. Firstly, we would like to hear more about what you like, what you don't like and how we can improve what we are doing with #NephJC. The second purpose is to know a little bit about you - all of you, who are following us on twitter or on facebook, who tweet at the chats or who lurk, or who get our weekly mailer.

Needless to say, completing the survey is completely voluntary. None of your information will be divulged. We do have institutional review board approval (from the Ottawa Hospital Health Sciences Research Ethics Board) to conduct this survey.

Lastly, this survey is conducted with Google docs. This makes it simple and easy, but please answer to the best of your ability, truthfully, and complete it only once.

thanks!

The #NephJC team

 

TWiN (The Week In Nephrology) 1 Feb 2016

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