#NephJC on AKI timing: some comparisons

Firstly, check out Joel's post here if you haven't already.

A nice comparison from the methods man, Perry Wilson, is available here, with some great points and comparative tables.

Some more comparisons:

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:

AKIKI https://t.co/HbpI0AkhPj

Vs

ELAINhttps://t.co/RVqRSDPm1c

Fight!

— Graham Abra, MD (@GrahamAbra) May 22, 2016

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?

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The DIABOLO #NephJC chat wrap up

Ted Cruz drops out, the primaries are over!

Thanks everyone for voting for what you want covered in NephJC.

The #NephJC primaries (see https://t.co/LtGiykk0y1 … for details): You would like to discuss:

— Nephrology Jrnl Club (@NephJC) April 29, 2016

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