The Filtrate:Joel TopfSwapnil HiremathSamira FaroukJennie LinMatt SparksAnd special guests:Agnes Fozo: John L. Shapiro Chair of Pathology at Vanderbilt University and on Twitter: https://twitter.com/AgnesFogoHua Su: Professor of Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaOsama El Shamy: Home Therapy Fellow at Mount Sinai and on Twitter: https://twitter.com/osamaelshamy88Chirag Parikh: Director of Nephrology Johns Hopkins and on Twitter: https://twitter.com/KidneydrChiragShow Notes:Mark Denison, Corona virus expert. https://www.vumc.org/viiii/person/mark-r-denison-md and on Twitter: https://twitter.com/DenisonLabDiscussion on Twitter that the 3electron microgrpahs may show clathrin coated pits rather than Conorna virus. https://twitter.com/vighnesh_w/status/1250880961463513088?s=20Chris Larsen’s case of collapsing glomerulopathy in a patient with COVID-19 https://www.kireports.org/article/S2468-0249(20)31172-4/abstractOsler's rule: States that a neurological defect has to be related to a specific lesion, in contrast to Hickam's dictum, which states that the neurological defect can be due to several lesions.Altered Lipid Metabolism in Recovered SARS Patients Twelve Years after Infection. https://www.ncbi.nlm.nih.gov/pubmed/28831119We don’t record (or roll) on the sabath https://www.youtube.com/watch?v=GPo9OBrIOi4Using a dialysis machine to make CRRT dialysate, the Tweet: https://twitter.com/KidneydrChirag/status/1249867795602583554Derek Fine, Parikh’s partner in crime: https://www.hopkinsmedicine.org/profiles/results/directory/profile/0007605/derek-fine and on Twitter: https://twitter.com/DerekFineMDTablo Machine makes its own dialysate. It does not look like a cooler. https://www.outsetmedical.com/tablo/Is Canada a communist country? https://www.quora.com/Is-Canada-a-communist-countryLokelma is not a sponsor of Freely FilteredComplications and Catheter Survival With Prolonged Embedding of Peritoneal Dialysis Catheters https://pubmed.ncbi.nlm.nih.gov/18281722/Ontario Nursing Homes,”It felt like a war zone” https://www.pri.org/stories/2020-04-24/it-felt-war-zone-coronavirus-tears-through-canada-nursing-homes
Cast:Joel TopfSwapnil HiremathSamira FaroukJennie LinMatt SparksAnd special guest Joshua WaitzMartin Pollak: http://www.nasonline.org/member-directory/members/20033579.htmlJosh Waitz @jwaitz100 Days of COVID-19: https://www.voanews.com/episode/100-days-covid-19-4236811MinTac: http://www.nephjc.com/news/mintacMy magical experience with minimal change disease. This is not the actual tweet, but a dramatization: http://pbfluids.com/2020/04/the-magic-of-treating-minimal-change-disease/Non-inferiority, NephJC: http://www.nephjc.com/news/2019/7/8/understanding-the-vortex-of-non-inferiority-trialsNon-inferiority, through the looking glass: https://pubmed.ncbi.nlm.nih.gov/21539749/Kevin Fowler on Tacrolimus side effects: https://twitter.com/gratefull080504/status/1247697780736512000?s=20Mt Sinai is converting some transplant patients from tacrolimus to belatecept: https://www.nejm.org/doi/full/10.1056/nejmoa1506027CAPSULOLOGY: Open the “Images” tab https://www.webmd.com/drugs/2/drug-10097-6108/tacrolimus-oral/tacrolimus-oral/detailsTacrolimus for your cat and dog dry eye needs: https://vcahospitals.com/know-your-pet/tacrolimus-ophthalmic-in-dogsWHO, NSAIDs, and double negatives: https://twitter.com/kidney_boy/status/1240452941187821570?s=20CJASN stands for the Clinical Journal of the American Society of Nephrology. The C does not stand for Canada. Sorry Swap.Conversion calculator from old world (SI) units, mg/mole Cr, to freedom units (gram protein / gram creatinine): http://www.scymed.com/en/smnxps/psdjf223.htmMichelle Rheault about starting the clock to relapse tweet: https://twitter.com/rheault_m/status/1247703322200596483?s=20Marvin Gonzalez calls for larger studies: https://twitter.com/MarvinGonzlez16/status/1247701186972733442?s=20Acute PD for COVID-19 is discussed in this article from CJASN: https://cjasn.asnjournals.org/content/early/2020/04/03/CJN.03750320PD for AKI, the experience from Brazil https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3525422/The lead author, Daniela Ponce is really the world authority on PD and AKI: https://www.ncbi.nlm.nih.gov/pubmed/?term=Ponce%20D%5BAuthor%5D&cauthor=true&cauthor_uid=22641732Nursing home outbreaks in Durham: https://www.newsobserver.com/news/coronavirus/article241975401.htmlPrison outbreak: https://www.npr.org/2020/04/06/827922287/inmates-staff-on-edge-as-covid-19-spreads-through-federal-prisonsOttawa COVID-19: https://ottawacitizen.com/news/local-news/covid-19-long-term-care-outbreaks-continue-devastating-spread-across-ontario/West Coast herd immunity: https://www.ksbw.com/article/new-study-investigates-californias-possible-herd-immunity-to-covid-19/32073873#The History of HIV associated Nephropathy: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3494840/Racial breakdown of NYC coronavirus deaths reveals ‘disparities,’ de Blasio says https://nypost.com/2020/04/08/de-blasio-releases-racial-breakdown-data-of-coronavirus-deaths/Michelle Rheault is tired: https://twitter.com/rheault_m/status/1248371721356402689?s=20KidneyCon Lite! Saturday April 18 from 9-11. Kidney Pathology workshop.Lunch Doodles with Mo Willems: https://youtu.be/7KBkUyE6MOwDr Glaucomflecken and Telehealth: https://twitter.com/DGlaucomflecken/status/1247709538322657282?s=20NephSim for kindergartner’s https://nephsim.comNephSim live: https://twitter.com/Neph_SIM/status/1247637727048327170?s=20
Loeb’s Laws of Medicine or Loeb’s Rules of TherapeuticsRobert Frederick Loeb (March 14, 1895-October 21, 1973) was a famous American Physician who provided some very simple common sense approach to treating patients know as:1. If what you are doing is doing good, keep doing it.2. If what you are doing is not doing good, stop doing it.3. If you do not know what to do, do nothing.4. Never make the treatment worse than the disease.The last ‘law’ in present times is often replaced with:“If at all possible, keep your patient out of the operating room.”Or“Above all, never let a surgeon get your patient.”This is a decent reference for this: https://www.ncbi.nlm.nih.gov/books/NBK13258/Dr. Glaucomflecken gives some tips for attending trying to go back to the ICU: https://twitter.com/DGlaucomflecken/status/1238954558140772354?s=20Francis Deng and going back to become an internist: https://twitter.com/francisdeng/status/1245475268158009349?s=20JCI article on using convalescent serum for treating disease: https://www.jci.org/articles/view/138003Human trial of convalescent serum from JAMA: https://jamanetwork.com/journals/jama/fullarticle/2763983 It works! (in uncontrolled, observational trials)Monkeys develop protective antibodies: https://www.biorxiv.org/content/10.1101/2020.03.13.990226v1Time course for antibodies and viral clearance in SARS-CoV2 from Nature: https://www.nature.com/articles/s41586-020-2196-xPeripheral blood monocyte proeonomics: https://www.biorxiv.org/content/10.1101/2020.03.31.019216v1.full.pdfCytokine storm in the New York Times. Check mate Rheumatologists: https://www.nytimes.com/2020/04/01/health/coronavirus-cytokine-storm-immune-system.htmlDr. Anthony Chang and Thrombi on COVID biopsies: https://twitter.com/ChangUCanSpare/status/1240686922332160001?s=20ASN April 2 Webinar on dialysis and COVID-19 with Anitha Vijayan (among others): https://www.asn-online.org/ntds/resources/Webcast_2020_04_02_COVID-19.mp4UK data on length of ventilatory support (ICNARC): https://t.co/WB1ZnODRFF?amp=1Swap forgot Michele Mokrzycki’s name. Her name is Michele.Samira’s elementary school shampoo: https://www.influenster.com/reviews/pert-plus-classic-clean-2-in-1-shampoo-conditionerProlonged Intermittent Renal Replacement Therapy (PIRRT): https://www.ncbi.nlm.nih.gov/pubmed/27113696MDCalc COVID-Resource Center: https://www.mdcalc.com/covid-19Acute PD for COVID-19 is discussed in this article from CJASN: https://cjasn.asnjournals.org/content/early/2020/04/03/CJN.03750320PD for AKI, the experience from Brazil https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3525422/The lead author, Daniela Ponce is really the world authority on PD and AKI: https://www.ncbi.nlm.nih.gov/pubmed/?term=Ponce%20D%5BAuthor%5D&cauthor=true&cauthor_uid=22641732NEJM ACE2 review article that Matt didn’t read or peer review: https://www.nejm.org/doi/full/10.1056/NEJMsr2005760NephJC COVID site: http://www.nephjc.com/covid19
NephJC’s COVID-19 and the Kidney PatientCast:Joel TopfSwapnil HiremathSamira FaroukJennie LinMatt SparksShow Notes:The NephJC Page on ACE2 and COVID-19Nature Letter showing AER2’s central role in lung injury (in mice). This was SARS from 2005.Losartan RCT in COVID-19; University of Minnesota:Outpatient NCT04311177Inpatient NCT04312009France's health ministry says NSAIDs may be bad in COVID-19 coverage by CNNWHO Tweets its position on NSAIDs.Early case report on COVID-19 and (heart) transplantMatt’s question to Twitter about cytokine stormASN Webinar on dialysis and COVID-19NephJC page on dialysis and COVID-19Dimitrios G. Oreopoulos, one of the giants of peritoneal dialysisTwitter Self Care BotTweetorial on Zoom by SamiraChristos Argyropoulos the Nostradamus of COVID-19
Plasma Exchange and Glucocorticoids in Severe ANCA-Associated VasculitisSummary on NephJCCast:Joel TopfSwapnil HiremathSamira FaroukJennie LinJordy CohenShow Notes:55th ERS-EDTA Congress, late breaking and high impact trials. June 2018The CJASN Review recommended by JennieMEPEX studyC5a antagonist, Avacopan in ANCA-Associated VasculitisThe fragility index as described in JAMA SurgeryMichael Walsh looks at the Fragility Index in 399 trials in medical literatureThe EVOLVE trial of Cinacalcet. Age-adjusted HR results in statistically significant results for primary outcome, but was not defined as the primary endpoint. Patients were one year older in the cinacalcet group; older age known to increase mortality in dialysis patients. Wiki Journal Club.Ron Falk and his irresponsible editorial.Cochrane Systematic Review and Meta-analysis of Anti‐cytokine targeted therapies for ANCA‐associated vasculitisNephMadness is now in full swing at the AJKDblog!
Just the dudes gathered to talk about the JAMA Internal Medicine Meta Analysis on Gadolinium in CKD stage 4 and 5.Risk of Nephrogenic Systemic Fibrosis in Patients With Stage 4 or 5 Chronic Kidney Disease Receiving a Group II Gadolinium-Based Contrast AgentA Systematic Review and Meta-analysis.Summary on NephJCCast:Joel TopfSwapnil HiremathMatt SparksShow Notes:Swap has a disclosure!He was an author on the Canadian Association of Radiology guidelines on use of Gad in CKD.Grobner’s original paper reporting the association between gadolinium and NSF.Matt’s article on alternatives to gadolinium in MRI:Diagnostic value of alternative techniques to gadolinium-based contrast agents in MR neuroimaging—a comprehensive overviewUsing Ferumoxytol as an MRI contrast agent.Saurabh Jha’s editorial (@RogueRad) for NephMadness when Gadolinium in CKD 4 was a team in 2018.PEXIVAS was an abstract in 2018 and was not published until 2020.A Cultural History of Rock-Paper-ScissorsMichelle’s recent case of NSF in a child (in case you thought this disease was gone)Removing Gad with dialysis.Matt’s tubular secretion: Biorender.comJohn Mandrola Expert or not an expert?JACC Case Reports on the Kardashian IndexRobert Cardiff’s editorial on the Kardashian Index in JACC Case Reports.Bryan Vartabedian blog post on Robert Cardiff’s editorialAnd NephMadness is coming! Friday March 13, 2020!
Cast:Joel TopfJennie LinSwapnil HiremathMatt SparksShow Notes:The NephJC discussion can be found here.The study was published in the NEJM.NephJC summary of the AJKD systematic review of uremic pruritusAtul Gawande on itching.Pinnacle MountainComprehensive review on toxicodendron dermatitis: poison ivy, oak, and sumac.KIDNEYconTom Oates 12 days of Poems on Twitter
Cast:Joel TopfJennie LinSwapnil HiremathMatt SparksSamira FaroukShow Notes:Pathway 2 Trialhttps://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)00257-3/fulltextNephJC discussion of Pathway2http://www.nephjc.com/pathwayThe DIAMOND Trial. Much more ambitious than I described in the podcast.https://clinicaltrials.gov/ct2/show/NCT03888066SPRINThttps://www.nejm.org/doi/full/10.1056/NEJMoa1511939Omron 907 BP cuffonly $678 from Amazon: https://www.amazon.com/Omron-HEM-907XL-IntelliSense-Professional/dp/B000FENZPSEvaluation of the Potential for Drug Interactions With Patiromer in Healthy Volunteers:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5555446/The TOPCAT Trial story: A Clinical Trial Torpedoed By Fraud and Incompetencehttps://blogs.sciencemag.org/pipeline/archives/2017/04/27/a-clinical-trial-torpedoed-by-fraud-and-incompetenceCJSAN article looking at 24-hour urine for calcium and phos with patiromerhttps://cjasn.asnjournals.org/content/14/1/103Swap’s best tweeters of #Kidney Wkaldorodrigo https://twitter.com/aldorodrigoAlex Meraz https://twitter.com/nephroguyJoshua Waitzman https://twitter.com/JwaitzKIDNEYconkidneycon.org
The Filtrate (minus Matt) gather to talk about the Deep Mind trial on predicting AKI. For the first time the Filtrate invited a guest, Perry Wilson, to help them navigate the trial.
Cast:Joel TopfJennie LinSwapnil HiremathPerry WilsonSamira FaroukShow Notes:A clinically applicable approach to continuous prediction of future acute kidney injury. https://www.ncbi.nlm.nih.gov/pubmed/?term=A+clinically+applicable+approach+to+continuous+prediction+of+future+acute+kidney+injury#Deep Mind National Health services scandal https://www.telegraph.co.uk/technology/2017/07/03/googles-deepmind-nhs-misused-patient-data-trial-watchdog-says/KDIGO AKI guidelines (PDF) https://kdigo.org/wp-content/uploads/2016/10/KDIGO-2012-AKI-Guideline-English.pdf Frank Harrell on the value of continuous variables http://biostat.mc.vanderbilt.edu/wiki/Main/CatContinuousThanks. Start with chapter 4 of https://t.co/nwJdNoBtU6 and https://t.co/FQh46EFqdK and my blog articles on https://t.co/8sdCD3RJoQ related to medical decision making— Frank Harrell (@f2harrell) September 25, 2019
Wilson’s AKI Alert trial published in The Lancet, Automated, electronic alerts for acute kidney injury: a single-blind, parallel-group, randomised controlled trial. http://www.nephjc.com/aki-alertThe NINJA trial http://www.nephjc.com/news/2016/8/3/ninja-using-technology-to-prevent-acute-kidney-injury?rq=ninja The end of EPICparodyEMR: https://twitter.com/EPICEMRparody/status/1178788488881299457?s=20Folks. It’s been fun. I think I’m done here for awhile (maybe forever). Things are stale. No new ideas. Actually blocked some people who annoyed me today. That means it’s time to turn off the screens and play with children and puppies. Bye for now. Hope I made you smile. pic.twitter.com/f7L6CLsD5t— EPICparodyEMR (@EPICEMRparody) September 30, 2019
EPICparodyEMR on Explore the Space: https://www.explorethespaceshow.com/podcasting/epicparodyemr-on-electronic-medical-records/Tweet where Nassim Nicholas Taleb calls Swap an imbecile: Imbecile, please show with precision where "he is wrong". With precision.— Nassim Nicholas Taleb (@nntaleb) September 29, 2019
Blood Pressure Medicines for Five Years to Prevent Death, Heart Attacks, and Strokes. https://www.thennt.com/nnt/anti-hypertensives-to-prevent-death-heart-attacks-and-strokes/NNT is SPRINT: In participants assigned to intensive BP lowering, major adverse cardiovascular events were reduced by 25% (5.2% v. 6.8%; hazard ratio [HR] 0.75, 95% confidence interval [CI] 0.64–0.89; number needed to treat [NNT] of 62 over 3 yr) and all-cause mortality was reduced by 27% (3.3% v. 4.5%; HR 0.73, 95% CI 0.60–0.90; NNT of 90 over 3 yr).NNT is highly misleading when assessing chronic disease prevention. https://www.ncbi.nlm.nih.gov/pubmed/25027390Washington University School of Medicine establishes Division of Physician-Scientists https://medicine.wustl.edu/news/school-of-medicine-establishes-division-of-physician-scientists/Physician scientists in the NEJM https://www.nejm.org/doi/full/10.1056/NEJMp1904482 NYT article on Physician Scientists: https://www.nytimes.com/2019/09/23/opinion/doctor-scientist-medical-research.htmlbrussels.sprout on Instagram https://www.instagram.com/brussels.sprout/?hl=en Superintelligence by Nick Bostrom https://www.amazon.com/Superintelligence-Dangers-Strategies-Nick-Bostrom/dp/1501227742Amazon bulk powdered cheese: https://www.amazon.com/s?k=powdered+cheese&ref=nb_sb_noss