Freely Filtered, a NephJC Podcast

The Filtrate:Matt SparksJennie LinSamira FaroukJoel TopfSwapnil HiremathAnd two special guests:Dawn J. Caster, Assistant Professor at University of LouisvilleAlfred Kim, Assistant Professor of Medicine at Washington University (Twitter)Show Notes:NephJC coverage of the trial: The Bliss trialIn the NEJM: https://www.nejm.org/doi/full/10.1056/NEJMoa2001180 Turtles all the way down: https://en.wikipedia.org/wiki/Turtles_all_the_way_down Nature previews Nephrology on BAFF: https://www.nature.com/articles/nri844 Phase III trial results with blisibimod, a selective inhibitor of B-cell activating factor, in subjects with systemic lupus erythematosus (SLE): results from a randomised, double-blind, placebo-controlled trial: https://pubmed.ncbi.nlm.nih.gov/29563108/ BRIGHT-SC: Blisibimod Response in IgA Nephropathy Following At-Home Treatment by Subcutaneous Administration: https://clinicaltrials.gov/ct2/show/NCT02062684 Guideline for naming monoclonal drugs: https://www.antibodysociety.org/wordpress/wp-content/uploads/2017/07/INN-2017-Reference-20.pdf A long-term study of hydroxychloroquine withdrawal on exacerbations in systemic lupus erythematosus. The Canadian Hydroxychloroquine Study Group: https://pubmed.ncbi.nlm.nih.gov/9541091/ Long-term follow-up of the MAINTAIN Nephritis Trial, comparing azathioprine and mycophenolate mofetil as maintenance therapy of lupus nephritis https://pubmed.ncbi.nlm.nih.gov/25757867/ A Day In The Life Of Dr. Anthony Fauci: https://www.huffpost.com/entry/anthony-fauci-fighting-covid-19_n_5fc7fed7c5b61bea2b14e3eeMC Arbatin MD FPCP FPSN @mcamd: the glomerulus tree: https://twitter.com/mcamd/status/1337744822543605760 finished product: https://twitter.com/mcamd/status/1338429211963322371

The Filtrate:Swapnil HiremathSamira FaroukMatt SparksJoel TopfJennie LinAnd two special guests:Katherine Tuttle Clinical Professor Division of Nephrology, Medical & Scientific Director, Providence Medical Research Center/Sacred Heart Center, Professor of Basic Medical Sciences, WWAMI Program Washington State Universityendocrinologist and nephrologist at the University of Washington Ian de Boer Professor in the Division of Nephrology, Adjunct Professor, Epidemiology and Associate Director, Kidney Research InstituteShow Notes:The GuidelineNephJC’s summaryAccord study showing harm from tight glycemic controlAdvance Trial the other trial showing harm from tight glycemic control2007 KDOQI diabetes guidelines2012 KDOQI diabetes guidelinesADA guidelinesRob Nelson, diabetes legendClassic pathology of diabetic nephropathyShould all patients with diabetes have a kidney biopsy?Flow trial: A Research Study to See How Semaglutide Works Compared to Placebo in People With Type 2 Diabetes and Chronic Kidney DiseaseThe Grading of Recommendations Assessment, Development and Evaluation (short GRADE) working group. Don’t you love it when the first word in an acronym is the acronym itself.Continuous Glucose Monitoring and Use of Alternative Markers To Assess Glycemia in Chronic Kidney DiseaseContinuous glucose monitoring and icodextrin. Keto diets have 1.2 to 1.7 g protein/kgUrinary Sodium and Potassium Excretion, Mortality, and Cardiovascular Events by the PURE investigatorsThe Association Between Kidney Disease and Diabetes Remission in Bariatric Surgery Patients With Type 2 DiabetesJordy Cohen and Bariatric surgery in CKD at Kidney WeekMetformin knocking out of the park in UKPDSKidneys at the Zoo: What Can We Learn from Comparative Renal Physiology? at Kidney Week

The Filtrate:Swapnil HiremathSamira FaroukMatt SparksJoel TopfJennie LinAnd two special guests:Katherine Tuttle Clinical Professor Division of Nephrology, Medical & Scientific Director, Providence Medical Research Center/Sacred Heart Center, Professor of Basic Medical Sciences, WWAMI Program Washington State Universityendocrinologist and nephrologist at the University of Washington Ian de Boer Professor in the Division of Nephrology, Adjunct Professor, Epidemiology and Associate Director, Kidney Research InstituteShow Notes:The GuidelineNephJC’s summaryAccord study showing harm from tight glycemic controlAdvance Trial the other trial showing harm from tight glycemic control2007 KDOQI diabetes guidelines2012 KDOQI diabetes guidelinesADA guidelinesRob Nelson, diabetes legendClassic pathology of diabetic nephropathyShould all patients with diabetes have a kidney biopsy?Flow trial: A Research Study to See How Semaglutide Works Compared to Placebo in People With Type 2 Diabetes and Chronic Kidney DiseaseThe Grading of Recommendations Assessment, Development and Evaluation (short GRADE) working group. Don’t you love it when the first word in an acronym is the acronym itself.Continuous Glucose Monitoring and Use of Alternative Markers To Assess Glycemia in Chronic Kidney DiseaseContinuous glucose monitoring and icodextrin. Keto diets have 1.2 to 1.7 g protein/kgUrinary Sodium and Potassium Excretion, Mortality, and Cardiovascular Events by the PURE investigatorsThe Association Between Kidney Disease and Diabetes Remission in Bariatric Surgery Patients With Type 2 DiabetesJordy Cohen and Bariatric surgery in CKD at Kidney WeekMetformin knocking out of the park in UKPDSKidneys at the Zoo: What Can We Learn from Comparative Renal Physiology? at Kidney Week

The Filtrate:Swapnil HiremathSamira FaroukMatt SparksJoel TopfAnd two special guests:Vandana Dua Niyyar, Professor of Medicine at Emory University and the president elect of American Society of Diagnostic and Interventional Nephrology. Wears lead.Sophia Ambruso, assistant professor and nephrologist at the University of Colorado.Show Notes:Drug-Coated Balloons for Dysfunctional Dialysis Arteriovenous FistulasThe NephJC summaryThe article in the NEJMThe Haskal study, Stent Graft versus Balloon Angioplasty for Failing Dialysis-Access Grafts in the NEJM from 2010Accuracy of physical examination in the detection of arteriovenous fistula stenosisThe Big Three was a trio of Major League Baseball starting pitchers for the Atlanta Braves from 1993-2002 which consisted of Greg Maddux, Tom Glavine, and John Smoltz. The Big Three combined to win seven National League Cy Young Awards in the 1990s and helped lead the Atlanta Braves to a 1995 World Series win. Each member of the Big Three has had their jersey retired by the Atlanta Braves and has been inducted into the Baseball Hall of Fame. (From Wikipedia)The Trerotola study, Drug Coated Balloon Angioplasty in Failing AV FistulaeScathing anti-interventional nephrologist editorial by TrerotolaRebuttal though data by Beathard, Effectiveness and safety of dialysis vascular access procedures performed by interventional nephrologistsAnd then a walk back and update by Tretola…What is the current and future status of interventional nephrology?Paclitaxel mechanism of action video with awesome musicThe role of fungus in the paclitaxel story Twitter comment on the half life of balloon delivered paclitaxelThe meta analysis of peripheral revasculaization having a mortality signal with paclitaxel: Risk of Death Following Application of Paclitaxel-Coated Balloons and Stents in the Femoropopliteal Artery of the Leg: A Systematic Review and Meta-Analysis of Randomized Controlled TrialsFDA warning about paclitaxel balloons: Treatment of Peripheral Arterial Disease with Paclitaxel-Coated Balloons and Paclitaxel-Eluting Stents Potentially Associated with Increased MortalityThe NephJC primer on non-inferiority trials: Understanding the vortex of non-inferiority trialsASN Distinguished Clinical Service Award 2020 goes to Vandana Dua Niyyar! (and Derek Fine, who is also a great guy)ASN Kidney Week Sessions:Samira: Embracing Technology: Nephrology 2.0Swapnil: Hard-to-Control Hypertension: What to Do Next?Vandana: A Look Inside: Noninvasive Imaging of Kidney Diseases

The Filtrate:Matt SparksJoel TopfSwapnil HiremathJennie LinJordy CohenAnd two special guests:Morgan Grams, study author.Talar Kharadjian, nephrology fellow UC San DiegoShow Notes:History of albuminuria from Matt’s opening monolog: https://academic.oup.com/ndt/article/18/7/1281/1809803Microalbuminuria As A Predictor Of Clinical Nephropathy In Insulin-Dependent Diabetes Mellitus in the Lancet 1982.Microalbuminuria Predicts Clinical Proteinuria and Early Mortality in Maturity-Onset Diabetes in the NEJM 1984Episode of Freely Filtered with Dr. Feldman, the big guy at the top of the CRIC trial: NSAIDs vs Opioids.The Aldo study where they didn’t do a meta-analysis but they should have: Aldosteronism is everywhere.Estimating Urine Albumin-to-Creatinine Ratio from Protein-to-Creatinine Ratio: Development of Equations using Same-Day Measurements. Canadian data. CJASNThe kidney failure risk equation has a dotcom: https://kidneyfailurerisk.comKDIGO Controversies Conference on Early Identification & Intervention in CKDChoose Your Own Adventure: Cave of Time.Witte et al. in 2009 JASN on first morning urine vs 24 hour collection: First Morning Voids Are More Reliable Than Spot Urine Samples to Assess MicroalbuminuriaSensitivity and specificity for Joel to studyYour Manuscript On Peer ReviewNephrology Business Leaders University (NBLU)Cloth Masks May Prevent Transmission of COVID-19: An Evidence-Based, Risk-Based Approach with lead author Catherine Clasehttps://www.clothmasks.caElimination or Prolongation of ACE Inhibitors and ARB in Coronavirus Disease 2019 (REPLACECOVID)Fast Grant. Apparently they are not just for Brian ByrdNephJC ACE2 Stuff as Jordy calls it: http://www.nephjc.com/news/covidace2The BRACE-CORONA trial a 700 person RCT of ACEi and ARB in Covid-19. No effect. Tweet stream by Swapnil.MC Hammer is a science nerd: https://cen.acs.org/education/science-communication/Hammer-time-Science-Twitter-drummers/98/i31Hammerman origin story for the MC Hammer cartoon.Bowman Society Lecture - Race & Renal Function CalculationsBasic Research Forum for Emerging Kidney Scientists: A Partnership Between APS and ASN

The Filtrate:Matt SparksJoel TopfSwapnil Hiremath COI: he was a sub-investigator on STARRTJennie LinAnd two special guests:Dr. Jay Koyner of the University of Chicago and #NephBBQ fame.Anitha Vijayan, professor of medicine at Wash U in St LouisShow Notes:The STARRT-AKI trial acronym is: Standard versus Accelerated Initiation of Renal-Replacement Therapy in Acute Kidney InjuryMatt suggests STAKRT-AKI Standard versus Accelerated Initiation of Kikdney-Replacement Therapy in Acute Kidney InjuryCoverage at NephJC: Time to Stop Starting RRT Early in AKIHouse of God by Samuel Shem. Contemporary Review in the New Yorker. AmazonRonco’s legendary dose of CRRT study. Lancet 2000.AJKD Meta analysis on initiation of dialysis in AKI by VF Seabra.Lead time biasTiming of Initiation of Dialysis in Critically Ill Patients with Acute Kidney Injury Initiation of dialysis by BUN in the Picard trial by Dr. Kathleen Liu.Jean-Luc PicardImmortal time biasAKIKI and ELAIN trials as covered by NephJCIssues surrounding informed consent in the ICUThe Chicago WayDr Palevsky’s ATN Study, AKA Intensity of Renal Support in Critically Ill Patients with Acute Kidney InjuryIs Irregardless A Word?Debate at Kidney Week: Intensivist vs Nephrologist for Renal Replacement Therapy (RRT) in the ICUInternal and External Validation of a Machine Learning Risk Score for Acute Kidney InjuryThat sweet sweet NephJC pot of goldFurosemide Stress Test and Biomarkers for the Prediction of AKI SeverityThai study that used FST to randomize patients for early versus late start KRT: Early versus standard initiation of renal replacement therapy in furosemide stress test non-responsive acute kidney injury patients (the FST trial)AKIKI 2 at clinical trials.govSwapnil’s Tubular secretion, the Twitter timeline of Oded RechaviMatt’s Tubular Secretion: #kidneydietchallengeAnitha comes from the land of coconuts. Lots of potassium in coconut water.The Skeleton Key Group on The Renal Fellow Network

The Filtrate:Matt SparksJoel TopfSwapnil HiremathSamira FaroukJennie LinAnd three special guests:Carina Seah a second year MD PhD student Mt Sinai who led the initiative to remove race from the eGFR formulasPoyan Mehr, founder of GlomCon and author of this post on the use of race in eGFR estimating formulas.Deidra Crews Professor of Medicine and researcher in health disparities.Show Notes:Petition for Removal of “Race Correction” in eGFR at Mount Sinai https://docs.google.com/document/d/1vJCwVndyzemWCx8RXZLvLm6JLuFN7NdgEFVCFaDnSOk/editDr Murphy, Dean For Clinical Integration And Population Health. Professor And System Chair. https://icahn.mssm.edu/profiles/barbara-murphyThe Bowman Society at the University of Chicago. I can not find a recording of the webinar https://pritzker.uchicago.edu/resources/bowman-societySocial Determinants of Racial Disparities in CKD https://jasn.asnjournals.org/content/27/9/2576Socioeconomic Disparities in Chronic Kidney Disease https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4291541/Shortcomings of the current GFR estimating equations https://pubs.glomcon.org/archives/1491Alan S Go’s work on eGFR, hospitalization and death: https://www.nejm.org/doi/full/10.1056/nejmoa041031Tangri Kidney Failure Risk Calculation https://kidneyfailurerisk.comDe-adjusting for body surface area: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2756662/2018 Nature Reviews Nephrology Porrini Estimated GFR: time for a critical appraisal https://www.nature.com/articles/s41581-018-0080-9Estimating Glomerular Filtration Rate from Serum Creatinine and Cystatin C https://www.nejm.org/doi/full/10.1056/nejmoa1114248Transdermal Measurement of Glomerular Filtration Rate in Mice https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6235579/Worldwide Frequencies of Apolipoprotein L1 Renal Risk Variants https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6482949/Health Affairs Blog about when and how to measure race in research: https://www.healthaffairs.org/do/10.1377/hblog20200630.939347/full/ASN Kidney Stars https://www.asn-online.org/grants/travel/details.aspx?app=MSR

The Filtrate:Joel TopfSwapnil HiremathSamira FaroukAnd special guests:Katalin Susztak, Professor of Medicine Perlman School of Medicine, University of Pennsylvania. @KSusztakShow Notes:CKD-FIX: Effects of Allopurinol on the Progression of Chronic Kidney DiseasePERL: Serum Urate Lowering with Allopurinol and Kidney Function in Type 1 DiabetesCoverage at NephJC: Effects of Allopurinol on the Progression of Chronic Kidney DiseaseRichard Johnson’s theory in pay-walled Nature Reviews Nephrology: Hypothesis: fructose-induced hyperuricemia as a causal mechanism for the epidemic of the metabolic syndromeRichard Johnson’s theory in open access Nehrology Dialysis and Transplantation: Uric acid and chronic kidney disease: which is chasing which?PERL: Preventing early renal lossIohexol, good for measuring GFR as well as causing contrast associated nephropathy?Uric acid versus urate: The Crystallization of Monosodium UrateAssociation of HLA-B*5801 allele and allopurinol-induced Stevens Johnson syndrome and toxic epidermal necrolysis: a systematic review and meta-analysisWHO list of essential medicationsFixing the numbers, specifically phosphorousGFR Decline as an End Point for Clinical Trials in CKD: A Scientific Workshop Sponsored by the National Kidney Foundation and the US Food and Drug AdministrationCost of allopurinol: $7/month but it is only $9 for 3 monthsFebuxostat Therapy for Patients With Stage 3 CKD and Asymptomatic Hyperuricemia: A Randomized TrialTipping point analysis - multiple imputation for stress test under missing not at random (MNAR) or a YouTube video if that’s your speed (sorry, I couldn’t find a TikTok on imputation stress tests).Mendelian randomization study of urate and CKD by Ron Do and teamDad jokesFake systematic review by Johnson’s group showing Urate lowering prevented CKDHyperuricemia As a trigger of Immune Response in Hypertension and Chronic Kidney Disease by Claudio Ponticelli published the week after these two RCTs were published.NEJM Editorial: Urate-Lowering Therapy and Chronic Kidney Disease Progression by Daniel FeigCOVID and PPI manuscriptHashtag the cowboy‘WhatsApp®’ening in nephrology trainingArkana LIVE Pathology SessionsNephJC Summer Book Club. Read Rana Awdish’s In Shock

The Filtrate:Joel TopfSwapnil HiremathSamira FaroukMatt SparksJordy CohenAnd special guests:Brian Byrd, a cardiologist investigating aldosteronism at the University of MichiganandSusan Steigerwalt, a nephrologist and hypertension specialist who unfortunately due to technical problems largely was cut out of this episode 😢.The Study: The Unrecognized Prevalence of Primary AldosteronismCoverage at NephJC: http://www.nephjc.com/news/aldosterone“What gets measured, gets managed.” Peter Drucker, or notHow much sodium comes from the food processing? 71%. Fourteen percent comes from the food itself, with 5% coming from food prep at home and another 5% from the salt shaker at the table. https://www.ahajournals.org/doi/epub/10.1161/CIRCULATIONAHA.116.024446Surgical versus medical therapy for primary hyperaldosteronism: https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.117.10596 .And the editorial by David Calhoun: https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.118.10759I could find no empiric data to support Swap’s supposition that the French and Italian people are more courageous than people in Canada. Citation needed.ENAC inhibitors as treatment for primary hyperaldosteronism: https://onlinelibrary.wiley.com/doi/full/10.1111/jch.13566Pathway 3 Trial: https://www.thelancet.com/journals/landia/article/PIIS2213-8587(15)00377-0/fulltextRennin in cow stomachs: http://www.vivo.colostate.edu/hbooks/pathphys/digestion/stomach/rennin.htmlSodium content of muffins: https://www.fatsecret.com/calories-nutrition/food/muffins/sodiumThe MICE Package in R: MICE: Multivariate Imputation via Chained Equations) https://www.analyticsvidhya.com/blog/2016/03/tutorial-powerful-packages-imputing-missing-values/Gender-Affirming Hormone Therapy, Vascular Health and Cardiovascular Disease in Transgender Adults https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.119.13080False-positive aldosterone renin ratios in patients on combined estrogen progesterone treatment (only with direct renin concentration, the plasma renin activity is not fooled) https://academic.oup.com/jcem/article/102/7/2329/3093639John Funder video commentary on the study: https://www.acpjournals.org/doi/abs/10.7326/M20-1758ACD blood pressure guidelines (note the absence of B): https://pubmed.ncbi.nlm.nih.gov/17083059/Pathway 2 study: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)00257-3/fulltextALLHAT trial: https://pubmed.ncbi.nlm.nih.gov/12479763/international.org/article/S0085-2538(20)30552-4/abstract