Freely Filtered, a NephJC Podcast

Cast:Joel TopfJennie LinSwapnil HiremathMatt SparksShow Notes:NephJC Coverage of MENTOR: http://www.nephjc.com/news/mentorMENTOR: https://www.nejm.org/doi/full/10.1056/NEJMoa1814427KDIGO Membranous recommendations: https://kdigo.org/wp-content/uploads/2017/02/KDIGO-2012-GN-Guideline-English.pdf2017 Kidney Week Abstract: https://www.asn-online.org/education/kidneyweek/2017/program-abstract.aspx?controlId=2831149PEXIVAS: http://www.nephjc.com/news/pexivasearlyHeymann Nephritis: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3042693/Susan Quaggin: https://www.feinberg.northwestern.edu/faculty-profiles/az/profile.html?xid=26269Manasi Bapat on non-inferiority trials: http://www.nephjc.com/news/2019/7/8/understanding-the-vortex-of-non-inferiority-trialsPrognosis and risk factors for idiopathic membranous nephropathy with nephrotic syndrome in Japan: https://www.sciencedirect.com/science/article/pii/S0085253815498503Nice review of Membranous by Alfaadhel and Cattrran that purports to say than CNI are the standard therapy for idiopathic membranous. (It doesn’t) https://www.ncbi.nlm.nih.gov/pubmed/27536673?dopt=AbstractPablo Garcia saves the day: https://twitter.com/PabloGarciaMD/status/1148767319323099136?s=20Larry beck’s land mark study demonstrating antiPLA2r as the antigen in idiopathic membranous. https://www.nejm.org/doi/full/10.1056/NEJMoa0810457GEMRITUX Study: https://www.ncbi.nlm.nih.gov/pubmed/27352623Jennie Lin’s How to Be a Nephrology Fellow, Choose Your Own Adventure: https://twitter.com/jenniejlin/status/1156329711057981442?s=20CJASN How to Review a Paper Podcast: https://www.asn-online.org/media/podcast/CJASN/2019_07_23_How_to_Write_a_Cons.mp3

Cast:Joel TopfJennie LinSamira FaroukSwapnil HiremathShow Notes:NephJC coverage of SONAR: http://www.nephjc.com/news/sonarSONAR in PubMed: https://www.ncbi.nlm.nih.gov/pubmed/30995972Avosentan for overt diabetic nephropathy, the ASCEND trial: https://www.ncbi.nlm.nih.gov/pubmed/20167702RADAR coverage at NephJC, May 2014: http://www.nephjc.com/atrasentanRADAR in PubMed: https://www.ncbi.nlm.nih.gov/pubmed/24722445/Google Hangout on RADAR: https://www.youtube.com/watch?v=pkkQbb-isog&feature=youtu.beVlado Perkovic: https://twitter.com/VladoPerkovicSONAR: https://en.wikipedia.org/wiki/SonarNephmadness adaptive trial: https://ajkdblog.org/2016/03/10/nephmadness-2016-statistics-in-nephrology-region/#adaptiveKIDNEYcon adaptive trial tweet thread: https://twitter.com/hswapnil/status/1117194018331471873?s=21Excellent NEJM review on adaptive trials: https://www.nejm.org/doi/10.1056/NEJMra1510061Potential role of Adaptive trials in AKI: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4869991/BNP levels in CKD: https://cjasn.asnjournals.org/content/3/6/1644Generalizability from Wikipedia: https://en.wikipedia.org/wiki/Generalizability_theoryAnemia (and other adverse effects) of Endothelin antagonists: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5210319/Data safety monitoring boards: https://www.nidcr.nih.gov/research/human-subjects-research/interventional-studies/data-and-safety-monitoring-board-guidelinesAbbVie Allergen Merger: https://www.barrons.com/articles/abbvie-allergan-merger-pharma-deals-takeda-celgene-bristol-myers-squibb-51563890831Tangri Kidney Failure Risk Equation: https://qxmd.com/calculate/calculator_308/kidney-failure-risk-equation-4-variableFragility index paper: https://www.ncbi.nlm.nih.gov/m/pubmed/24508144/LITFL write up: https://litfl.com/fragility-index/Calculator: https://clincalc.com/Stats/FragilityIndex.aspxCANVAS Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1811744Rates of Hyperkalemia after Publication of the Randomized Aldactone Evaluation Study by David Juurlink et al.: https://www.nejm.org/doi/full/10.1056/NEJMoa040135Vinay Prasad: https://en.wikipedia.org/wiki/Vinay_PrasadClassic mouse studies looking at endothelin: https://www.jci.org/articles/view/119297/pdfhttps://www.ncbi.nlm.nih.gov/pubmed/8377387/https://diabetes.diabetesjournals.org/content/65/8/2429Nice reviews:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4698004/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4216619/Review of vascular effects:https://www.ncbi.nlm.nih.gov/pubmed/28223322

Joel TopfJennie LinMatt SparksSwapnil HiremathShow Notes: IgA Nephropathy ScoreLevi Strauss: https://www.biography.com/fashion-designer/levi-straussLevey MDRD study: https://www.ncbi.nlm.nih.gov/pubmed/10075613ADPKD Total Kidney Volume: https://www.nejm.org/doi/10.1056/NEJMoa054341Halt PKD: https://www.nejm.org/doi/full/10.1056/nejmoa1402685Tempo 3:4 Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1205511Description description of IgA nephropathy by Berger and Hiunglais: https://www.ncbi.nlm.nih.gov/pubmed/4180586The reprint in JASN in 2000 with commentary as part of the Milestones in Nephrology series: https://jasn.asnjournals.org/content/jnephrol/11/10/1957.full.pdf JASN supplies an English translation from the original French.Nice reference from JASN backing up Matt’s assertion that preeclampsia and not IgA nephropathy is the most common glomerular disease in the world: https://jasn.asnjournals.org/content/18/8/2281Description of the Singapore Army screening recruits from the Oxford Textbook of Clinical Nephrology: https://books.google.com/books?id=fVItBQAAQBAJ&lpg=PA485&ots=JRoOnUnleT&dq=singapore%20kidney%20biopsy%20army&pg=PA485#v=onepage&q&f=falseDescription of the Japanese glomerulonephritis screening program: https://cjasn.asnjournals.org/content/2/6/1360Swapnil’s studies on autopsy studies:Finland: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC501386/Japan: https://www.ncbi.nlm.nih.gov/pubmed/12753320/Nephrology Secrets, either one of the best or the best nephrology textbooks ever: https://www.amazon.com/Nephrology-Secrets-Book-Edgar-Lerma-ebook/dp/B079TSYNQW/ref=sr_1_1TESTING Trial on NephJC: http://www.nephjc.com/news/2017/8/28/testingStop-Iga Trial on NephJC: http://www.nephjc.com/iga-nephropathyTesting Trial two: Therapeutic Evaluation of Steroids in IgA Nephropathy Global Study Low Dose Study: https://clinicaltrials.gov/ct2/show/NCT01560052MEST Score versus MEST-C in NephJC: http://www.nephjc.com/news/2016/10/16/do-crescents-matter-for-iga-nephropathyNice discussion of the statistical tests during the Tweet Chat by people who know their stats (I.e. not Joel): https://twitter.com/NephJC/status/1133546750814367746Tweet-length description of IDI: https://twitter.com/kiwiskiNZ/status/1133595698929098752Assessing the performance of prediction models: a framework for traditional and novel measures. https://www.ncbi.nlm.nih.gov/pubmed/20010215/Net Reclassification Indices for Evaluating Risk-Prediction Instruments: A Critical Review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3918180/Predicting Progression in CKD: Perspectives and Precautions https://www.ajkd.org/article/S0272-6386(15)01413-4/abstractThe Article by Nancy Cook in Circulation that Jennie was talking about: Use and misuse of the receiver operating characteristic curve in risk prediction. https://www.ncbi.nlm.nih.gov/pubmed/17309939Discovery of new risk loci for IgA nephropathy implicates genes involved in immunity against intestinal pathogens https://www.nature.com/articles/ng.3118Genome-wide polygenic risk predictors for kidney disease https://www.nature.com/articles/s41581-018-0067-6Where does Matt find minutia like the grams of IgA produced a day? Here: https://www.annualreviews.org/doi/abs/10.1146/annurev-pathol-011110-130216Animal models of IgA nephropathy: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4337240/Matt’s Book Originals: https://www.amazon.com/gp/product/014312885X/ref=dbs_a_def_rwt_bibl_vppi_i1Eric Neilson, Dean of Northwestern University https://www.feinberg.northwestern.edu/faculty-profiles/az/profile.html?xid=23239Brussels sprout Insta-famous dog and future dean of the medical school: https://www.instagram.com/brussels.sprout/?hl=enJosh Farkas Rantorial about Contrast Nephropathy: https://twitter.com/PulmCrit/status/1134922050794139648Swapnil’s Tweetorial about Contrast Nephropathy: https://twitter.com/hswapnil/status/1133906398096609280Tukaram’s pic of NEJM’s progression from Contrast Induced Nephropathy to Contrast Associated Nephropathy: https://twitter.com/tukaramj/status/1135214980985266178Zero sodium dialysate for heart failure? https://twitter.com/i/moments/1134811009217155072

Joel TopfJennie LinMatt SparksSamira FaroukThe strange story of Jennifer Strange.https://insiderexclusive.com/radios-deadly-stunts-the-jennifer-strange-story/Water Pokerhttps://www.thelocal.se/20120706/41878Nintendo Game Consoleshttps://en.wikipedia.org/wiki/Nintendo_video_game_consoles2019 Narins winner, Mitchel Rosner on MDMA induced hyponatremiahttps://www.ncbi.nlm.nih.gov/pubmed/18684895And Rosner again on exercise induced hyponatremia.https://cjasn.asnjournals.org/content/2/1/151The Arieff article on the dangers of severe hyponatremia: Hyponatremia, Convulsions, Respiratory Arrest, and Permanent Brain Damage after Elective Surgery in Healthy Womenhttps://www.nejm.org/doi/full/10.1056/NEJM198606123142401The Richard Sterns article on the dangers of rapid correction of hyponatremia: Osmotic Demyelination Syndrome Following Correction of Hyponatremiahttps://www.nejm.org/doi/10.1056/NEJM198606123142402The editorial by the man himself, Robert Narins: Therapy of Hyponatremiahttps://www.nejm.org/doi/full/10.1056/NEJM198606123142409The infant study showing seizures associated with rapid correction of hypernatremia.https://www.ncbi.nlm.nih.gov/pubmed/35558?dopt=AbstractFollow up study with oral rehydration.https://www.ncbi.nlm.nih.gov/pubmed/3958850?dopt=AbstractThe Linder study of adults admitted to the ICUhttps://www.ncbi.nlm.nih.gov/pubmed/18037096French study on patients presenting to the ER with hypernatremia.https://bmcnephrol.biomedcentral.com/articles/10.1186/1471-2369-15-37Study on US veterans showing poorer outcomes with slow correction of hypernatremia.https://www.ncbi.nlm.nih.gov/pubmed/21358313Cerebral edema during the treatment of DKA.https://emj.bmj.com/content/21/2/141The MIMIC 3 Database. MIMIC is an openly available dataset developed by the MIT Lab for Computational Physiology, comprising deidentified health data associated with ~40,000 critical care patients. It includes demographics, vital signs, laboratory tests, medications, and more.https://mimic.physionet.orgChalrson Comorbidity Indexhttps://www.mdcalc.com/charlson-comorbidity-index-cci#creator-insightsThe paper: A new method of classifying prognostic comorbidity in longitudinal studies: development and validation.https://www.ncbi.nlm.nih.gov/pubmed/3558716JCI article on organic brain osmnoles in response to hypernatremiahttps://www.ncbi.nlm.nih.gov/pubmed/2332498?dopt=AbstractJohn Booth on the value of MIMIC 3https://twitter.com/ThePeanutKidney/status/1128742219471642624Sri Lekha on checking labs in hypernatremiahttps://twitter.com/LTummalapalli/status/1128479041634226176Steve Coca on chunky water administrationhttps://twitter.com/scoca1/status/1128744643422769152Steve Coca musing the Cersei’s sodium levelhttps://twitter.com/scoca1/status/1128698514026975232Steve Coca swearing in High Valarlian:https://twitter.com/scoca1/status/1128629713826721792Steve Coca proving the non-existence of hypernatremia therapy being associated with brain damage through the inability of trial lawyers to find and sue doctors for this issue:https://twitter.com/scoca1/status/1128652586612080642The original paper on the Kardashian Indexhttps://genomebiology.biomedcentral.com/articles/10.1186/s13059-014-0424-0Kardashian Index Calculatorhttp://theinformationalturn.net/kardashian-index/Facebook CEO Mark Zuckerberg says the ‘future is private’https://www.theverge.com/2019/4/30/18524188/facebook-f8-keynote-mark-zuckerberg-privacy-future-2019Khenar Jhaveri et al on ‘WhatsApp’ening in nephrology traininghttps://academic.oup.com/ckj/advance-article/doi/10.1093/ckj/sfz045/5482109Mike Morrison’s video on how to rebuild the scientific posterhttps://www.youtube.com/watch?v=1RwJbhkCA58Mike’s Twitter: https://twitter.com/mikemorrison?lang=en with lot’s of examples of his design in the wild.Make your own QR code: https://www.qr-code-generator.comGoodRx: https://www.goodrx.comTen Worst Drugs for your Kidney: https://www.goodrx.com/blog/10-worst-medications-for-your-kidneys/Drugs that can falsely elevate your creatinine levels: https://www.goodrx.com/blog/drugs-cause-false-high-creatinine-levels-blood-test/Dr Orrange, not wishing to engage on Twitter in a meaningful way: https://twitter.com/Orrangemd/status/1129165083194511361

This week we discussed the CREDENCE trial published in the NEJM, on the effect of Canaglifozin on diabetic nephropathy. There was lots to discuss so it may be a long podcast.The article is available here.The NephJC summary can be read here, with links to the visual abstract, and the wrapup.Links from the show:Swapnil’s first post at AJKDblog on SGLT2i in 2014! SGLT-2 Inhibitors: Can They Prevent Diabetic Nephropathy?Lonnie Pyne’s brilliant tweetorial on proteinuria as a proposed end-point in CKD trials.Combined RAAS blockade (don’t do it)Combining ACEI and direct renin inhibitorsCombining ACEi and ARBWe repeatedly compare CREDENCE to IDNT by Ed Lewis and RENAAL by Barry BrennerYou will need to be familiar with EMPA-REG and CANVAS (links to summaries on NephJC)Why run-in periods are bad for clinical trials: Run-in Periods in Randomized TrialsImplications for the Application of Results in Clinical PracticeHispanics in the study: https://twitter.com/VladoPerkovic/status/1121078118029103105Lot of discussion on mechanisms: • The original description of phlorizin by Josef von Mering in 1800• Podocyte effects in JCI• Effect on Hyperfiltration by SGlT2i in humans• Emerging role of proximal tubule in CKD via GWAS studies• SGLT2i effect on Na/H exchangers in heart and kidney• SGLT2i interact with heart NHE1 (mouse model)• SGLT2i as the ‘betablockers’ of the kidney?Jordan Weinstein on the clinical scientists’ mechanism of SHGLT2i:https://twitter.com/drjjw/status/1121577808164159491Why subgroups should be interpreted very carefullyHost: Joel TopfDiscussants: Samira Farouk, Swapnil Hiremath, Jennie Lin and Matt Sparks.

This week we discussed the ASCEND trial published in Annals of Internal Medicine, on the comparative effectiveness of cognitive behavioural therapy and Sertraline in patients on dialysis with depression.The article is available here.The NephJC summary can be read here, with links to the visual abstract.Links from the show:In the background section, we mentioned the data from a recent JASN study on cardiovascular safety of different antidepressants. The contrast with the CAST trial came up as well. PDF links to the BDI, QIDS-SR and QIDS-C scores.KIDNEYCon 2020 will be in April. Follow @KIDNEYCon to stay updated, as well for the links to the recorded sessions from #KIDNEYCon 2019.Host: Joel TopfDiscussants: Swapnil Hiremath, Jennie Lin and Matt Sparks. We missed Samira Farouk who was travelling.

This is the audio commentary of the NephJC Chats on March 19 and 20, 2019.This week we discussed the study published in JAMA Network Open, on the kidney outcomes in NSAID users from the US military.The article (open access) is available here.The NephJC summary can be read here, with links to the visual abstract.Links from the show:In the background section, we mentioned the data from the Physicians Health Study (two reports) and the Nurses Health Study. There was also discussion about this high quality study from Switzerland in patients with rheumatoid arthritis.The NephMadness pain region scouting report, from Sam GelfandThe PRECISION trial published in NEJM, and the NephJC summary by Scherly LeonHigh risk of GI bleeding in CKD patientsA study from Taiwan reporting high risk of stroke with NSAIDs even in anuric patientsHost: Joel TopfCo-hosts: Samira Farouk, Swapnil Hiremath, Jennie Lin and Matt Sparks