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1) Welcome to a 🆕accredited tweetorial from @cardiomet_CE! We welcome back expert faculty @ChristosArgyrop to discuss screening for #CKD in pts w/ #T2D & the role of routine assessment for #microalbuminuria as an effective diagnostic, risk stratification, & patient ed tool.
2) Christos Argyropoulos MD, PhD @ChristosArgyrop is Division Chief, Nephrology @UNMHSC. #CKD is chronic #kidneydisease, #ESKD is end-stage kidney disease.
#FOAMed #nephtwitter #cardiotwitter @MedTweetorials @NephUCommunity @ISNkidneycare @KidneyDiseaseFm
#FOAMed #nephtwitter #cardiotwitter @MedTweetorials @NephUCommunity @ISNkidneycare @KidneyDiseaseFm
3) This program is intended for #HCPs and is supported by an unrestricted educational grant from Bayer. Statement of accreditation & faculty disclosures at cardiometabolic-ce.com/disclosures/.
FOLLOW US for more expert-authored #tweetorials and earn #MedEd
FOLLOW US for more expert-authored #tweetorials and earn #MedEd
1/This July’s @aspneph pathology webinar was all about pediatric Antineutrophil Cytoplasmic Antibody (ANCA)- associated vasculitis (AAV). Let's kick off this pediatric AAV tweetorial✍️with a quick question #NephTwitter
🤔 What is the role of ANCA antibodies❓
🤔 What is the role of ANCA antibodies❓
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✅Diagnostic marker and Pathogenic in nature
▶️ Proteinase-3 (PR3) and Myeloperoxidase (MPO) antigens are sequestered in neutrophil primary granules
▶️ Antigen exposure triggers immune response leading to endothelial activation
linkinghub.elsevier.com/retrieve/pii/S…
✅Diagnostic marker and Pathogenic in nature
▶️ Proteinase-3 (PR3) and Myeloperoxidase (MPO) antigens are sequestered in neutrophil primary granules
▶️ Antigen exposure triggers immune response leading to endothelial activation
linkinghub.elsevier.com/retrieve/pii/S…
3/
Mechanisms
📌Defective neutrophil apoptosis, leading to NETosis
📌Inefficient clearance of PR3/MPO
📌Antimicrobial antibodies cross reacting with PR3/MPO
📌Medication induced
Mechanisms
📌Defective neutrophil apoptosis, leading to NETosis
📌Inefficient clearance of PR3/MPO
📌Antimicrobial antibodies cross reacting with PR3/MPO
📌Medication induced
Dr. Tuttle discussing diabetic CKD and benefits of relatively new med Finerenone #AACE2022
#diabetes is responsible for half of #CKD. CKD worsens CVD risk. 90% die from other cause before reaching ESRD #AACE2022 #endotwitter
1/ Monitoring eGFR in CKD is almost a reflex🦵!
But how did we get here?
What are we trying to assess?
And how does eGFR help?
#NephMadness #primarycare pits GFR vs proteinuria in CKD
In this tweetorial let's take a closer look at GFR
But first, who has your vote?#NephTwitter
But how did we get here?
What are we trying to assess?
And how does eGFR help?
#NephMadness #primarycare pits GFR vs proteinuria in CKD
In this tweetorial let's take a closer look at GFR
But first, who has your vote?#NephTwitter
2/ The concept of GFR as a marker of kidney function dates way back to the 1950s. (Apologies to the tubules, we do❤️you!)
But how could we measure GFR??
It was suggested that if a solute had certain characteristics its plasma clearance would = GFR
Let's briefly recap🤓
But how could we measure GFR??
It was suggested that if a solute had certain characteristics its plasma clearance would = GFR
Let's briefly recap🤓
3/ The solution, INULIN, a non-toxic exogenous molecule, came through studies on aglomerular fish! #AnimalHouse
INULIN renal clearance= measured GFR
It is considered the GOLD standard🏆
But it comes with baggage
🧳It's expensive
🧳It's tedious
🧳It's hardly available anymore
INULIN renal clearance= measured GFR
It is considered the GOLD standard🏆
But it comes with baggage
🧳It's expensive
🧳It's tedious
🧳It's hardly available anymore
❇️ Quiz for the “KDIGO 2020 Clinical Practice Guideline for Diabetes Management in CKD”
⚡️You can review the Tweetorial on the KDIGO Guideline before answering the quiz - see below👇🏽
@goKDIGO
#KDIGO
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⚡️You can review the Tweetorial on the KDIGO Guideline before answering the quiz - see below👇🏽
@goKDIGO
#KDIGO
1/
❇️ Question 1
⚡️Prolonged use of Metformin (use for > than 4 years) can cause deficiency of this vitamin?
2/
⚡️Prolonged use of Metformin (use for > than 4 years) can cause deficiency of this vitamin?
2/
❇️ Metformin interferes with the intestinal absorption of Vitamin B12
⚡️In NHANES Study, Vitamin B12 deficiency was noted in 5.8% patients with T2DM on metformin
⚡️Vitamin B12 monitoring should be considered in pts. on prolonged metformin Rx (> 4 yrs)
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⚡️In NHANES Study, Vitamin B12 deficiency was noted in 5.8% patients with T2DM on metformin
⚡️Vitamin B12 monitoring should be considered in pts. on prolonged metformin Rx (> 4 yrs)
3/
💥KDIGO 2020 Clinical Practice Guideline for Diabetes Management in CKD
Tweetorial
☄️Comprehensive Care in DM & CKD
☄️Glycemic Monitoring & Targets
☄️Lifestyle Interventions
☄️Anti-glycemic Rx
👉🏽 tinyurl.com/yyth59kn
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@goKDIGO @Kidney_Int
#KDIGO
Tweetorial
☄️Comprehensive Care in DM & CKD
☄️Glycemic Monitoring & Targets
☄️Lifestyle Interventions
☄️Anti-glycemic Rx
👉🏽 tinyurl.com/yyth59kn
1/
@goKDIGO @Kidney_Int
#KDIGO
💥Before reviewing the guidelines, note the difference between the:
⚡️Recommendations
⚡️Practice Points
💥Recommendations are based on strong evidence whereas for the Practice Points the evidence is insufficient or inconclusive👇🏽
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⚡️Recommendations
⚡️Practice Points
💥Recommendations are based on strong evidence whereas for the Practice Points the evidence is insufficient or inconclusive👇🏽
2/
💥Comprehensive Care is needed for pts. with DM & CKD to ⬇️ risk of
CV disease & Kidney Disease progression👇🏽
✅ Glycemic Control
✅ BP Control
✅ Lipid Rx
✅ Nutrition
✅ Exercise
✅ Smoking Cessation
🌟RAS Blockade & SGLT2i👇🏽
🌟Anti-platelet Rx👇🏽
3/
CV disease & Kidney Disease progression👇🏽
✅ Glycemic Control
✅ BP Control
✅ Lipid Rx
✅ Nutrition
✅ Exercise
✅ Smoking Cessation
🌟RAS Blockade & SGLT2i👇🏽
🌟Anti-platelet Rx👇🏽
3/
