Joel M. Topf, MD FACP Profile picture
Saying the product of the kidneys is urine is like saying the product of a factory is pollution. Urine is a by-product. The product is homeostasis COI: link👇🏼

Apr 7, 2022, 11 tweets

Pathophysiology of CKD Anemia and Strategies four Making Treatment Decisions with Steve Fishbane

COI: I’m a huge Fishbane fan 🤩 #NKFClinicals

Starting with a poll #NKFClinicals

Spoiler, its hepcidin. #NKFClinicals

Stop saying CKD has erythropoietin deficiency. They have more! #NKFClinicals

Hepcidin the master regulator of iron #NKFClinicals

Hepcidin is regulated by iron and inflammation.
Inflammation inhibits other aspects of red cell production. #NKFClinicals

Renal Erythropoietin-producing (REP) cells are oxygen sensors in the the kidneys that control EPO production. Anemia and hypoxia stimulates EPO. In CKD there is disordered oxygen sensing. #NKFClinicals

Anemia is multi factorial and there is a TON of iron deficiency in CKD #NKFClinicals

It’s not the Hgb it’s the EPO (maybe, observational data) #NKFClinicals

40% of non-dialysis CKD receive a transfusion in the 2 years prior to ESRD. Results in increased anti-HLA antibodies. #NKFClinicals

Conclusions #NKFClinicals

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