Thread by @NephJC

Welcome to #TenTweetNephJC for a short recap! Nephrologists warned of renalism neglecting cardiac ischemia in kidney pts. ISCHEMIA-CKD dashed hopes. Waiting for a deceased donor kidney transplant in the US is a grueling journey for +100K pts with advanced chronic kidney disease

2/10
What did I miss?
🌤️Retrospective study: asymptomatic kidney transplant candidates tested for coronary heart disease (CHD) vs non-tested pubmed.ncbi.nlm.nih.gov/36595271/
Aim: to determine the effect of CHD testing on the risk of death or acute MI within 30 days after transplant

3/10
1 tweet methods

⏪ Retrospective cohort study, USRDS, 2000-2014

✅ 79334 Adults, 1st time kidney transplant

✅ CHD testing 12 months before transplant

🛠️ Instrumental analysis variable - less biased by confounding than standard methods @Husamjz

4/10
1 tweet results
❤️‍ Primary outcome reached in 5.3% (4604) patients - are this numbers correct?
💔Death in 2063 patients while acute MI in 2329 patients

5/10
A figure paints 1000 words
From: ahajournals.org/doi/full/10.11…
H/T @ssfarouk

6/10
Give me something clever to say

We are quoting a cardiologist, but not every cardiologist, the son of a nephrologist @jelevenson

7/10
Chat consensus?

1️⃣ Revascularization (by extension testing) isn't benign. Denying transplants is definitely doing people harm

2️⃣ Isn't dialysis a form of stress testing?

3️⃣ CV events decline after transplant. We should think of transplant as revascularization by proxy

8/10
Quote of the fortnight!
Is @hswapnil the most quoted in #TenTweetNephJC? 🧠

9/10
I want more info
✅Follow @gchertow, @BaiocchiMike & @StanfordNeph
✅ About journey to the waitlist in @Nephmasness blog
ajkdblog.org/2023/03/01/nep…
✅#NephJC summary: @DrCool_Beans @meyyappannephro
nephjc.com/news/pre-trans…

✅2 VAs by @renspasilan @Nihal_Hamary @MedPEEdsKidneys

10/10
Final thoughts
✳️ Waitlist journey can be daunting as it is, our patients don’t need more impediments when aren't really necessary
➡️Up next, Rolling Stone's new hit Hydrochlorothiazide couldn't give any satisfaction in preventing kidney stones
pubmed.ncbi.nlm.nih.gov/36856614/

I admit sometimes I'm stumbling more than I'm learning. But thanks to truly fantastic support and guidance of #NephJC people, I am here today, 1 year after hosting my 1st #NephJC, happy to continue my journey along with #NephJC & @NSMCInternship Cristina Popa, @NephroSeeker