Thread by @scoca1

@hswapnil @ssfarouk @Marty_Fried @kidney_boy Sorry was packing up for two back to back trips 😎😎

NSAIDs in a non-prostaglandin dependent group....
😴😴😴😴😴

Marginal associations - weak effect sizes with lots of residual confounding based on the distribution and non-granularity of the covariates
🙄🙄🙄

@hswapnil @ssfarouk @Marty_Fried @kidney_boy But - another point I will make is that the fear of “kidney failure” and absolute totalitarianism against NSAIDs in patients with have mild to moderate CKD is appalling to me.

So people with bothersome musculoskeletal pain can never take an NSAID for fear of AKI?! A rise in SCr?

@hswapnil @ssfarouk @Marty_Fried @kidney_boy It’s all about moderation and common sense. No one feels their creatinine, but they can sure feel knee back hip pain or a muscular strain

Some docs need to loosen up on NSAIDs and stop being so nephrocentric at the expense of quality of life of our patients!!

@hswapnil @ssfarouk @Marty_Fried @kidney_boy Things that burn me up:
1. No NSAIDs for CKD3 pt who limps into office
2. No aminoglycoside given to pt with GNR sepsis because of AKI
3. Cutting back or stopping diuretics for CHF patient 15 lbs up b/c creatinine bumped
4. No SGLT2i for eligible pt for fear of “dehydration”

@hswapnil @ssfarouk @Marty_Fried @kidney_boy 5. Docs still giving mucomyst to prevent CIN (why ignore the millions of $$ spent on PRESERVE?!?)
6. Water restriction in pts who have edema but not hyponatremic
7. Ignoring hypernatremia in ICU patients if they can feel thirst
8. Shotgun GN workup for anyone with proteinuria