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Joel M. Topf, MD FACP

28 Dec, 8 tweets, 3 min read

So there is about a week left to apply to the Nephrology Social Media Collective Internship. One of the advantages we describe is the ability to become part of the leadership in nephrology. Let me show you what that looks like

nsmc.blog/application-20…

Kidney Medicine is the newest journal from the National Kidney Foundation. Take a look at the masthead and see three of our graduates running social media for them

Go to CJASN and find more of our graduates*

*Actually Joel and Edgar were never NSMC interns

@Maximal_Change

What about at the ASN Innovations in Kidney Education Contest? We got two of the three winners from 2020 and a 2018 winner. Plus faculty member @Maximal_Change won in 2016

What about the new GlomCon Fellowship? All three of the course directors are NSMC grads

@RenalFellowNtwk

And our graduates are all over the grand daddy of them all, @RenalFellowNtwk

There are other examples.

And I want to be clear that these people are rock stars and I'm sure they would be leaders of nephrology even without the NSMC internship.

But I like to think that the projects, mentorship, and opportunities of the NSMC acted as career accelerants

Take some time this week and apply to be one of our interns, you won't regret it.

nsmc.blog/application-20…

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Joel M. Topf, MD FACP

@kidney_boy

9 Dec

Let's talk about the evidence behind the use of visual abstracts to communicate SCIENCE!!

@AndrewMIbrahim

This field started with @AndrewMIbrahim, the whizz kid from @UMich. He was a surgical resident exploring ways to communicate scientific manuscripts and came up with the visual abstract

opmed.doximity.com/articles/visua…

H/T @TDAungst

@Atul_Gawande

He realized that these would be a great way to communicate information on social media and started creating visual abstracts as part of his gig as creative director at Annals of Surgery (what do you mean your journal doesn't have a creative director?) @Atul_Gawande agreed

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Joel M. Topf, MD FACP

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It's time to vote for the nephrology study of the year in the #NephJCkidneys. I think a lot of people are going to vote for DAPA-CKD and there is no doubt that it is an important study, but...

DAPA-CKD is largely just a replication study of CREDENCE, last year's winner. I'd like to make the case for ISCHEMIA-CKD

NephJC summary: nephjc.com/news/ischemiac…
NEJM: nejm.org/doi/full/10.10…

Think of how common this clinical scenario is:

A dialysis patient misses a dialysis session and comes to the hospital with shortness of breath. The ER orders a troponin. The troponin is elevated but is stable over three draws.

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Joel M. Topf, MD FACP

@kidney_boy

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I have a patient with anti-PLA2r + membranous nephropathy who was taking a lot of NSAIDs before the onset of disease. Does the anti-PLA2r antibodies exonerate the NSAIDs? #AskRenal

It is an incredibly interesting case. The patient, who was born in east Asia, presented to me years ago with a history of HIV (treated with tenofovir disoproxil fumarate) with a mild increase in cr. U/A showed heavy proteinuria.

Patient was not concerned with the increased proteinuria but the lower extremity edema. We treated with furosemide and did a biopsy. The biopsy was inadequate with only 2 gloms🤯
both sclerosed 🤯🤯🤯

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Joel M. Topf, MD FACP

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@jordy_bc

Great talk by @jordy_bc on obesity and CKD. It is not all obesity glomerulopathy #KidneyWk

@kamkalantar

Obesity paradox alive and well in ESRD #KidneyWk @kamkalantar

Possible mechanisms #KidneyWk

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Joel M. Topf, MD FACP

@kidney_boy

22 Oct

AKI in COVID? Nothing fancy, mostly just ATN #KidneyWk

Hold the presses, though a number of cases of collapsing glomerulopathy. Patients often (always?) with 2 risk alleles for APOL1

See #KidneyWk

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Joel M. Topf, MD FACP

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Patient with advancing CKD, currently stage 4. Labs show HCO3 19 on the last two lab draws. Anion gap 13. What do you do?

So the current thinking is that correcting metabolic acidosis (CO2 < 22) slows the progression of CKD. This has been shown in RCTs with oral sodium bicarbonate (placebo controlled):

kidney-international.org/article/S0085-…