1/ Let's dive into today's session : “Optimising renal replacement in the elderly” 🫘🧓
With a great panel of experts :
🗣️ @EdwinaBrown_PD
🗣️ @jirotmans
🗣️ @pepinmarion1
Tweets by #ERA24 #SoMe Team @FirketLouis
2/ Let’s start with @EdwinaBrown_PD , also president of @ISPD1 , who gave us an amazing talk about how to choose the best RRT option in the elderly patients and especially how (assisted-)PD could be a great option in this population.
3/ She first recalled that old age is a conundrum with numerous comorbidities and geriatric syndromes that need to be taken into account in the case of end-stage CKD.
Check out the highlights and the following tweetorial to learn how to approach this disease.
Speaker: @ericolinger1
Panel: John Sayer, Jan Halbritter and @ecorneclegall
@ERAkidney @EuRefNetwork
2/When to suspect a monogenic tubulointerstitial kidney disease?
Ø If family history +
Ø Exclude secondary causes
Ø Do urinalysis, imaging and then genetics
3/Mostly a diagnosis of exclusion
Diagnostic criteria from @KDIGO 👇🏻 👇🏻 👇🏻
Ø Family history important but definitive by genetics
Ø Biopsy does not help in diagnosis
MN occurs due to immune complex deposition in the subepithelial GBM. @SethiRenalPath reckons classification of MN should be made based on the antigen, much like the nomenclature of complement activated GN following better understanding of the role of complement dysregulation.
☄️Hot off the press review suggesting we should consider MN as a pattern of injury. @SethiRenalPath@CKJsocial
🔍Let's take a look at the discovery of antigens in MN.
➡️Native kidney biopsy plays a crucial role in the diagnosis of many conditions and, while generally safe, can be associated with bleeding complications.
Would you biopsy a patient with aspirin exposure?🤔
Bleeding complication rates are low, with less than 2% of patients requiring transfusion and less than 0.5% requiring an intervention to control the bleeding.
⚠️These complication rates are higher in hospitalized patients and those with AKI.
Time for a tweetorial on renal MRI! MRI is used to look at structure, but advanced sequences can measure function too. Multiple sequences in 1 session = multiparametric MRI = loads of data!
Could be used to triage risk in CKD, reduce invasive tests, or for translational research
An imaging biomarker is already being used in clinical practice. For which condition?
It's ADPKD! 🙌🙌🙌
Total kidney volume is approved by the FDA to identify patients at high risk of progressive renal impairment to treat with tolvaptan. TKV is best measured by kidney MRI and evaluated using the Mayo classification