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Aisha Shaikh Profile picture
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5 Nov, 5 tweets, 3 min read
High Impact Clinical Trials
TESTING Study: Steroids vs. Placebo in High Risk IgAN @VladoPerkovic

💥Conclusion: A 6-9 month course of oral methylprednisolone reduced risk of major kidney outcomes by 47% and kidney failure by 41%
#KidneyWk ImageImageImageImage
TESTING Study - Basline Characteristics Image
Effect on primary outcome based on full and reduced Steroid dose ImageImage
Take home message: Low dose Steroid is the comeback kid for IgAN Rx but need to be accompanied by PCP prophylaxis.
Most infections seen with steroids use occurred in the first 12-weeks
Steroid dose in TESTING IgA Trial
Full dose vs. Reduced dose Image

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More from @aishaikh

Aisha Shaikh Profile picture
3 Aug
Polyuria : The Perfect Storm

-Nephrology is consulted for Urine output of 9L in one day

-Pt. with AML, T2DM has been in the hospital for > 2 weeks for pneumonia, sepsis & subsequently developed Sweet Syndrome & was started on steroids

1/
Approach to polyuria
Step: 1
Is this water diuresis or solute diuresis?

-Check urine osmolality
Measured Urine osm. = 368 mOsm/kg
So, total daily osmole excretion = 3312 osmoles (368 X 9 L as the patient’s urine output is 9L)

This is solute diuresis
2/
Why is this solute diuresis?
Normal daily osmole excretion in an adult on a regular diet is about 750-900 mOsm/day

This patient’s urine osmolar excretion in one day was
3312 osmoles

3/
Read 17 tweets
Aisha Shaikh Profile picture
29 Jul
💥Parathyroid Hormone-related Protein - PTHrP

⚡️Who was the first person to postulate the existence of PTHrP?

⚡️What is the mechanism of PTHrP mediated hypercalcemia of malignancy?

⚡️Does PTHrP have a physiological function?

#Onconephrology
#PTHrP
1/
Dr. Fuller Albright, in 1941, was the first to postulate the presence of a ‘substance’ that caused features of hyperparathyroidism in a cancer patient
2/
In this report, Dr. Albright essentially described the presence of PTH-like hormone in a cancer patient.
“I suspected that the tumor might be producing PTH. I therefore had it assayed but no PTH hormone was found”-Albright👇🏽
3/
 nejm.org/doi/full/10.10…
Read 17 tweets
Aisha Shaikh Profile picture
25 May
“Antibody response to Moderna (mRNA-1273) vaccine in hemodialysis patients with and without prior COVID-19”- our manuscript published in @CJASN

@LilCh4n, @Nick84130497 @ZeldisEtti @kirkcampbell @NephJC

👉🏽 cjasn.asnjournals.org/content/early/…

Study findings 🧵
1/
⚡️Antibody (Ab) response to Pfizer vaccine in hemodialysis pts. has been reported, but the Ab response to Moderna vaccine in hemodialysis patients is not well known
Here we report Ab response to Moderna vaccine in patients on maintenance hemodialysis
2/
⚡️61 hemodialysis patients received the 2-dose Moderna vaccine series
-Of the 61 hemodialysis patients, 20 patients had prior h/o COVID-19
3/
Read 17 tweets
Aisha Shaikh Profile picture
21 May
💥What is Monoclonal Gammopathy and when does it’s presence indicate presence of cancer?

💥What is MGUS and MGRS?

#Onconephrology
1/
💥Monoclonal gammopathy is presence of monoclonal immunoglobulin (Ig) in serum, urine or both

💥Monoclonal immunoglobulins are produced by either clonal Plasma cells (often) or by
B lymphocytes (less often)

2/
⚡️Hematologic criteria for diagnosis of cancer in the setting of monoclonal gammopathy is based on 2 factors:

1. Tumor burden (clonal mass)
2. End-organ damage

3/
Read 15 tweets
Aisha Shaikh Profile picture
24 Apr
💥Endocrine adverse effects of Immune Checkpoint Inhibitors - a brief Tweetorial for Nephrologists

A thread based on an article published in @NatureRevEndo

👉🏽 nature.com/articles/s4157…

#Onconephrology
1/
⚡️It important for Nephrologists to be familiar with immune checkpoint inhibitor induced endocrinopathies as thyroid, pituitary & adrenal disorders can present with👇🏽
-Hyponatremia
-Hyperkalemia
-Metabolic acidosis
-Hypotension
2/
⚡️Immune checkpoint inhibitors (ICIs) are monoclonal antibodies that target immune checkpoint proteins:

-Cytotoxic T lymphocyte antigen 4 (CTLA4)

-Programmed cell death 1 (PD1)

-Programmed cell death ligand 1 (PDL1)

3/
Read 21 tweets
Aisha Shaikh Profile picture
8 Apr
💥Happening now: Dialysis vascular access emergencies at @nkf Meeting

Rapidly enlarging AV access pseudoaneurysms @bharvioza
Steal Syndrome @aurbanes
AV Access related malignancy @JeremyCraneMD
HD CVC related R atrial thrombus @SaadTheodore #NKFClinicals
Rapidly enlarging pseudoaneurysms by @bharvioza
Rapidly enlarging AV access pseudoaneurysms by @bharvioza
#NKFClinicals
Read 10 tweets

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