Nephrology Journal Club Profile picture
Dec 29, 2021 12 tweets 15 min read Read on X
as we come to the end of the year, let's do a quick recap of the year in review for #NephJC

We discussed 24 topics in 2021, including
14 RCTs
6 observational studies
3 guidelines
1 book club
nephjc.com/news/?category…
New this year was the #NephTrials initiative with @ISNkidneycare with 3 chats on
- Cluster RCTs
- Pragmatic RCTs
- Run in periods
More to come in 2022
nephjc.com/news/tag/nepht…
nephjc.com had ~ 450K + page views in 2021
some oldies (eg nephjc.com/news/rasaftera… from @roxytonin)
or the COVID pages nephjc.com/covid19 have high traffic, but let's review the 2021 #NephJC summaries which received the most page views (so far)
at #10 was the summary of the new GFR equations from @NEJM nephjc.com/news/new-gfr-e…
Summary by @Slatts_1 @kidney_boy & @hswapnil
#VisualAbstract from @MdYoshinosuke
at #9 was the BASICS trial in @JAMA from @f_g_zampieri et al
nephjc.com/news/basics summary for #NephJC by @hellokidneyMD who also made this great VA and this superb comparative table
at #8 was LANDMARK, which set out to show Lanthanum is superior and demonstrated the exact opposite

#NephJC Summary by @SRameshMD and @jadav_md nephjc.com/news/2021/7/20… with a commentary nephjc.com/news/landmark-… by @hswapnil
and VA by @dr_missyhanna
This time with the #VisualAbstract from @dr_missyhanna 😅
#7 was the Roxadustat trials from @KIReports
#NephJC summary from @Deep_Phachu & @priyamisdead
nephjc.com/news/2021/2/23…
VAs from @alunieczka & @drkeia

+ a wrinkle, as we have updated on the blog
We discussed the stats shenanigans with @DrDanMO here nephjc.com/freelyfiltered…
coming in at #6 was the ADVOCATE trial on Avocapan for ANCA vasculitis - another advance in this area

(watch out for the steroid dose of course)

#NephJC summary by @Elena_Cervants @drkeia and @alunieczka

#VisualAbstract from @Deep_Phachu
Coming up are the top 5 by page views (which skew to older discussions of course)
and at #5 was the discussion of the AURORA trial
Voclosporin sparkles for Lupus
#NephJC summary by @bourneauguste and @JMTeakell nephjc.com/news/2021/6/21…
An inspired VA by @katierizzolo

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More from @NephJC

Jun 7, 2023
Welcome to #TenTweetNephJC
✳️10 tweets #NephJC catch-up ✳️

In the last NephJC, we discussed interim results📊from the PROTECT trial on efficacy & safety of Sparsentan in IgAN.

New light✨on the horizon for IgAN yet?

Check out this flying summary in case you've missed the chat! Image
2/10
What did I miss?

3 decades of fateful trials of ERAs in PAH, HTN, DKD, FSGS & IgAN (AFFINITY,ALIGN) set the stage for

🛡️PROTECT🛡️
Sparsentan🎲Irbesartan
thelancet.com/journals/lance…

✔️Phase3⃣RCT
✔️Active-controlled
✔️Double-blind🚫

✔️18 countries🗺️
✔️134 sites🏥

The cohort⬇️ Image
3/10
1 tweet methods

n=406
270 weeks (114+156 weeks open label with SGLT2i!)

➡️Carefully selected population for nil significant cardio/cerebro-vascular or hepatic disease
➡️On MLD/50% MLD of RAASi
➡️1:1 randomisation
➡️Stratification as per eGFR & proteinuria
➡️MMRM statistics Image
Read 11 tweets
Apr 5, 2023
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 Image
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 ImageImage
Read 11 tweets
Dec 20, 2022
#1
A few hours to go for the #NephJC chat on the MYTEMP trial ⏳

❓Have you ever paused to wonder how we came up with the ‘standard’ dialysate temperature of 37°C (98.6°F)???🤔

❓How does core body temperature (CBT) differ in dialysis patients from the general population?🤔
#2
👉Historical reasons for std dialysate 🌡️seem unclear

👉37°C considered avg body 🌡️in adults ⏩ arbitrarily selected as ‘neutral’ dialysate 🌡️

👉Assumed to prevent body 🌡️ changes during HD

#NephJC

pubmed.ncbi.nlm.nih.gov/15211448/
#3
❓How did we come up with 37°C as the normal body 🌡️?

👉From Dr. Carl Wunderlich
▶️Father of clinical thermometry
▶️Analyzed >1million axillary 🌡️from 25K adults (pre-digital era!🤯)
▶️Noted 🌡️differences with race, sex, circadian rhythm
#NephJC
pubmed.ncbi.nlm.nih.gov/8011836/
Read 7 tweets
Dec 9, 2022
Would a new drug option for resistant hypertension get you excited? How about a superior trial design?

Time to learn about PRECISION - our twitter journal club had 720 tweets, but you can catch the highlights quickly with the regular #TenTweetNephJC thread👇 Image
2/10
What did I miss?

We know we miss targeting many pathways that contribute to resistant hypertension, a condition with high cardiovascular morbidity.

Enter aprocitentan, a dual endothelin receptor antagonist, for it’s crack at a Phase 3 trial.

pubmed.ncbi.nlm.nih.gov/36356632/
3/10
1 tweet methods

✅ Multi-center, blinded, randomised, parallel-group

✅ Elaborate run-in (figure) to give all amlod + HCTZ + valsartan, and then exclude pseudoresistant hypertension

✅ Does adding aprocitentan to regime improve unattended automated office BP 🆚 placebo? Image
Read 10 tweets
Apr 8, 2022
✳️ #TenTweetNephJC ✳️

👉 where we catch you up on the week's #NephJC chat in 10 tweets 

The topic at hand was Plasma Exchange and Vasculitis: the infamous debate of to PLEX or not to PLEX in AAV

Check out this thread to see if you change your mind on this comPLEX topic 👇 Image
What did I miss?

PLEX, with its plausible biological rationale, has been in the center of debate for management of AAV since the 1980s, with several RCTs in favor of PLEX or against it

🔸️An updated meta-analysis which included the PEXIVAS results was discussed
1 tweet methods

✅ updated systematic review & meta-analysis

✅ RCTs of patients with AAV or pauci-immune RPGN receiving PLEX and ≥12mo. follow-up

✅ Outcome measures were at least one of: mortality, ESKD, serious infection, relapse, AE or health-related QoL
Read 10 tweets
Mar 25, 2022
✳️ Welcome to #TenTweetNephJC, where we catch you up on the week's #NephJC chat in 10 tweets ✳️

The topic at hand was diuretic resistance, specifically compensatory post-diuretic sodium reabsorption (CPDSR). Let’s walk you through how it all flowed 💧
What did I miss?

We teach medical students that diuretic resistance occurs in large part due to CPDSR. While this has been validated in healthy individuals, does this hold true in patients w/ acute decomp heart failure (ADHF)?
Enter the study in question
pubmed.ncbi.nlm.nih.gov/34529781/
1 tweet methods

✅Single center, prospective, observational study, with a randomized sub-cohort
✅Evaluating mechanisms of diuretic resistance in patients with ADHF on IV loops 💉
✅Supervised urine collection pre and post diuresis
✅Primary outcome = level of CPDSR
Read 10 tweets

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