Pathophysiology of CKD Anemia and Strategies four Making Treatment Decisions with Steve Fishbane

COI: I’m a huge Fishbane fan 🤩 #NKFClinicals
Starting with a poll #NKFClinicals
Spoiler, its hepcidin. #NKFClinicals
Stop saying CKD has erythropoietin deficiency. They have more! #NKFClinicals
Hepcidin the master regulator of iron #NKFClinicals
Hepcidin is regulated by iron and inflammation.
Inflammation inhibits other aspects of red cell production. #NKFClinicals
Renal Erythropoietin-producing (REP) cells are oxygen sensors in the the kidneys that control EPO production. Anemia and hypoxia stimulates EPO. In CKD there is disordered oxygen sensing. #NKFClinicals
Anemia is multi factorial and there is a TON of iron deficiency in CKD #NKFClinicals
It’s not the Hgb it’s the EPO (maybe, observational data) #NKFClinicals
40% of non-dialysis CKD receive a transfusion in the 2 years prior to ESRD. Results in increased anti-HLA antibodies. #NKFClinicals
Conclusions #NKFClinicals

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More from @kidney_boy

Apr 7
Here for the Late-Breaking Abstracts #NKFClinicals
The line-up #NKFClinicals
Matt Weir, Ajay Singh, and Glenn Chertow. All-star line up. Image
First up Matt Weir for the CKD outcomes in the DIAMOND Trial #NKFClinicals Image
Read 13 tweets
Apr 7
Welcome @taraichang this year’s #NKFClinicals chairperson. Time for the Presidents Address! Image
Following Dr Chang, is @PaulPalevsky, president of the @nkf

Starts talking about the meeting desert we have just crossed. #NKFClinicals Image
It is more fun to be here in person rather than squares on a computer screen. #NKFClinicals
Read 17 tweets
Apr 7
Next up is Kirsten Johansen from U of Minnesota on Emerging therapies for CKD-related anemia. She starts with a question. This is a nightmare question and will not be participating. She mocks the audience for answering wrong. #NKFClinicals
Big list of trials so you can keep the trials straight #NKFClinicals
After showing data that the HIF stabilizers raise the hemoglobin she gets to the MACE data. First up Roxa. (Emoji, my addition) #NKFClinicals
Read 9 tweets
Apr 7
Next up is Wendy St Peter Pharm D on the Challenges in Anemia Management. She starts with a Polling Question
Spoiler, according to table mate @nephrologyPharm, MSL for Amgen it is A. #NKFClinicals
Quick tour through Beserab CREATE, CHOIR, TREAT. Meta analysis #NKFClinicals
Read 8 tweets
Apr 7
Brad Rovin from The Ohio State University. Hmm are they in the #FrozenFour? No. No they re not #GoBlue #NKFClinicals
Brad is a fill in for Samir Parik
He has massive COI all over the place. Every drug. Every company. #NKFClinicals Image
Starts out with a case. Cr up from 0.6 to 1.2. 3500 mg of protein. Biopsy is WHO 4 and 5. She does not respond to MMF and steroids. Then does not respond to CYT. What to do?

Beware of getting on the roulette wheel of immunosuppression Image
Read 15 tweets
Apr 7
Lupus Lupus Lupus talk two: Dawn Caster, the moderator, calls her own number and is going to speak on New Options and Brighter Future. #NKFClinicals
Patient call. Had to miss a chunk of her talk. Sorry #ClinicalNephrologistProblems #NKFClinicals
We target proteinuria because reducing proteinuria is associated with good outcomes. Turns out, people whose kidneys heal have better outcomes. #NKFClinicals
Read 11 tweets

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