The line-up #NKFClinicals
Matt Weir, Ajay Singh, and Glenn Chertow. All-star line up.
First up Matt Weir for the CKD outcomes in the DIAMOND Trial #NKFClinicals
RAASi are underutilized and underdosed in heart failure. Can potassium binders help with that? #NKFClinicals
We underuse and underdose because of hyperkalemia. This data represents the best case story and still one in four develop hyperkalemia. #NKFClinicals
The US Sucks at prescribing RAASi in CKD #NKFClinicals
No clinical studies show the utility of dietary management of hyperkalemia. #NKFClinicals
Patiromer is a calcium potassium exchange binders.
DIAMOND Trial is a CV outcome clinical trial to see if potassium mitigation moves the needle on CV events.
Enrolled people with hyperkalemia, then run-in with everyone on patiromer and then change half to placebo. But COVID got in the way and they had to knock down to a more modest outcomes. This study became underpowered to show reduced events. #FuckCovid#NKFClinicals
Table 1. People were on high doses of RAASi and MRA #NKFClinicals
Less hyperkalemia with the binder, no difference in events. #NKFClinicals
Pre-specified subgroup analysis of patients with GFR < 60 #NKFClinicals
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
Brad is a fill in for Samir Parik
He has massive COI all over the place. Every drug. Every company. #NKFClinicals
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
We target proteinuria because reducing proteinuria is associated with good outcomes. Turns out, people whose kidneys heal have better outcomes. #NKFClinicals