#JHMChat Transcript
Healthcare social media transcript of the #JHMChat hashtag.
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| Profile | Tweet |
|---|---|
 | Liz Neporent @lizzyfit #JHMChat @kidney_boy - this ONE TIME I forgot my hashtag. geesh. :-( :-) |
 | Amy Nadel @amynadel RT @SHMLive: @MedscapeStudent Looking forward to having our @Medscape friends join us for #JHMChat! Thanks for spreading the word. |
 | J Hospital Medicine @JHospMedicine Hi everyone @FutureDocs here for tonights #jhmchat (fixed hashtag) - please introduce yourself! |
 | J. Brian Byrd, MD, MS 🐦 @thebyrdlab @kidney_boy Thanks! Let's do this! #JHMChat |
 | Nikhil Shah @dr_nikhilshah RT @Medscape: Medscape is joining the #JHMChat, 'Things we docs do for no reason' tweet chat. STARTING NOW. Join the convo: https://t.co/Snw8Zbthix |
 | Celine Goetz, MD @celinegoetzmd #JHMChat Hi everyone - @celinegoetzmd from Mount Sinai in NYC. Love the topic! |
 | Amit Kumar Pahwa @Pahwa amit pahwa, hospitalist, @Hopkins_GIM @hopkinsmedicine first author on paper #jhmchat |
 | ABIM Foundation @ABIMFoundation RT @Medscape: Medscape is joining the #JHMChat, 'Things we docs do for no reason' tweet chat. STARTING NOW. Join the convo: https://t.co/Snw8Zbthix |
 | Society of Hospital Medicine @SocietyHospMed And away we go! Join the #JHMChat convo now to discuss #ThingsWeDoForNoReason. https://t.co/xkAhXtusTn |
| ABIM Foundation @ABIMFoundation RT @FutureDocs: Follow @jhospmedicine for the next hour where I will be moderating #JHMchat on #thingswedofornoreason #choosingwisely |
 | Suneel Udani @captainkidney79 #JHMChat. Hello, Suneel Udani clinical nephrologist in Chicago |
| Liz Neporent @lizzyfit https://t.co/mPWdRF1dgJ is also joining the choosing wisely chat. #JHMChat. |
 | Medscape @medscape https://t.co/lNWHF2GEqN is also joining the choosing wisely chat. #JHMChat. |
| Nikhil Shah @dr_nikhilshah RT @Pahwa: amit pahwa, hospitalist, @Hopkins_GIM @hopkinsmedicine first author on paper #jhmchat |
 | Vinny Arora MD MAPP @FutureDocs Looks like there are some #teamFena out there - look forward to the dialogue with @Pahwa and others! #JHMChat |
 | Joel Topf, MD FACP @kidney_boy Joel Topf, salt whisperer, er nephrologist from Detroit. No COI #jhmchat |
| J. Brian Byrd, MD, MS 🐦 @thebyrdlab Brian Byrd, Ann Arbor, scientist, cardiologist, hypertension nerd. #JHMChat |
| Medscape @medscape Not sure why Tweet deck wants to convert #Medscape to a bitly but we're here. #JHMChat |
 | Swapnil Hiremath, MD, MPH @hswapnil Swapnil Hiremath, nephrologist @OttawaHospital #NephJC co-founder no CoI (though tell students *all* the FENa exceptions) #JHMchat |
| Nikhil Shah @dr_nikhilshah Nikhil Shah, nephrologist, home dialysis fellow, University of Alberta. #jhmchat |
| J Hospital Medicine @JHospMedicine @Medscape welcome! #jhmchat |
 | Malvinder Parmar @wittykidney #JHMChat Malvinder Parmar nephrologist, no COI |
 | Daniel Wolfson @WolfsonD #choosingwisely @ABIMFoundation following #JHMChat https://t.co/7wkr0kRDTX |
 | Chris Moriates, MD @ChrisMoriates Chris Moriates, hospitalist @UCSFDHM . Member of @CostsofCare team. And series editor for @JAMAInternalMed #teachablemoments. #jhmchat |
| Medscape @medscape #JHMchat Happy to be chatting about this important topic. |
| J Hospital Medicine @JHospMedicine For tonight's #JHMChat will discuss getting FeNa and FUrea in Acute Kidney Injury with @Pahwa - paper https://t.co/2MNXkZ4a4D |
 | @HyungChoMD @HyungChoMD #JHMChat Harry Cho, hospitalist from @MountSinaiNYC |
| J Hospital Medicine @JHospMedicine T1 up in a moment...#JHMChat |
 | Scented Bychkov @scentedbychkov RT thebyrdlab: Brian Byrd, Ann Arbor, scientist, cardiologist, hypertension nerd. #JHMChat,https://t.co/JqisEQ313n |
 | Nick van Terheyden @drnic1 RT @FutureDocs: Looks like there are some #teamFena out there - look forward to the dialogue with @Pahwa and others! #JHMChat |
| Amy Nadel @amynadel @amynadel joining #jhmchat from @Medscape too |
 | Wisit C @wisit661 Wisit Cheungpasitporn, Neph fellow from Rochester, MN. ☃ cold never bothers me #jhmchat |
 | Belimumab Lupus @benlysta RT @JHospMedicine: T1 up in a moment...#JHMChat |
 | Sri Lekha Tummalapalli, MD, MBA @LTummalapalli #JHMChat Looking forward to the discussion! Lekha Tummalapalli here @MountSinaiNYC @FutureDocs |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: For tonight's #JHMChat will discuss getting FeNa and FUrea in Acute Kidney Injury with @Pahwa - paper https://t.co/2MNXkZ4a4D |
| J Hospital Medicine @JHospMedicine T1 #JHMChat- Do you order FeNa and FeUrea in differentiating AKI? Why or why not? |
 | Andrew Auerbach @ADAuerbachMD Welcoming everyone to the #JHMChat starting...Now! Why is the FeNa something we do for no reason? #choosingwisely @SHMLive |
 | Kakashei sensei @ketamaniac RT @MedscapePeds: Medscape is joining the #JHMChat, 'Things we docs do for no reason' tweet chat. STARTING NOW. Join the convo: https://t.co/vryiTA7imJ |
| Society of Hospital Medicine @SocietyHospMed Get ready for the first #JHMChat question of the night! Thanks for joining this important conversation. https://t.co/dVQmR7O3aR |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: T1 #JHMChat- Do you order FeNa and FeUrea in differentiating AKI? Why or why not? |
| Vinny Arora MD MAPP @FutureDocs Live on #jhmchat now - bring it! https://t.co/n3dPYBt7py |
| J. Brian Byrd, MD, MS 🐦 @thebyrdlab @JHospMedicine My residents do this reflexively. Value often seems non-obvious to me. #JHMChat |
| Joel Topf, MD FACP @kidney_boy T1 in order to truly "be the Kidney"I like to know the FENa in appropriate cases. Never in contrast or rhabdo. FEUrea often in CHF #jhmchat |
| Amit Kumar Pahwa @Pahwa @jhospmedicine No surprise here - I actually don’t & @HopkinsMedicine residents have been less and less #jhmchat |
| Wisit C @wisit661 @JHospMedicine I do check FeNa in the setting of AKI, but only in 1) oliguric AKI and 2) no diuretic use. #TeamFeNa #JHMChat |
| J Hospital Medicine @JHospMedicine @ltummalapalli thanks for joining #jhmchat! |
| Joel Topf, MD FACP @kidney_boy T1 and I never order it for no reason. That is just foolish #jhmchat |
| Malvinder Parmar @wittykidney #JHMChat Yes FeNa with the understanding that all tests has limitations and ordering is one thing 1/2 |
| Swapnil Hiremath, MD, MPH @hswapnil T1: my residents/fellows usually order b4 I see. I just tell them why it's not very useful (cardiorenal, hepatorenal, CIN etc) #JHMchat |
 | Matthew Sparks, MD, FASN, FAHA @Nephro_Sparks Matt Sparks, Duke Nephrology APD no COI #jhmchat |
| Amit Kumar Pahwa @Pahwa RT @thebyrdlab: @JHospMedicine My residents do this reflexively. Value often seems non-obvious to me. #JHMChat |
| Joel Topf, MD FACP @kidney_boy Wide right! #jhmchat |
| Suneel Udani @captainkidney79 #JHMChat. Not compare. I use combo urine:plasma creatinine ratio, urine Na v urine K, FENA, FEUrea for complete renal blood flow picture |
| J Hospital Medicine @JHospMedicine RT @pahwa: @JHospMedicine No surprise here - I actually don’t & @HopkinsMedicine residents have been less and less #jhmchat |
| Vinny Arora MD MAPP @FutureDocs RT @pahwa: @JHospMedicine No surprise here - I actually don’t & @HopkinsMedicine residents have been less and less #jhmchat |
| Joel Topf, MD FACP @kidney_boy +1 RT @wittykidney: #JHMChat Yes FeNa with the understanding that all tests has limitations and ordering is one thing 1/2 #jhmchat |
| Amit Kumar Pahwa @Pahwa @thebyrdlab i agree by the time they get the calculation the Cr has already changed with whatever they decide to do #jhmchat |
| Matthew Sparks, MD, FASN, FAHA @Nephro_Sparks T1: my residents/fellows usually order b4 I see. I just tell them why it's not very useful (cardiorenal, hepatorenal, CIN ) #JHMchat agreed |
| Malvinder Parmar @wittykidney #JHMChat 2/2 but when actually the test is done, that is urine collected or sent is completely a different thing & that I think limits it |
| Amit Kumar Pahwa @Pahwa @wisit661 well you have a reason and the article does lay out its utility in that population #jhmchat |
| J Hospital Medicine @JHospMedicine RT @thebyrdlab: @JHospMedicine My residents do this reflexively. Value often seems non-obvious to me. #JHMChat |
| J. Brian Byrd, MD, MS 🐦 @thebyrdlab @hswapnil +1 #JHMChat |
| J Hospital Medicine @JHospMedicine RT @Nephro_Sparks: T1: my residents/fellows usually order b4 I see. I just tell them why it's not very useful (cardiorenal, hepatorenal, CIN ) #JHMchat agreed |
| J Hospital Medicine @JHospMedicine RT @Pahwa: @thebyrdlab i agree by the time they get the calculation the Cr has already changed with whatever they decide to do #jhmchat |
| J Hospital Medicine @JHospMedicine RT @kidney_boy: +1 RT @wittykidney: #JHMChat Yes FeNa with the understanding that all tests has limitations and ordering is one thing 1/2 #jhmchat |
| ABIM Foundation @ABIMFoundation RT @WolfsonD: #choosingwisely @ABIMFoundation following #JHMChat https://t.co/7wkr0kRDTX |
| Amit Kumar Pahwa @Pahwa @nephro_sparks someone read the article before coming to class #jhmchat |
| Belimumab Lupus @benlysta RT @JHospMedicine: T1 #JHMChat- Do you order FeNa and FeUrea in differentiating AKI? Why or why not? |
| Belimumab Lupus @benlysta RT @Pahwa: @thebyrdlab i agree by the time they get the calculation the Cr has already changed with whatever they decide to do #jhmchat |
| Society of Hospital Medicine @SocietyHospMed Hope you can join #JHMChat w/ @JHospMedicine NOW on FeNa and FUrea in acute kidney injury. Remember to use the hashtag to participate! |
| ABIM Foundation @ABIMFoundation RT @SHMLive: Get ready for the first #JHMChat question of the night! Thanks for joining this important conversation. https://t.co/dVQmR7O3aR |
| Joel Topf, MD FACP @kidney_boy Where's @nephondemand? I thought he was coming? #jhmchat |
| J Hospital Medicine @JHospMedicine Special question for @pahwa, can you tell us the impetus of this article? why is this important? #JHMChat |
| Vinny Arora MD MAPP @FutureDocs Special question for @pahwa, can you tell us the impetus of this article? why is this important? #JHMChat |
| Joel Topf, MD FACP @kidney_boy Clemson looks better than MSU #jhmchat |
| J Hospital Medicine @JHospMedicine RT @SHMLive: Hope you can join #JHMChat w/ @JHospMedicine NOW on FeNa and FUrea in acute kidney injury. Remember to use the hashtag to participate! |
 | Medical Board Reform @medboardreform RT @JHospMedicine: Special question for @pahwa, can you tell us the impetus of this article? why is this important? #JHMChat |
| Malvinder Parmar @wittykidney #JHMChat in your centre where it is ordered, is this done on the same day. Many places you can get CT/MRI on same day that urine tests |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: Special question for @pahwa, can you tell us the impetus of this article? why is this important? #JHMChat |
| Daniel Wolfson @WolfsonD RT @FutureDocs: Special question for @pahwa, can you tell us the impetus of this article? why is this important? #JHMChat |
| Vinny Arora MD MAPP @FutureDocs Twitter journal club is "flipped classroom in action"! @pahwa @nephrosparks #jhmchat #Meded |
 | Costs of Care @CostsofCare RT @SHMLive: Get ready for the first #JHMChat question of the night! Thanks for joining this important conversation. https://t.co/dVQmR7O3aR |
 | Adriana Bello @adrianabello RT @JHospMedicine: please join us tonight 9p ET for #JHMChat as we discuss Things We Do For No Reason "Urinary Fractional Excretion... https://t.co/H0iJM8eSYX |
| Amit Kumar Pahwa @Pahwa @futuredocs started as @doclennyf series #thingswedofornoreason @SHMLive meetings - saw it & said i do do this without thinking #jhmchat |
| Adriana Bello @adrianabello RT @hswapnil: #JHMChat tonight at 9 pm. See primer from PBF @kidney_boy w/ clear explanation of FENa, TGF and more https://t.co/uqf0a5dnXX |
 | Kelly Burdge @kb927 #jhmchat I teach that Fena is like d dimer- helpful if low, indeterminate if not. Kelly Burdge, boston, no COI |
| Adriana Bello @adrianabello RT @kidney_boy: Some of my thoughts on FENa before tonight's #jhmchat https://t.co/xUbo4PHbOM |
 | Pat Rich @pat_health #jhmchat #bcsm and #bioethx chat all at same the same time on Monday. What is this madness? It's Monday. |
| J Hospital Medicine @JHospMedicine @kidney_boy @nephondemand do want to say thank to our nephrology colleagues for joining #jhmchat to weigh in! |
| J Hospital Medicine @JHospMedicine RT @FutureDocs: Twitter journal club is "flipped classroom in action"! @pahwa @nephrosparks #jhmchat #Meded |
| Society of Hospital Medicine @SocietyHospMed RT @FutureDocs: Twitter journal club is "flipped classroom in action"! @pahwa @nephrosparks #jhmchat #Meded |
| J Hospital Medicine @JHospMedicine RT @Pahwa: @futuredocs started as @doclennyf series #thingswedofornoreason @SHMLive meetings - saw it & said i do do this without thinking #jhmchat |
 | Johns Hopkins GIM @Hopkins_GIM RT @Pahwa: amit pahwa, hospitalist, @Hopkins_GIM @hopkinsmedicine first author on paper #jhmchat |
| Amit Kumar Pahwa @Pahwa RT @KB927: #jhmchat I teach that Fena is like d dimer- helpful if low, indeterminate if not. Kelly Burdge, boston, no COI |
| Nikhil Shah @dr_nikhilshah RT @JHospMedicine: @kidney_boy @nephondemand do want to say thank to our nephrology colleagues for joining #jhmchat to weigh in! |
| J Hospital Medicine @JHospMedicine Great discussion lets keep it going...T2 up in a moment...#JHMChat |
| Joel Topf, MD FACP @kidney_boy Is there any test that should be #thingswedofornoreason ? Seems like a low bar. No reason, = no value. #jhmchat |
| Medical Board Reform @medboardreform RT @JHospMedicine: Great discussion lets keep it going...T2 up in a moment...#JHMChat |
| Amit Kumar Pahwa @Pahwa @kb927 looking at the article you can see the test characteristics worsen when indeterminate included (Diskin) #JHMChat |
| Liz Neporent @lizzyfit RT @kidney_boy: Is there any test that should be #thingswedofornoreason ? Seems like a low bar. No reason, = no value. #jhmchat |
| Malvinder Parmar @wittykidney #JHMChat on the same note, you don't need ultrasound in most of AKIs, but often r done to so called rule out obstruction |
| ABIM Foundation @ABIMFoundation RT @FutureDocs: Twitter journal club is "flipped classroom in action"! @pahwa @nephrosparks #jhmchat #Meded |
| J. Brian Byrd, MD, MS 🐦 @thebyrdlab OK, nephrology consultation: @kidney_boy, how should I think of #FeNa as relates to heart failure? Or should I? #FeNa or @FeNo? #JHMChat |
| J Hospital Medicine @JHospMedicine RT @wittykidney: #JHMChat on the same note, you don't need ultrasound in most of AKIs, but often r done to so called rule out obstruction |
| Joel Topf, MD FACP @kidney_boy @wittykidney treatment of obstruction is not dialysis. U/S rarely positive but changes treatment when it is. #jhmchat |
| Amit Kumar Pahwa @Pahwa @kidney_boy I will tell you that my coauthor Sperati (nephrologist) feels the title can be dichotomous #JHMchat |
| Swapnil Hiremath, MD, MPH @hswapnil T1: and if confirmed, this from @drseanbagshaw https://t.co/Ce3JzynCKU kills FENa for ICU patients #JHMChat https://t.co/OTrrLOFIMz |
 | Hector Madariaga, MD @hecmagsmd RT @wittykidney: #JHMChat on the same note, you don't need ultrasound in most of AKIs, but often r done to so called rule out obstruction |
| J Hospital Medicine @JHospMedicine @pat_health sorry we did look at when there were the fewest chats! #jhmchat #tweetchatoverload |
| Society of Hospital Medicine @SocietyHospMed Get ready! #JHMChat is live! https://t.co/R3FUVzqnQU |
| Joel Topf, MD FACP @kidney_boy Proof that nurse giving the diuretic? RT @thebyrdlab: how should I think of #FeNa as relates to heart failure? #FeNa or @FeNo? #JHMChat |
| Scented Bychkov @scentedbychkov RT ScentedBychkov: RT thebyrdlab: Brian Byrd, Ann Arbor, scientist, cardiologist, hypertension nerd. #JHMChat,https://t.co/7EGVDT7WeD |
| Amit Kumar Pahwa @Pahwa @wittykidney Very true, didn’t address here but did on our student modules on AKI https://t.co/FBndjZbfLq mess if want to test #jhmchat |
| J Hospital Medicine @JHospMedicine T2 #JHMChat Given the evidence in @pahwa article, are you ready to stop ordering FeNA and FUrea in workup of AKI? why or why not? |
| Joel Topf, MD FACP @kidney_boy @JHospMedicine @pat_health as long as you don't conflict with #NephJC #jhmchat |
| Sri Lekha Tummalapalli, MD, MBA @LTummalapalli RT @wittykidney: #JHMChat on the same note, you don't need ultrasound in most of AKIs, but often r done to so called rule out obstruction |
 | Tecfidera @dalbavancin RT @JHospMedicine: T2 #JHMChat Given the evidence in @pahwa article, are you ready to stop ordering FeNA and FUrea in workup of AKI? why or why not? |
| J Hospital Medicine @JHospMedicine RT @kidney_boy: @JHospMedicine @pat_health as long as you don't conflict with #NephJC #jhmchat |
 | Healing Art Misnomer @scotussaveus RT @JHospMedicine: T2 #JHMChat Given the evidence in @pahwa article, are you ready to stop ordering FeNA and FUrea in workup of AKI? why or why not? |
| Kelly Burdge @kb927 #jhmchat low urine Na tells you two things: 1. Tubules are working & 2. They are Na avid. It does not tell you why. |
| Healing Art Misnomer @scotussaveus RT @SHMLive: Get ready! #JHMChat is live! https://t.co/R3FUVzqnQU |
| Society of Hospital Medicine @SocietyHospMed Join the #JHMChat now - let your voice be heard! https://t.co/YiPtbzG6if |
| Hector Madariaga, MD @hecmagsmd @Wisit661 @JHospMedicine Hey friend, would you get FeNA in non-oliguria, too? #jhmchat |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: T2 #JHMChat Given the evidence in @pahwa article, are you ready to stop ordering FeNA and FUrea in workup of AKI? why or why not? |
| Joel Topf, MD FACP @kidney_boy I would argue this can be useful information RT @KB927: #jhmchat low urine Na tells you Tubules are working & They are Na avid |
| Amit Kumar Pahwa @Pahwa RT @KB927: #jhmchat low urine Na tells you two things: 1. Tubules are working & 2. They are Na avid. It does not tell you why. |
| Hector Madariaga, MD @hecmagsmd RT @kidney_boy: I would argue this can be useful information RT @KB927: #jhmchat low urine Na tells you Tubules are working & They are Na avid |
| Daniel Wolfson @WolfsonD #JHMChat Is there significant costs or downstream costs? Why is a value vs quality discussion? Help me out here., |
| Joel Topf, MD FACP @kidney_boy takes a marginal test and makes it bad MT @HekmagsMD: @Wisit661 @JHospMedicine Hey friend, would you get FeNA in non-oliguria, too? #jhmchat |
| Swapnil Hiremath, MD, MPH @hswapnil RT @KB927: #jhmchat low urine Na tells you two things: 1. Tubules are working & 2. They are Na avid. It does not tell you why. |
| J Hospital Medicine @JHospMedicine RT @kidney_boy: takes a marginal test and makes it bad MT @HekmagsMD: @Wisit661 @JHospMedicine Hey friend, would you get FeNA in non-oliguria, too? #jhmchat |
| Celine Goetz, MD @celinegoetzmd RT @wittykidney: #JHMChat on the same note, you don't need ultrasound in most of AKIs, but often r done to so called rule out obstruction |
| Swapnil Hiremath, MD, MPH @hswapnil RT @kidney_boy: takes a marginal test and makes it bad MT @HekmagsMD: @Wisit661 @JHospMedicine Hey friend, would you get FeNA in non-oliguria, too? #jhmchat |
| Swapnil Hiremath, MD, MPH @hswapnil T2: so do FENa only in select patients, not reflexly in all AKI? #JHMChat https://t.co/UyPmDF8tEw |
| Hector Madariaga, MD @hecmagsmd RT @kidney_boy: takes a marginal test and makes it bad MT @HekmagsMD: @Wisit661 @JHospMedicine Hey friend, would you get FeNA in non-oliguria, too? #jhmchat |
| Matthew Sparks, MD, FASN, FAHA @Nephro_Sparks RT @FutureDocs: Twitter journal club is "flipped classroom in action"! @pahwa @nephrosparks #jhmchat #Meded |
| Amit Kumar Pahwa @Pahwa @wolfsond according to article we would save very little Medicare reimburses about $7 for each indices. Goal is to think b4 order #jhmchat |
| Healing Art Misnomer @scotussaveus RT @JHospMedicine: T1 #JHMChat- Do you order FeNa and FeUrea in differentiating AKI? Why or why not? |
| Healing Art Misnomer @scotussaveus RT @kidney_boy: takes a marginal test and makes it bad MT @HekmagsMD: @Wisit661 @JHospMedicine Hey friend, would you get FeNA in non-oliguria, too? #jhmchat |
 | Ibrutinib Hu @ibrutinib RT @JHospMedicine: T1 #JHMChat- Do you order FeNa and FeUrea in differentiating AKI? Why or why not? |
| Sri Lekha Tummalapalli, MD, MBA @LTummalapalli #JHMChat #thingswedofornoreason If we order it to be "complete" or anticipating labs a consult may want, we aren't thinking rigorously |
| J Hospital Medicine @JHospMedicine Q from Tweetchat: Great question from @wolfsonD for #JHMChat tonight-- @pahwa any ideas? https://t.co/dn438adlVz |
| J Hospital Medicine @JHospMedicine RT @WolfsonD: #JHMChat Is there significant costs or downstream costs? Why is a value vs quality discussion? Help me out here., |
 | @MissouriDIFP Reform @cyramza RT @SHMLive: Get ready! #JHMChat is live! https://t.co/R3FUVzqnQU |
| @MissouriDIFP Reform @cyramza RT @JHospMedicine: T2 #JHMChat Given the evidence in @pahwa article, are you ready to stop ordering FeNA and FUrea in workup of AKI? why or why not? |
| Joel Topf, MD FACP @kidney_boy like all tests RT @hswapnil: T2: so do FENa only in select patients, not reflexly in all AKI? #JHMChat https://t.co/ixiFNc75EL |
| Medical Board Reform @medboardreform RT @SHMLive: Get ready! #JHMChat is live! https://t.co/R3FUVzqnQU |
| Medical Board Reform @medboardreform RT @JHospMedicine: T2 #JHMChat Given the evidence in @pahwa article, are you ready to stop ordering FeNA and FUrea in workup of AKI? why or why not? |
| Medical Board Reform @medboardreform RT @kidney_boy: @JHospMedicine @pat_health as long as you don't conflict with #NephJC #jhmchat |
| J Hospital Medicine @JHospMedicine Q from Tweetchat: Great question from @wolfsonD for #JHMChat tonight-- @pahwa any ideas? https://t.co/dn438adlVz https://t.co/8gjkkEA5ar |
| Amit Kumar Pahwa @Pahwa RT @LTummalapalli: #JHMChat #thingswedofornoreason If we order it to be "complete" or anticipating labs a consult may want, we aren't thinking rigorously |
| J Hospital Medicine @JHospMedicine RT @LTummalapalli: #JHMChat #thingswedofornoreason If we order it to be "complete" or anticipating labs a consult may want, we aren't thinking rigorously |
| Malvinder Parmar @wittykidney @Pahwa @WolfsonD that goal, "think b4 u order" should be applicable to all tests #jhmchat |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: Q from Tweetchat: Great question from @wolfsonD for #JHMChat tonight-- @pahwa any ideas? https://t.co/dn438adlVz https://t.co/8gjkkEA5ar |
| Swapnil Hiremath, MD, MPH @hswapnil RT @LTummalapalli: #JHMChat #thingswedofornoreason If we order it to be "complete" or anticipating labs a consult may want, we aren't thinking rigorously |
| J Hospital Medicine @JHospMedicine RT @kidney_boy: like all tests RT @hswapnil: T2: so do FENa only in select patients, not reflexly in all AKI? #JHMChat https://t.co/ixiFNc75EL |
| Swapnil Hiremath, MD, MPH @hswapnil RT @kidney_boy: like all tests RT @hswapnil: T2: so do FENa only in select patients, not reflexly in all AKI? #JHMChat https://t.co/ixiFNc75EL |
| Amit Kumar Pahwa @Pahwa @jhospmedicine @wolfsond value is always quality/price. while price is low quality of test for all those with AKI is marginal #jhmchat |
| @HyungChoMD @HyungChoMD @Pahwa @wolfsond #JHMChat the issue is urine lytes are just reflexive initial testing that’s been taught in our schools |
| J Hospital Medicine @JHospMedicine RT @Pahwa: @wolfsond according to article we would save very little Medicare reimburses about $7 for each indices. Goal is to think b4 order #jhmchat |
| Liz Neporent @lizzyfit RT @wittykidney: @Pahwa @WolfsonD that goal, "think b4 u order" should be applicable to all tests #jhmchat |
| J Hospital Medicine @JHospMedicine RT @Pahwa: @jhospmedicine @wolfsond value is always quality/price. while price is low quality of test for all those with AKI is marginal #jhmchat |
| J Hospital Medicine @JHospMedicine RT @Pahwa: @jhospmedicine @wolfsond value is always quality/price. while price is low quality of test for all those with AKI is marginal #jhmchat |
| J Hospital Medicine @JHospMedicine RT @Pahwa: @jhospmedicine @wolfsond value is always quality/price. while price is low quality of test for all those with AKI is marginal #jhmchat |
| J Hospital Medicine @JHospMedicine RT @HyungChoMD: @Pahwa @wolfsond #JHMChat the issue is urine lytes are just reflexive initial testing that’s been taught in our schools |
| J Hospital Medicine @JHospMedicine RT @wittykidney: @Pahwa @WolfsonD that goal, "think b4 u order" should be applicable to all tests #jhmchat |
| Matthew Sparks, MD, FASN, FAHA @Nephro_Sparks RT @kidney_boy: like all tests RT @hswapnil: T2: so do FENa only in select patients, not reflexly in all AKI? #JHMChat https://t.co/ixiFNc75EL |
| Suneel Udani @captainkidney79 Do we always know a priori when it will be helpful? #JHMChat https://t.co/oN5xBJB7ha |
| Tecfidera @dalbavancin RT @HyungChoMD: @Pahwa @wolfsond #JHMChat the issue is urine lytes are just reflexive initial testing that’s been taught in our schools |
| Tecfidera @dalbavancin RT @HyungChoMD: @Pahwa @wolfsond #JHMChat the issue is urine lytes are just reflexive initial testing that’s been taught in our schools |
| Amit Kumar Pahwa @Pahwa @hyungchomd @wolfsond we @hopkinsMedicine are changing with r IM clerkship - check out our modules - gave 2 ur clerkship director #jhmchat |
 | Zaire Ebolavirus @dasabuvir RT @WolfsonD: #JHMChat Is there significant costs or downstream costs? Why is a value vs quality discussion? Help me out here., |
| Joel Topf, MD FACP @kidney_boy @CaptainKidney79 What does the FENa do in AIN? #JHMChat |
| Matthew Sparks, MD, FASN, FAHA @Nephro_Sparks @Pahwa @HyungChoMD @WolfsonD @HopkinsMedicine they should change based on new information #jhmchat |
| Amit Kumar Pahwa @Pahwa @captainkidney79 no but that is what we need to teach the future of medicine #jhmchat |
| Vinny Arora MD MAPP @FutureDocs RT @Pahwa: @hyungchomd @wolfsond we @hopkinsMedicine are changing with r IM clerkship - check out our modules - gave 2 ur clerkship director #jhmchat |
| Vinny Arora MD MAPP @FutureDocs RT @HyungChoMD: @Pahwa @wolfsond #JHMChat the issue is urine lytes are just reflexive initial testing that’s been taught in our schools |
| J. Brian Byrd, MD, MS 🐦 @thebyrdlab @kidney_boy Do you at times order the Fe Urea in a heart failure patient who is being diuresed? #JHMChat |
| Kelly Burdge @kb927 #jhmchat T2: helpful for CRS, helpful if multiple insults , but you have to look at the patient 1st, not order 1st. |
| Vinny Arora MD MAPP @FutureDocs . @HyungChoMD @Pahwa @WolfsonD the reflexivity of lab ordering is a serious problem #JHMChat |
| Malvinder Parmar @wittykidney @HyungChoMD @Pahwa @WolfsonD agree that "knee-jerk medicine" should be avoided & test should be done if & when strongly indicated #JHMChat |
| Suneel Udani @captainkidney79 @kidney_boy I find high FENA highlights tubular dysfunction can suggest AIN #JHMChat |
| Amit Kumar Pahwa @Pahwa RT @KB927: #jhmchat T2: helpful for CRS, helpful if multiple insults , but you have to look at the patient 1st, not order 1st. |
| Amit Kumar Pahwa @Pahwa RT @wittykidney: @HyungChoMD @Pahwa @WolfsonD agree that "knee-jerk medicine" should be avoided & test should be done if & when strongly indicated #JHMChat |
| Amit Kumar Pahwa @Pahwa RT @FutureDocs: . @HyungChoMD @Pahwa @WolfsonD the reflexivity of lab ordering is a serious problem #JHMChat |
| @HyungChoMD @HyungChoMD RT @FutureDocs: . @HyungChoMD @Pahwa @WolfsonD the reflexivity of lab ordering is a serious problem #JHMChat |
| J Hospital Medicine @JHospMedicine Great dialogue! Learning a ton....Just a heads up that we will be introducing T3 in a moment...#JHMChat |
| Liz Neporent @lizzyfit RT @JHospMedicine: Great dialogue! Learning a ton....Just a heads up that we will be introducing T3 in a moment...#JHMChat |
| Healing Art Misnomer @scotussaveus RT @JHospMedicine: Great dialogue! Learning a ton....Just a heads up that we will be introducing T3 in a moment...#JHMChat |
| J Hospital Medicine @JHospMedicine RT @wittykidney: @HyungChoMD @Pahwa @WolfsonD agree that "knee-jerk medicine" should be avoided & test should be done if & when strongly indicated #JHMChat |
| Society of Hospital Medicine @SocietyHospMed RT @FutureDocs: . @HyungChoMD @Pahwa @WolfsonD the reflexivity of lab ordering is a serious problem #JHMChat |
| Joel Topf, MD FACP @kidney_boy Sometimes helpful RT @thebyrdlab: @kidney_boy Do you at times order the Fe Urea in a heart failure patient who is being diuresed? #JHMChat |
| ABIM Foundation @ABIMFoundation RT @SHMLive: Get ready! #JHMChat is live! https://t.co/R3FUVzqnQU |
| Amit Kumar Pahwa @Pahwa @captainkidney79 @kidney_boy or high salt load? #jhmchat #snackingonchipsfornationalchampionship |
| Matthew Sparks, MD, FASN, FAHA @Nephro_Sparks RT @kidney_boy: Sometimes helpful RT @thebyrdlab: @kidney_boy Do you at times order the Fe Urea in a heart failure patient who is being diuresed? #JHMChat |
| J Hospital Medicine @JHospMedicine "you have to look at the patient 1st, not order 1st." - heard on #JHMChat https://t.co/pPDj9i6RiK |
| Joel Topf, MD FACP @kidney_boy Anybody else see this? RT @CaptainKidney79: @kidney_boy I find high FENA highlights tubular dysfunction can suggest AIN #JHMChat |
| Wisit C @wisit661 @HekmagsMD @JHospMedicine I do not. I think it is inaccurate in non-oliguric setting. #JHMChat Good to see you join the discussion, buddy! |
| Society of Hospital Medicine @SocietyHospMed Don't miss out on translating #hospitalmedicine #research into practice w/ #JHMChat happening now - join in! https://t.co/TqtzXeGPsE |
 | TomMD @tomas_md RT @hswapnil: T2: so do FENa only in select patients, not reflexly in all AKI? #JHMChat https://t.co/UyPmDF8tEw |
| Society of Hospital Medicine @SocietyHospMed Do you agree? There's still time to join in the #JHMChat discussion! https://t.co/XXIFg4F5zI |
| Joel Topf, MD FACP @kidney_boy The article says the FENa can be helpful in HRS. In my experience FENa always low in cirrhosis regardless of ATN, pre renal or HRS #jhmchat |
| Scented Bychkov @scentedbychkov RT ScentedBychkov: RT ScentedBychkov: RT thebyrdlab: Brian Byrd, Ann Arbor, scientist, cardiologist, hypertension nerd. #JHMChat,http://ift… |
| J Hospital Medicine @JHospMedicine T3 now LIVE: #JHMChat - What is the most effective way to translate these findings into practice & improve workup of AKI? |
| Sri Lekha Tummalapalli, MD, MBA @LTummalapalli #JHMChat There are asymmetric incentives. Ordering a test without indication is an error similar to "missing something." |
| Zaire Ebolavirus @dasabuvir RT @JHospMedicine: T3 now LIVE: #JHMChat - What is the most effective way to translate these findings into practice & improve workup of AKI? |
| ABIM Foundation @ABIMFoundation RT @JHospMedicine: T3 now LIVE: #JHMChat - What is the most effective way to translate these findings into practice & improve workup of AKI? |
| J. Brian Byrd, MD, MS 🐦 @thebyrdlab @kidney_boy Seems right--aldosterone is sky high typically. #JHMChat |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: T3 now LIVE: #JHMChat - What is the most effective way to translate these findings into practice & improve workup of AKI? |
| Matthew Sparks, MD, FASN, FAHA @Nephro_Sparks @JHospMedicine T3: I think we need to do a better job on describing appropriate use FeNa #jhmchat |
| @HyungChoMD @HyungChoMD RT @LTummalapalli: #JHMChat There are asymmetric incentives. Ordering a test without indication is an error similar to "missing something." |
| Amit Kumar Pahwa @Pahwa @jhospmedicine T3 is what @kb927 said look at the patient 1st#JHMChat |
 | Brendon Neuen @brendonln RT @JHospMedicine: For tonight's #JHMChat will discuss getting FeNa and FUrea in Acute Kidney Injury with @Pahwa - paper https://t.co/2MNXkZ4a4D |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: T3 now LIVE: #JHMChat - What is the most effective way to translate these findings into practice & improve workup of AKI? |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: "you have to look at the patient 1st, not order 1st." - heard on #JHMChat https://t.co/pPDj9i6RiK |
| Vinny Arora MD MAPP @FutureDocs RT @wittykidney: @HyungChoMD @Pahwa @WolfsonD agree that "knee-jerk medicine" should be avoided & test should be done if & when strongly indicated #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @Nephro_Sparks: @JHospMedicine T3: I think we need to do a better job on describing appropriate use FeNa #jhmchat |
| Swapnil Hiremath, MD, MPH @hswapnil Agree. Found that strange Sodium avid state #JHMChat https://t.co/Bi5j2arFQD |
 | Tᴇᴊᴀs Dᴇsᴀɪ, MD (Physician-💻 Coder) @nephondemand NOD Analytics of #JHMChat : Top tweeters thus far @JHospMedicine @SHMLive @Pahwa @FutureDocs @ABIMFoundation https://t.co/G3U47qHk1x |
| J. Brian Byrd, MD, MS 🐦 @thebyrdlab @Nephro_Sparks @JHospMedicine I'm certainly interested in that question #JHMChat |
 | Medical Board Reform @tenaciousmeded RT @JHospMedicine: Great dialogue! Learning a ton....Just a heads up that we will be introducing T3 in a moment...#JHMChat |
| Medical Board Reform @tenaciousmeded RT @JHospMedicine: "you have to look at the patient 1st, not order 1st." - heard on #JHMChat https://t.co/pPDj9i6RiK |
| Hector Madariaga, MD @hecmagsmd RT @kidney_boy: The article says the FENa can be helpful in HRS. In my experience FENa always low in cirrhosis regardless of ATN, pre renal or HRS #jhmchat |
| Amit Kumar Pahwa @Pahwa RT @Nephro_Sparks: @JHospMedicine T3: I think we need to do a better job on describing appropriate use FeNa #jhmchat |
| Matthew Sparks, MD, FASN, FAHA @Nephro_Sparks @kidney_boy occasionally if FeNa high in cirrhosis, suggest ATN though. and this is helpful #jhmchat |
| Medscape @medscape What we can add to this convo... a study on the difficulties to managing AKI - https://t.co/2lID1q0OO3 #JHMChat |
| J Hospital Medicine @JHospMedicine thx for the data for #JHMChat! https://t.co/5fcI5kf2ag |
| J Hospital Medicine @JHospMedicine RT @LTummalapalli: #JHMChat There are asymmetric incentives. Ordering a test without indication is an error similar to "missing something." |
| Amit Kumar Pahwa @Pahwa @kidney_boy I agree with you but we did not mean to say helpful but part of diagnostic criteria #JHMChat |
| Matthew Sparks, MD, FASN, FAHA @Nephro_Sparks @nephondemand Hey Tejas. hope you are doing well. #jhmchat |
 | ChristosArgyropoulos @ChristosArgyrop @JHospMedicine #JHMChat Ultimately FeNa is used to justify a fluid challenge vs no fluid challange. Why not fluid challenge directly? |
| J Hospital Medicine @JHospMedicine @Nephro_Sparks how to disseminate/teach this info? #JHMChat |
| Matthew Sparks, MD, FASN, FAHA @Nephro_Sparks @JHospMedicine @Nephro_Sparks We have been preaching it on SM for years now. in the halls and anyone who will listen #jhmchat |
| Amit Kumar Pahwa @Pahwa Thanks@Medscape #jhmchat https://t.co/XMKPBSXlao |
| J Hospital Medicine @JHospMedicine RT @Wisit661: @HekmagsMD @JHospMedicine I do not. I think it is inaccurate in non-oliguric setting. #JHMChat Good to see you join the discussion, buddy! |
| Swapnil Hiremath, MD, MPH @hswapnil RT @ChristosArgyrop: @JHospMedicine #JHMChat Ultimately FeNa is used to justify a fluid challenge vs no fluid challange. Why not fluid challenge directly? |
 | Marty Muntz @mmteacherdoc RT @FutureDocs: . @HyungChoMD @Pahwa @WolfsonD the reflexivity of lab ordering is a serious problem #JHMChat |
| J Hospital Medicine @JHospMedicine RT @Nephro_Sparks: @JHospMedicine @Nephro_Sparks We have been preaching it on SM for years now. in the halls and anyone who will listen #jhmchat |
| Joel Topf, MD FACP @kidney_boy @Pahwa that makes more sense #jhmchat |
| Amit Kumar Pahwa @Pahwa @christosargyrop @jhospmedicine 100% agree. that was the gold standard in the original Espinel group of 17 to validate indices #jhmchat |
| Society of Hospital Medicine @SocietyHospMed RT @Medscape: What we can add to this convo... a study on the difficulties to managing AKI - https://t.co/2lID1q0OO3 #JHMChat |
| ABIM Foundation @ABIMFoundation RT @nephondemand: NOD Analytics of #JHMChat : Top tweeters thus far @JHospMedicine @SHMLive @Pahwa @FutureDocs @ABIMFoundation https://t.co/G3U47qHk1x |
| J Hospital Medicine @JHospMedicine - @pahwa was definitely making this argument in the @JHospMedicine article #jhmchat https://t.co/JCyPVSgzdC |
| Tᴇᴊᴀs Dᴇsᴀɪ, MD (Physician-💻 Coder) @nephondemand NOD Analytics of #JHMChat: more detailed Twitter metrics ④ 🔝 tweeters @JHospMedicine @SHMLive @Pahwa @futuredocs https://t.co/V0imstjlxI |
| Matthew Sparks, MD, FASN, FAHA @Nephro_Sparks @ChristosArgyrop @JHospMedicine typically fluid challenge is done at same time IMO #jhmchat |
 | Magdeline Carrasco A @magdeline_ca RT @Medscape: Medscape is joining the #JHMChat, 'Things we docs do for no reason' tweet chat. STARTING NOW. Join the convo: https://t.co/Snw8Zbthix |
| J Hospital Medicine @JHospMedicine thx for the data for #JHMChat! https://t.co/5fcI5kf2ag https://t.co/nLoBby4Gyt |
| Amit Kumar Pahwa @Pahwa @adauerbachmd @jhospmedicine get a story - that will help you most of the time without additional diagnostics. #jhmchat |
| Matthew Sparks, MD, FASN, FAHA @Nephro_Sparks Here is our #NephMadness FeNa discussion https://t.co/rNra6bn4tZ #jhmchat |
| ChristosArgyropoulos @ChristosArgyrop @Nephro_Sparks @JHospMedicine #JHMChat One may argue (in theory) that dynamic changes of FeNa/FeUr would be more informative #renalPCWP |
| Wisit C @wisit661 @Nephro_Sparks @kidney_boy just had HRS, with low FeNa, turned to high FeNa and urine microscopy showing ATN! So I'm on #TeamFeNa #jhmchat |
| ChristosArgyropoulos @ChristosArgyrop @Nephro_Sparks @JHospMedicine #JHMChat If you do it at the same time (also the pattern I've observed) then why bother w FeNa? |
| Amit Kumar Pahwa @Pahwa @ADAuerbachMD unfortunately there are too many things distracting us from talking to patients so we order #jhmchat #guilty |
| J Hospital Medicine @JHospMedicine Remember tag T3 #JHMChat - What is the most effective way to translate these findings into practice & improve workup of AKI? |
| Zaire Ebolavirus @dasabuvir RT @JHospMedicine: thx for the data for #JHMChat! https://t.co/5fcI5kf2ag https://t.co/nLoBby4Gyt |
| Tᴇᴊᴀs Dᴇsᴀɪ, MD (Physician-💻 Coder) @nephondemand @JHospMedicine More #JHMChat data to come in the next few days. |
| Matthew Sparks, MD, FASN, FAHA @Nephro_Sparks @Pahwa @ADAuerbachMD sad to hear that #jhmchat |
| Sri Lekha Tummalapalli, MD, MBA @LTummalapalli #JHMChat Perhaps with increased bedside ultrasound use, we can assess volume status better by looking at the IVC. But operator dependent |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: Remember tag T3 #JHMChat - What is the most effective way to translate these findings into practice & improve workup of AKI? |
| Matthew Sparks, MD, FASN, FAHA @Nephro_Sparks it happens #jhmchat just think if they gave them a kidney transpant https://t.co/xASHuHwALV |
| J Hospital Medicine @JHospMedicine RT @LTummalapalli: #JHMChat Perhaps with increased bedside ultrasound use, we can assess volume status better by looking at the IVC. But operator dependent |
| J Hospital Medicine @JHospMedicine @nephondemand Look forward to it - thanks! #JHMChat |
| J Hospital Medicine @JHospMedicine RT @Pahwa: @ADAuerbachMD unfortunately there are too many things distracting us from talking to patients so we order #jhmchat #guilty |
| J Hospital Medicine @JHospMedicine "Get a story" --words to live by for hospitalists #JHMChat https://t.co/x1Ds4MtljZ |
| Joel Topf, MD FACP @kidney_boy You can use FENa in CKD, but it is only instructive if it is low, normally will be higher with lower baseline GFRs #jhmchat |
| Matthew Sparks, MD, FASN, FAHA @Nephro_Sparks all physicians really RT @JHospMedicine: "Get a story" --words to live by for hospitalists #JHMChat https://t.co/mC9lxUWe7q |
| J Hospital Medicine @JHospMedicine - @pahwa was definitely making this argument in the @JHospMedicine article #jhmchat https://t.co/JCyPVSgzdC https://t.co/GBdG1Zw8IS |
| Zaire Ebolavirus @dasabuvir RT @Pahwa: @ADAuerbachMD unfortunately there are too many things distracting us from talking to patients so we order #jhmchat #guilty |
| Tecfidera @dalbavancin RT @Pahwa: @ADAuerbachMD unfortunately there are too many things distracting us from talking to patients so we order #jhmchat #guilty |
| Tecfidera @dalbavancin RT @JHospMedicine: - @pahwa was definitely making this argument in the @JHospMedicine article #jhmchat https://t.co/JCyPVSgzdC https://t.co/GBdG1Zw8IS |
| Amit Kumar Pahwa @Pahwa @jhospmedicine I agree with @chritosargyrop - don’t order something if it won’t change your management #jhmchat |
| Zaire Ebolavirus @dasabuvir RT @JHospMedicine: - @pahwa was definitely making this argument in the @JHospMedicine article #jhmchat https://t.co/JCyPVSgzdC https://t.co/GBdG1Zw8IS |
| Swapnil Hiremath, MD, MPH @hswapnil T3: maybe this, eventually if we all reach it right? #JHMChat https://t.co/a979rtoX4L |
| J Hospital Medicine @JHospMedicine T4 Last question: What is your main take home lesson from this tweetchat? Has it informed the way you will practice/teach? #JHMChat |
| ChristosArgyropoulos @ChristosArgyrop @kidney_boy #JHMChat The urine one sends to the lab in cirrhotics is usually vintage variety from hrs ago. So FeNa worthless dt high BL aldo |
| J Hospital Medicine @JHospMedicine RT @Pahwa: @jhospmedicine I agree with @chritosargyrop - don’t order something if it won’t change your management #jhmchat |
| J Hospital Medicine @JHospMedicine RT @Pahwa: @jhospmedicine I agree with @chritosargyrop - don’t order something if it won’t change your management #jhmchat |
| J Hospital Medicine @JHospMedicine RT @Pahwa: @jhospmedicine I agree with @chritosargyrop - don’t order something if it won’t change your management #jhmchat |
| Amit Kumar Pahwa @Pahwa @wisit661 @nephro_sparks @kidney_boy be careful with n of 1 or 17. #jhmchat |
 | 2nd Guess Med Boards @obinutuzumab RT @JHospMedicine: T4 Last question: What is your main take home lesson from this tweetchat? Has it informed the way you will practice/teach? #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: T4 Last question: What is your main take home lesson from this tweetchat? Has it informed the way you will practice/teach? #JHMChat |
 | avro lancaster @thomasrenaghan RT @Pahwa: @adauerbachmd @jhospmedicine get a story - that will help you most of the time without additional diagnostics. #jhmchat |
| Swapnil Hiremath, MD, MPH @hswapnil RT @kidney_boy: You can use FENa in CKD, but it is only instructive if it is low, normally will be higher with lower baseline GFRs #jhmchat |
| Vinny Arora MD MAPP @FutureDocs RT @Pahwa: @wisit661 @nephro_sparks @kidney_boy be careful with n of 1 or 17. #jhmchat |
| Amit Kumar Pahwa @Pahwa @ltummalapalli we did address in paper but it requires a lot of training #jhmchat |
| Vinny Arora MD MAPP @FutureDocs RT @hswapnil: T3: maybe this, eventually if we all reach it right? #JHMChat https://t.co/a979rtoX4L |
| ABIM Foundation @ABIMFoundation RT @JHospMedicine: T4 Last question: What is your main take home lesson from this tweetchat? Has it informed the way you will practice/teach? #JHMChat |
| Vinny Arora MD MAPP @FutureDocs @hswapnil wow that's amazing thx for share #jhmchat |
| ChristosArgyropoulos @ChristosArgyrop @hswapnil #JHMChat Cynic 😏 |
| Amit Kumar Pahwa @Pahwa @christosargyrop @kidney_boy I agree even the studies “validating” the test could never time it properly #jhmchat |
| Tecfidera @dalbavancin RT @FutureDocs: @hswapnil wow that's amazing thx for share #jhmchat |
| Tecfidera @dalbavancin RT @Pahwa: @wisit661 @nephro_sparks @kidney_boy be careful with n of 1 or 17. #jhmchat |
| Society of Hospital Medicine @SocietyHospMed Jump right in on the last #JHMChat question for this time - don't forget to include the hashtag in your tweets: https://t.co/BnQ6Fl6zC9 |
| Suneel Udani @captainkidney79 #JHMChat T3 one simple point FENA = decreased renal blood flow and tubular Na avidity. It does not = volume depletion |
| Matthew Sparks, MD, FASN, FAHA @Nephro_Sparks RT @hswapnil: T3: maybe this, eventually if we all reach it right? #JHMChat https://t.co/a979rtoX4L |
| J. Brian Byrd, MD, MS 🐦 @thebyrdlab If the patient has had an echo, the data exists there for your review, too. #JHMChat https://t.co/HZFVMLrylO |
| J Hospital Medicine @JHospMedicine RT @SHMLive: Jump right in on the last #JHMChat question for this time - don't forget to include the hashtag in your tweets: https://t.co/BnQ6Fl6zC9 |
| Amit Kumar Pahwa @Pahwa T4 writing this taught me that tests should be performed in a the population they were validated in #jhmchat |
 | Medical BoardScandal @thebesianveins RT @Pahwa: @wisit661 @nephro_sparks @kidney_boy be careful with n of 1 or 17. #jhmchat |
 | Seth Trueger @MDaware RT @hswapnil: T3: maybe this, eventually if we all reach it right? #JHMChat https://t.co/a979rtoX4L |
| Matthew Sparks, MD, FASN, FAHA @Nephro_Sparks @thebyrdlab interesting that the patient with the FeNa also had their 3rd ECHO $$$ #jhmchat |
| Matthew Sparks, MD, FASN, FAHA @Nephro_Sparks RT @Pahwa: T4 writing this taught me that tests should be performed in a the population they were validated in #jhmchat |
| Amit Kumar Pahwa @Pahwa RT @CaptainKidney79: #JHMChat T3 one simple point FENA = decreased renal blood flow and tubular Na avidity. It does not = volume depletion |
| J Hospital Medicine @JHospMedicine another one for another day cc @WolfsonD #JHMChat https://t.co/wa5HNtgBMC |
| J Hospital Medicine @JHospMedicine RT @Pahwa: T4 writing this taught me that tests should be performed in a the population they were validated in #jhmchat |
| J Hospital Medicine @JHospMedicine another one for another day cc @WolfsonD #JHMChat https://t.co/wa5HNtgBMC https://t.co/voq2xYgsvY |
| Suneel Udani @captainkidney79 #JHMChat T3. Train renal fellow and residents to review urine microscopy and combine what they see with FENA |
| ChristosArgyropoulos @ChristosArgyrop @JHospMedicine #JHMChat One may teach the inconvenient truth, but ppl will gravitate towards the textbook/board Q false prophesy |
| Amit Kumar Pahwa @Pahwa T4 when we go over evidence in rounds or starting therapy i ask residents to look at the study population in article #EBM #jhmchat |
| J Hospital Medicine @JHospMedicine @Wisit661 @ambrus07 @HekmagsMD be sure to index #JHMChat thanks for joining! |
 | José Miguel Bernucci @pajarobere RT @SHMLive: Do you agree? There's still time to join in the #JHMChat discussion! https://t.co/XXIFg4F5zI |
| J Hospital Medicine @JHospMedicine @Medscape Thanks for sharing and joining us #JHMChat |
| Suneel Udani @captainkidney79 #JHMChat T4. Always remind me to ask trainees "why did you order that test?" |
| J Hospital Medicine @JHospMedicine RT @Pahwa: T4 when we go over evidence in rounds or starting therapy i ask residents to look at the study population in article #EBM #jhmchat |
| Matthew Sparks, MD, FASN, FAHA @Nephro_Sparks feel like broken record myself RT @CaptainKidney79: #JHMChat T4. Always remind me to ask trainees "why did you order that test?" |
| Medscape @medscape Thanks so much for holding this chat. #Interesting #JHMChat |
| Wisit C @wisit661 @Nephro_Sparks @kidney_boy So, we can tell after liver Tx, those with high FeNa may recover kidney function slower than low FeNa #JHMChat |
 | Ben Kinnear @Midwest_MedPeds Learning a lot following #JHMChat about FeNa and FUrea https://t.co/pq4J8NzwEC |
| J. Brian Byrd, MD, MS 🐦 @thebyrdlab RT @Nephro_Sparks: feel like broken record myself RT @CaptainKidney79: #JHMChat T4. Always remind me to ask trainees "why did you order that test?" |
| J Hospital Medicine @JHospMedicine RT @CaptainKidney79: #JHMChat T4. Always remind me to ask trainees "why did you order that test?" |
| Amy Nadel @amynadel RT @Medscape: Thanks so much for holding this chat. #Interesting #JHMChat |
| Amit Kumar Pahwa @Pahwa @nephro_sparks @captainkidney79 keep doing it eventually there will be change #maninmirror @ChrisMoriates #JHMChat |
| J Hospital Medicine @JHospMedicine RT @Midwest_MedPeds: Learning a lot following #JHMChat about FeNa and FUrea https://t.co/pq4J8NzwEC |
| Andrew Auerbach @ADAuerbachMD Thanks for sharing and leading us #JHMChat @Pahwa @FutureDocs @JHospMedicine @SHMLive @ABIMFoundation |
| Sri Lekha Tummalapalli, MD, MBA @LTummalapalli #JHMChat Attending leadership to probe residents into why they ordered urine electrolytes will stimulate critical thinking |
| Society of Hospital Medicine @SocietyHospMed RT @Midwest_MedPeds: Learning a lot following #JHMChat about FeNa and FUrea https://t.co/pq4J8NzwEC |
| J. Brian Byrd, MD, MS 🐦 @thebyrdlab Thanks for letting a cardiologist hang out! Remember, the kidneys need us.... #JHMChat |
| Malvinder Parmar @wittykidney @Nephro_Sparks @CaptainKidney79 actually I have a talk titled, "Why did I do that?" #JHMChat for family physicians |
| Society of Hospital Medicine @SocietyHospMed RT @ADAuerbachMD: Thanks for sharing and leading us #JHMChat @Pahwa @FutureDocs @JHospMedicine @SHMLive @ABIMFoundation |
| J Hospital Medicine @JHospMedicine RT @Medscape: Thanks so much for holding this chat. #Interesting #JHMChat |
| @HyungChoMD @HyungChoMD @JHospMedicine #JHMChat If I ever create an initiative here on urine lytes, I’m calling it “The #FeNa or #FeNo project.” thanks @thebyrdlab |
| Amit Kumar Pahwa @Pahwa @adauerbachmd @futuredocs @jhospmedicine @shmlive @abimfoundation Thanks for inviting me. Coffee worked! #jhmchat |
| ChristosArgyropoulos @ChristosArgyrop @CaptainKidney79 #JHMChat Notwithstanding the JASN paper from a few yrs ago, ppl tend to overcall ATN on the basis of 1-2 casts in the micro |
| Amit Kumar Pahwa @Pahwa RT @LTummalapalli: #JHMChat Attending leadership to probe residents into why they ordered urine electrolytes will stimulate critical thinking |
| Society of Hospital Medicine @SocietyHospMed Thanks to all who joined #JHMChat & added to a very important convo! @JHospMedicine @FutureDocs @Pahwa @ABIMFoundation @CostsofCare |
| Malvinder Parmar @wittykidney @thebyrdlab if there is no pump, there is no need for filter #JHMChat 😀 |
| J Hospital Medicine @JHospMedicine Thanks everyone for great #JHMChat with a shout out to @pahwa our author & partners @costsofcare @ABIMfoundation and @SHMLive! |
| Tecfidera @dalbavancin RT @JHospMedicine: Thanks everyone for great #JHMChat with a shout out to @pahwa our author & partners @costsofcare @ABIMfoundation and @SHMLive! |
| Amit Kumar Pahwa @Pahwa @hyungchomd @jhospmedicine @thebyrdlab yes #FeNo is awesome. I am saying it in rounds next time #JHMChat |
| J Hospital Medicine @JHospMedicine RT @HyungChoMD: @JHospMedicine #JHMChat If I ever create an initiative here on urine lytes, I’m calling it “The #FeNa or #FeNo project.” thanks @thebyrdlab |
| J Hospital Medicine @JHospMedicine RT @thebyrdlab: Thanks for letting a cardiologist hang out! Remember, the kidneys need us.... #JHMChat |
| J Hospital Medicine @JHospMedicine RT @LTummalapalli: #JHMChat Attending leadership to probe residents into why they ordered urine electrolytes will stimulate critical thinking |
| J Hospital Medicine @JHospMedicine RT @ADAuerbachMD: Thanks for sharing and leading us #JHMChat @Pahwa @FutureDocs @JHospMedicine @SHMLive @ABIMFoundation |
| J. Brian Byrd, MD, MS 🐦 @thebyrdlab Truer words have never been Tweeted #JHMChat https://t.co/ab9szsNthk |
| Matthew Sparks, MD, FASN, FAHA @Nephro_Sparks Really interesting chat. Thanks to @pahwa for joining #jhmchat |
| Vinny Arora MD MAPP @FutureDocs RT @ADAuerbachMD: Thanks for sharing and leading us #JHMChat @Pahwa @FutureDocs @JHospMedicine @SHMLive @ABIMFoundation |
| Wisit C @wisit661 @JHospMedicine @Pahwa @CostsofCare @ABIMFoundation @SHMLive Thank you! This is great! 😃👍🏻 #JHMChat |
| Amit Kumar Pahwa @Pahwa @christosargyrop @captainkidney79 in the paper we talk a little about how no test is perfect (1/3 changed after biopsy!) #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @thebyrdlab: Truer words have never been Tweeted #JHMChat https://t.co/ab9szsNthk |
| Vinny Arora MD MAPP @FutureDocs RT @Pahwa: @hyungchomd @jhospmedicine @thebyrdlab yes #FeNo is awesome. I am saying it in rounds next time #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: Thanks everyone for great #JHMChat with a shout out to @pahwa our author & partners @costsofcare @ABIMfoundation and @SHMLive! |
| Vinny Arora MD MAPP @FutureDocs RT @SHMLive: Thanks to all who joined #JHMChat & added to a very important convo! @JHospMedicine @FutureDocs @Pahwa @ABIMFoundation @CostsofCare |
| Vinny Arora MD MAPP @FutureDocs RT @Pahwa: @adauerbachmd @futuredocs @jhospmedicine @shmlive @abimfoundation Thanks for inviting me. Coffee worked! #jhmchat |
| Medical BoardScandal @thebesianveins RT @thebyrdlab: Truer words have never been Tweeted #JHMChat https://t.co/ab9szsNthk |
| Vinny Arora MD MAPP @FutureDocs RT @LTummalapalli: #JHMChat Attending leadership to probe residents into why they ordered urine electrolytes will stimulate critical thinking |
| 2nd Guess Med Boards @obinutuzumab RT @Pahwa: @hyungchomd @jhospmedicine @thebyrdlab yes #FeNo is awesome. I am saying it in rounds next time #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @Pahwa: @nephro_sparks @captainkidney79 keep doing it eventually there will be change #maninmirror @ChrisMoriates #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @CaptainKidney79: #JHMChat T4. Always remind me to ask trainees "why did you order that test?" |
| Vinny Arora MD MAPP @FutureDocs RT @Pahwa: @christosargyrop @captainkidney79 in the paper we talk a little about how no test is perfect (1/3 changed after biopsy!) #JHMChat |
| 2nd Guess Med Boards @obinutuzumab RT @thebyrdlab: Truer words have never been Tweeted #JHMChat https://t.co/ab9szsNthk |
| Vinny Arora MD MAPP @FutureDocs RT @Nephro_Sparks: Really interesting chat. Thanks to @pahwa for joining #jhmchat |
 | State Medical Board @rifapentine RT @CaptainKidney79: #JHMChat T3. Train renal fellow and residents to review urine microscopy and combine what they see with FENA |
| ChristosArgyropoulos @ChristosArgyrop @Pahwa @CaptainKidney79 #JHMChat Raising the question that maybe ordering no test is called for and rely on clinical impression+f/u? #cynic |
| Amit Kumar Pahwa @Pahwa RT @ChristosArgyrop: @Pahwa @CaptainKidney79 #JHMChat Raising the question that maybe ordering no test is called for and rely on clinical impression+f/u? #cynic |
| Vinny Arora MD MAPP @FutureDocs Thx @pahwa!! Def gonna be more thoughtful about AKI work ups...#JHMChat |
| Amit Kumar Pahwa @Pahwa @futuredocs Thank You! #jhmchat |
| Daniel Wolfson @WolfsonD #JHMChat Thank you @ADAuerbachMD @Pahwa @FutureDocs @JHospMedicine @SHMLive |
| J Hospital Medicine @JHospMedicine RT @WolfsonD: #JHMChat Thank you @ADAuerbachMD @Pahwa @FutureDocs @JHospMedicine @SHMLive |
| 2nd Guess Med Boards @obinutuzumab RT @FutureDocs: Thx @pahwa!! Def gonna be more thoughtful about AKI work ups...#JHMChat |
| J Hospital Medicine @JHospMedicine @WolfsonD @ADAuerbachMD @Pahwa @FutureDocs @SHMLive Thanks for joining us! #JHMChat |
| Joel Topf, MD FACP @kidney_boy Nice chat. Thanks. #jhmchat |
 | Zackary Berger @DrZackaryBerger RT @CaptainKidney79: #JHMChat T4. Always remind me to ask trainees "why did you order that test?" |
| ChristosArgyropoulos @ChristosArgyrop @Pahwa @CaptainKidney79 #JHMChat FDA is now re-evaluating NGAL so we will end up ordering many more of those w/o knowing what to do with 'em |
 | Benjamin P. Geisler @ben_geisler Here's another cool FeNa article https://t.co/D7DMigd0w3 #JHMChat |
| Amit Kumar Pahwa @Pahwa @christosargyrop @captainkidney79 Ugh! #jhmchat |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: @WolfsonD @ADAuerbachMD @Pahwa @FutureDocs @SHMLive Thanks for joining us! #JHMChat |
 | Jonathan Rottersmith @jrottersmith RT @hswapnil: T3: maybe this, eventually if we all reach it right? #JHMChat https://t.co/a979rtoX4L |
 | John P Erwin III MD FACC @HeartOTXHeartMD RT @hswapnil: T3: maybe this, eventually if we all reach it right? #JHMChat https://t.co/a979rtoX4L |
| Vinny Arora MD MAPP @FutureDocs RT @WolfsonD: #JHMChat Thank you @ADAuerbachMD @Pahwa @FutureDocs @JHospMedicine @SHMLive |
| Vinny Arora MD MAPP @FutureDocs RT @Pahwa: T4 when we go over evidence in rounds or starting therapy i ask residents to look at the study population in article #EBM #jhmchat |
| Vinny Arora MD MAPP @FutureDocs RT @Pahwa: T4 writing this taught me that tests should be performed in a the population they were validated in #jhmchat |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: - @pahwa was definitely making this argument in the @JHospMedicine article #jhmchat https://t.co/JCyPVSgzdC https://t.co/GBdG1Zw8IS |
| Vinny Arora MD MAPP @FutureDocs RT @LTummalapalli: #JHMChat #thingswedofornoreason If we order it to be "complete" or anticipating labs a consult may want, we aren't thinking rigorously |
| Vinny Arora MD MAPP @FutureDocs RT @kidney_boy: takes a marginal test and makes it bad MT @HekmagsMD: @Wisit661 @JHospMedicine Hey friend, would you get FeNA in non-oliguria, too? #jhmchat |
| Vinny Arora MD MAPP @FutureDocs RT @wittykidney: #JHMChat on the same note, you don't need ultrasound in most of AKIs, but often r done to so called rule out obstruction |
| Vinny Arora MD MAPP @FutureDocs RT @Nephro_Sparks: T1: my residents/fellows usually order b4 I see. I just tell them why it's not very useful (cardiorenal, hepatorenal, CIN ) #JHMchat agreed |
| Nick van Terheyden @drnic1 RT @FutureDocs: Thx @pahwa!! Def gonna be more thoughtful about AKI work ups...#JHMChat |
| Amit Kumar Pahwa @Pahwa RT @ben_geisler: Here's another cool FeNa article https://t.co/D7DMigd0w3 #JHMChat |
| Matthew Sparks, MD, FASN, FAHA @Nephro_Sparks RT @HyungChoMD: @JHospMedicine #JHMChat If I ever create an initiative here on urine lytes, I’m calling it “The #FeNa or #FeNo project.” thanks @thebyrdlab |
| State Medical Board @rifapentine RT @JHospMedicine: - @pahwa was definitely making this argument in the @JHospMedicine article #jhmchat https://t.co/JCyPVSgzdC https://t.co/GBdG1Zw8IS |
| Society of Hospital Medicine @SocietyHospMed @SHMLive Thanks for joining #JHMChat on Things We Do for No Reason - FeNA in Eval of AKI Check out the convo: https://t.co/ujeGeWwPA5 |
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