#JHMChat Transcript

Healthcare social media transcript of the #JHMChat hashtag.
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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 @SHMLive
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
Medscape @medscape
#JHMchat Happy to be chatting about this important topic.
Chris Moriates, MD @ChrisMoriates
Chris Moriates, hospitalist @UCSFDHM . Member of @CostsofCare team. And series editor for @JAMAInternalMed #teachablemoments. #jhmchat
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
Hyung (Harry) Cho, MD @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 @SHMLive
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 @SHMLive
Get ready for the first #JHMChat question of the night! Thanks for joining this important conversation. https://t.co/dVQmR7O3aR
Society of Hospital Medicine @SHMLive
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
Matt Sparks @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
Matt Sparks @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 @SHMLive
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
Vinny Arora MD MAPP @FutureDocs
Special question for @pahwa, can you tell us the impetus of this article? why is this important? #JHMChat
J Hospital Medicine @JHospMedicine
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 @SHMLive
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 @SHMLive
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 @SHMLive
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 @SHMLive
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
Matt Sparks @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?
J Hospital Medicine @JHospMedicine
Q from Tweetchat: Great question from @wolfsonD for #JHMChat tonight-- @pahwa any ideas? https://t.co/dn438adlVz
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
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?
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
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
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
Society of Hospital Medicine @SHMLive
RT @JHospMedicine: Q from Tweetchat: Great question from @wolfsonD for #JHMChat tonight-- @pahwa any ideas? https://t.co/dn438adlVz https://t.co/8gjkkEA5ar
Malvinder Parmar @wittykidney
@Pahwa @WolfsonD that goal, "think b4 u order" should be applicable to all tests #jhmchat
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
Hyung (Harry) Cho, MD @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
Matt Sparks @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
Matt Sparks @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
Hyung (Harry) Cho, MD @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
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
Society of Hospital Medicine @SHMLive
RT @FutureDocs: . @HyungChoMD @Pahwa @WolfsonD the reflexivity of lab ordering is a serious problem #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
ABIM Foundation @ABIMFoundation
RT @SHMLive: Get ready! #JHMChat is live! https://t.co/R3FUVzqnQU
Matt Sparks @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
Amit Kumar Pahwa @pahwa
@captainkidney79 @kidney_boy or high salt load? #jhmchat #snackingonchipsfornationalchampionship
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 @SHMLive
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 @SHMLive
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 @SHMLive
RT @JHospMedicine: T3 now LIVE: #JHMChat - What is the most effective way to translate these findings into practice & improve workup of AKI?
Matt Sparks @Nephro_Sparks
@JHospMedicine T3: I think we need to do a better job on describing appropriate use FeNa #jhmchat
Hyung (Harry) Cho, MD @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 🇺🇸 @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
Matt Sparks @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
Matt Sparks @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
Matt Sparks @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 @SHMLive
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 🇺🇸 @nephondemand
NOD Analytics of #JHMChat: more detailed Twitter metrics ④ 🔝 tweeters @JHospMedicine @SHMLive @Pahwa @futuredocs https://t.co/V0imstjlxI
Matt Sparks @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
Matt Sparks @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?
J Hospital Medicine @JHospMedicine
Remember tag T3 #JHMChat - What is the most effective way to translate these findings into practice & improve workup of AKI?
Amit Kumar Pahwa @pahwa
@ADAuerbachMD unfortunately there are too many things distracting us from talking to patients so we order #jhmchat #guilty
Zaire Ebolavirus @dasabuvir
RT @JHospMedicine: thx for the data for #JHMChat! https://t.co/5fcI5kf2ag https://t.co/nLoBby4Gyt
Tᴇᴊᴀs Dᴇsᴀɪ, MD 🇺🇸 @nephondemand
@JHospMedicine More #JHMChat data to come in the next few days.
Matt Sparks @Nephro_Sparks
@Pahwa @ADAuerbachMD sad to hear that #jhmchat
Society of Hospital Medicine @SHMLive
RT @JHospMedicine: Remember tag T3 #JHMChat - What is the most effective way to translate these findings into practice & improve workup of AKI?
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
Matt Sparks @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
Matt Sparks @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
J Hospital Medicine @JHospMedicine
RT @Pahwa: @jhospmedicine I agree with @chritosargyrop - don’t order something if it won’t change your management #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
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
Amit Kumar Pahwa @pahwa
@wisit661 @nephro_sparks @kidney_boy be careful with n of 1 or 17. #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 @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
Suneel Udani @captainkidney79
#JHMChat T3 one simple point FENA = decreased renal blood flow and tubular Na avidity. It does not = volume depletion
Matt Sparks @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
Matt Sparks @Nephro_Sparks
@thebyrdlab interesting that the patient with the FeNa also had their 3rd ECHO $$$ #jhmchat
Matt Sparks @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
Matt Sparks @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 @SHMLive
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 @SHMLive
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
Hyung (Harry) Cho, MD @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 @SHMLive
Thanks to all who joined #JHMChat & added to a very important convo! @JHospMedicine @FutureDocs @Pahwa @ABIMFoundation @CostsofCare
J Hospital Medicine @JHospMedicine
Thanks everyone for great #JHMChat with a shout out to @pahwa our author & partners @costsofcare @ABIMfoundation and @SHMLive!
Malvinder Parmar @wittykidney
@thebyrdlab if there is no pump, there is no need for filter #JHMChat 😀
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
Matt Sparks @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, MD, PhD @ZackBergerMDPhD
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 @SHMLive
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✭ @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
Matt Sparks @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
Jay @amrienj
RT @ChristosArgyrop: @JHospMedicine #JHMChat One may teach the inconvenient truth, but ppl will gravitate towards the textbook/board Q false prophesy
Society of Hospital Medicine @SHMLive
@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
#JHMChat content from Twitter.