#NephJC Transcript

Healthcare social media transcript of the #NephJC hashtag.
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Sarah Gleeson @sarah_gleeson_
RT @divyaa24: Beginning 2019 with a bang! Participate in the first edition of Asian #NephJC at a time convenient to you (check below) to di…
Liz Wallin @DrEWallin
RT @NephJC: Active vitamin D in dialysis gets an RCT and it goes about as well as you'd expect. Join us Tuesday and Wednesday to chat about…
Alex Hamilton @_ajhamilton
@toates_19 Great topic - looking forward to getting back on the #nephjc wagon. Hope @Walnutrained @NephroICUDoc @Iainsmi @GeorgeKimp @littlesaira @BertPower can join in!
Ana Maria Matias @AMCMA6
RT @divyaa24: Beginning 2019 with a bang! Participate in the first edition of Asian #NephJC at a time convenient to you (check below) to di…
Carlo Alfieri @carlo_alfieri
Secondary and tertiary hPTH https://t.co/gxaB7w00FK #ckd #vitaminD #ckdmbd #calcium @SinReni @ASNKidney @ERAEDTA @NephJC #nephjc #kidney
Eala O'Bruadair @kronbergexp
RT @toates_19: Do you prescribe alfacalcidol? Of course you bloody do, in which case #NephJC is a cannot miss this week https://t.co/BozRmp…
Krishna K Agrawal @agrawalkris
RT @divyaa24: Beginning 2019 with a bang! Participate in the first edition of Asian #NephJC at a time convenient to you (check below) to di…
Swapnil Hiremath, MD, MPH @hswapnil
RT @divyaa24: Beginning 2019 with a bang! Participate in the first edition of Asian #NephJC at a time convenient to you (check below) to di…
Swapnil Hiremath, MD, MPH @hswapnil
RT @NephJC: Active vitamin D in dialysis gets an RCT and it goes about as well as you'd expect. Join us Tuesday and Wednesday to chat about…
Nephrology Jrnl Club @NephJC
RT @NephJC: Active vitamin D in dialysis gets an RCT and it goes about as well as you'd expect. Join us Tuesday and Wednesday to chat about…
Mayuri Trivedi @MayuriTrivedi80
RT @divyaa24: Beginning 2019 with a bang! Participate in the first edition of Asian #NephJC at a time convenient to you (check below) to di…
Swapnil Hiremath, MD, MPH @hswapnil
RT @arvindcanchi: Calling all Indian and Asian Twitterati to make this big. An Asian edition of the #nephjc, an online journal club for nep…
Orolu muyideen o @rolly8012
RT @NephJC: Active vitamin D in dialysis gets an RCT and it goes about as well as you'd expect. Join us Tuesday and Wednesday to chat about…
J Fretz @JAFretz
RT @NephJC: Active vitamin D in dialysis gets an RCT and it goes about as well as you'd expect. Join us Tuesday and Wednesday to chat about…
Sarah Melville @sarahkmels
RT @NephJC: Active vitamin D in dialysis gets an RCT and it goes about as well as you'd expect. Join us Tuesday and Wednesday to chat about…
Vineet Behera @BeheraVineet
RT @divyaa24: Beginning 2019 with a bang! Participate in the first edition of Asian #NephJC at a time convenient to you (check below) to di…
Jinn-Yuh Guh @guhjy
RT @NephJC: Active vitamin D in dialysis gets an RCT and it goes about as well as you'd expect. Join us Tuesday and Wednesday to chat about…
Lovy @drlovygaur
The upcoming #NephJC deals with one of the most controversial topics in nephrology - Vitamin D and dialysis.. interesting discussion to look forward to..
Scherly Leon, MD @SLeonMD
RT @NephJC: Active vitamin D in dialysis gets an RCT and it goes about as well as you'd expect. Join us Tuesday and Wednesday to chat about…
Scherly Leon, MD @SLeonMD
RT @divyaa24: Beginning 2019 with a bang! Participate in the first edition of Asian #NephJC at a time convenient to you (check below) to di…
Krystahl Andújar, MD @Krystahllopathy
RT @NephJC: Active vitamin D in dialysis gets an RCT and it goes about as well as you'd expect. Join us Tuesday and Wednesday to chat about…
Krishna K Agrawal @agrawalkris
RT @drlovygaur: The upcoming #NephJC deals with one of the most controversial topics in nephrology - Vitamin D and dialysis.. interesting d…
Divya Bajpai 🇮🇳 @divyaa24
RT @arvindcanchi: Calling all Indian and Asian Twitterati to make this big. An Asian edition of the #nephjc, an online journal club for nep…
Krishna K Agrawal @agrawalkris
RT @NephJC: Active vitamin D in dialysis gets an RCT and it goes about as well as you'd expect. Join us Tuesday and Wednesday to chat about…
Aakash Shingada @aakashshingada
RT @drlovygaur: The upcoming #NephJC deals with one of the most controversial topics in nephrology - Vitamin D and dialysis.. interesting d…
Aakash Shingada @aakashshingada
RT @arvindcanchi: Calling all Indian and Asian Twitterati to make this big. An Asian edition of the #nephjc, an online journal club for nep…
Alex M ⚕🇲🇽 @NephroGuy
RT @NephJC: Active vitamin D in dialysis gets an RCT and it goes about as well as you'd expect. Join us Tuesday and Wednesday to chat about…
Khaled @khaledyb
RT @NephJC: Active vitamin D in dialysis gets an RCT and it goes about as well as you'd expect. Join us Tuesday and Wednesday to chat about…
Dr Narayanan @dr_narayanan
RT @arvindcanchi: Calling all Indian and Asian Twitterati to make this big. An Asian edition of the #nephjc, an online journal club for nep…
URO_Tweet @TweetUro
RT @divyaa24: Beginning 2019 with a bang! Participate in the first edition of Asian #NephJC at a time convenient to you (check below) to di…
Matt Graham-Brown @DrMattGB
RT @toates_19: Do you prescribe alfacalcidol? Of course you bloody do, in which case #NephJC is a cannot miss this week https://t.co/BozRmp…
PCCM @PedCritCareMed
What is the prevalence and outcomes of acute #kidney injury in children with diabetic ketoacidosis? Read this January article and find out! #NephJC #PedsICU #renal @SCCM @WFPICCS #diabetes #endocrinology Article by Weissbach, @GKadmon et al.: https://t.co/02nqBuGRuD https://t.co/kSYj1oNnGa
Sapna Kudchadkar, MD, PhD @SapnaKmd
RT @PedCritCareMed: What is the prevalence and outcomes of acute #kidney injury in children with diabetic ketoacidosis? Read this January a…
Miguel Rodríguez Rubio @miguelrdgzrubio
RT @PedCritCareMed: What is the prevalence and outcomes of acute #kidney injury in children with diabetic ketoacidosis? Read this January a…
ESPNIC @ESPNIC_Society
RT @PedCritCareMed: What is the prevalence and outcomes of acute #kidney injury in children with diabetic ketoacidosis? Read this January a…
Ahmed @drsalama7
RT @PedCritCareMed: What is the prevalence and outcomes of acute #kidney injury in children with diabetic ketoacidosis? Read this January a…
Chas Caracoles @WeightHormones
RT https://t.co/RmnhJGMcpF What is the prevalence and outcomes of acute #kidney injury in children with diabetic ketoacidosis? Read this January article and find out! #NephJC #PedsICU #renhttps://t.co/Uz4WsUBwZq
Jonathan Lee @ThatJonLee
RT @PedCritCareMed: What is the prevalence and outcomes of acute #kidney injury in children with diabetic ketoacidosis? Read this January a…
Dr.salmaeeni @DrSalmaeeni
RT @PedCritCareMed: What is the prevalence and outcomes of acute #kidney injury in children with diabetic ketoacidosis? Read this January a…
Landmark Nephrology @landmark_neph
RT @NephJC: Active vitamin D in dialysis gets an RCT and it goes about as well as you'd expect. Join us Tuesday and Wednesday to chat about…
Blake @cobra6blake
RT @PedCritCareMed: What is the prevalence and outcomes of acute #kidney injury in children with diabetic ketoacidosis? Read this January a…
Luis F. Mendoza M. @Drluisfmendozam
RT @PedCritCareMed: What is the prevalence and outcomes of acute #kidney injury in children with diabetic ketoacidosis? Read this January a…
Nikhil Shah @dr_nikhilshah
RT @arvindcanchi: Calling all Indian and Asian Twitterati to make this big. An Asian edition of the #nephjc, an online journal club for nep…
Nikhil Shah @dr_nikhilshah
RT @divyaa24: Beginning 2019 with a bang! Participate in the first edition of Asian #NephJC at a time convenient to you (check below) to di…
Nephrology Jrnl Club @NephJC
Hey everyone! 2 hrs to go until tonights #NephJC. We will be discussing the @JAMA_current paper on use of Alfacalcidol in Hemodialysis patients – JDAVID trial. Not read the paper yet? Worry not. Read the summary and check out the visual abstract https://t.co/fyt0okUOLs https://t.co/JJnbUqyNWE
hydir lucia sanchez @hydirlucia
RT @PedCritCareMed: What is the prevalence and outcomes of acute #kidney injury in children with diabetic ketoacidosis? Read this January a…
Brandi Wynne @brandimwynne
RT @NephJC: Hey everyone! 2 hrs to go until tonights #NephJC. We will be discussing the @JAMA_current paper on use of Alfacalcidol in Hemod…
Nathaniel Reisinger @nephrothaniel
RT @NephJC: Hey everyone! 2 hrs to go until tonights #NephJC. We will be discussing the @JAMA_current paper on use of Alfacalcidol in Hemod…
Krystahl Andújar, MD @Krystahllopathy
RT @NephJC: Hey everyone! 2 hrs to go until tonights #NephJC. We will be discussing the @JAMA_current paper on use of Alfacalcidol in Hemod…
Swapnil Hiremath, MD, MPH @hswapnil
RT @NephJC: Hey everyone! 2 hrs to go until tonights #NephJC. We will be discussing the @JAMA_current paper on use of Alfacalcidol in Hemod…
Nephrology Jrnl Club @NephJC
Less than an hour to go. stay tuned! Since we have some time – some background on use of Vitamin D in CKD patients – These are the current KDIGO (2017) guidelines on use of active Vit D/ VDRAs #NephJC 1/n https://t.co/VpJNJQiAKv
Swapnil Hiremath, MD, MPH @hswapnil
RT @NephJC: Less than an hour to go. stay tuned! Since we have some time – some background on use of Vitamin D in CKD patients – These are…
Nephrology Jrnl Club @NephJC
PRIMO trial – Double Blind Placebo Controlled Trial | Effect of Paricalcitol on LV mass over 48 weeks in CKD 3 & 4 patients – No difference in LVMI change between 2 grps, greater reduction of PTH, risk of Hypercalcemia in paricalcitol grp #NephJC 2/n https://t.co/MN8Uu1wzkV
Nephrology Jrnl Club @NephJC
OPERA trial - Double blind RCT, Paricalcitol in CKD3-5 pts with LVH. No difference in change in LVMI compared to placebo but significantly reduced PTH #NephJC 3/n https://t.co/04vAM3Euc0
Aakash Shingada @aakashshingada
RT @NephJC: PRIMO trial – Double Blind Placebo Controlled Trial | Effect of Paricalcitol on LV mass over 48 weeks in CKD 3 & 4 patients – N…
Aakash Shingada @aakashshingada
RT @NephJC: OPERA trial - Double blind RCT, Paricalcitol in CKD3-5 pts with LVH. No difference in change in LVMI compared to placebo but…
Nephrology Jrnl Club @NephJC
Observational data suggest pleotropic benefit of Vitamin D on cardiovascular outcomes, but data from RCT was lacking especially in patients on Hemodialysis. J-DAVID trial set out to attempt & fill this void 4/4 #NephJC
Nephrology Jrnl Club @NephJC
Check out the commentary on this study on the #lastmonthinnephrology blog by @tukaramj @vskeskar https://t.co/1ST9bmwvcq #NephJC
Aakash Shingada @aakashshingada
RT @NephJC: Check out the commentary on this study on the #lastmonthinnephrology blog by @tukaramj @vskeskar https://t.co/1ST9bmwvcq #Neph
Swapnil Hiremath, MD, MPH @hswapnil
RT @NephJC: Check out the commentary on this study on the #lastmonthinnephrology blog by @tukaramj @vskeskar https://t.co/1ST9bmwvcq #Neph
Swapnil Hiremath, MD, MPH @hswapnil
RT @NephJC: Observational data suggest pleotropic benefit of Vitamin D on cardiovascular outcomes, but data from RCT was lacking especially…
Nephrology Jrnl Club @NephJC
Time Flies! We are just 10 minutes out.. don’t go anywhere, we will be with you shortly #NephJC https://t.co/8BiZpT4VKj
Swapnil Hiremath, MD, MPH @hswapnil
RT @NephJC: Time Flies! We are just 10 minutes out.. don’t go anywhere, we will be with you shortly #NephJC https://t.co/8BiZpT4VKj
Dr MK #NephrologistOnICU @_Dr_MK
When you’re on the Vitamin D trail in #CostaRica, searching for ways you might join the #nephjc chat @NephJC https://t.co/5lpvKh38eI
Mario Funes MD @MarioFunesMD
Mentorship in the internet era. Proud of the #NephJC community. #NephForward
Krystahl Andújar, MD @Krystahllopathy
RT @NephJC: Time Flies! We are just 10 minutes out.. don’t go anywhere, we will be with you shortly #NephJC https://t.co/8BiZpT4VKj
Mario Funes MD @MarioFunesMD
Ready for today's #NephJC. Join us in the next 5 minutes. https://t.co/upQjFChu2f
Brandi Wynne @brandimwynne
RT @NephJC: Time Flies! We are just 10 minutes out.. don’t go anywhere, we will be with you shortly #NephJC https://t.co/8BiZpT4VKj
Sarah Melville @sarahkmels
RT @NephJC: OPERA trial - Double blind RCT, Paricalcitol in CKD3-5 pts with LVH. No difference in change in LVMI compared to placebo but…
Aakash Shingada @aakashshingada
RT @MarioFunesMD: Ready for today's #NephJC. Join us in the next 5 minutes. https://t.co/upQjFChu2f
Sarah Melville @sarahkmels
RT @NephJC: PRIMO trial – Double Blind Placebo Controlled Trial | Effect of Paricalcitol on LV mass over 48 weeks in CKD 3 & 4 patients – N…
Sarah Melville @sarahkmels
RT @NephJC: Less than an hour to go. stay tuned! Since we have some time – some background on use of Vitamin D in CKD patients – These are…
Sarah Melville @sarahkmels
RT @drlovygaur: The upcoming #NephJC deals with one of the most controversial topics in nephrology - Vitamin D and dialysis.. interesting d…
Nephrology Jrnl Club @NephJC
Hello everyone. Its 9pm Tuesday. I am Aakash Shingada @aakashshingada, ur host 4 tonight. I m a final year nephrology fellow from New Delhi. This is the first time I get to say it on twitter– I am an #NSMC faculty mentor for the incoming class of 2019! No COI Welcome to #Nephjc
Nephrology Jrnl Club @NephJC
RT @MarioFunesMD: Ready for today's #NephJC. Join us in the next 5 minutes. https://t.co/upQjFChu2f
Diana Mina @DiMiRenalMD
Hello! Diana here, nephrologist in Dallas. COI: D is my favorite letter 🤷🏻‍♀️ #NephJC
Swapnil Hiremath, MD, MPH @hswapnil
RT @NephJC: Hello everyone. Its 9pm Tuesday. I am Aakash Shingada @aakashshingada, ur host 4 tonight. I m a final year nephrology fellow fr…
Aakash Shingada @aakashshingada
So glad that #NephJC is back after the winter break. I am Aakash Shingada, from new Delhi COI - I Will be hosting #NephJC tonight! Can't control the excitement! https://t.co/sjoJbQBDAQ
Nephrology Jrnl Club @NephJC
Everyone, please introduce yourselves and reveal any relevant conflicts of interest (COI) #NephJC
Nephrology Jrnl Club @NephJC
Don’t forget to add the hashtag #NephJC to every tweet if you want to be part of the discussion. We don’t want to miss any amazing tweets.
Silvi Shah, MD, MS @silvishah
Hi this is Silvi Shah from Ucincy no Coi #NephJC
Cathy Quinlan @KidneyCathy
Awesome to join #nephjc but will mainly lurk as also at a meeting. No COI. Paed neph in Melbourne.
Anna Burgner MD MEHP @anna_burgner
@NephJC @aakashshingada Hi #NephJC! Anna Burgner APD and general nephrologist at @VUMCKidney. Ready for #NephJC tonight! No COI
Samira Farouk, MD, MS @ssfarouk
Samira Farouk, transplant nephrologist @ISMMSKidney. No COI #NephJC
Syed Husain @SAHusainMD
syed ali husain, transplant nephro at @ColumbiaKidney. no COI #nephjc
Nikhil Shah @dr_nikhilshah
@NephJC @aakashshingada #NephJC Not to forget also running the #Asian #Nephjc chat tomorrow with @divyaa24 - Congratulations and all the best! You guys are amazing!
Edgar V. Lerma 🇵🇭 @edgarvlermamd
Edgar Lerma, Chicago-based Nephrologist #NephJC #DaBears https://t.co/sllUzMkVZO
Nephrology Jrnl Club @NephJC
We suggest using tweetdeck or the native client in browser (https://t.co/LkGCHautmO) (Tchat will truncate your tweets at 140 characters) #NephJC
Dave White @kidneywarrior
Dave White here - dialysis 2009-2015, happily transplanted since. #kidneyhealthinitiative Patient and Family Partnership Council Chair. Looking forward to learning something! COI Amgen and CareDx #NephJC
James Novak @JamesNovakNeph
James Novak, @HFNephrology TPD and NSMC graduate 2018. My COI: I’m skeptical of all CKD-MBD treatments. #NephJC
Nephrology Jrnl Club @NephJC
@silvishah Hi silvi! COngratulations on the paper! #NephJC
Urmila Anandh @AnandhUrmila
RT @aakashshingada: So glad that #NephJC is back after the winter break. I am Aakash Shingada, from new Delhi COI - I Will be hosting #Neph
Raymond Hsu @DrRaymondHsu
Hi all! gen neph at @ucsfnehrology no coi #nephjc
Mario Funes MD @MarioFunesMD
Hello everyone! Mario Funes. PGY2 IM at Saint Peter’s University Hospital in NJ. Nephrology applicant 2019. Currently in Nephrology elective. No COI. #NephJC
Rasheeda Hall @Rasheeda_HallMD
Rasheeda Hall at @DukeKidney; geriatric nephrology; no COI; tuning in for a moment since I contributed to the editorial on JDAVID #nephjc
Annabel Biruete 🇲🇽 @anniebelch
Annabel Biruete, postoc @IUKidney @IUMedSchool. No COI. Just finished reading the great summary! Partially lurking, excited for the discussion #NephJC
Kevin J. Fowler @gratefull080504
@gratefull080504 lurking tonight #nephJC
Hector Madariaga, MD @HecmagsMD
Héctor Madariaga, no COI. From #PatriotsNation . No COI. Hello, everybody! 👋 #NephJC https://t.co/tF4YtUmAs3
L. Parker Gregg @LParkerGregg1
Hi all! I'm Parker Gregg from Dallas. Mostly lurking and trying to figure out how to use tweedeck. No COI, #NephJC first timer!
Swapnil Hiremath, MD, MPH @hswapnil
Swapnil Hiremath, from @ottawarenal #nephjc cofounder No conflicts, except vitamin D-skeptic https://t.co/EGO5zEjs0f
David Santos @DavidSa37565535
Hello, David Santos, Medical student from El Salvador. Is my first time I join you #nephjc
Nephrology Jrnl Club @NephJC
Tonight at #NephJC we are discussing the @JAMA_current paper, “Effect of Oral Alfacalcidol on Clinical Outcomes in Patients Without Secondary Hyperparathyroidism Receiving Maintenance Hemodialysis” The J-DAVID Trial https://t.co/zUAidMQXya
Nephrology Jrnl Club @NephJC
#NephJC is a great way to build your personal learning network, so hit that follow button early and often!
Nikhil Shah @dr_nikhilshah
#nephjc Nikhil Shah, Clinical Nephrologist , Home Dialysis enthusiast. from Edmonton, Canada.
Swapnil Hiremath, MD, MPH @hswapnil
@LParkerGregg1 Welcome to #NephJC!
Krystahl Andújar, MD @Krystahllopathy
Hello! Krystahl Andujar reporting, nephrologist based in San Juan, Puerto Rico. Excited to join in tonight on the first #nephjc of the year
Arvind Canchi 🇮🇳 @arvindcanchi
@NephJC @aakashshingada Congrats @aakashshingada ! Good morning from Bangalore. Hello all, Will lurk and join the Asian edition tonight.#nephjc https://t.co/0b3ZHiCWxX
Mario Funes MD @MarioFunesMD
@LParkerGregg1 Welcome! #NephJC
Swapnil Hiremath, MD, MPH @hswapnil
@DavidSa37565535 Welcome to #NephJC !
Nephrology Jrnl Club @NephJC
As we are back after a long break lets refresh the anatomy of the chat – T0 – Introduction(~15mins), T1 – Methods (~10mins), T2 – Results(~15mins), T3 – Discussion(~15mins), T4 – concluding remarks #NephJC
Gates Colbert, MD @DoctorGates
Dallas Nephrologist. No COI. Ready to hear some thoughts on Vitamin D in CKD. #nephjc
Anshul Bhalla @BhallaAnshul
Hi everyone. Anshul here. Transp Neph fellow at hopkins. No COI #NephJC
Sri Lekha Tummalapalli, MD, MBA @LTummalapalli
Ready for #EBMinNephrology - Sri Lekha Tummalapalli, UCSF Nephrology Fellow, great #NephJC summary @aakashshingada! #NSMC
Michelle Rheault @rheault_m
@NephJC Hello, Michelle Rheault here. Ped neph, COI in bio. #NephJC
Sarah Melville @sarahkmels
RT @Rasheeda_HallMD: Rasheeda Hall at @DukeKidney; geriatric nephrology; no COI; tuning in for a moment since I contributed to the editoria…
Divya Bajpai 🇮🇳 @divyaa24
Hi Divya here, Nephrologist from mumbai, #nsmc graduate not a big fan of vit D in ckdVD, otherwise no coi #NephJC
Edgar V. Lerma 🇵🇭 @edgarvlermamd
J-DAVID 🇯🇵 : Among patients on hemodialysis without SHPT, PO alfacalcidol DID NOT reduce the risk of a composite outcome of CV events ca. 2018 from @JAMA_current #VisualAbstract by @aakashshingada #CKDMBD #Nephpearls #NephJC 👉🏼 https://t.co/oNskMPiWg2 https://t.co/1vcDLYVCqV
Nephrology Jrnl Club @NephJC
HI nikhil! Yes excited for the first #NephJC Asia!
Swapnil Hiremath, MD, MPH @hswapnil
@BhallaAnshul Welcome to #NephJc!
Michelle Rheault @rheault_m
RT @NephJC: Tonight at #NephJC we are discussing the @JAMA_current paper, “Effect of Oral Alfacalcidol on Clinical Outcomes in Patients Wit…
Nephrology Jrnl Club @NephJC
If you were unable to read the article AND the summary check out my #Visualabstract here for a quick recap #NephJC https://t.co/ZFL2RA2pa1
Nephrology Jrnl Club @NephJC
Check out the summary of the article #NephJC https://t.co/fyt0olcpD0
Swapnil Hiremath, MD, MPH @hswapnil
Whoah what a turn out! #nephjc
Nephrology Jrnl Club @NephJC
T0a: What is your threshold for starting active vit D or a VDRA? Do all patients get it, or only if PTH elevated? What’s your PTH target? Do you actively use Vit D for CVS risk reduction? #NephJC
Rajesh rajan @rajeshrajan79
Hello. Hi everyone. Rajesh Rajan. Clinical nephrologist in small town. No COI. #nephjc
Mohamed E. Elrggal @M_Elraggal
Hi everyone, Mohamed Elrggal from Egypt, no COI, #NephJC
Jefferson T. @TRIOZZIJL
@NephJC Jefferson PGY-2 from Baylor COM in Houston, TX; no COI #NephJC
Joel Topf, MD FACP @kidney_boy
Joel Topf, clinical nephrologist from Detroit. No COI. Becoming quite disillusioned with the entire CKD-MBD field. #NephJC https://t.co/fXJgIsTHQ8
Krystahl Andújar, MD @Krystahllopathy
RT @edgarvlermamd: J-DAVID 🇯🇵 : Among patients on hemodialysis without SHPT, PO alfacalcidol DID NOT reduce the risk of a composite outcom…
Salt @Saltwebsite
Hello everyone! Gerren Hobby. No COI. #nephjc
Gates Colbert, MD @DoctorGates
@NephJC This was an impressive summary. Great job! #NephJC
Nephrology Jrnl Club @NephJC
RT @edgarvlermamd: J-DAVID 🇯🇵 : Among patients on hemodialysis without SHPT, PO alfacalcidol DID NOT reduce the risk of a composite outcom…
Sarah Melville @sarahkmels
Hi, Sarah Melville, clinical research associate in Saint John, Canada- no COI - formerly from #PatriotsNation - #NephJC
Matt Sparks @Nephro_Sparks
Matt Sparks ⚡️ @DukeKidney APD no COI... in and out as leaving for Arkansas and packing #NephJC
Bhavnish @Buck1486
Chief Fellow at OSU Wexner Medical Center. Trying to get as much learning from the experts #nephjc #curious
Nikhil Shah @dr_nikhilshah
RT @NephJC: As we are back after a long break lets refresh the anatomy of the chat – T0 – Introduction(~15mins), T1 – Methods (~10mins),…
Swapnil Hiremath, MD, MPH @hswapnil
RT @NephJC: If you were unable to read the article AND the summary check out my #Visualabstract here for a quick recap #NephJC https://t.co…
Swapnil Hiremath, MD, MPH @hswapnil
@rajeshrajan79 Welcome to #NephJC!
Nephrology Jrnl Club @NephJC
@Buck1486 Welcome to #NephJC Bhavnish! Glad to have you here!
Annabel Biruete 🇲🇽 @anniebelch
@kidney_boy Haha! There’s so much more to CKD-MBD than biochemical abnormalities #NephJC
Hector Madariaga, MD @HecmagsMD
@rajeshrajan79 Welcome, Rajesh! #Nephjc
Swapnil Hiremath, MD, MPH @hswapnil
@TRIOZZIJL @NephJC Welcome to #NephJC!
James Novak @JamesNovakNeph
@NephJC We use the KDIGO PTH range of 120-600 in ESRD, so calcitriol is a drug that’s useful to keep it there. Who knows what’s going on in the bone? PTH doesn’t correlate very well, and the assays are fraught with inconsistencies. PRIMO showed no CVD benefit from paricalcitol. #NephJC
Brandi Wynne @brandimwynne
Brandi Wynne Lurking whole packing as well... #NephJC No COI
Tiffany Caza @Tiff_Caza
@NephJC Hello! I'm Tiffany and am a renal path fellow. No COI. Looking forward to learning 😁. #NephJC
Nephrology Jrnl Club @NephJC
RT @JamesNovakNeph: @NephJC We use the KDIGO PTH range of 120-600 in ESRD, so calcitriol is a drug that’s useful to keep it there. Who know…
Divya Bajpai 🇮🇳 @divyaa24
@kidney_boy True CKDMBD field is the field of "surrogate outcomes" #NephJC
Nephrology Jrnl Club @NephJC
@brandimwynne Welcome to #NEphJC Brandi!
Swapnil Hiremath, MD, MPH @hswapnil
@anniebelch @kidney_boy But at least the trials are being done now! #NephJC
Nephrology Jrnl Club @NephJC
A lot of us (including myself) might initially doubt the rationale of even conducting this trial in patients were normal/2x normal PTH. What are your thoughts? #nephjc
Swapnil Hiremath, MD, MPH @hswapnil
RT @JamesNovakNeph: @NephJC We use the KDIGO PTH range of 120-600 in ESRD, so calcitriol is a drug that’s useful to keep it there. Who know…
Swapnil Hiremath, MD, MPH @hswapnil
@Tiff_Caza @NephJC Welcome to #NephJC
Nimra Sarfaraz @DrNimraS
Nephron from Dallas w @DallasRenal no COI :D #NephJC
Silvi Shah, MD, MS @silvishah
@NephJC Agree. That’s the thought occurred to me when I saw the study. #nephJC
Sarah Melville @sarahkmels
RT @NephJC: If you were unable to read the article AND the summary check out my #Visualabstract here for a quick recap #NephJC https://t.co…
আকাশ ರಾಜ್ राज़दान @Ateendriyo
RT @NephJC: If you were unable to read the article AND the summary check out my #Visualabstract here for a quick recap #NephJC https://t.co…
Nephrology Jrnl Club @NephJC
RT @divyaa24: @kidney_boy True CKDMBD field is the field of "surrogate outcomes" #NephJC
L. Parker Gregg @LParkerGregg1
@NephJC So glad I'm not the only one who thought this #NephJC
Swapnil Hiremath, MD, MPH @hswapnil
@NephJC Yeah. Since their guideline said > 180 should be treated, they went below. Not a bad start Not the question that interests me, but OK #NephJC
Edgar V. Lerma 🇵🇭 @edgarvlermamd
Vitamin D supplementation in Stages 3-4 CKD Update ca. 2018 📌 25(OH)D < 15 should be treated irrespective of PTH 📌 25(OH)D 15-20 may not require treatment if there is no evidence of counter-regulatory hormone activity #Nephpearls #NephJC 👉🏼 https://t.co/rIHegbLMVO https://t.co/DLN5Z2guUF
Nephrology Jrnl Club @NephJC
@silvishah Japanese guidelines suggest keeping a low target PTH. While the trial was conceived target PTH was < 180 pg/mL & while trial was ongoing, this was liberalized to < 240 pg/mL. This is different from the KDIGO recommendation of maintaining PTH 2x-9x times ULN #NephJC
Samira Farouk, MD, MS @ssfarouk
@NephJC I covered a dialysis shift as a fellow and 0 patients would have met inclusion criteria for this study based on iPTH and P #NephJC
Mohamed E. Elrggal @M_Elraggal
#NephJC
Silvi Shah, MD, MS @silvishah
The whole concept of vit d replacement is debAtable. I think twice - some drugs are very expensive #nephJC
Divya Bajpai 🇮🇳 @divyaa24
@NephJC We use vit D very cautiously only if PTH > 9 times normal AND RISING. Cvs risk reduction needs more probing, not an indication till now. #NephJC
Gates Colbert, MD @DoctorGates
Reminder tonight: Tertiary Hyperparathyroidism is Real. Debilitating. Expensive. And leads to increased Mortality. This discussion is with PTH levels prior to Secondary HyperPara. Try not to lump the spectrum together. #nephjc
James Novak @JamesNovakNeph
@NephJC In fact, now that I’m getting warmed up, EVOLVE didn’t show any CVD benefit of cinacalcet, either. Nor have there been any large placebo-controlled RCTs with phosphate binders. All we know right now is that these drugs are useful to keep labs where we want them. #NephJC
Swapnil Hiremath, MD, MPH @hswapnil
RT @NephJC: @silvishah Japanese guidelines suggest keeping a low target PTH. While the trial was conceived target PTH was < 180 pg/mL & whi…
Cathy Quinlan @KidneyCathy
RT @NephJC: If you were unable to read the article AND the summary check out my #Visualabstract here for a quick recap #NephJC https://t.co…
Ross Morton @signindoc
#NephJC Nephrology & Mineral Metabolism from NB lurking
Matt Sparks @Nephro_Sparks
@LParkerGregg1 @NephJC I was like... what #NephJC https://t.co/PNzjXjgcom
Nephrology Jrnl Club @NephJC
@silvishah J-DAVID investigators set out to test whether addition of alfacalcidol helps in cardiovascular event reduction even at a low PTH, thereby truly testing for pleotropic effects of Active Vit D #NephJC PS: For people using SI units, PTH < 180 pg/ml = ~ PTH < 19 pMol/L
Silvi Shah, MD, MS @silvishah
@JamesNovakNeph @NephJC Totally agree #nephJC
Cathy Quinlan @KidneyCathy
RT @NephJC: As we are back after a long break lets refresh the anatomy of the chat – T0 – Introduction(~15mins), T1 – Methods (~10mins),…
Krishna K Agrawal @agrawalkris
#NephJC Krishna from Nepal no CLI
Swapnil Hiremath, MD, MPH @hswapnil
@JamesNovakNeph @NephJC Jumping the gun, but agree We probably need a trial of PO4 targets and PTH targets, not a drug vs placebo RCT? #NephJC
Edgar V. Lerma 🇵🇭 @edgarvlermamd
Vitamin D analogs #CKDMBD #Nephpearls #NephSecrets #NephJC https://t.co/ZX6NzjY6nW
Nephrology Jrnl Club @NephJC
RT @edgarvlermamd: Vitamin D analogs #CKDMBD #Nephpearls #NephSecrets #NephJC https://t.co/ZX6NzjY6nW
Nikhil Shah @dr_nikhilshah
@JamesNovakNeph @NephJC #nephjc Can we safely say that this trial was not about CKDMBD at all, but other effects of Vit D on dialysis patients.
Samira Farouk, MD, MS @ssfarouk
@dr_nikhilshah @JamesNovakNeph @NephJC ...on rare dialysis patients without SHPTH #NephJC
Rasheeda Hall @Rasheeda_HallMD
PTH targets are lower in Japan to aim for potential mortality benefit at low PTH #nephjc
Matt Sparks @Nephro_Sparks
@JamesNovakNeph @NephJC and then we are finishing for the evening #NephJC https://t.co/NrT0ueusot
🇬🇹José Alejandro J.N.🇬🇹 @elplexo1
RT @edgarvlermamd: Vitamin D supplementation in Stages 3-4 CKD Update ca. 2018 📌 25(OH)D < 15 should be treated irrespective of PTH 📌 25(…
Krishna K Agrawal @agrawalkris
Which vitamin D u measure #NephJC
Divya Bajpai 🇮🇳 @divyaa24
@dr_nikhilshah @JamesNovakNeph @NephJC very true! it was a CV risk reduction trial. even mortality was a secondary endpoint #NephJC
Nephrology Jrnl Club @NephJC
@DoctorGates Yes! The study focuses on the Pleotropic Effects of VItamin D on CVS risk. This is not a PTH target study #NephJC
Michelle Rheault @rheault_m
@dr_nikhilshah @JamesNovakNeph @NephJC Would love to see a pediatric dialysis trial of PTH targets looking at growth as an outcome. You think you guys don't know what you're doing...#NephJC
Nimra Sarfaraz @DrNimraS
@NephJC yeah thats what I was perplexed by too, given we give vit d analoques when PTH is high #NephJC
Nephrology Jrnl Club @NephJC
T1a: Methods – this was a Prospective randomized, open-label, blinded end point clinical trial to examine the effect of alfacalcidol vs no VDRAs on cardiovascular events in patients receiving maintenance hemodialysis without secondary hyperparathyroidism over 48 months #NephJC
Swapnil Hiremath, MD, MPH @hswapnil
@silvishah Indeed Vitamin D is the classic observational vs RCT paradox As @skathire put it https://t.co/m5gkOCe8hm #NephJC
Matt Sparks @Nephro_Sparks
good point. we are narrowly focus on our CV outcomes. Growth for kids important and need to know what is going on there. #NephJC
Nikhil Shah @dr_nikhilshah
@ssfarouk @JamesNovakNeph @NephJC #nephjc Which brings me to the question - Why does a regular incenter HD patient have such low PTH in the first place. Are we selecting a specific group to study here?
Krystahl Andújar, MD @Krystahllopathy
RT @NephJC: @DoctorGates Yes! The study focuses on the Pleotropic Effects of VItamin D on CVS risk. This is not a PTH target study #NephJC
Annabel Biruete 🇲🇽 @anniebelch
@JamesNovakNeph @NephJC Didn’t they show in the secondary analysis that if it reduced FGF23, CVD was reduced? #NephJC
Sarah Melville @sarahkmels
RT @edgarvlermamd: Vitamin D analogs #CKDMBD #Nephpearls #NephSecrets #NephJC https://t.co/ZX6NzjY6nW
Nephrology Jrnl Club @NephJC
@dr_nikhilshah @JamesNovakNeph Exactly! Main purpose was to study benefit of Vit D(on CV risk) BEYOND reduction in PTH #NephJC
Nimra Sarfaraz @DrNimraS
@NephJC anecdotally I've noticed that asian patients tended to have much lower PTH compared to other ethnicities, I trained in Flushing Queens and there is a large Vietnamese population in Dallas #NephJC
Swapnil Hiremath, MD, MPH @hswapnil
RT @NephJC: T1a: Methods – this was a Prospective randomized, open-label, blinded end point clinical trial to examine the effect of alfacal…
Nephrology Jrnl Club @NephJC
T1b: The protocol of the trial was published here - https://t.co/bxb7ifDQ2A PTH targets in Japanese guidelines are <180pg/mL, this was liberalized to 240pg/mL #NephJC https://t.co/o0ETNPnmla
James Novak @JamesNovakNeph
@hswapnil @NephJC That’s the big question. Same thing with ESAs: is the ESA dose or the Hb achieved that causes harm? And statins: dose versus LDL achieved that confers benefit? For phosphate binders, one could design a trial to compare dietary vs drug-mediated phosphate reduction. #NephJC
Nimra Sarfaraz @DrNimraS
@Nephro_Sparks @LParkerGregg1 @NephJC @Nephro_Sparks how are you getting gifs in with tweetdeck?! #NephJC
Divya Bajpai 🇮🇳 @divyaa24
@ssfarouk @dr_nikhilshah @JamesNovakNeph @NephJC I initially felt that this is a scary group to select many of our such pts progress to develop adynamic bone disease #NephJC
Mohamed E. Elrggal @M_Elraggal
@NephJC Strange enough to find a dialysis patient without SHPT !! #NephJC
Nephrology Jrnl Club @NephJC
@dr_nikhilshah @ssfarouk @JamesNovakNeph Japanese Targets are lower. Might Explain. #NephJC https://t.co/HMT9PcO3zs
Nimra Sarfaraz @DrNimraS
RT @edgarvlermamd: Vitamin D supplementation in Stages 3-4 CKD Update ca. 2018 📌 25(OH)D < 15 should be treated irrespective of PTH 📌 25(…
Nephrology Jrnl Club @NephJC
T1c: Intervention - oral alfacalcidol at 0.5 μg per day. Other VDRAs were allowed in the experimental group while the control group was asked to avoid them. Dose reduction, modification or temporary cessation was allowed (Dose range of alfacalcidol 0.25 to 7 mcg/wk) #NephJC
Swapnil Hiremath, MD, MPH @hswapnil
@dr_nikhilshah @ssfarouk @JamesNovakNeph @NephJC Yeah. Japan is very very different (low deceased donor Tx rates, great survival etc) And yes, recruitment was slower for that reason #NephJC
Swapnil Hiremath, MD, MPH @hswapnil
RT @NephJC: @dr_nikhilshah @JamesNovakNeph Exactly! Main purpose was to study benefit of Vit D(on CV risk) BEYOND reduction in PTH #NephJC
Bhavnish @Buck1486
Physiology and medicine aside, I imagine it would have been hard to implement this in the US with the 'bundle' system. What parameters to be monitored if this is for patients without SHPT? When to start, when to stop etc... @NephJC #nephjc
James Novak @JamesNovakNeph
@divyaa24 @ssfarouk @dr_nikhilshah @NephJC Do you do bone biopsies to diagnose adynamic bone disease? These are rarely done in the U.S. #NephJC
Edgar V. Lerma 🇵🇭 @edgarvlermamd
GOLDFARB: Don't screen for Vitamin D unless 🔲 BMD is low 🔲 CKD #AUA17 🇺🇸 #Nephpearls #NephJC https://t.co/kwDzKqmAnx
Nephrology Jrnl Club @NephJC
@divyaa24 @ssfarouk @dr_nikhilshah @JamesNovakNeph We'll see this later. But surprisingly very low rates of Adynamic disease in this study! #NephJC
Joel Topf, MD FACP @kidney_boy
@M_Elraggal @NephJC There was a non-calcium versus calcium containing binders study presented at #KidneyWk that also showed remarkably different CKD-MBD cohort than we are used to. #JapanIsDifferent #NephJC
Nephrology Jrnl Club @NephJC
RT @hswapnil: @dr_nikhilshah @ssfarouk @JamesNovakNeph @NephJC Yeah. Japan is very very different (low deceased donor Tx rates, great survi…
Swapnil Hiremath, MD, MPH @hswapnil
Important point Control arm could receive VDRAs or cinacalcet too for PTH reasons #NephJC
B. Wagner, M.D. @Wagner_Nephro
@weddellite #NephJC
Nephrology Jrnl Club @NephJC
RT @kidney_boy: @M_Elraggal @NephJC There was a non-calcium versus calcium containing binders study presented at #KidneyWk that also showed…
Nephrology Jrnl Club @NephJC
T1d : Primary Endpoint – What do you think of the Composite of Cardiovascular events – details don’t fit in 280 characters! Too much performance pressure on Alfacalcidol?! Secondary endpoint – All cause mortality #NephJC https://t.co/TO5v8hULRo
Divya Bajpai 🇮🇳 @divyaa24
@JamesNovakNeph @ssfarouk @dr_nikhilshah @NephJC Very rarely, Only in severely symptomatic pts. we do lateral Xray, CECT for vascualr calcifications low PTH in HD is not uncommon here #NephJC
Joel Topf, MD FACP @kidney_boy
Amen brother #WheresTheBeef in #CKDMBD #NephJC
James Novak @JamesNovakNeph
@anniebelch @NephJC FGF23 is another wrench in the gears. Associated with LVH in clinical cohorts, and causes LVH in animal models, but it’s complicated. I’m waiting for an FGF23 inhibitor clinical trial. #NephJC
Ross Morton @signindoc
@divyaa24 @ssfarouk @dr_nikhilshah @JamesNovakNeph @NephJC Certainly low turnover bone disease is a concern, but could be mixed with OM which can be hard to diagnose without biposies #NephJC
Nimra Sarfaraz @DrNimraS
RT @divyaa24: @JamesNovakNeph @ssfarouk @dr_nikhilshah @NephJC Very rarely, Only in severely symptomatic pts. we do lateral Xray, CECT for…
Nephrology Jrnl Club @NephJC
@hswapnil Yes. Dropout considered only if VDRA continued for > 12 weeks! Lot of contamination! #NephJC
Sri Lekha Tummalapalli, MD, MBA @LTummalapalli
The evidence the cite about pleitropic effects of Vitamin D is weak - only one human study, the rest experimental. Do others think of Vitamin D as having important pleiotropic effects? #nephjc
Nikhil Shah @dr_nikhilshah
@JamesNovakNeph @divyaa24 @ssfarouk @NephJC #nephjc Not here and have not heard of it being done regularly in Canada either.
Nephrology Jrnl Club @NephJC
RT @LTummalapalli: The evidence the cite about pleitropic effects of Vitamin D is weak - only one human study, the rest experimental. Do ot…
Swapnil Hiremath, MD, MPH @hswapnil
#Ambitious But observational studies (and 🐭 data?) suggest vit D is an elixir for immortality, so why not? #NephJC
B. Wagner, M.D. @Wagner_Nephro
RT @hswapnil: #Ambitious But observational studies (and 🐭 data?) suggest vit D is an elixir for immortality, so why not? #NephJC https://t.…
Matt Sparks @Nephro_Sparks
@LTummalapalli Uggh. pleiotropic for 100 alex. Not a fan of that word in any sense. Hand waving. #NephJC
James Novak @JamesNovakNeph
@DrRaymondHsu @NephJC @divyaa24 @ssfarouk @dr_nikhilshah There’s some evidence that alkaline phosphatase is more specific (and stable) compared to PTH. #NephJC
Joel Topf, MD FACP @kidney_boy
@anniebelch @JamesNovakNeph @NephJC Let's not get into secondary analysis when primary analysis is negative. And saying if a drug works (and it usually didn't) then it reduces mortality is not a very compelling finding. #NephJC
Swapnil Hiremath, MD, MPH @hswapnil
@JamesNovakNeph @anniebelch @NephJC See this though https://t.co/zzy01UqBw9 from @RichardHaynes3 et al I am becoming an FGF-skeptic #NephJC
Ross Morton @signindoc
@LTummalapalli I think this stems from the presence of VDRs in many places. Seems logical that the hormonal form has multiple actions. #NephJC
Swapnil Hiremath, MD, MPH @hswapnil
RT @NephJC: @hswapnil Yes. Dropout considered only if VDRA continued for > 12 weeks! Lot of contamination! #NephJC
Michelle Rheault @rheault_m
@Nephro_Sparks @LTummalapalli Are you practicing for #KidneyCon Jeopardy already? #NephJC
Edgar V. Lerma 🇵🇭 @edgarvlermamd
Vitamin D 101 from @RenalFellowNtwk #Nephpearls #CKDMBD #NephJC 👉🏼 https://t.co/JXARB4h3PH https://t.co/uJIQnaUYzK
Swapnil Hiremath, MD, MPH @hswapnil
#NephJC
Nephrology Jrnl Club @NephJC
RT @hswapnil: #NephJC https://t.co/jiLFENSBuh
Nephrology Jrnl Club @NephJC
T1g: What do you think of the methods? Is open label and allowing other VDRAs and cinacalcet to be used a problem? Target PTH was same in both arms too #NephJC
Raymond Hsu @DrRaymondHsu
@JamesNovakNeph @NephJC @divyaa24 @ssfarouk @dr_nikhilshah alk phos. a number i completely ignore on the monthly labs (also ignore the ca-phos product) #nephjc #stopreportingplease
sidsdoc @sidsdoc
excellent initiative. #NephJC
Swapnil Hiremath, MD, MPH @hswapnil
@skathire @silvishah Indeed. And the study we are discussing tonight is also....negative https://t.co/zBrPXrEP6m #NephJC
Joel Topf, MD FACP @kidney_boy
@NephJC Always suspicious of CHF admissions in a dialysis study. So many dialysis patients with run of the mill fluid overload admitted with CHF. #NephJC
Ross Morton @signindoc
@Nephro_Sparks @LTummalapalli Fair comment, but if VDRs abound, they are there for a reason. #NephJC
Mohamed E. Elrggal @M_Elraggal
#NephJC
Carmen A. Peralta @Peralta_KHRC
HI Carmen Peralta here from @crickethealth and @UCSFNephrology #NephJC still hoping not to have JC during dinner time :)
Rasheeda Hall @Rasheeda_HallMD
slightly more CV events in intervention arm compared to control arm 21 vs 18% - is it because of higher calcium levels? #NephJC
Sarah Melville @sarahkmels
RT @hswapnil: @JamesNovakNeph @anniebelch @NephJC See this though https://t.co/zzy01UqBw9 from @RichardHaynes3 et al I am becoming an FGF-…
Nimra Sarfaraz @DrNimraS
@dr_nikhilshah @JamesNovakNeph @divyaa24 @ssfarouk @NephJC Never done one #NephJC
Nimra Sarfaraz @DrNimraS
RT @JamesNovakNeph: @DrRaymondHsu @NephJC @divyaa24 @ssfarouk @dr_nikhilshah There’s some evidence that alkaline phosphatase is more specif…
Swapnil Hiremath, MD, MPH @hswapnil
@gautamphadke See poll: https://t.co/Nw9TEclaH2 #NephJC
Nephrology Jrnl Club @NephJC
@DrRaymondHsu @JamesNovakNeph @divyaa24 @ssfarouk @dr_nikhilshah I use a combination of Alk Phos, PTH and PO4 to try and gauge whats going on? Whats the percentage of patients undergoing Bone biopsy at your centre? #NephJC
د . منير @batman_2030
RT @edgarvlermamd: Vitamin D analogs #CKDMBD #Nephpearls #NephSecrets #NephJC https://t.co/ZX6NzjY6nW
Joel Topf, MD FACP @kidney_boy
@NephJC Similarly, I don't love acute MI with all of our dialysis patients running around with "positive troponins" a bit of chest pain and bang it's another NSTEMI #NephJC
Annabel Biruete 🇲🇽 @anniebelch
@Nephro_Sparks @JamesNovakNeph @NephJC Is burosumab going to be tested in CKD? #NephJC
Nephrology Jrnl Club @NephJC
T2a – Results: 976 patients were randomized and 964 were included in analysis (488 in the intervention group and 476 in the control group). There was significant dropout in both the intervention and control groups. #NephJC https://t.co/oWrGUwDTQF
Sri Lekha Tummalapalli, MD, MBA @LTummalapalli
@Nephro_Sparks Haha. I am still a believer in pleiotropic effects of statins. Your labmates agree 🐭 🐭 🐭 #NephJC
James Novak @JamesNovakNeph
@NephJC @DrRaymondHsu @divyaa24 @ssfarouk @dr_nikhilshah Round down to 0%. #NephJC
Michelle Rheault @rheault_m
@NephJC @DrRaymondHsu @JamesNovakNeph @divyaa24 @ssfarouk @dr_nikhilshah Bone biopsy? 0% #NephJC
Swapnil Hiremath, MD, MPH @hswapnil
@kidney_boy @NephJC Good point - since trial open label (though blinded endpoints FWIW) #nephjc
Edgar V. Lerma 🇵🇭 @edgarvlermamd
Vitamin D related outcomes most relevant to #CKDMBD Guidelines ca. 2018 #Nephpearls #NephJC 👉🏼 https://t.co/XLHBNSvWg9 https://t.co/5k8yUjWOBz
Matt Sparks @Nephro_Sparks
@NephJC I kind of like the simplicity of it. also that no SHPTH. pretty much showing no pleiotropy. #NephJC
Nimra Sarfaraz @DrNimraS
RT @edgarvlermamd: Vitamin D 101 from @RenalFellowNtwk #Nephpearls #CKDMBD #NephJC 👉🏼 https://t.co/JXARB4h3PH https://t.co/uJIQnaUYzK
Swapnil Hiremath, MD, MPH @hswapnil
RT @NephJC: T2a – Results: 976 patients were randomized and 964 were included in analysis (488 in the intervention group and 476 in the con…
Sarah Melville @sarahkmels
RT @edgarvlermamd: Vitamin D 101 from @RenalFellowNtwk #Nephpearls #CKDMBD #NephJC 👉🏼 https://t.co/JXARB4h3PH https://t.co/uJIQnaUYzK
Divya Bajpai 🇮🇳 @divyaa24
Have found Alk Phos helpful in some pts, to complete the picture. Any ideas of how to use these in pediatrc population with a growing skeleton producing lots of ALP? #NephJC
Nephrology Jrnl Club @NephJC
T2b: Let’s take a closer look at the patients recruited. Median Age 65 yrs, Most patients receiving calcium containing po4 binders and 5-6 % patients on Cinacalcet in each group.~ 30% were on furosemide (so presumably had residual function) #NephJC https://t.co/Y8tokEV4kA
Joel Topf, MD FACP @kidney_boy
@divyaa24 A land filled with positive retrospective trials and negative RCTs. #NephJC
Nephrology Jrnl Club @NephJC
@Rasheeda_HallMD Good point! We'll get to it soon! #NephJC
James Novak @JamesNovakNeph
@hswapnil @anniebelch @NephJC @RichardHaynes3 I’m on the fence. Need to see clinical trial data with a specific inhibitor. #NephJC
Sarah Melville @sarahkmels
RT @hswapnil: #NephJC https://t.co/jiLFENSBuh
Carmen A. Peralta @Peralta_KHRC
Hi #NephJC if your patient has trouble even paying for copays of meds where evidence is solid (ie. ARB), would you tell them to spend $ on vit D (any kind?)
Natasha N. Dave @NatashaNDave
Natasha from @BCMKidneyHealth checking in late for #NephJC no COI, will be lurking 😎
Swapnil Hiremath, MD, MPH @hswapnil
RT @NephJC: T2b: Let’s take a closer look at the patients recruited. Median Age 65 yrs, Most patients receiving calcium containing po4 bind…
Krishna K Agrawal @agrawalkris
Is there a role for testing 1,25 vitamin d rather 25 d along with PTH and calcium. @NephJC , #NephJC
Divya Bajpai 🇮🇳 @divyaa24
@NephJC @DrRaymondHsu @JamesNovakNeph @ssfarouk @dr_nikhilshah seen only 2 in last 5 years spent in nephrology #NephJC
Jay Koyner @jaykoyner
jay koyner - nephrologist, chicago - no relevant COI - just lurking tonight #nephjc
Gates Colbert, MD @DoctorGates
@NephJC Lots of dropout, but almost everyone accounted for in the end 98%. Why everyone quit playing? #NephJC
Krystahl Andújar, MD @Krystahllopathy
@NephJC @DrRaymondHsu @JamesNovakNeph @divyaa24 @ssfarouk @dr_nikhilshah 0% #NephJC
Syed Husain @SAHusainMD
@NephJC and important fairly long average dialysis duration prior to study initiation #NephJC
Nikhil Shah @dr_nikhilshah
@Peralta_KHRC @crickethealth @UCSFNephrology #nephjc with dinner!! https://t.co/RH1ujAbvUU
Edgar V. Lerma 🇵🇭 @edgarvlermamd
@MarioFunesMD @NephJC Something is missing in this picture #NephJC #NephSecrets https://t.co/74n8e7wdYm
Divya Bajpai 🇮🇳 @divyaa24
@NephJC Reason for so much drop outs in control group? #NephJC
James Novak @JamesNovakNeph
@agrawalkris @NephJC Only if you’re working up hypercalcemia. Compared to 25(OH)D, 1,25(OH)2D has a much shorter half-life and is present at only 1/1000 the concentration. #NephJC
Matt Sparks @Nephro_Sparks
RT @LParkerGregg1: Hi all! I'm Parker Gregg from Dallas. Mostly lurking and trying to figure out how to use tweedeck. No COI, #NephJC first…
Swapnil Hiremath, MD, MPH @hswapnil
@Peralta_KHRC Agree. Waste of money #nephjc
Nephrology Jrnl Club @NephJC
T2c: The primary outcome occurred in 103 patients (21%) in the intervention group and 85 patients (18%) in the control group (absolute difference, 3% [95% CI, −1.75% to 8.24%]; hazard ratio, 1.25 [95% CI, 0.94-1.67]; P = .13). Surprised? #NephJC https://t.co/WcEMJAPdal
Nimra Sarfaraz @DrNimraS
RT @JamesNovakNeph: @agrawalkris @NephJC Only if you’re working up hypercalcemia. Compared to 25(OH)D, 1,25(OH)2D has a much shorter half-l…
Ross Morton @signindoc
@NephJC @DrRaymondHsu @JamesNovakNeph @divyaa24 @ssfarouk @dr_nikhilshah https://t.co/qUw81DXNad suggests this might be the way to go. #NephJC
Steven Coca @scoca1
@LTummalapalli @Nephro_Sparks I think it’s ok to handwave some pleiotropy for meds that actually work for improving clinical outcomes in multiple RCTs (statins, SGLT2i) Otherwise 🙄🙄🙄 #NephJC
Swapnil Hiremath, MD, MPH @hswapnil
@JamesNovakNeph @agrawalkris @NephJC Agree And expensive We rarely check #NephJC
Divya Bajpai 🇮🇳 @divyaa24
@Peralta_KHRC Also increasing pill burden in already overburdened pts. both psychologically and financially #NephJC
Nephrology Jrnl Club @NephJC
@divyaa24 Lot of them received VDRAs / Active Vitamin D to control PTH, and if these were contd for > 12 weeks they were considered drop outs #NephJC
Krystahl Andújar, MD @Krystahllopathy
RT @JamesNovakNeph: @agrawalkris @NephJC Only if you’re working up hypercalcemia. Compared to 25(OH)D, 1,25(OH)2D has a much shorter half-l…
Nephrology Jrnl Club @NephJC
T2d: There was no significant difference between the intervention and control group in the secondary outcome of all-cause death (18.2% vs 16.8%, respectively; hazard ratio, 1.12 [95% CI, 0.83- 1.52]; P = .46) #NephJC https://t.co/sGyZh3tUPG
Swapnil Hiremath, MD, MPH @hswapnil
RT @SAHusainMD: @NephJC and important fairly long average dialysis duration prior to study initiation #NephJC
Matt Sparks @Nephro_Sparks
@NephJC Uggh. well, those curves going wrong way. #NephJC
Nephrology Jrnl Club @NephJC
RT @SAHusainMD: @NephJC and important fairly long average dialysis duration prior to study initiation #NephJC
Sarah Melville @sarahkmels
RT @edgarvlermamd: Vitamin D related outcomes most relevant to #CKDMBD Guidelines ca. 2018 #Nephpearls #NephJC 👉🏼 https://t.co/XLHBNSvWg9…
Swapnil Hiremath, MD, MPH @hswapnil
@divyaa24 @NephJC Started on a VDRA #NephJC
Swapnil Hiremath, MD, MPH @hswapnil
RT @NephJC: T2c: The primary outcome occurred in 103 patients (21%) in the intervention group and 85 patients (18%) in the control group (a…
L. Parker Gregg @LParkerGregg1
@NephJC @DrRaymondHsu @JamesNovakNeph @divyaa24 @ssfarouk @dr_nikhilshah I don't know how I would go about getting a bone biopsy done even if I wanted one. Haven't seen it done yet. #NephJC
Joel Topf, MD FACP @kidney_boy
@DoctorGates @NephJC likely PTH went up in the control group and down in the alfacaldol group #NephJC
Matt Sparks @Nephro_Sparks
@NephJC need to put that as 1 to 0 on the y axis and put an inlet for the blow up. #NephJC #JDAVID
Swapnil Hiremath, MD, MPH @hswapnil
RT @NephJC: T2d: There was no significant difference between the intervention and control group in the secondary outcome of all-cause death…
Juan Manuel Hernandez @JuanmaHernande
RT @edgarvlermamd: Vitamin D analogs #CKDMBD #Nephpearls #NephSecrets #NephJC https://t.co/ZX6NzjY6nW
James Novak @JamesNovakNeph
@Peralta_KHRC Good point. Even if they can afford the D, is it worth adding medication #23 to a regimen they already have trouble remembering? I’m in favor of giving as many medications as possible IV during dialysis to improve adherence. The Bundle, however, has other ideas... #NephJC
Joel Topf, MD FACP @kidney_boy
RT @scoca1: @LTummalapalli @Nephro_Sparks I think it’s ok to handwave some pleiotropy for meds that actually work for improving clinical ou…
Divya Bajpai 🇮🇳 @divyaa24
@SAHusainMD @NephJC Yes and thats a good thing for study looking at CV end points #NephJC
B. Wagner, M.D. @Wagner_Nephro
RT @JamesNovakNeph: @Peralta_KHRC Good point. Even if they can afford the D, is it worth adding medication #23 to a regimen they already ha…
Nephrology Jrnl Club @NephJC
T2e: The table summarizes the composite and individual cardiovascular events that occurred. The number of SAEs was similar between the groups. #NephJC https://t.co/u8CKo8JuYu
Matt Sparks @Nephro_Sparks
@scoca1 @LTummalapalli pleiotropy gets the grants and the papers. But after it is defined... it is no longer pleiotripoy... it is a real effect that is targeted #NephJC
Dr Narayanan @dr_narayanan
RT @edgarvlermamd: Vitamin D analogs #CKDMBD #Nephpearls #NephSecrets #NephJC https://t.co/ZX6NzjY6nW
Sarah Melville @sarahkmels
RT @signindoc: @NephJC @DrRaymondHsu @JamesNovakNeph @divyaa24 @ssfarouk @dr_nikhilshah https://t.co/qUw81DXNad suggests this might be the…
Beje Thomas @bthomas215
Beje Thomas no COI nephrologist DC #nephjc
Raymond Hsu @DrRaymondHsu
@LParkerGregg1 @NephJC @JamesNovakNeph @divyaa24 @ssfarouk @dr_nikhilshah We ask the orthopod to get a sample if going to OR for surgery anyway. Totally just academic. Problem also not sure if bone pathologists routinely look at bone turnover disease; more experienced at malignancies. #nephjc
James Novak @JamesNovakNeph
@LTummalapalli The Institute of Medicine #IOM wasn’t too impressed with the evidence for vitamin D pleiotropy when they published their guidelines. #NephJC
Matt Sparks @Nephro_Sparks
@scoca1 @LTummalapalli books are written about the VitD pleiotropy. #NephJC lets get these effects sorted and target something that works.
Jefferson T. @TRIOZZIJL
@NephJC Are the plots separating over time? Eyes may be playing tricks on me. Wonder what would be seen if followed longer after randomization. #NephJC
Annabel Biruete 🇲🇽 @anniebelch
@divyaa24 @SAHusainMD @NephJC That BMI! Definitely not comparable to the US 😐 #NephJC
Mohamed E. Elrggal @M_Elraggal
@Nephro_Sparks @NephJC Is it hyperCa, vascular calcifications ?! #NephJC
L. Parker Gregg @LParkerGregg1
@Nephro_Sparks @scoca1 @LTummalapalli Wait please tell me how to get grants and papers...I need to know the secrets #NephJC
Brandi Wynne @brandimwynne
@Nephro_Sparks @NephJC Even lurkers can agree on this figure... #NephJC
Nephrology Jrnl Club @NephJC
T2f: What happened to calcium, PO4 and PTH during the trial? Since this was an open label a lot of changes were made, as can be seen here: #nephJC https://t.co/Ow4kYe5IWP
Nephrology Jrnl Club @NephJC
@DrRaymondHsu @LParkerGregg1 @JamesNovakNeph @divyaa24 @ssfarouk @dr_nikhilshah correct me if i am wrong. Dont you need 2 biopsies to document low turnover. (to look for tetracycline binding over 2 weeks!) Single biopsy will only inform on Volume and mineralisation. Never done or seen one in my short career. #NephJC
Rasheeda Hall @Rasheeda_HallMD
these confidence intervals do not rule out potential harm #NephJC
Nephrology Jrnl Club @NephJC
T2f: One might wonder why the biochemical parameters did not change despite a drug versus no drug comparison? The answer is seen below: #NephJC https://t.co/zcMLL6W5gl
Nephrology Jrnl Club @NephJC
RT @Nephro_Sparks: @scoca1 @LTummalapalli books are written about the VitD pleiotropy. #NephJC lets get these effects sorted and target som…
Brandi Wynne @brandimwynne
@LParkerGregg1 Welcome! #NephJC
Swapnil Hiremath, MD, MPH @hswapnil
RT @NephJC: T2f: What happened to calcium, PO4 and PTH during the trial? Since this was an open label a lot of changes were made, as can be…
Krystahl Andújar, MD @Krystahllopathy
@NephJC Increased risk for hypercalcemia and vascular calcifications? #NephJC
Matt Sparks @Nephro_Sparks
@Rasheeda_HallMD totally agree. #nephjc
B. Wagner, M.D. @Wagner_Nephro
LANTHANUM! https://t.co/9NkGscf17u #NephJC
Joel Topf, MD FACP @kidney_boy
When are we talking about the power analysis because this is a massively underpowered trial even before the cross over. They thought they needed 1600 and they had less than a 1000. #NephJC
Nephrology Jrnl Club @NephJC
@M_Elraggal @Nephro_Sparks Being an open label study, they managed to maintain similar biochemical parameters in both groups. #NephJC. Not sure if hypercalcemia contributed to the apparent harm(nonsignificant) in this study
Humberto Alvarez, MD @halvarezl
RT @edgarvlermamd: Vitamin D supplementation in Stages 3-4 CKD Update ca. 2018 📌 25(OH)D < 15 should be treated irrespective of PTH 📌 25(…
James Novak @JamesNovakNeph
@gautamphadke @rheault_m @NephJC @DrRaymondHsu @divyaa24 @ssfarouk @dr_nikhilshah I’m embarrassed to admit that we actually have an endocrinologist on site who does bone biopsies, but we still never have them done. I think it might be difficult to translate the result into a therapeutic plan, especially in cases with both high and low turnover bone Dz. #NephJC
Divya Bajpai 🇮🇳 @divyaa24
@NephJC I am truly worried about pts with low PTH getting so much vit D, ca carbonate and lanthanum #NephJC
Sarah Melville @sarahkmels
RT @Wagner_Nephro: LANTHANUM! https://t.co/9NkGscf17u #NephJC https://t.co/C8YoUaVWoC
Ross Morton @signindoc
@NephJC @DrRaymondHsu @LParkerGregg1 @JamesNovakNeph @divyaa24 @ssfarouk @dr_nikhilshah Giving the tetracycline 2 weeks apart leaves 2 deposits on the bone: the distance between the deposits indicates bone laid down during that time. #NephJC
Swapnil Hiremath, MD, MPH @hswapnil
RT @NephJC: T2f: One might wonder why the biochemical parameters did not change despite a drug versus no drug comparison? The answer is see…
B. Wagner, M.D. @Wagner_Nephro
RT @divyaa24: @NephJC I am truly worried about pts with low PTH getting so much vit D, ca carbonate and lanthanum #NephJC
Raymond Hsu @DrRaymondHsu
@kidney_boy the sample size is based on 20% risk reduction. #ambitious. based on minimal prelim data from what i could tell. #nephjc
Joel Topf, MD FACP @kidney_boy
@NephJC same thing was seen in EVOLVE. If you want to study CKD-MBD you can't just study a drug, you need to study a biochemical profile strategy (low Ca or low PTH or both) because there are so many tools to move the numbers around #NephJC
Rasheeda Hall @Rasheeda_HallMD
@kidney_boy I wonder what the incentives for participation in the study may have been? #nephjc
Matt Sparks @Nephro_Sparks
if you can't get to sleep tonight #nephjc
Nephrology Jrnl Club @NephJC
T3a: The trial showed that in patients without secondary hyperparathyroidism receiving maintenance hemodialysis, oral alfacalcidol compared with usual care DID NOT reduce the risk of significant cardiovascular events. #NephJC
Matt Sparks @Nephro_Sparks
If you can't get to sleep tonight --> The pleiotropic actions of vitamin D. https://t.co/U5uVSfdM0L #nephjc
James Novak @JamesNovakNeph
@divyaa24 @NephJC There is evidence that calcium loading can worsen vascular calcification. Especially in patients with adynamic disease, the Ca has nowhere else to go but into the arterial media. #NephJC
Kamel Hatahet @kamel_hatahet
RT @edgarvlermamd: Vitamin D supplementation in Stages 3-4 CKD Update ca. 2018 📌 25(OH)D < 15 should be treated irrespective of PTH 📌 25(…
Divya Bajpai 🇮🇳 @divyaa24
@JamesNovakNeph @NephJC And there is more evidence for this than for pleiotropic effects and CV reduction with vit D #NephJC
Nephrology Jrnl Club @NephJC
T3b The study has a signal of potential harm rather than benefit of VDRAs in patients without elevated serum intact PTH levels. The occurrence of stroke was twice as high in the intervention group than the control group (28 vs 14). #NephJC
Dr SC Tiwari @Sctiwari15
RT @sidsdoc: excellent initiative. #NephJC https://t.co/YQLwSVuIpj
Matt Sparks @Nephro_Sparks
@JamesNovakNeph @divyaa24 @NephJC I worry about a certain company making a binder that starts with a S and end with an R pushes this argument. #NephJC... need a study to show benefit first
Joel Topf, MD FACP @kidney_boy
@DrRaymondHsu no, that was the original plan, the actual plan was 30% reduction #NephJC #IMustBeTakingCrazyPills https://t.co/TTtpEOQjxc
Nimra Sarfaraz @DrNimraS
RT @JamesNovakNeph: @divyaa24 @NephJC There is evidence that calcium loading can worsen vascular calcification. Especially in patients with…
Mario Funes MD @MarioFunesMD
@Krystahllopathy @NephJC Difference in cardiovascular events in intervention group. #NephJC https://t.co/cZBUX49LHM
Nephrology Jrnl Club @NephJC
T3c What do you think of the trial, the results? There were some significant limitations – Underpowered Trial Unblinded Study Contamination of study groups Caution in extrapolating to non Japanese pts Study data can’t be extrapolated to pts with true SHPT #NephJC
Dr SC Tiwari @Sctiwari15
RT @divyaa24: @NephJC We use vit D very cautiously only if PTH > 9 times normal AND RISING. Cvs risk reduction needs more probing, not an…
Raymond Hsu @DrRaymondHsu
@Nephro_Sparks @scoca1 @LTummalapalli searched "pleiotropic" in NIH reporter - so many studies! LOL #nephjc
James Novak @JamesNovakNeph
@Nephro_Sparks @divyaa24 @NephJC Geoffrey Block’s study from 15 years ago showed this, although DCOR ultimately showed no difference in outcomes between sevelamer and Ca-based binders (problematic study, though). #NephJC
Bhavnish @Buck1486
@NephJC #nephjc Wonder how many patients would have developed calcific uremic arteriolopathy if this study went on for > 48 months.
B. Wagner, M.D. @Wagner_Nephro
RT @Buck1486: @NephJC #nephjc Wonder how many patients would have developed calcific uremic arteriolopathy if this study went on for > 48 m…
Nephrology Jrnl Club @NephJC
RT @Buck1486: @NephJC #nephjc Wonder how many patients would have developed calcific uremic arteriolopathy if this study went on for > 48 m…
Rasheeda Hall @Rasheeda_HallMD
that pretty much sums it up #NephJC
Mohamed E. Elrggal @M_Elraggal
@Nephro_Sparks @JamesNovakNeph @divyaa24 @NephJC It is not S and R here in Egypt, it is M and A #NephJC
Swapnil Hiremath, MD, MPH @hswapnil
RT @kidney_boy: @NephJC same thing was seen in EVOLVE. If you want to study CKD-MBD you can't just study a drug, you need to study a bioche…
Matt Sparks @Nephro_Sparks
@JamesNovakNeph @divyaa24 @NephJC I recall @virtualpun presenting at JC #NephJC funded by the S---R company
Syed Husain @SAHusainMD
@scoca1 @kidney_boy @DrRaymondHsu exactly, especially when participants already have 5 years dialysis exposure-- have already accumulated so much risk #NephJC
Nephrology Jrnl Club @NephJC
T3d: This was not a trial of different PTH targets, it was a trial of alfacalcidol versus placebo (most of whom did receive another VDRA) at PTH levels where most of us would not use either active vitamin D or a VDRA. #NephJC
Swapnil Hiremath, MD, MPH @hswapnil
RT @NephJC: T3b The study has a signal of potential harm rather than benefit of VDRAs in patients without elevated serum intact PTH levels.…
Krystahl Andújar, MD @Krystahllopathy
@MarioFunesMD @NephJC I keep looking at that increase in stroke risk in the intervention group! #NephJC
Ross Morton @signindoc
@NephJC Adds more to the Vitamin D-ud than the Vitamin D-light side of the argument. Yet in my bones I believe in vitamin D for more than rickets and osteomalacia. #NephJC
Divya Bajpai 🇮🇳 @divyaa24
Are there any pediatric nephrologists around? Any views of how to treat these abnormalities in kids? gets very confusing but there might be a place for Vit D there #NephJC
Annabel Biruete 🇲🇽 @anniebelch
@Nephro_Sparks @JamesNovakNeph @divyaa24 @NephJC I think any non-calcium-based binder could make that argument #NephJC
Swapnil Hiremath, MD, MPH @hswapnil
@Buck1486 @NephJC Likely still very low...#NephJc
Joel Topf, MD FACP @kidney_boy
@NephJC In these studies the doctors target the same guideline generated biochemical goals and these are just opinion/expert consensus. This biochemical convergence narrows the ability to see any differences between the groups and generate ebb goals #Catch22 #NephJC
Rasheeda Hall @Rasheeda_HallMD
I think we found that Ca+ bath typically is higher in Japan than US. someone can fact check.. #nephjc
Raymond Hsu @DrRaymondHsu
thank u, next (vitamin D/agonist study?) #nephjc
Matt Sparks @Nephro_Sparks
@LTummalapalli A very novel and pleiotropic effect found #NephJC
Matt Sparks @Nephro_Sparks
@anniebelch @JamesNovakNeph @divyaa24 @NephJC and they do #NephJC
Nephrology Jrnl Club @NephJC
T3e What does this trial truly show? VDRAs have been promoted for improving cardiovascular health, immune function and other pleotropic effects. This study does not support this practice. ½ #NephJC
Cathy Quinlan @KidneyCathy
RT @NephJC: T3d: This was not a trial of different PTH targets, it was a trial of alfacalcidol versus placebo (most of whom did receive ano…
Swapnil Hiremath, MD, MPH @hswapnil
RT @signindoc: @NephJC Adds more to the Vitamin D-ud than the Vitamin D-light side of the argument. Yet in my bones I believe in vitamin D…
Swapnil Hiremath, MD, MPH @hswapnil
QFT And #NephJC
Nephrology Jrnl Club @NephJC
Most of us have expressed the fear of promoting adynamic bone disease by over suppression of PTH which would subsequently increase risk of vascular calcification & adverse cardiovascular outcomes. But no such adverse effect was seen in this study 2/2 #NephJC
Ross Morton @signindoc
@hswapnil True that #NephJC
Divya Bajpai 🇮🇳 @divyaa24
@KidneyCathy what are your PTH targets in Kids? when do u give phosphate binders? #NephJC
Nephrology Jrnl Club @NephJC
T3f: Does this study change your practice? Do you, or will you, treat your CKD-D patients with VDRA in the setting of normal PTH to address CV risk? #NephJC
James Novak @JamesNovakNeph
@anniebelch @Nephro_Sparks @divyaa24 @NephJC They do. I’m starting to believe it, although it hasn’t changed my practice. There are a number of small trials that have accumulated over the years showing less vascular calcification and lower mortality with non-calcium binders. Not ironclad evidence. #NephJC
Nephrology Jrnl Club @NephJC
So what caused increased CV events, though statistically insignificant, in the intervention grp? Pleotropic harmful effect of Vit D?!! #NephJC
Mohamed E. Elrggal @M_Elraggal
@NephJC Absolutely not, #NephJC
Joel Topf, MD FACP @kidney_boy
@scoca1 @DrRaymondHsu repeat that with 20% too. Let's shoot for 10-15% changes. #NephJC
Matt Sparks @Nephro_Sparks
@NephJC Don't do it currently and this study certainly shows no benefit. There are long argument that you need to treat CKDMB before overt. but currently no evidence to say we should #NephJC
James Novak @JamesNovakNeph
@NephJC I don’t know that the trial was long enough to rule out long-term adverse events. #NephJC
Beje Thomas @bthomas215
Interesting to note less invasive cardiac interventions in the control group #nephjc
Jefferson T. @TRIOZZIJL
@Krystahllopathy @MarioFunesMD @NephJC Especially in under-powered study #type2error #NephJC
Nephrology Jrnl Club @NephJC
T3g: Does this open the door for a trial of active vitamin D, or a VDRAs at higher levels of PTH? Do we need a trial of differing PTH targets (using calcimimetics or VDRAs and other drugs to achieve the PTH)? Can we isolate the drug effect from any PTH effect? #NephJC
Rasheeda Hall @Rasheeda_HallMD
RT @M_Elraggal: @NephJC Absolutely not, #NephJC
Matt Sparks @Nephro_Sparks
So... I said I would lurk and what do you know. Tweeted a storm. Going to pack now. and watch basketball. #NephJC oh... and please stop baclofen in CKD... thank you and good night
Swapnil Hiremath, MD, MPH @hswapnil
@JamesNovakNeph @NephJC Agree. No benefit, harm not ruled out Let’s stop using Vit D/VDRAs if used in such populations #NephJC
Mario Funes MD @MarioFunesMD
@TRIOZZIJL @Krystahllopathy @NephJC Yes indeed @TRIOZZIJL #NephJC
Joel Topf, MD FACP @kidney_boy
@JamesNovakNeph @NephJC 4 years in a hemodialysis cohort is long enough for me. #NephJC
Swapnil Hiremath, MD, MPH @hswapnil
RT @NephJC: T3g: Does this open the door for a trial of active vitamin D, or a VDRAs at higher levels of PTH? Do we need a trial of differi…
Nephrology Jrnl Club @NephJC
@JamesNovakNeph This is a genuine doubt - how long would you have wnated the trial to run for? IF/u period was 48 mths. How long does it take to oversuppress PTh causing adynamic bone disease? #NephJC
Swapnil Hiremath, MD, MPH @hswapnil
@Nephro_Sparks @NephJC True - and 4 years as in this study is long enough! #NephJC
Annabel Biruete 🇲🇽 @anniebelch
@JamesNovakNeph @Nephro_Sparks @divyaa24 @NephJC Maybe the relationship relies on the total calcium intake (diet, supplements, and binders) and if they’re are constantly on a positive Ca balance #NephJC
Nephrology Jrnl Club @NephJC
Last few minutes left. What are your take home points? Final thoughts? #NephJC
James Novak @JamesNovakNeph
@hswapnil @NephJC Now, if only we could convince stakeholders (i.e., CMS) to ignore biochemical parameters we don’t believe in. #NephJC
Rasheeda Hall @Rasheeda_HallMD
@NephJC Too little cinacalcet:) #nephjc
Matt Sparks @Nephro_Sparks
@anniebelch @JamesNovakNeph @divyaa24 @NephJC they need to do a study and stop theorizing. the S--R and L--M drugs are expensive. #NephJC
Matt Sparks @Nephro_Sparks
The #VitD Chat 98 Participants. January 15th 2019. More #NephJC 📊 here https://t.co/cAPQg6b96k via @symplur
Swapnil Hiremath, MD, MPH @hswapnil
RT @JamesNovakNeph: @hswapnil @NephJC Now, if only we could convince stakeholders (i.e., CMS) to ignore biochemical parameters we don’t bel…
Sri Lekha Tummalapalli, MD, MBA @LTummalapalli
There is discussion about dropping the calcium metric but adding a phosphorus metric. #NephJC
Joel Topf, MD FACP @kidney_boy
@anniebelch @JamesNovakNeph @Nephro_Sparks @divyaa24 @NephJC did you see the calcium in the dialysate over there. Quite high. Probably explains the low PTH. #NephJC https://t.co/7yuTEBnBsU
David Santos @DavidSa37565535
Some patients had more than 2 cardiovascular SAEs. How many in control and intervention group? and what kind of cardiovascular SAE? #nephjc
Nephrology Jrnl Club @NephJC
@Nephro_Sparks @anniebelch @JamesNovakNeph @divyaa24 You couldn't stay away even after saying goodbye!!! Thats love for #NephJC
Matt Sparks @Nephro_Sparks
@hswapnil always gets me #NephJC https://t.co/nxSLzTScIK
Swapnil Hiremath, MD, MPH @hswapnil
@LTummalapalli Ugh! Let’s wait for the PO4 target trials to be done #NephJC
James Novak @JamesNovakNeph
@NephJC Hard to say without serial bone biopsies, but there’s a practical limit to how long a trial can run. #NephJC
Joel Topf, MD FACP @kidney_boy
@LTummalapalli out of the non-evidence* based frying pan into the non-evidence* based fire. #NephJC *and by non-EBM I mean no RCT to show that it makes a difference.
Ross Morton @signindoc
@Nephro_Sparks @anniebelch @JamesNovakNeph @divyaa24 @NephJC Always knew a "rare" earth element such as La would end up being expensive - it's in the name #NephJC
Gates Colbert, MD @DoctorGates
@kidney_boy @anniebelch @JamesNovakNeph @Nephro_Sparks @divyaa24 @NephJC ALSO, the majority of patients were on Ca Carb too. #NephJC
Matt Sparks @Nephro_Sparks
thanks to @ssfarouk for moderating and @aakashshingada for summary and VisAb and tomorrow doing the #EU and #Asia #nephJC I will count the pleiotropy when we are done
JAMA @JAMA_current
RT @NephJC: Tonight at #NephJC we are discussing the @JAMA_current paper, “Effect of Oral Alfacalcidol on Clinical Outcomes in Patients Wit…
Nephrology Jrnl Club @NephJC
Wrapping up! Time’s up! The hour just flew by! #NephJC
Ross Morton @signindoc
@Nephro_Sparks @ssfarouk @aakashshingada Sounds like a non-traditional way of doing things #NephJC
Nephrology Jrnl Club @NephJC
Thank you so much for joining us tonight! Your contributions are what makes #NephJC fun and informative
Nephrology Jrnl Club @NephJC
If you haven’t, please sign up for our weekly newsletter https://t.co/5aumn8qL85 #NephJC
Nephrology Jrnl Club @NephJC
For 2019, team NephJC is excited to announce the addition of a third chat focused on people in Asia. Join me again for the First Asian Version of NephJC today at 9pm Indian Time. #NephJC
Joel Topf, MD FACP @kidney_boy
What a great #NephJC. Thanks everyone!
Nimra Sarfaraz @DrNimraS
@Nephro_Sparks @ssfarouk @aakashshingada good job guys! #NephJC
Divya Bajpai 🇮🇳 @divyaa24
@NephJC Great Chat! Good to have RCT in CKDMBD even if its negative #NephJC
Cynthia Peachy Dory @Ab_Synthia2
RT @NephJC: Tonight at #NephJC we are discussing the @JAMA_current paper, “Effect of Oral Alfacalcidol on Clinical Outcomes in Patients Wit…
Krystahl Andújar, MD @Krystahllopathy
What a treat, glad to have been able to join in tonight! #NephJC
Mario Funes MD @MarioFunesMD
@DrNimraS @Nephro_Sparks @ssfarouk @aakashshingada Great one! Thank you guys! Good night everyone! #NephJC
Nephrology Jrnl Club @NephJC
Would you like to have some #NephJC swag? Order it here https://t.co/eTUrZYjJeY https://t.co/djec3ejQZ0
Bhavnish @Buck1486
@NephJC Discussing Medicine with Tool playing in the background is always fun. #NephJC. Thank you. Looking forward to next session.
Swapnil Hiremath, MD, MPH @hswapnil
RT @NephJC: If you haven’t, please sign up for our weekly newsletter https://t.co/5aumn8qL85 #NephJC
Ross Morton @signindoc
Great stuff tonight - thank you to all #NephJC
JCMO @marquezjuanc
RT @NephJC: Tonight at #NephJC we are discussing the @JAMA_current paper, “Effect of Oral Alfacalcidol on Clinical Outcomes in Patients Wit…
Annabel Biruete 🇲🇽 @anniebelch
@DrNimraS @Nephro_Sparks @ssfarouk @aakashshingada Thank you! #NephJC
Divya Bajpai 🇮🇳 @divyaa24
@rheault_m @KidneyCathy And how regularly you do vit D levels? Do u give Vit D only if levels are low? #NephJC
Swapnil Hiremath, MD, MPH @hswapnil
Nice job @aakashshingada doing summary, #VisualAbstract and hosting! The #NephJC trifecta
Sarah Melville @sarahkmels
Thank you for the summary & interesting discussion #NephJC
Divya Bajpai 🇮🇳 @divyaa24
#NephJC
Divya Bajpai 🇮🇳 @divyaa24
#NephJC
Divya Bajpai 🇮🇳 @divyaa24
#NephJC
Matt Sparks @Nephro_Sparks
@Rasheeda_HallMD @DukeKidney Nice job @Rasheeda_HallMD 👇 #NephJC https://t.co/UVlWuPnEjO
Joel Topf, MD FACP @kidney_boy
RT @hswapnil: Nice job @aakashshingada doing summary, #VisualAbstract and hosting! The #NephJC trifecta
Sarah Melville @sarahkmels
RT @Nephro_Sparks: @Rasheeda_HallMD @DukeKidney Nice job @Rasheeda_HallMD 👇 #NephJC https://t.co/UVlWuPnEjO
Aakash Shingada @aakashshingada
The numbers: 352 Tweets. 57 Participants. 9pm-10pm est January 15th 2019. More #NephJC 📊 here https://t.co/8c2OFuPlqu via @symplur
Swapnil Hiremath, MD, MPH @hswapnil
RT @Nephro_Sparks: @Rasheeda_HallMD @DukeKidney Nice job @Rasheeda_HallMD 👇 #NephJC https://t.co/UVlWuPnEjO
Sarah Melville @sarahkmels
RT @aakashshingada: The numbers: 352 Tweets. 57 Participants. 9pm-10pm est January 15th 2019. More #NephJC 📊 here https://t.co/8c2OFuPlqu v…
Aakash Shingada @aakashshingada
@hswapnil Thank you. Major credit to you and @kidney_boy for the summary! #NephJC
Swapnil Hiremath, MD, MPH @hswapnil
RT @NephJC: For 2019, team NephJC is excited to announce the addition of a third chat focused on people in Asia. Join me again for the Firs…
Matt Sparks @Nephro_Sparks
@aakashshingada @ssfarouk Then thank you again @aakashshingada #NephJC
Alex M ⚕🇲🇽 @NephroGuy
RT @JamesNovakNeph: @NephJC In fact, now that I’m getting warmed up, EVOLVE didn’t show any CVD benefit of cinacalcet, either. Nor have the…
Diana Mina @DiMiRenalMD
RT @NephJC: Would you like to have some #NephJC swag? Order it here https://t.co/eTUrZYjJeY https://t.co/djec3ejQZ0
Renal Fellow Network @RenalFellowNtwk
RT @edgarvlermamd: Vitamin D 101 from @RenalFellowNtwk #Nephpearls #CKDMBD #NephJC 👉🏼 https://t.co/JXARB4h3PH https://t.co/uJIQnaUYzK
☤| Ƿɪ̐ᵃᶰᵒ..❥♪' @pianiste13
RT @edgarvlermamd: GOLDFARB: Don't screen for Vitamin D unless 🔲 BMD is low 🔲 CKD #AUA17 🇺🇸 #Nephpearls #NephJC https://t.co/kwDzKqmAnx
PCCM @PedCritCareMed
RT @PedCritCareMed: What is the prevalence and outcomes of acute #kidney injury in children with diabetic ketoacidosis? Read this January a…
Sapna Kudchadkar, MD, PhD @SapnaKmd
#nephjc #PedsICU
Israel rivas @Israrivas123
RT @edgarvlermamd: Vitamin D 101 from @RenalFellowNtwk #Nephpearls #CKDMBD #NephJC 👉🏼 https://t.co/JXARB4h3PH https://t.co/uJIQnaUYzK
Nimra Sarfaraz @DrNimraS
RT @edgarvlermamd: Nephrolithiasis 101: Appearance of stones on urinary tract imaging #Nephpearls #NephJC http://t.co/HqTLgMCzXQ … … http:…
Mohamed Elkhatib @Elkhatibmmm66
RT @edgarvlermamd: Vitamin D analogs #CKDMBD #Nephpearls #NephSecrets #NephJC https://t.co/ZX6NzjY6nW
Mohamed Elkhatib @Elkhatibmmm66
RT @edgarvlermamd: Vitamin D supplementation in Stages 3-4 CKD Update ca. 2018 📌 25(OH)D < 15 should be treated irrespective of PTH 📌 25(…
Brandi Wynne @brandimwynne
RT @NephJC: If you haven’t, please sign up for our weekly newsletter https://t.co/5aumn8qL85 #NephJC
Khaled Shawwa @khaledshawwa
@hswapnil @JamesNovakNeph @NephJC If vitamin D were to comment on the biologic plausibility👇 #nephjc https://t.co/XMJEYLMsDd
Arshad Ali @docarshadali
RT @NephJC: If you haven’t, please sign up for our weekly newsletter https://t.co/5aumn8qL85 #NephJC
Saulo Fernández @saufdez
RT @edgarvlermamd: Vitamin D analogs #CKDMBD #Nephpearls #NephSecrets #NephJC https://t.co/ZX6NzjY6nW
Saulo Fernández @saufdez
RT @edgarvlermamd: Vitamin D supplementation in Stages 3-4 CKD Update ca. 2018 📌 25(OH)D < 15 should be treated irrespective of PTH 📌 25(…
Sejal P. Jobanputra @sejaljobanputra
RT @divyaa24: Are there any pediatric nephrologists around? Any views of how to treat these abnormalities in kids? gets very confusing but…
Thomasjordan1703 @Thomasjordan173
RT @edgarvlermamd: J-DAVID 🇯🇵 : Among patients on hemodialysis without SHPT, PO alfacalcidol DID NOT reduce the risk of a composite outcom…
Tess Harris @Elektra
RT @rheault_m: @dr_nikhilshah @JamesNovakNeph @NephJC Would love to see a pediatric dialysis trial of PTH targets looking at growth as an o…
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