#NephJC Transcript
Healthcare social media transcript of the #NephJC hashtag.
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See #NephJC Influencers/Analytics.
| Profile | Tweet |
|---|---|
 | Nephrology Journal Club @NephJC Tonight we are going to discuss the use of Difelikefalin in uremic pruritus? #NephJC |
 | Tiffany Caza @Tiff_Caza @NephJC I am! Looking forward to an exciting discussion as always 🙂. #nephjc |
 | KatieOverV @KatieKwonMD @NephJC Hi! Participating because @kidney_boy called me out for only tweeting at Kidney Week. So now I'm tweeting two whole days AFTER Kidney Week! Private practice, no COI. #NephJC |
 | Swapnil Hiremath @hswapnil@bsky.social @hswapnil Swapnil Hiremath from @OttawaHospital #NephJC cofounder Hemodialyser Struggle to help patients with pruritis No other CoI Pic from @rolandbastphoto https://t.co/4uLgKm3iAx |
| Nephrology Journal Club @NephJC Welcome everyone! This is Pablo Garcia @PabloGarciaMD, Nephrology Fellow @StanfordNeph live from Palo Alto, CA #NephJC |
| Nephrology Journal Club @NephJC If you are having #KidneyWk withdrawal syndrome as @Krystahllopathy please KALM!!! and join us we will take care of it with this #NephJC discussion about the KALM-1 trial |
 | Vipin Varghese @vipvargh Vipin Varghese, tuning in from New Orleans. #NephJC |
 | Vineet Behera @BeheraVineet Hi i am vineet behera from mumbai india #nsmc intern 2019 #NephJC.. Itching to discuss more about this topic.. no COI |
| Nephrology Journal Club @NephJC First, please introduce yourself and declare any Conflicts of Interest (COI) you may have. #NephJC |
 | Hector Madariaga, MD FASN 🇲🇽 @HecmagsMD Héctor Madariaga. No COI. Hi, everyone! From #PatriotsNation #Nephjc https://t.co/agpOZJhhuR |
 | Mario Funes, MD @MarioFunesMD Mario Funes. PGY3 IM Resident in New Brunswick, NJ. Awaiting match day! #NSMC intern 2019. No COI. #NephJC |
| Hector Madariaga, MD FASN 🇲🇽 @HecmagsMD @Tiff_Caza @NephJC Hi Tiffany. Hope all is well! :) #NephJC |
 | Dhwanil Patel @iheartkidneys Dhwanil Patel, fellow at NYU. Following along from NYC. #NephJC |
 | Dr. Divya Bajpai 🇮🇳 @divyaa24 #NephJC Hi Divya here, Nephrologist from Mumbai. #nsmc faculty. Super excited to learn how to decrease "The Itch" in our patients. No Coi |
 | NephroPOCUS @NephroP Abhilash Koratala #NSMC intern ☝️🏻 No COI #NephJC |
 | Anju Yadav MD FASN FNKF @docanjuyadav Anju Yadav from Philly. No COI #NephJC |
 | L. Parker Gregg @LParkerGregg1 Parker, nephrologist in Dallas, mostly lurking tonight. No COI. #NSMC intern #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil @iheartkidneys Hey Dhwanil! Nice meeting you at #KidneyWk- welcome to #NephJC |
 | Michelle Rheault @rheault_m @S_brimble Same. Michelle here. Lurking while driving around with kids. #nephjc COI in bio. |
 | Silvi Shah, MD, MS @silvishah Hi this is Silvi from UCincy no coi #nephJC |
| Nephrology Journal Club @NephJC #KidneyWk was a great meeting and one of the High-Impact Clinical Trials presented at the meeting was “Efficacy and Safety of Difelikefalin in Patients Undergoing Hemodialysis with Pruritus: Results from a Phase 3 Randomized, Controlled Study (KALM-1)” #NephJC https://t.co/oxqrDI6rpa |
 | Christian Bolanos @cg_bolanos Hi everyone, Christian Bolanos from @StanfordNeph no COI. #NephJC |
 | nilu desai @niludesai1 Hoping to learn how to say this new drug name #nephjc |
 | Bea Concepcion @KidneyBea_n Bea Concepcion, @VUMCKidney transplant nephrologist, no COI #nephjc |
| Nephrology Journal Club @NephJC Please take a look at @HSwapnil live coverage at #KidneyWk #NephJC https://t.co/LTPBhmS6lk |
 | Kenar Jhaveri @kdjhaveri RT @NephJC: #KidneyWk was a great meeting and one of the High-Impact Clinical Trials presented at the meeting was “Efficacy and Safety of Difelikefalin in Patients Undergoing Hemodialysis with Pruritus: Results from a Phase 3 Randomized, Controlled Study (KALM-1)” #NephJC https://t.co/oxqrDI6rpa |
 | Joel M. Topf, MD FACP @kidney_boy #NephJC Joel Topf here. College unexpectedly stopped by. Probably won’t be able to spend much time. |
 | Krystahl Andújar (grateful human bean) 🇵🇷 @Krystahllopathy RT @NephJC: If you are having #KidneyWk withdrawal syndrome as @Krystahllopathy please KALM!!! and join us we will take care of it with this #NephJC discussion about the KALM-1 trial |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil @ansakhuja @OttawaHospital @rolandbastphoto Hey Ankit! Nice to see you again #NephJC |
| Nephrology Journal Club @NephJC The KALM-1 trial was published at @NEJM and here is the paper #NephJC https://t.co/gEjFCZ8Zvq |
 | Khaled Shawwa @khaledshawwa Khaled Shawwa, Nephrology fellow, Rochester, MN. No COI. #NephJC |
 | Anna Burgner MD MEHP @anna_burgner Hi everyone! Gen nephrologist @VUMCKidney, no coi #NephJC |
| Dr. Divya Bajpai 🇮🇳 @divyaa24 @rheault_m @thePNRC Now that you brought it - as We treat both adults and kids here, I feel itch is very less in kids as compared to adults in our practice. Why? Does it have something to do with duration? #nephjc |
 | Ankit Sakhuja 🇺🇸 @ansakhuja @kidney_boy Hi Joel, #nephjc |
 | Timothy Yau @Maximal_Change Hi all, recovering from #KidneyWk, Tim Yau from @WUNephrology. Exciting trial, will be lurking until kids in bed, no COI #NephJC |
| Nephrology Journal Club @NephJC Here is the #VisualAbstract by @kidney_boy and thanks to the #NephJC team for their quick and actionable feedback on this visual abstract https://t.co/AQMecQRpKM |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @NephJC: The KALM-1 trial was published at @NEJM and here is the paper #NephJC https://t.co/gEjFCZ8Zvq |
| Krystahl Andújar (grateful human bean) 🇵🇷 @Krystahllopathy Hi, everyone! Krystahl Andújar here from Puerto Rico🇵🇷. No COI. |
| L. Parker Gregg @LParkerGregg1 RT @NephJC: Here is the #VisualAbstract by @kidney_boy and thanks to the #NephJC team for their quick and actionable feedback on this visual abstract https://t.co/AQMecQRpKM |
| Vipin Varghese @vipvargh RT @NephJC: Here is the #VisualAbstract by @kidney_boy and thanks to the #NephJC team for their quick and actionable feedback on this visual abstract https://t.co/AQMecQRpKM |
| Nephrology Journal Club @NephJC Check the #NephJC summary by @kidney_boy https://t.co/QbuWlWQYkh |
| Tiffany Caza @Tiff_Caza @NephJC Hi! I'm Tiff. I'm a kidney pathologist and have no COI. Looking forward to learning about this new trial 😁 #NephJC |
 | Edgar V. Lerma 🇵🇭 @edgarvlermamd Pruritus and Patient Reported Outcomes in Non-Dialysis CKD ca. 2019 from @CJASN #NephJC #Nephpearls 👉🏼 https://t.co/4lZkwE3WaG https://t.co/eWesX10Ixt |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @NephJC: Here is the #VisualAbstract by @kidney_boy and thanks to the #NephJC team for their quick and actionable feedback on this visual abstract https://t.co/AQMecQRpKM |
| Mario Funes, MD @MarioFunesMD Unusual drug name. Although remember is a Kappa opioid (enkephalins) receptor agonist. Mu receptor stimulations increases itching and kappa decrease itching. #NephJC |
| Hector Madariaga, MD FASN 🇲🇽 @HecmagsMD Me trying to pronounce difffhejsisffnin ...ahem... difelikefalin... #Nephjc https://t.co/Mqn4Sseg2R |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @edgarvlermamd: Pruritus and Patient Reported Outcomes in Non-Dialysis CKD ca. 2019 from @CJASN #NephJC #Nephpearls 👉🏼 https://t.co/4lZkwE3WaG https://t.co/eWesX10Ixt |
 | Samira Farouk, MD, MSCR @ssfarouk Samira, transplant nephrologist @ISMMSKidney #NephJC |
| Vipin Varghese @vipvargh RT @MarioFunesMD: Unusual drug name. Although remember is a Kappa opioid (enkephalins) receptor agonist. Mu receptor stimulations increases itching and kappa decrease itching. #NephJC |
| Nephrology Journal Club @NephJC RT @MarioFunesMD: Unusual drug name. Although remember is a Kappa opioid (enkephalins) receptor agonist. Mu receptor stimulations increases itching and kappa decrease itching. #NephJC |
| Nephrology Journal Club @NephJC T0: How many of your patients suffer from pruritus and tell us more about it #NephJC |
| Dr. Divya Bajpai 🇮🇳 @divyaa24 Still not sure how to pronounce it #NephJC |
 | Anitha Vijayan @VijayanMD Anitha Vijayan from Wash U St. Louis. No COI. Mostly lurking tonight. #nephjc |
| Edgar V. Lerma 🇵🇭 @edgarvlermamd International Comparisons of Prevalence, Awareness, and Treatment of Pruritus in People on Hemodialysis ca. 2017 from @CJASN #NephJC #Nephpearls 👉🏼 https://t.co/oLfZJHEuYn https://t.co/DmuDdvIHyh |
| Hector Madariaga, MD FASN 🇲🇽 @HecmagsMD Very cool design #NephJC |
 | Prakash Gudsoorkar @gudnephron #NephJC had to go back to basic physiology Guyton to look at the itch pathway and receptors. Had kept this topic optimal during Med school days. |
 | Cathy Quinlan @CathyQuinlan.bsky.social @KidneyCathy Cathy Quinlan. Paed neph. Have never seen uraemia priorities Lurking with jet lag. #nephjc no COI |
 | Gustavo Guevara Nolivos. @gpguevara_nefro @NephJC Hi, I'm Gustavo Guevara, Nephrologist from Ecuador. No COI #NephJC |
 | Mohamed E. Elrggal @M_Elraggal #nephjc Mohamed Elrggal, from Egypt, No COI |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil @NephJC Gets worse in winter Hydroxyzine is meh We recommend non-drying soap, good moisturizer A combo cream that @petermagner2 recs Is menthol + camphor + hydrocortisone #NephJC |
 | Sayna Norouzi, MD, FASN @SaynaNorouzi Hi this is Sayna; nephrology fellow; no CoI. #nephjc |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @NephJC: T0: T0: How many of your patients suffer from pruritus and tell us more about it #NephJC |
| Anju Yadav MD FASN FNKF @docanjuyadav Have few pts with itch. I make sure phos is well controlled. Next step is trai of a different dialyser, which has worked for me well for almost all pts. Some still on Benadryl. @hswapnil #NephJC |
| Edgar V. Lerma 🇵🇭 @edgarvlermamd Treatment of Uremic Pruritus: A Systematic Review ca. 2017 from @AJKDonline #NephJC #Nephpearls 👉🏼 https://t.co/Vq7UT4tRUv https://t.co/9GPeoljfo5 |
| Nephrology Journal Club @NephJC A @CJASN study found that at least 68% of the patients suffer from pruritus in the US. and 65% of medical directors estimated that, 5% of their patients suffered from severe pruritus #NephJC https://t.co/MQp2efKv0f https://t.co/cVFEo6vB0l |
| KatieOverV @KatieKwonMD @NephJC I feel like I really only talk about itching when I see Kyrle's lesions. Frustrating to treat. Ca x P doesn't seem to make a big difference. Have tried lotions, gabapentin, oral charcoal, capsaicin cream. . . #NephJC |
| Christian Bolanos @cg_bolanos @NephJC In our dialysis unit > than 70% of patients suffer from some kind of uremic pruritus, ranging from mild to severe #NephJC |
 | Nupur Gupta @nupur_nephron @KatieKwonMD @NephJC @kidney_boy Nupur Gupta, no coo, #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil @ansakhuja @MarioFunesMD Seems novel agent Absolutely right: either antihistamines or offlabel gabapentin at present Not great #NephJC |
| Hector Madariaga, MD FASN 🇲🇽 @HecmagsMD @divyaa24 Also known as D-Phe-D-Phe-D-Leu-D-Lys-[γ-(4-N-piperidinyl) amino carboxylic acid. #Itshard https://t.co/P6lbsbFJLA. #NephJC |
| Dr. Divya Bajpai 🇮🇳 @divyaa24 @KidneyCathy Yes somehow itch is very less in kids, we see it much more in adults than in kids #nephjc |
| Nephrology Journal Club @NephJC T0: Are your patients with pruritus suffer from restless sleep? #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @NephJC: A @CJASN study found that at least 68% of the patients suffer from pruritus in the US. and 65% of medical directors estimated that, 5% of their patients suffered from severe pruritus #NephJC https://t.co/MQp2efKv0f https://t.co/cVFEo6vB0l |
| Nephrology Journal Club @NephJC T0: A @CJASN study showed that patients with moderate pruritus had a higher prevalence of patient-reported depression and restless sleep compared with patients without pruritus. #NephJC https://t.co/FypLHIlYnZ |
| Dr. Divya Bajpai 🇮🇳 @divyaa24 @hswapnil @NephJC @petermagner2 Camphor does work in our experience. I started using it after my grandmother told that it's a household remedy for any itch #nephjc |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil @gpguevara_neph @NephJC Hi Gustavo! Welcome to #NephJC |
| Nephrology Journal Club @NephJC T0: How do you deal with the pruritus symptoms? Which medications do you use? #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil @divyaa24 @NephJC @petermagner2 I think the sublimation causes soothing/cooling effect? #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @NephJC: T0: T0: How do you deal with the pruritus symptoms? Which medications do you use? #NephJC |
| Anju Yadav MD FASN FNKF @docanjuyadav Any recs in dermatology consults??? #NephJC |
| Edgar V. Lerma 🇵🇭 @edgarvlermamd Pruritus in ESRD ca. 2017 from @AJKDonline #NephJC #Nephpearls 👉🏼 https://t.co/3LX8GpzhoC https://t.co/0hSxFk3DTJ |
| Mohamed E. Elrggal @M_Elraggal @divyaa24 @hswapnil @NephJC @petermagner2 Old is gold @divyaa24 #Nephjc |
| Mario Funes, MD @MarioFunesMD @hswapnil @ansakhuja Complex, many pathway, though novel emerging therapies. Great review of current therapies and mechanisms. #NephJC https://t.co/I6zyYQeNgR https://t.co/IyoeD4RNW7 |
 | Les @LBEBEN Pruritus as a herald to calciphylaxis is of great interest to us. |
 | Enzo Vásquez @renal_enzo @NephJC @kidney_boy Hi, I’m Enzo Vásquez, Nephrology Fellow from Mexico #Nephjc |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @MarioFunesMD: @hswapnil @ansakhuja Complex, many pathway, though novel emerging therapies. Great review of current therapies and mechanisms. #NephJC https://t.co/I6zyYQeNgR https://t.co/IyoeD4RNW7 |
| Nephrology Journal Club @NephJC T0: The pathogenesis of CKD–associated pruritus is not well understood #NephJC |
| Nephrology Journal Club @NephJC T0:Several hypotheses have been proposed, including metabolic disturbances, dysregulated immune response,and imbalances in the endogenous opioid system #NephJC |
| Vipin Varghese @vipvargh RT @MarioFunesMD: @hswapnil @ansakhuja Complex, many pathway, though novel emerging therapies. Great review of current therapies and mechanisms. #NephJC https://t.co/I6zyYQeNgR https://t.co/IyoeD4RNW7 |
| Nephrology Journal Club @NephJC T0: There is currently no approved therapy for uremic pruritus in the United States or Europe #NephJC |
| Anitha Vijayan @VijayanMD @NephJC Emollients/creams, diphenhydramine, hydroxyzine. Really nothing that works. #nephjc |
| Hector Madariaga, MD FASN 🇲🇽 @HecmagsMD Does anybody has any experience with UVB phototherapy for treating uremic pruritus? Any Derms in house? #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil @docanjuyadav We can ping @RoxanaDaneshjou to ask what Derm MDs think about referral for uremic pruritis #NephJC |
| Dr. Divya Bajpai 🇮🇳 @divyaa24 @NephJC Moisturizer, anti histsminics, CAMPHOR, sometimes liberalizing fluid intake and phos control helps too #nephjc |
| Hector Madariaga, MD FASN 🇲🇽 @HecmagsMD @gpguevara_neph @NephJC Bienvenido, Gustavo. #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil Sweet! First author in the house! #NephJC |
 | Dr. Guillén 🇲🇽 @drguillenvargas RT @NephJC: T0: T0: How many of your patients suffer from pruritus and tell us more about it #NephJC |
| Anitha Vijayan @VijayanMD @KatieKwonMD @docanjuyadav Derm has also prescribed urea cream!! #nephjc |
| Edgar V. Lerma 🇵🇭 @edgarvlermamd Pruritus Treatment algorithm for patients on hemodialysis from @BCRenalAgency #NephJC #Nephpearls https://t.co/wBiNDx9Jvy |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil @sfishbane Welcome to #NephJC Dr Fishbane! Great presentation at #KidneyWk |
| Nephrology Journal Club @NephJC @sfishbane Thanks for joining #NephJC |
| Nephrology Journal Club @NephJC T0: Difelikefalin (CR845) is a peripherally restricted, selective kappa opioid receptor agonist that exerts antipruritic effects by means of activation of kappa opioid receptors on peripheral neurons and immune cells #NephJC |
| Hector Madariaga, MD FASN 🇲🇽 @HecmagsMD @renal_padawan @NephJC @kidney_boy Bienvenido, Enzo! :) #NephJC |
| Nephrology Journal Club @NephJC RT @hswapnil: Sweet! First author in the house! #NephJC |
| Nephrology Journal Club @NephJC T0: Tonight we will discuss the results of the KALM-1 trial. A phase 3 trial evaluating the efficacy and safety of difelikefalin in adult patients undergoing hemodialysis who had moderate-to-severe pruritus #NephJC |
 | Vincent Anthony Tang @VASTangMD RT @edgarvlermamd: Pruritus Treatment algorithm for patients on hemodialysis from @BCRenalAgency #NephJC #Nephpearls https://t.co/wBiNDx9Jvy |
 | Franklin Loachamin @FranLoachamin Good night #NephJC Franklin Loachamin, Quito Ecuador no COI |
| Nephrology Journal Club @NephJC T1: Let us start with the methods. KALM-1 was a randomized, double-blind, placebo-controlled, phase 3 trial that was conducted at 56 sites in the United States #NephJC |
| Mohamed E. Elrggal @M_Elraggal #Nephjc |
| KatieOverV @KatieKwonMD @edgarvlermamd @BCRenalAgency If 70% of my patients have pruritis and changing the dialyzer is part of the treatment algorithm, maybe I'm just stocking the wrong dialyzers? What's the success rate of that maneuver? #NephJC |
| Nephrology Journal Club @NephJC T1: Eligible patients were adults (≥18 years of age) with end-stage kidney disease who had been undergoing hemodialysis at least three times per week for at least 3 months and who had moderate-to-severe pruritus #NephJC |
| Anitha Vijayan @VijayanMD @KatieKwonMD @docanjuyadav I thought so too - but apparently a Tx for dry skin — 70% urea cream #nephjc |
| Nephrology Journal Club @NephJC T1: Moderate-to-severe pruritus was defined as a weekly mean score of more than 4 points on the 24-hour Worst Itching Intensity Numerical Rating Scale (WI-NRS)The WI-NRS is a validated 11-point scale, with higher scores indicating greater itch intensity #NephJC https://t.co/LZLOMouady |
| Nephrology Journal Club @NephJC T1: The mean score was calculated with the use of daily assessments performed during a 7-day run-in period before randomization #NephJC |
 | Charbel C Khoury @Charbel_Khoury @VijayanMD @NephJC I tend to reach for Sertraline or gabapentin #nephjc |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @NephJC: T1: T1: Moderate-to-severe pruritus was defined as a weekly mean score of more than 4 points on the 24-hour Worst Itching Intensity Numerical Rating Scale (WI-NRS)The WI-NRS is a validated 11-point scale, with higher scores indicating greater itch intensity #NephJC https://t.co/LZLOMouady |
| Anitha Vijayan @VijayanMD @KatieKwonMD @docanjuyadav #nephjc - also on Amazon :-) https://t.co/tdhsUGJAUF |
| Nephrology Journal Club @NephJC T1: For those who love the details here is the complete inclusion and exclusion criteria (supplement) #NephJC https://t.co/x40NMTrCjl |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @NephJC: T1: T1: For those who love the details here is the complete inclusion and exclusion criteria (supplement) #NephJC https://t.co/x40NMTrCjl |
| Mario Funes, MD @MarioFunesMD I would be ideal to find a common substance/receptor to all the known pruritus pathways. Like PPI vs H2 Blockers. #NephJC |
| Nephrology Journal Club @NephJC T1: Eligible patients were randomly assigned (in a 1:1 ratio) to receive intravenous difelikefalin (at a dose of 0.5 μg per kilogram of body weight) or matched placebo three times per week for 12 weeks #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil @NephJC Well done @PabloGarciaMD #NephJC https://t.co/QhNabdw71V |
| Dr. Divya Bajpai 🇮🇳 @divyaa24 @VijayanMD @KatieKwonMD @docanjuyadav Does this work? #nephjc |
| KatieOverV @KatieKwonMD @VijayanMD @docanjuyadav They recommend it for keratosis pilaris as well ("chicken skin" bumps) but the smell can be problematic. I understood it to be a mild chemical exfoliant. Lots of different brands at Ulta and Sephora if you're fancy. #NephJC |
| Nephrology Journal Club @NephJC T1: Difelikefalin or placebo was administered as an intravenous bolus into the venous port of the dialysis circuit after each dialysis session #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @NephJC: T1: T1: Difelikefalin or placebo was administered as an intravenous bolus into the venous port of the dialysis circuit after each dialysis session #NephJC |
 | TEJAS PATEL MD, FACP, FASN @GenNextMD @Charbel_Khoury @VijayanMD @NephJC Placebo..hard to know if it really works..any med that is used from pruritus to urinary incontinence..we got problem understanding the drug, not just the disease..#nephjc |
| Mohamed E. Elrggal @M_Elraggal RT @NephJC: T1: T1: Difelikefalin or placebo was administered as an intravenous bolus into the venous port of the dialysis circuit after each dialysis session #NephJC |
| Nephrology Journal Club @NephJC T1: Concomitant treatment with stable doses of antihistamines, glucocorticoids, opioids, gabapentin, and pregabalin was permitted if used at the time of the screening visit #NephJC |
| Nephrology Journal Club @NephJC T1: But the initiation of new antipruritic medications after the screening visit was prohibited #NephJC |
| Mario Funes, MD @MarioFunesMD Is pruritus more common in HD or PD patients? #NephJC |
| Edgar V. Lerma 🇵🇭 @edgarvlermamd Management of pruritus in patients with CKD ca. 2017 from @BCRenalAgency #NephJC #Nephpearls 👉🏼 https://t.co/r89y98bUIy https://t.co/qsaEHBcIE5 |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil @MarioFunesMD Itch is complex. Also subjective - eg mirror therapy helps some patients - see @Atul_Gawande https://t.co/no800i1PYa #NephJC |
| Hector Madariaga, MD FASN 🇲🇽 @HecmagsMD @NephJC Is this a validated score? I see it’s used a lot in patients with psoriasis, but I’d assume the same principles are applied to patients with uremic pruritus…? #NephJC |
| Nephrology Journal Club @NephJC T1: During the 12-week intervention period, patients reported their worst itching intensity over the past 24 hours daily using the WI-NRS #NephJC |
| Prakash Gudsoorkar @gudnephron #NephJC Found this article interesting. https://t.co/3CR5ghKTsq https://t.co/qid7YkaKDZ |
| Nephrology Journal Club @NephJC T1: Itch-related quality of life was measured with the use of two validated instruments, the 5-D itch and the Skindex-10 multidimensional questionnaires #NephJC |
 | devika nair md msci @devimol @NephJC was the use of these medications adjusted for (or otherwise accounted for) in the final analyses? #NephJC |
| Nephrology Journal Club @NephJC T1: After the completion of the 12-week intervention period, patients entered a 2-week discontinuation period during which no difelikefalin or placebo was administered #NephJC |
| Mohamed E. Elrggal @M_Elraggal RT @edgarvlermamd: Management of pruritus in patients with CKD ca. 2017 from @BCRenalAgency #NephJC #Nephpearls 👉🏼 https://t.co/r89y98bUIy https://t.co/qsaEHBcIE5 |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil Brand name will be ‘Korsuva’ for Difelikefalin Funny when that sounds promising/like breaking news #NephJC |
| Nephrology Journal Club @NephJC T1: Patients, research staff, and the sponsor (Cara Therapeutics) trial team remained unaware of the trial-group assignments at all times. #NephJC |
| Mario Funes, MD @MarioFunesMD @hswapnil @Atul_Gawande Yes, I agree. I'm still amazed about placebo effect in RCTs. Almost 30% showed improvement in the placebo group. #NephJC |
| Mohamed E. Elrggal @M_Elraggal RT @edgarvlermamd: Pruritus Treatment algorithm for patients on hemodialysis from @BCRenalAgency #NephJC #Nephpearls https://t.co/wBiNDx9Jvy |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil #NephJC |
| Nephrology Journal Club @NephJC T1: The primary efficacy outcome was the percentage of patients who had an improvement (decrease) of at least 3 points from baseline at week 12 in the weekly mean score on the daily WI-NRS #NephJC |
| Nephrology Journal Club @NephJC T1: The prespecified secondary efficacy outcomes were the mean change from baseline at week 12 in the 5-D itch scale total score, the mean change from baseline at week 12 in the Skindex-10 scale total score, #NephJC |
| Hector Madariaga, MD FASN 🇲🇽 @HecmagsMD @MarioFunesMD I think is independent of type of dialysis or etiology of ESKD. Even ethnicity. #NephJC |
| Mohamed E. Elrggal @M_Elraggal RT @prakashneph: #NephJC Found this article interesting. https://t.co/3CR5ghKTsq https://t.co/qid7YkaKDZ |
| TEJAS PATEL MD, FACP, FASN @GenNextMD @hswapnil When is expected to arrive commercially? Cost? Sorry to jump the gun! #nephjc @NephJC |
| Nephrology Journal Club @NephJC #nephjc |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @MarioFunesMD: Is pruritus more common in HD or PD patients? #NephJC |
| Nephrology Journal Club @NephJC T1: and the percentage of patients who had an improvement (decrease) of at least 4 points from baseline at week 12 in the weekly mean WI-NRS score #NephJC |
| Dhwanil Patel @iheartkidneys #NephJC https://t.co/btR5Q67V1C |
| Nephrology Journal Club @NephJC T1: The authors calculated that a planned sample of 350 patients would provide the trial with 79% to 90% or greater power to detect a between-group difference ranging from 15 to 20 percentage points in the primary outcome #NephJC |
 | Flory Tsobo Muanda @FloryTsobo RT @hswapnil: The #NephJC poster tour continues at 872 Could baclofen be bad for people with CKD? Also published in @JAMA_current https://t.co/77TyqoYdKU from @ICESOntario #KidneyWk https://t.co/v54eIufc3G |
| Nephrology Journal Club @NephJC T1: The trial was funded by Cara Therapeutics, the maker of this drug #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil @GenNextMD @NephJC We should ping @sfishbane on those questions #NephJC You can see we are eager to help our patients with this vexing issue! |
| Nephrology Journal Club @NephJC T2: Any questions on the methods? #NephJC |
| Hector Madariaga, MD FASN 🇲🇽 @HecmagsMD Korsuva is the trade name for difelikefalin #NephJC |
| Charbel C Khoury @Charbel_Khoury Any input from our @WUSTLmed Itch Doctor @itchdoctor on Difelikefalin?#NephJC https://t.co/ry8igybaEB |
| Nephrology Journal Club @NephJC T2: Lets move to the results #NephJC |
| TEJAS PATEL MD, FACP, FASN @GenNextMD @NephJC Percentage drop out same in each arm? #nephjc |
| Nephrology Journal Club @NephJC T2: They enrolled and randomized 378 patients #NephJC https://t.co/kldIPtTqAE |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @NephJC: T2: T2: They enrolled and randomized 378 patients #NephJC https://t.co/kldIPtTqAE |
| Mario Funes, MD @MarioFunesMD @HecmagsMD @NephJC WI-NRS is a validated score, but seems like the Skindex-10 (part of secondary outcomes) was validated and developed for uremic pruritus. #NephJC https://t.co/nyaQCf5QEE https://t.co/M5X24XyxP4 |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil @VijayanMD Definitely something @Incant8n might use 😏#NephJC |
| Nephrology Journal Club @NephJC T2: You can see the demographics and baseline characteristics in Table 1 #NephJC https://t.co/9EuzC1SxoT |
| Nephrology Journal Club @NephJC T2: Concomitant use of an antipruritic medication was reported by 38.1% of the patients in the difelikefalin group and by 41.5% of patients in the placebo group #NephJC https://t.co/SGh5iNq0ob |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil @NephJC How come no one was on gabapentin @sfishbane? Is it not used in US? #NephJC |
| Edgar V. Lerma 🇵🇭 @edgarvlermamd Low-Dose Doxepin for Treatment of Pruritus in Patients on Hemodialysis ca. 2007 #NephJC #Nephpearls 👉🏼 https://t.co/urV5bBvwvY https://t.co/xq8ShrXOeT |
| Hector Madariaga, MD FASN 🇲🇽 @HecmagsMD RT @MarioFunesMD: @HecmagsMD @NephJC WI-NRS is a validated score, but seems like the Skindex-10 (part of secondary outcomes) was validated and developed for uremic pruritus. #NephJC https://t.co/nyaQCf5QEE https://t.co/M5X24XyxP4 |
| Charbel C Khoury @Charbel_Khoury @GenNextMD @VijayanMD @NephJC That’s how I preface my suggestion to the patients, it may not work but we can try it #NephJC |
| Prakash Gudsoorkar @gudnephron RT @edgarvlermamd: Pruritus Treatment algorithm for patients on hemodialysis from @BCRenalAgency #NephJC #Nephpearls https://t.co/wBiNDx9Jvy |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil @NephJC @sfishbane & was also curious how time since ESRD longer than time on HD? Perhaps a few patients with failed PD or transplants? #NephJC https://t.co/vwaDWrEcHd |
| Nephrology Journal Club @NephJC #NephJC How come no one was on gabapentin ? Is it not used in US? @hswapnil |
| Nephrology Journal Club @NephJC T2: Primary outcome #NephJC |
| TEJAS PATEL MD, FACP, FASN @GenNextMD @hswapnil @NephJC @sfishbane Neuromodulator and may alter the efficacy?? #nephjc |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil #NephJC |
 | Jennie Lin 👩🏻⚕️🧬 @jenniejlin @NephJC Hi, joining super late due to scrounging up NSAIDs for super sore arms. The reason will become apparent in the near future. No COI #NephJC |
| Nephrology Journal Club @NephJC T2: At week 12, the estimated percentage of patients who had an improvement (decrease) of at least 3 points from baseline on the WI-NRS was significantly greater in the difelikefalin group than in the placebo group (49.1% vs. 27.9%) #NephJC https://t.co/EWd0dw9kiQ |
| Hector Madariaga, MD FASN 🇲🇽 @HecmagsMD @hswapnil @NephJC @sfishbane I think some patients were on gabapentin, right? #NephJC https://t.co/j1uowDs4qK |
| Nephrology Journal Club @NephJC T2: The treatment effect was evident at weeks 1-2 #NephJC https://t.co/gvaV8w2YTh |
| Nephrology Journal Club @NephJC T2: Secondary outcomes #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil @HecmagsMD @NephJC @sfishbane Was permitted, but none on it from table 1 #NephJC https://t.co/99pdWu5QML |
| KatieOverV @KatieKwonMD @NephJC Do we know on this scale what kind of reduction is meaningful to patients? #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @NephJC: T2: T2: The treatment effect was evident at weeks 1-2 #NephJC https://t.co/gvaV8w2YTh |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @NephJC: T2: T2: At week 12, the estimated percentage of patients who had an improvement (decrease) of at least 3 points from baseline on the WI-NRS was significantly greater in the difelikefalin group than in the placebo group (49.1% vs. 27.9%) #NephJC https://t.co/EWd0dw9kiQ |
| Nephrology Journal Club @NephJC T2: All secondary outcomes showed significant improvement with difelikefalin as compared with placebo #NephJC https://t.co/TKzOW0Y2q9 |
| Nephrology Journal Club @NephJC @KatieKwonMD The categorical threshold of a decrease of at least 3 points was selected on the basis of a psychometric analysis of data from a previous phase 2 that showed that a 3-point decrease represented a clinically meaningful improvement in itch intensity in this patient group #NephJC |
| Hector Madariaga, MD FASN 🇲🇽 @HecmagsMD @hswapnil @NephJC @sfishbane Got it #NephJC |
| Nephrology Journal Club @NephJC T2: there were very high rate of adverse events but they were generally balanced between groups with the exception of diarrhea, vomiting, and dizziness which were all increased with difelikefalin compared to placebo #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil @KatieKwonMD @NephJC @sfishbane Ahhhhh Makes sense - they are associated badness eg https://t.co/YhBA4IZk7n from @JASN_News #NephJC |
| KatieOverV @KatieKwonMD @NephJC Thanks - looks like the intervention group (can't even type the drug much less say it) barely made it to the 3 point threshold by the end. #NephJC |
| Nephrology Journal Club @NephJC T2: Serious adverse events occurred in 49 patients (25.9%) in the difelikefalin group and in 41 patients (21.8%) in the placebo group during the 12-week intervention period #NephJC https://t.co/fqgYEPSF53 |
| Mohamed E. Elrggal @M_Elraggal RT @NephJC: T2: T2: there were very high rate of adverse events but they were generally balanced between groups with the exception of diarrhea, vomiting, and dizziness which were all increased with difelikefalin compared to placebo #NephJC |
| Michelle Rheault @rheault_m @NephJC Is diarrhea, dizziness, and vomiting better than itching? #NephJC |
| Mohamed E. Elrggal @M_Elraggal RT @hswapnil: @KatieKwonMD @NephJC @sfishbane Ahhhhh Makes sense - they are associated badness eg https://t.co/YhBA4IZk7n from @JASN_News #NephJC |
| Nephrology Journal Club @NephJC T3: what do you think about this drug? Would you prescribe this drug? Tell us more #NephJC |
| Dr. Divya Bajpai 🇮🇳 @divyaa24 @hswapnil @NephJC @sfishbane In our setup, HD is delayed till they have really severe uremic symptoms which warrant HD, so not surprising. what is your practice? #nephjc |
| TEJAS PATEL MD, FACP, FASN @GenNextMD @NephJC Interesting nasopharyngitis was considered serious adr. If we remove that it’s looks better. #nephjc |
| TEJAS PATEL MD, FACP, FASN @GenNextMD @rheault_m @NephJC In placebo you mean? 😅 #nephjc |
| KatieOverV @KatieKwonMD So I wish they had used an overall quality of life measure like KDQOL. Would like to know if the drug with its side effects was a net positive in patients' well-being. #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil @divyaa24 @NephJC @sfishbane Well I don’t call it ESKD until they are on HD/PD - it’s CKD5 ND till then #NephJC |
| Edgar V. Lerma 🇵🇭 @edgarvlermamd KALM-1: Efficacy and Safety of Difelikefalin in Patients Undergoing Hemodialysis with Pruritus: Results from a Phase 3 Randomized, Controlled Study from @sfishbane @NEJM #VisualAbstract by @kidney_boy #NephJC #Nephpearls 👉🏼 https://t.co/RlgtMWAymj https://t.co/eDj2lkyAAU |
| Nephrology Journal Club @NephJC T3: Are you ok with less itching vs slightly more diarrhea or dizziness? #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @KatieKwonMD: So I wish they had used an overall quality of life measure like KDQOL. Would like to know if the drug with its side effects was a net positive in patients' well-being. #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @NephJC: T3: T3: what do you think about this drug? Would you prescribe this drug? Tell us more #NephJC |
| TEJAS PATEL MD, FACP, FASN @GenNextMD @NephJC Nephros are hard sell...#nephjc |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil @NephJC I would discuss with patients A trial may be appropriate Though cost/coverage will be an issue given IV drug #NephJC |
| Dr. Divya Bajpai 🇮🇳 @divyaa24 @rheault_m @NephJC Good question. Mostly will depend on severity of itching. But personally would prefer itching as compared to these. #nephjc |
| Nephrology Journal Club @NephJC T3: For that 22% who wants more data...an open label continuation of the trial is ongoing so we need to wait for more results #NephJC |
| TEJAS PATEL MD, FACP, FASN @GenNextMD @KatieKwonMD @NephJC ..and we got bundled! 😊 #nephjc |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @NephJC: T3: T3: For that 22% who wants more data...an open label continuation of the trial is ongoing so we need to wait for more results #NephJC |
| Michelle Rheault @rheault_m @KatieKwonMD @GenNextMD @NephJC When approved, will this be part of the bundle?? It’s never going to be prescribed. #nephjc |
| Nephrology Journal Club @NephJC T3: Cara therapeutics is running some trials on an oral medication and BTW the commercial name seems to be Korsuva #NephJC |
| Hector Madariaga, MD FASN 🇲🇽 @HecmagsMD @NephJC Shared decision making . Which one is the lesser evil? #nephjc |
| Mohamed E. Elrggal @M_Elraggal #nephjc |
| Nephrology Journal Club @NephJC T3: here is from the Cara tx website #NephJC https://t.co/bMfylidegc |
| Nephrology Journal Club @NephJC T3: do we need more RCTs and if so, what is a good comparator, gabapentinoids? #NephJC |
| Khaled Shawwa @khaledshawwa @NephJC It might depend on when would the diarrhea occur, might interfere with completing the hemodialysis run. In the end, it’s a shared-decision making process #NephJC |
| KatieOverV @KatieKwonMD @sfishbane My thinking is that if they feel overall better despite any side effects that's a win for the drug. I've been surprised in reviewing KDQOLs in patients who've had significant physical health setbacks that their overall well-being scores haven't changed. #NephJC |
| TEJAS PATEL MD, FACP, FASN @GenNextMD @rheault_m @KatieKwonMD @NephJC That would not be good for the company..put in a lot of effort to bring it to the market. #nephjc |
| Nephrology Journal Club @NephJC #NephJC |
| Tiffany Caza @Tiff_Caza RT @MarioFunesMD: @hswapnil @ansakhuja Complex, many pathway, though novel emerging therapies. Great review of current therapies and mechanisms. #NephJC https://t.co/I6zyYQeNgR https://t.co/IyoeD4RNW7 |
| Hector Madariaga, MD FASN 🇲🇽 @HecmagsMD #NephJC |
| Anitha Vijayan @VijayanMD @rheault_m @KatieKwonMD @GenNextMD @NephJC Hope not in bundle 🤞#nephjc |
| Michelle Rheault @rheault_m #NephJC |
| Khaled Shawwa @khaledshawwa @NephJC Off-label use of molecular adsorbent recirculating system (MARS) for refractory pruritis. #NephJC |
| Mario Funes, MD @MarioFunesMD @NephJC If proved to be better and safer than antihistamines and gabapentinoids then it will be easier to adopt it. In real life likely used on conjunction with other modalities. #NephJC |
| Kenar Jhaveri @kdjhaveri RT @NephJC: T0: T0: A @CJASN study showed that patients with moderate pruritus had a higher prevalence of patient-reported depression and restless sleep compared with patients without pruritus. #NephJC https://t.co/FypLHIlYnZ |
| KatieOverV @KatieKwonMD More about the SKINDEX scale here: https://t.co/r5zDMVVQIJ #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @KatieKwonMD: More about the SKINDEX scale here: More about the SKINDEX scale here: https://t.co/r5zDMVVQIJ #NephJC |
| Nephrology Journal Club @NephJC Thanks to all for joining us in this discussion and thanks Dr. Fishbane @sfishbane for joining @HofstraKidney #NephJC |
| Nephrology Journal Club @NephJC Please sign up for our weekly, fun and informative newsletter here: https://t.co/5aumn8qL85 #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @NephJC: Thanks to all for joining us in this discussion and thanks Dr. Fishbane @sfishbane for joining @HofstraKidney #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @NephJC: Please sign up for our weekly, fun and informative newsletter here: Please sign up for our weekly, fun and informative newsletter here: https://t.co/5aumn8qL85 #NephJC |
| Dr. Divya Bajpai 🇮🇳 @divyaa24 @hswapnil @NephJC @sfishbane O...I used to call all CKD stage V as ESKD?? May be I'm wrong. Which definition we are following here? #nephjc |
| TEJAS PATEL MD, FACP, FASN @GenNextMD @eric_weinhandl @rheault_m @KatieKwonMD @NephJC U mean anti-innovation..company has essentially 2 yrs to recoup the cost if that is the case..hard to attract new drugs in this space...#nephjc |
| Nephrology Journal Club @NephJC Join us tomorrow for the Asian chat and the EU chat #NephJC https://t.co/ydLndohgG9 |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @NephJC: Join us tomorrow for the Asian chat and the EU chat #NephJC https://t.co/ydLndohgG9 |
| TEJAS PATEL MD, FACP, FASN @GenNextMD RT @GenNextMD: @eric_weinhandl @rheault_m @KatieKwonMD @NephJC U mean anti-innovation..company has essentially 2 yrs to recoup the cost if that is the case..hard to attract new drugs in this space...#nephjc |
| Mario Funes, MD @MarioFunesMD RT @NephJC: Join us tomorrow for the Asian chat and the EU chat #NephJC https://t.co/ydLndohgG9 |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil The drug does seem promising. Easy to administer. No CNS side effects Cost will be a major consideration of course #nephjc |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil Should there be a gabapentin vs difelikefalin RCT? Or make sure add-on (ie both) are still safe - if we use that combo in recalcitrant situations! #NephJC |
| Mario Funes, MD @MarioFunesMD Great chat today! Thank you @PabloGarciaMD for hosting and well done last minute summary and VA by the boss @kidney_boy. #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil Do read the #PatientVoice feature from our last #NephJC pruritis chat, from @suziekjos here https://t.co/tZ009oSlhS |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil And this video https://t.co/runnJ8ySeL from the @midlandhighnhs team #NephJC |
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