#NephJC Transcript
Healthcare social media transcript of the #NephJC hashtag.
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See #NephJC Influencers/Analytics.
| Profile | Tweet |
|---|---|
 | Nephrology Journal Club @NephJC Welcome to tonight’s discussion on the role of cystatin C in prediction #NephJC https://t.co/X7XiSHU5mG |
 | Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @AravindCheruku1 Me too #nephjc |
| Nephrology Journal Club @NephJC Your host tonight is @hswapnil from @OttawaRenal, so better make sure you have read the supplement https://t.co/NCNIyen6fG #NephJC |
| Nephrology Journal Club @NephJC Please introduce yourself & declare any conflicts of interest (COIs) & Don’t forget the hashtag, it’s #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @AravindCheruku1 Me too #nephJC |
 | Kenar Jhaveri @kdjhaveri RT @NephJC: Your host tonight is @hswapnil from @OttawaRenal, so better make sure you have read the supplement https://t.co/NCNIyen6fG #NephJC |
 | James Novak, MD PhD FACP FASN FNKF @JamesNovakNeph @NephJC James Novak, @HFNephrology TPD, NSMC intern 2018, no COI. #NephJC |
 | Swapnil Hiremath @hswapnil@bsky.social @hswapnil Swapnil Hiremath from @OttawasDofM There’s supplementary tables and extended tables - make sure you read all of them! #NephJc Pic from @rolandbastphoto https://t.co/oGB0MNTKMI |
 | Silvi Shah, MD, MS @silvishah Hi this is Silvi from UCincy no coi #nephJC |
 | Matthew Sparks, MD @Nephro_Sparks Matt Sparks, Durham NC, reporting for duty. no COI #NephJC |
| Nephrology Journal Club @NephJC PSA: Try the native client in browser (https://t.co/LkGCHacSvg) or Tweetdeck (Tchat will truncate your tweets at 140 characters) #NephJC |
 | Aravind Cherukuri PhD MRCP (UK) @AravindCheruku1 #nephjc Aravind Cherukuri from Pittsburgh. No COI, but will be in the group of creatinine haters! |
| Nephrology Journal Club @NephJC Hiya Matt, Kevin, Silvi, Aravind, James! #nephjc |
 | Edgar V. Lerma 🇵🇭 @edgarvlermamd Edgar Lerma, Chicago-based Nephrologist #NephJC Photo Credit: Barry Butler Photography 📸 https://t.co/eWMVI6KFon https://t.co/VawGmmxJ3y |
 | Nathaniel Reisinger @nephrothaniel Nathaniel nephrologist #NephJC |
| Nephrology Journal Club @NephJC New to #NephJC? Check out this helpful tipsheet from @Stones_ https://t.co/hTTxDX14O6 |
 | Gates Colbert, MD @DoctorGates Dallas Nephrologist. Glad to be back after a few weeks of missing. No COI. #NephJC |
 | Michelle Starr MD MPH @mcstarr1 Michelle Starr, peds neph at @IUPedsKidney. No COI, except I use a lot of cystatin C in my pediatric and neonatal patients! #nephjc |
 | Angel Cesar Ortiz @AngelCesarOrtiz Hi everyone! Angel Ortiz from Mexico. No COI #NephJC |
 | Aisha Shaikh @aishaikh Aisha Shaikh from NYC - no COI #NephJC |
 | Joel M. Topf, MD FACP @kidney_boy Joel Topf, clinical nephrologist. COI: I think nephrology's genuflection to GFR is a big problem. GFR is only one dimension of the multidimensional disease of CKD. #NephJC |
 | Jochen Reiser MD PhD @JochenReiser RT @edgarvlermamd: Edgar Lerma, Chicago-based Nephrologist #NephJC Photo Credit: Barry Butler Photography 📸 https://t.co/eWMVI6KFon https://t.co/VawGmmxJ3y |
| Nephrology Journal Club @NephJC Hi Gates, Nathaniel, Angel, Aisha and Edgar - and Michelle Starr #nephjc |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 #nephjc @gratefull080504 : checking in from Chicago COI: @eGenesisBio @GileadSciences Bayer, Chiesi @OtsukaUS @TapCloudHealth Excited about the topic! |
| Nephrology Journal Club @NephJC Tonight, we are discussing the observational study in @NatureMedicine on cystatin C Link https://t.co/HTeZ1AF7FZ #NephJC |
 | Jefferson L. Triozzi, M.D. @nepherson @NephJC Jefferson, internal medicine resident at Baylor COM in Houston, TX, no COI #nephjc |
 | KatieOverV @KatieKwonMD Katie Kwon, private practice in SW Michigan. Lurking tonight. #NephJC |
 | Gerren Hobby @ghobby Gerren Hobby joining. Private practice nephrologist. No COI. #NephJC |
| Nephrology Journal Club @NephJC Abbreviations: CVD: cardiovascular disease uACR = urinary albumin:creatinine ratio eGFR = estimated GFR Cr = creatinine Cys = cystatin C #NephJC |
 | Michelle Rheault @rheault_m @NephJC Michelle here lurking. #NephJC Trying not to freeze to death. https://t.co/Q9OLlnNJ8Z |
| Nephrology Journal Club @NephJC Christian, Gerren, Joel, Katie, Jefferson and Michelle R - whew! #nephjc |
 | Dhwanil Patel @iheartkidneys Dhwanil, renal fellow. COI, what does that even mean? ;) #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @Nephro_Sparks Hi @Nephro_Sparks ! Great selection for tonight's #nephjc chat. |
| James Novak, MD PhD FACP FASN FNKF @JamesNovakNeph @kidney_boy Yeah, but it’s hard to quantify the other things...#NephJC |
| Nephrology Journal Club @NephJC Haven’t read the paper? Check out the excellent summary from @Stones_ https://t.co/Z4LTsfdV5v #NephJC |
| Edgar V. Lerma 🇵🇭 @edgarvlermamd GFR by differing measures, albuminuria and prediction of CVD, mortality and ESKD ca. 2019 from @NatureMedicine #VisualAbstract by @krithicism #NephJC #Nephpearls 👉🏼 https://t.co/ws6VUnmU9I https://t.co/9rnJRkn6ZM |
 | Krithika Mohan @krithicism Hi this is Krithika, nephrology fellow from India, no COI #NephJC |
| Nephrology Journal Club @NephJC T0 warmup How many of you already use Cystatin. C? #NephJC twitter poll |
 | Marvin Gonzalez. MD, Ph.D @MarvinGonzlez16 Hi everyone!, Marvin González. From Nicaragua. No COI. This a very important topic for nephrologist and epidemiologist. #NephJC |
| Aravind Cherukuri PhD MRCP (UK) @AravindCheruku1 @NephJC #nephjc it takes very little for me to use it |
 | Ian McCoy, MD, MS @NephroNinja Ian McCoy, Palo Alto. No COI. #nephjc |
| Nephrology Journal Club @NephJC And the #VisualAbstract from @krithicism #NephJC https://t.co/8wAXnpuap3 |
 | Anubha Mutneja @AnubhaMutneja Hi this is Anubha Mutneja from WashU No COI #NephJC |
| Joel M. Topf, MD FACP @kidney_boy @JamesNovakNeph That makes nephrology sound like the drunk looking for his keys. #NephJC https://t.co/YEbrcdA67B |
| Nephrology Journal Club @NephJC Hi Marvin, Anubha, Dhwanil, Ian, Krithika! #nephjc |
| Joel M. Topf, MD FACP @kidney_boy And the designer of tonight's #VisualAbstract #NephJC |
| Edgar V. Lerma 🇵🇭 @edgarvlermamd Factors that limit the use of eGFR from creatinine and cystatin C #Nephpearls #NephSecrets #NephJC https://t.co/nahNyxyKDd |
 | Anitha Vijayan @VijayanMD Anitha Vijayan from Wash U. No COI mostly lurking tonight #NephJC |
| Nephrology Journal Club @NephJC follow up T0 if you use cys C in specific situations, when are these? #NephJC |
| Nephrology Journal Club @NephJC RT @kidney_boy: And the designer of tonight's #VisualAbstract #NephJC |
| James Novak, MD PhD FACP FASN FNKF @JamesNovakNeph @NephJC I find cystatin C useful to confirm good kidney function in someone whose creatinine is suspiciously high (high muscle mass, creatinine efflux inhibitors, etc.). Otherwise, little additional clinical utility. #NephJC |
| Joel M. Topf, MD FACP @kidney_boy Oh, I guess I do have relevant COI. #NephJC |
| Nephrology Journal Club @NephJC vote in this twitter poll https://t.co/HtXtBiDsma #nephjc |
| Ian McCoy, MD, MS @NephroNinja Anyone know the cost different between cystatin C and creatinine measurement? Can cystatin C be measured on the same equipment? #nephjc |
 | rupali92 @rupali921 Hi there, Have a good day. Are you looking for a graphic designer for design a #flat/minimal, #Mortagage, #logo #banner #poster #buisness card something design?? if you have 1 minute please visit my profile with your valuable time link: https://t.co/ZrYDKxJaqm |
| Joel M. Topf, MD FACP @kidney_boy The only time I see cystatin C is when a patient comes to me for a second opinion and brings it with them. Just not part of what I do. #NephJC |
| Nephrology Journal Club @NephJC Did you know that @NICEComms recommends use of cystatin C for confirmation of CKD diagnosis? (I did not) #NephJC DOes @nkf have any position on this? Other places? |
 | Gustavo Guevara Nolivos. @gpguevara_nefro @NephJC Hi, I'm Gustavo Guevara, nephrologist from Ecuador. no COI #nephjc |
| Nephrology Journal Club @NephJC @NephroNinja Disadvantage of cystatin C? Cost (currently 10x creatinine per NICE in UK atleast) #NephJC |
 | Jay R. Seltzer @jrseltzer Jay Seltzer, St. Louis, no COI, lurking while working on EPIC notes... #NephJC |
| Matthew Sparks, MD @Nephro_Sparks @JamesNovakNeph @NephJC I have used only a few times and they are as James describes #NephJC |
| Nephrology Journal Club @NephJC Theoretical advantage of cystatin C over creatinine: not affected by muscle mass )so not by race/ethnicity); freely filtered, not secreted #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 Indeed a great summary of @Stones__ #NEPHJC |
| Nephrology Journal Club @NephJC RT @NephJC: T0 warmup How many of you already use Cystatin. C? #NephJC twitter poll |
| Silvi Shah, MD, MS @silvishah @NephJC We are routinely using it for gfr calculation for donor evaluation and for liver kidney transplant candidates. #nephJC |
| Edgar V. Lerma 🇵🇭 @edgarvlermamd Adding cystatin C to the combination of creatinine and ACR measures, improved the predictive accuracy for all-cause mortality and ESKD ca. 2011 from @Peralta_KHRC @KHRC_research @JAMA_current #Nephpearls #NephJC 👉🏼 https://t.co/VywTCve2DR https://t.co/gP1JLdr4PL |
| James Novak, MD PhD FACP FASN FNKF @JamesNovakNeph @kidney_boy I don’t have a pithy comic, just a pithy aphorism: “When all you have is a hammer, everything looks like a...creatinine-based eGFR determination.” #NephJC |
| Joel M. Topf, MD FACP @kidney_boy @JamesNovakNeph @NephJC I run into those situations and I use a 24-hour CrCl to control for creatinine production (up or down) #NephJC |
| Michelle Starr MD MPH @mcstarr1 @NephJC I use a lot in certain pediatric populations - ex neonates, those with abnormal muscle mass (CF, chronic disease) #nephjc |
| Marvin Gonzalez. MD, Ph.D @MarvinGonzlez16 @NephJC I have used creatinine and Cystatin C in my cohort study. #NephJC https://t.co/1Snepm8I9C https://t.co/1Snepm8I9C |
| Nephrology Journal Club @NephJC @gpguevara_neph welcome Gustavo! #NephJC |
| Nephrology Journal Club @NephJC @jrseltzer Hi Jay - important to keep clicking those boxes on @EPICEMRparody ! #NephJC |
| Nathaniel Reisinger @nephrothaniel RT @edgarvlermamd: Factors that limit the use of eGFR from creatinine and cystatin C #Nephpearls #NephSecrets #NephJC https://t.co/nahNyxyKDd |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @mcstarr1: @NephJC I use a lot in certain pediatric populations - ex neonates, those with abnormal muscle mass (CF, chronic disease) #nephjc |
| Krithika Mohan @krithicism RT @edgarvlermamd: Adding cystatin C to the combination of creatinine and ACR measures, improved the predictive accuracy for all-cause mortality and ESKD ca. 2011 from @Peralta_KHRC @KHRC_research @JAMA_current #Nephpearls #NephJC 👉🏼 https://t.co/VywTCve2DR https://t.co/gP1JLdr4PL |
| James Novak, MD PhD FACP FASN FNKF @JamesNovakNeph @kidney_boy @NephJC I do those, too, but am often left wondering about the completeness of the collection. Normalizing the collection to the mass of creatinine has a large margin of error. #NephJC |
| Nephrology Journal Club @NephJC Great start. Moving on to T1 and methods in a few minutes. (searching for methods right now) #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 On my next appointment with my transplant nephrologist I will ask about the role of #cystatinc post-kidney transplant Seems like there is a role considering the CVD risk #nephJC |
| Nephrology Journal Club @NephJC RT @JamesNovakNeph: @kidney_boy @NephJC I do those, too, but am often left wondering about the completeness of the collection. Normalizing the collection to the mass of creatinine has a large margin of error. #NephJC |
| Nephrology Journal Club @NephJC RT @MarvinGonzlez16: @NephJC I have used creatinine and Cystatin C in my cohort study. #NephJC https://t.co/1Snepm8I9C https://t.co/1Snepm8I9C |
| Gates Colbert, MD @DoctorGates @NephJC Yes we need a better marker than muscle mass! I had a recent patient with AKI. BUN 140, Cr 1.0 mg/dL. He had ALS and no muscle mass. Likely Cr should be 10.0 mg/dL #NephJC |
| Nephrology Journal Club @NephJC RT @silvishah: @NephJC We are routinely using it for gfr calculation for donor evaluation and for liver kidney transplant candidates. #nephJC |
| Nephrology Journal Club @NephJC @silvishah find it better than measured GFR? #NephJC |
| Michelle Starr MD MPH @mcstarr1 @NephJC Growing evidence in pediatric CKD shows it may be more accurate estimation of eGFR so use is growing #nephjc https://t.co/IUbSkZLem2 |
| Nephrology Journal Club @NephJC T1: Method section is buried in small print at the end of the article. Let’s boo @NatureMedicine for this first #NephJC https://t.co/B3LHxceSc8 |
| Silvi Shah, MD, MS @silvishah @NephJC and seen lot of discrepancy with mdrd, 24 hour creatinine clearance. and ckd-epi. Cystatin c has been superior to those #nephjc |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @mcstarr1: @NephJC Growing evidence in pediatric CKD shows it may be more accurate estimation of eGFR so use is growing #nephjc https://t.co/IUbSkZLem2 |
 | Edward Carey @etcarey2 RT @kidney_boy: Joel Topf, clinical nephrologist. COI: Joel Topf, clinical nephrologist. COI: I think nephrology's genuflection to GFR is a big problem. GFR is only one dimension of the multidimensional disease of CKD. #NephJC |
| Nephrology Journal Club @NephJC RT @silvishah: @NephJC and seen lot of discrepancy with mdrd, 24 hour creatinine clearance. and ckd-epi. Cystatin c has been superior to those #nephjc |
| Nephrology Journal Club @NephJC RT @DoctorGates: @NephJC Yes we need a better marker than muscle mass! I had a recent patient with AKI. BUN 140, Cr 1.0 mg/dL. He had ALS and no muscle mass. Likely Cr should be 10.0 mg/dL #NephJC |
| Nephrology Journal Club @NephJC @jbda19 Hey Justin! #NephJC |
 | Ryan Mullane @rmullane7 RT @edgarvlermamd: Factors that limit the use of eGFR from creatinine and cystatin C #Nephpearls #NephSecrets #NephJC https://t.co/nahNyxyKDd |
| James Novak, MD PhD FACP FASN FNKF @JamesNovakNeph @DoctorGates @NephJC That would be a great clinical scenario to use cystatin C. But, these situations are uncommon. #NephJC |
| Nephrology Journal Club @NephJC T1 Methods: this study, like many others used the @UK_Biobank which seems like an awesome resource - data incl blood samples from 500,000 UK individuals #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @NephJC: T1: T1: Method section is buried in small print at the end of the article. Let’s boo @NatureMedicine for this first #NephJC https://t.co/B3LHxceSc8 |
| Silvi Shah, MD, MS @silvishah @NephJC Yes. It’s superior and accurate than that. #nephJC |
| Nephrology Journal Club @NephJC T1: They excluded individuals with no blood samples, or with prior CV disease, GFR < 15 or on dialysis #NephJC |
| Silvi Shah, MD, MS @silvishah @DoctorGates @NephJC Cystatin C is the way to go #nephJC |
| Nephrology Journal Club @NephJC Exposure was eGFR estimated by 3 different ways and albuminuria #NephJC |
| Nephrology Journal Club @NephJC eGFR by eGFR-cr, eGFR-cys and eGFR-cr-cys; links to all formulae at many places incl @NKF website here https://t.co/FJZxhqUmNV #NephJC |
| Ian McCoy, MD, MS @NephroNinja @silvishah @NephJC I would think cheaper and easier to get as well. #nephjc |
| Nephrology Journal Club @NephJC Exposure was categorized by CKD stages ≥90, 60–89, 45–59, 30–44, 15–30. Note 15-30 was reference (so lower hazards with higher GFR expected) #NephJC |
| Nephrology Journal Club @NephJC @SAHusainMD @NephroNinja Hey Syed! Welcome back to #NephJC |
| Nephrology Journal Club @NephJC Outcome: mortality, non fatal & fatal CVD events and incident ESKD (all ICD10 codes) Follow up till any one event or end of follow up (so not recurrent event analysis) #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @silvishah @NephJC @silvishah : To confirm you have found #cyststinc to be 24 hour urine collection? #nephjc |
| Marvin Gonzalez. MD, Ph.D @MarvinGonzlez16 @silvishah @NephJC Totally agree with you @silvishah. The CKD-EPI equation performed better than the MDRD equation, especially at higher GFR, with less bias and greater accuracy. #NephJC @CistaNicaragua |
| James Novak, MD PhD FACP FASN FNKF @JamesNovakNeph @jbda19 @NephJC Cystatin C is a send-out for us. #NephJC |
| Nephrology Journal Club @NephJC They used @f2harrell c-statistic https://t.co/RnACEO0vq0 to see if eGFR (& uACR) by any of these criteria improved prediction compared to usual CV rsik factors #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 T0 Does anyone use #cystatin c in kidney transplant recipients? If so , where? #nephJC |
| Nephrology Journal Club @NephJC Some more fun analysis done - which we will discuss in results (NRI, discordant analysis) #NephJC |
 | Divya Kondapi @divya_kondapi RT @kidney_boy: The only time I see cystatin C is when a patient comes to me for a second opinion and brings it with them. Just not part of what I do. #NephJC |
| Nephrology Journal Club @NephJC RT @gratefull080504: T0 Does anyone use #cystatin c in kidney transplant recipients? If so , where? #nephJC |
| Nephrology Journal Club @NephJC Funding for study from Chest, Heart and Stroke Association Scotland + @jennifer_s_lees has funding from @Kidney_Research & @theBHF #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 To clarify greater than 24 hour urine #nephJC |
| Nephrology Journal Club @NephJC Any other questions about methods? Not that I could answer them! #NephJC save them up for @jennifer_s_lees |
 | John Pickering, Skrymaster, 43.6S 172.6E @kiwiskiNZ Lurking #NephJC COI - ancient (>5yr old) research on pCysC and uCysC in ICU context. All eGFR are poor just some are poorer than others |
| Nephrology Journal Club @NephJC The authors are @jennifer_s_lees @DrClaireEWelsh and #BlazerGuru @DrPaddyMark who are all probably asleep now but let’s get their notifications crazy for when they wake up #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @Nephro_Sparks What would the right clinical scenario be? #nephJC |
| Nephrology Journal Club @NephJC @kiwiskiNZ Hey John - hope you can comment on the results/analysis (NRI c-stats etc) later - thanks #NephJC |
| Nephrology Journal Club @NephJC already 22 minutes past the hour! T2: Results coming up. Lots of data - we may not get through all of it #NephJC |
| Nephrology Journal Club @NephJC The authors didn’t include a proper figure 1, so we made it up - see #NephJC |
| Nephrology Journal Club @NephJC The authors didn’t include a proper figure 1, so we made it up - see #NephJC sorry see this https://t.co/YTzguYMSkt |
| Nephrology Journal Club @NephJC @Nephro_Sparks @NatureMedicine good man! #NephJC |
 | Mario Funes, MD @MarioFunesMD Mario Funes. Future @StanfordNeph fellow. Just lurking as I'm still admitting tonight. No COI. #NSMC intern 2019. #NephJC |
| Krithika Mohan @krithicism RT @NephJC: The authors didn’t include a proper figure 1, so we made it up - see #NephJC sorry see this https://t.co/YTzguYMSkt |
| Nephrology Journal Club @NephJC So of ~ 500,000, about 400,000 made it in. Looks pretty OK to me..#nephjc |
| James Novak, MD PhD FACP FASN FNKF @JamesNovakNeph @Nephro_Sparks @DoctorGates @NephJC The most cost-effective test is to compare the creatinine to a previous baseline. Was it 0.1 or 1.0 mg/dL 3 months ago? If the creatinine is unchanged, then it’s not AKI, just azotemia. #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 #nephjc. I think it is noteworthy that NICE has approved the use of #cystatinc in CKD They clearly must see the value in prevention |
| Joel M. Topf, MD FACP @kidney_boy Endorse #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @SAHusainMD @silvishah @NephJC How often is measured GFR used in practice ? #nephJC |
| Nephrology Journal Club @NephJC Now lets look at table 1: variables by eGFR (by creatinine) category. Lower eGFR = older men with diabetes, on BP meds, statins, higher ACR, lower DBP. #NephJC https://t.co/uTHh7eR8FI |
| Nephrology Journal Club @NephJC @gratefull080504 @SAHusainMD @silvishah usually at the margin- for critical decisions at threshold Otherwise in CKD 35 or 37 doesn't matter; but for kidney donation, 75 or 80 might matter? #NephJC |
| James Novak, MD PhD FACP FASN FNKF @JamesNovakNeph @SAHusainMD @silvishah @NephJC Creatinine and cystatin C are both used to estimate GFR, so would not be as accurate as direct measurement. No one uses the gold standard for GFR measurement, inulin clearance, in clinical practice. #NephJC |
| Joel M. Topf, MD FACP @kidney_boy @DocRockne No, it helps, but I think eGFR assessment is way overblown. How does a difference in eGFR of 10-15% at the high range effect therapy? #NephJC |
| Aisha Shaikh @aishaikh @DoctorGates @NephJC Oops the current link #nephjc https://t.co/cr3IIY5T9E |
| Nephrology Journal Club @NephJC RT @kidney_boy: @DocRockne No, it helps, but I think eGFR assessment is way overblown. How does a difference in eGFR of 10-15% at the high range effect therapy? #NephJC |
| Michelle Rheault @rheault_m RT @edgarvlermamd: Factors that limit the use of eGFR from creatinine and cystatin C #Nephpearls #NephSecrets #NephJC https://t.co/nahNyxyKDd |
| Nephrology Journal Club @NephJC Table 1 variants by eGFRcys and eGFRcys-Cr are supp tables S1 and S2 #NephJC https://t.co/O2coYlLPQq |
| James Novak, MD PhD FACP FASN FNKF @JamesNovakNeph @kidney_boy @DocRockne Only to determine kidney donation eligibility. @silvishah #NephJC |
| Nephrology Journal Club @NephJC Bottom of Table 1 (and tables S1, S2) also shows you the outcomes by eGFR categories, unadjusted. SO you can see lower eGFR = more badness, as expected #NephJC https://t.co/ki8Xq7vc2f |
| Matthew Sparks, MD @Nephro_Sparks @SAHusainMD @JamesNovakNeph @silvishah @NephJC Can’t wait to see NIC kidney FITC Sinestrin used more and avoid these equations etc #NephJC |
 | Shubharthi Kar, MD, FISN @shubharthikar Shubharthi Kar from Sylhet Bangladesh. No COI.#NephJC |
| Nephrology Journal Club @NephJC But these are sicker people (eg older, DM etc). DOes adding GFR add anything to the prediction? Let’s see in tables 2 - 4 #NephJC |
| Joel M. Topf, MD FACP @kidney_boy @JamesNovakNeph @DocRockne @silvishah And how evidence based is that? #NephJC Those criteria always felt a bit arbitrary to me. |
| Aisha Shaikh @aishaikh @SAHusainMD @JamesNovakNeph @silvishah @NephJC -Unfortunately a lot of places don't have the ability to do iothalamate clearance. -On the other hand, when I was a fellow at Mayo Clinic almost every patient used to get an iothalamate clearance #NephJC |
| Aravind Cherukuri PhD MRCP (UK) @AravindCheruku1 @NephJC #nephjc this was exactly my concern. Moreover what is the real world utility of improving the c statistic from 0.74 to 0.76 or there abouts? |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @aishaikh: @SAHusainMD @JamesNovakNeph @silvishah @NephJC -Unfortunately a lot of places don't have the ability to do iothalamate clearance. -On the other hand, when I was a fellow at Mayo Clinic almost every patient used to get an iothalamate clearance #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil @shubharthikar Hey Shubarthi! Good morning - what time there? #NephJC |
 | Airawat ऐरावत @Renaltubules Ashwasena. From Himalays. Thinking about coi. #NephJC |
| Nephrology Journal Club @NephJC In table 2: remember GFR 15-30 is reference, so lower HR = more ‘significant’ For all cause mortality, eGFRCr is kinda meh (95% CI 0.96 - 1) but eGFRcys really shines for all outcomes #NephJC https://t.co/eo1qIHQxpD |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @aishaikh @SAHusainMD @JamesNovakNeph @silvishah @NephJC For routine clinical practice? #nephjc |
| Matthew Sparks, MD @Nephro_Sparks But remember this paper is about grouping a TON of patients and predicting RISK not looking at accuracy of GFR #NephJC |
| Marvin Gonzalez. MD, Ph.D @MarvinGonzlez16 @CristhianMuM @NephroNinja We have seen that if you have serial measurements of SCr from the same patient or subject. This is good enough to eGFR because within-person variation is less. I mention this because we compared eGFRcr and eGFRCys and we have not seen difference between them. #NephJC #JASN |
| Aravind Cherukuri PhD MRCP (UK) @AravindCheruku1 @NephJC #nephjc is it not apparant that atherosclerotic risk factors predict yes outcomes with a c statistic of more than 7 with a very small change by adding cystatin based assessment |
| Nephrology Journal Club @NephJC QFT Matt! #NephJC |
| Joel M. Topf, MD FACP @kidney_boy RT @AravindCheruku1: @NephJC #nephjc this was exactly my concern. Moreover what is the real world utility of improving the c statistic from 0.74 to 0.76 or there abouts? |
| James Novak, MD PhD FACP FASN FNKF @JamesNovakNeph @aishaikh @SAHusainMD @silvishah @NephJC Why? #NephJC |
| Nephrology Journal Club @NephJC Table 3 is NRI = net reclassification improvement for CV endpoints. Again as you can see, eGFRCr doesn’t add much to traditional atherosclerotic risk factors. eGFRCys does #NephJC https://t.co/8LhwsnE9Tz |
| James Novak, MD PhD FACP FASN FNKF @JamesNovakNeph @kidney_boy @DocRockne @silvishah Me too (sotto voce). #NephJC |
 | Tiffany Caza @Tiff_Caza Nice summary of cystatin C in cardiovascular risk assessment by @Stones__ #NephJC https://t.co/Fcl8py4hQE |
| Nephrology Journal Club @NephJC @JamesNovakNeph @aishaikh @SAHusainMD @silvishah is it just institutional culture? We do nuclear GFR for all donors; our neighbour @CHEOhospital does cystatin C for *everyone* #NephJC |
 | Jim Myers @kidneystories RT @gratefull080504: #nephjc. I think it is noteworthy that NICE has approved the use of #cystatinc in CKD They clearly must see the value in prevention |
| Nephrology Journal Club @NephJC Figure 3 is the (famous) @f2harrell c-statistics. Making it more obvious how much eGFRCys makes a difference #NephJC https://t.co/5x1qNft3r0 |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 Correct @NephJC Isn’t the objective of this study to address the independent risk associated with CKD + thus determine the role of cystatinc? #nephJC |
| Nephrology Journal Club @NephJC we have heard CKD is a risk factor for CV outcomes But when adjusted for known CV risk factors, eGFRCr here didn't do as much for all cause mortality as eGFRCys did does it matter? #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @Tiff_Caza @Stones__ Very nice summary by @Stones__ #nephJC |
| John Pickering, Skrymaster, 43.6S 172.6E @kiwiskiNZ @NephJC #NephJC - NRI appropriately done for events/non-events separately, but use of 7.5% risk threshold is arbitrary (all above & all below are not the same). IDI analysis would have been more informative. |
| Aravind Cherukuri PhD MRCP (UK) @AravindCheruku1 @NephJC @f2harrell #nephjc the magnitude of difference seems to be small although statistically significant. The linear relationship to the outcome looks more impressive. |
| Aisha Shaikh @aishaikh @NephJC @JamesNovakNeph @SAHusainMD @silvishah @CHEOhospital I think so, and it has been utilized for a lot of GFR studies that have been published by them. Perhaps someone who is currently at the Mayo Clinic now could comment on this - if iothlamate clearances are still ‘commonly’ done there on most patients? #nephjc |
| Nephrology Journal Club @NephJC RT @kiwiskiNZ: @NephJC #NephJC - NRI appropriately done for events/non-events separately, but use of 7.5% risk threshold is arbitrary (all above & all below are not the same). IDI analysis would have been more informative. |
| Matthew Sparks, MD @Nephro_Sparks @cdchu Didn’t you just do your GR on this?? #nephjc |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @NephJC I think so #nephJC |
| Marvin Gonzalez. MD, Ph.D @MarvinGonzlez16 @AravindCheruku1 @kidney_boy @NephJC From my point of view, I do not see a huge improvement in this models, because the difference was 0.02 #NephJC |
| Nephrology Journal Club @NephJC @kiwiskiNZ indeed - the authors say 7.5% came from @AHAScience 2013 guidelines somewhat arbitrary agreed #NephJC |
| Matthew Sparks, MD @Nephro_Sparks @NephJC If it reinforces aggressive risk factor modification earlier then the answer is yes. Patients die from CVD. #NephJC |
| Nephrology Journal Club @NephJC RT @AravindCheruku1: @NephJC @f2harrell #nephjc the magnitude of difference seems to be small although statistically significant. The linear relationship to the outcome looks more impressive. |
| Airawat ऐरावत @Renaltubules I hate to say this but cardiologist have trop and CK as a marker of myocardial injury. However we are still searching better marker than creat and urea for kidney injury in last 100 years. #nephjc |
| John Pickering, Skrymaster, 43.6S 172.6E @kiwiskiNZ @NephJC @f2harrell The 95%CIs are v v small because of large numbers. The effect size, though, is tiny. The benefit would need to be huge for anything but minimal cost. #NephJC |
| Nephrology Journal Club @NephJC RT @Nephro_Sparks: @NephJC If it reinforces aggressive risk factor modification earlier then the answer is yes. Patients die from CVD. #NephJC |
| Nephrology Journal Club @NephJC RT @kiwiskiNZ: @NephJC @f2harrell The 95%CIs are v v small because of large numbers. The effect size, though, is tiny. The benefit would need to be huge for anything but minimal cost. #NephJC |
| Matthew Sparks, MD @Nephro_Sparks @Renaltubules This is looking at risk of CVD not injury #NephJC |
| Nephrology Journal Club @NephJC Figure 2 is heatmap combining uACR (columns) & eGFR (rows). After adjusting for eGFR, uACR looks kinda meh to me #NephJC https://t.co/HQptP4hiw6 |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @Nephro_Sparks @NephJC Isn’t that the goal Matt? Upstream intervention rather than passive acceptance ? #nephJC |
| Nephrology Journal Club @NephJC #NephJC this! |
| Nephrology Journal Club @NephJC Lastly there is the discordant analysis. Discordant = when eGFRCr and eGFRcys were off by > 20%. This occurred in a whopping 41% of individuals #NephJC |
| Aisha Shaikh @aishaikh @silvishah @NephJC @JamesNovakNeph @SAHusainMD @CHEOhospital Definitely cumbersome - requires urine sample collection after 2 hours of iothalamate administration. But places like Mayo Clinic and Cleveland Clinic are well-oiled machines so they can pull it off #nephjc |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @Renaltubules Doesn’t cystatinc offer some improvement? #nephJC |
| Matthew Sparks, MD @Nephro_Sparks @NephJC Breaking out my magnifying glass #NephJC https://t.co/8NFcznWhHA |
| Joel M. Topf, MD FACP @kidney_boy @Nephro_Sparks @NephJC Yes, but patients with crGFR of 30 and a CysGFR of 30 both need aggressive risk factor modification. I don't see the utility here. At what eGFR do you stop caring about ASA/Statin/BP? #NephJC |
| Nephrology Journal Club @NephJC Table 4 shows the change in c-statistic in those discordant, or not #NephJC https://t.co/msHTCdrgx7 |
| John Pickering, Skrymaster, 43.6S 172.6E @kiwiskiNZ @Nephro_Sparks I'm not sure I've ever understood what drives grouping in the first place. #NephJC |
 | Franklin Loachamin @FranLoachamin RT @NephroNinja: Anyone know the cost different between cystatin C and creatinine measurement? Can cystatin C be measured on the same equipment? #nephjc |
| Joel M. Topf, MD FACP @kidney_boy #NephJC |
| Nephrology Journal Club @NephJC forgot the figure 1 from paper in the excitement as @SAHusainMD points out, note the linear relation (middle panel) with eGFRCys compared ot the other two #NephJC https://t.co/IiLjmSeu99 |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @kidney_boy @Nephro_Sparks @NephJC @kidney_boy : the benefit of cystatinc is that detects CKD earlier and thus the rationale for earlier intervention. #nephJC |
| James Novak, MD PhD FACP FASN FNKF @JamesNovakNeph @Nephro_Sparks @NephJC I’ve often wondered about the value of these markers in patient care (not research). Would a cystatin C measurement change my decision to prescribe a statin or an SGLT2 inhibitor? Maybe, but not often. #NephJC |
| Nephrology Journal Club @NephJC @gratefull080504 @kidney_boy @Nephro_Sparks exactly! look at the difference in risk shown at high end of GFR Joel between extreme left (eGFRcr) and middle column (eGFRcys) #NephJC https://t.co/NEZrZ7Bmfo |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 #nephjc. I clearly see the value of cystatinc if the goal of a healthcare system is early intervention of CKD NICE approved this test because their CKD system rewards slowing down the progression of #ckd |
| Nephrology Journal Club @NephJC RT @JamesNovakNeph: @Nephro_Sparks @NephJC I’ve often wondered about the value of these markers in patient care (not research). Would a cystatin C measurement change my decision to prescribe a statin or an SGLT2 inhibitor? Maybe, but not often. #NephJC |
| Joel M. Topf, MD FACP @kidney_boy @gratefull080504 @Nephro_Sparks @NephJC I would need to see the data that detecting an actual GFR of 60 two years earlier has any meaningful difference in outcome. #NephJC |
| Dhwanil Patel @iheartkidneys @kidney_boy @gratefull080504 @Nephro_Sparks @NephJC Too soon to change the skeleton? #NephJC https://t.co/KdOl9aHS9I |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @JamesNovakNeph @Nephro_Sparks @NephJC If cystatin is able to detect #kidneydisease earlier then yes #nephJC |
| Nephrology Journal Club @NephJC @CristhianMuM yup so relation of uACR and CV outcomes is *not* linear (unlike uACR and ESKD) *after* adjustment for other factors #NephJC https://t.co/swEm61bBys |
| Aravind Cherukuri PhD MRCP (UK) @AravindCheruku1 #nephjc the most strikingthing, I felt was the fact that cystatin based gfr of 15-30 trumps albuminuria as a risk classifier in their risk stratification tables. |
| Nephrology Journal Club @NephJC RT @AravindCheruku1: #nephjc the most strikingthing, I felt was the fact that cystatin based gfr of 15-30 trumps albuminuria as a risk classifier in their risk stratification tables. |
 | Jung Hoon Son, M.D. @junghoon_sonMD RT @kidney_boy: Joel Topf, clinical nephrologist. COI: Joel Topf, clinical nephrologist. COI: I think nephrology's genuflection to GFR is a big problem. GFR is only one dimension of the multidimensional disease of CKD. #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @iheartkidneys @kidney_boy @Nephro_Sparks @NephJC I don’t think so #nephJC |
| Marvin Gonzalez. MD, Ph.D @MarvinGonzlez16 @NephJC How did they measure the serum creatinine and Cystatin C? was it in a single batch or many batches? if creatinine and Cys C were measured in a single batch, this reduce the variability and this would be different depending on which scale you used. #NephJC |
| Nephrology Journal Club @NephJC T3 is what happens next @Kidney_boy is not convinced are others thinking eGFRCys adds anything? #NephJC |
| John Pickering, Skrymaster, 43.6S 172.6E @kiwiskiNZ @NephJC @SAHusainMD Love this graph. Curious "wiggle" in Cr curves (why?), nice and smooth for CysC. #NephJC (note: Reference HR is 1 at 90 ml/min). |
| Ian McCoy, MD, MS @NephroNinja @kidney_boy @Nephro_Sparks @NephJC Practically/operationally, you need a threshold GFR beyond which the CKD is significant enough to be a CVD risk factor. Doesn't this analysis suggest that eGFRcr of 75 isn't worrisome whereas eGFRcys of 75 is? #nephjc |
| James Novak, MD PhD FACP FASN FNKF @JamesNovakNeph @gratefull080504 @Nephro_Sparks @NephJC Well, the value in detecting a disease is in instituting a management plan to modify its course, or in some cases for genetic counseling. I’m not sure that routine cystatin C measurement would benefit most patients. #NephJc |
| Aravind Cherukuri PhD MRCP (UK) @AravindCheruku1 #nephjc cystatin c GFR of 15-30, you are in the red. That’s a big change for me |
| Nephrology Journal Club @NephJC @MarvinGonzlez16 good Q uACR was random spot, not first morning as a limitation not sure about single vs many batches for creat/cys C. A Q for @jennifer_s_lees for tomorrow #NephJC |
| Tiffany Caza @Tiff_Caza @gratefull080504 @kidney_boy @Nephro_Sparks @NephJC Could it help with identification of CKD patients overall? It seems like it might be difficult clinically to detect CKD1-2 patients if they don't have proteinuria or other clinical signs. What do you guys think? #nephJC |
| Nephrology Journal Club @NephJC RT @kiwiskiNZ: @NephJC @SAHusainMD Love this graph. Curious "wiggle" in Cr curves (why?), nice and smooth for CysC. #NephJC (note: @NephJC @SAHusainMD Love this graph. Curious "wiggle" in Cr curves (why?), nice and smooth for CysC. #NephJC (note: Reference HR is 1 at 90 ml/min). |
| Nephrology Journal Club @NephJC RT @AravindCheruku1: #nephjc cystatin c GFR of 15-30, you are in the red. That’s a big change for me |
| John Pickering, Skrymaster, 43.6S 172.6E @kiwiskiNZ @AravindCheruku1 @MarvinGonzlez16 @kidney_boy @NephJC Which is why I'm the referee who always asks for statements about "statistical significance" & p<0.05 to be dropped 👿. Unnecessary & meaningless. #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @NephJC @kidney_boy I do because I clearly see the value in detecting kidney disease earlier than GFR If someone is interested in detecting kidney disease earlier, then I see a tool that can be used to help make a better diagnosis of #ckd We have upstream treatments now Why wait? #nephJC |
| Aravind Cherukuri PhD MRCP (UK) @AravindCheruku1 Cannot agree more. The craziness for the p should go! |
| John Pickering, Skrymaster, 43.6S 172.6E @kiwiskiNZ @NephroNinja @kidney_boy @Nephro_Sparks @NephJC Do you really need a threshold? Why not simply a probablity of 5yr (say) event and discuss with patient in front of you? #NephJC |
| Aisha Shaikh @aishaikh @NephJC @CristhianMuM Interesting finding... Any thoughts on why this might be? #NephJC |
| James Novak, MD PhD FACP FASN FNKF @JamesNovakNeph @Tiff_Caza @gratefull080504 @kidney_boy @Nephro_Sparks @NephJC I’m not sure there’s much value in differentiating CKD 1 from 2 in the absence of proteinuria. An eGFR cutoff of 75 seems to make more sense to identify CV risk in younger patients, as discussed in a recent #CJASN editorial by @RichardGlassock. #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @JamesNovakNeph @Nephro_Sparks @NephJC Doesn’t have to be routine but could be used to confirm diagnosis as NICE recommends NICE throws money around like throwing a manhole cover around #nephJC |
| Nephrology Journal Club @NephJC @aishaikh @CristhianMuM not sure some interaction with other factors? Medications? confounding? #NephJC |
| Matthew Sparks, MD @Nephro_Sparks Nice chat all!! Enjoyed the discussion Thanks @Stones__ for the writeup @krithicism for the visual abstract @hswapnil for the moderating #NephTwitter for the discussion #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @JamesNovakNeph @Tiff_Caza @kidney_boy @Nephro_Sparks @NephJC @RichardGlassock I am referring to CKD 3 #nephJC |
| Nephrology Journal Club @NephJC RT @kiwiskiNZ: @AravindCheruku1 @MarvinGonzlez16 @kidney_boy @NephJC Which is why I'm the referee who always asks for statements about "statistical significance" & p<0.05 to be dropped 👿. Unnecessary & meaningless. #NephJC |
| Tiffany Caza @Tiff_Caza @gratefull080504 @NephJC @kidney_boy This makes a lot of sense. I learned at Kidney Week that we don't do so well in CKD surveillance (in US, for the general population). Tools for improvement would be terrific 🙂 #NephJC |
| Nephrology Journal Club @NephJC see mean event rates for eGFRCr vs eGFRCys for all cause mortality by different GFR categories as well #NephJC https://t.co/thLphbBh30 |
| Nephrology Journal Club @NephJC Thanks for joining us today and for contributing to this rich discussion, and a special thank you to @SAHusainMD @kiwiskiNZ @AravindCheruku1 (and the usual suspects of course) for tonight’s main event! #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @Tiff_Caza @NephJC @kidney_boy That is my point exactly This subject is near + dear to my heart after participating in the @goKDIGO conference on the early detection + interventions of #ckd That is my position #nephjc |
| Aravind Cherukuri PhD MRCP (UK) @AravindCheruku1 @NephJC #nephjc unlike the c statistic table, this appears impressive |
| Marvin Gonzalez. MD, Ph.D @MarvinGonzlez16 @CristhianMuM we tried to develop a prediction score to identify individuals at risk of CKDu. In this study, we used eGFRcr, NGAL and uACR, but we did not seen any improvement when last two markers were added to the model. https://t.co/qWKsPv1VtO #nephjc #BMC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @JamesNovakNeph @Tiff_Caza @kidney_boy @Nephro_Sparks @NephJC @RichardGlassock Me either #nephJC |
| Nephrology Journal Club @NephJC Apply - or ask someone to apply- to the NSMC internship, due Jan 5 2020 https://t.co/WHoAwVIVqQ #NephJC https://t.co/mab634jdij |
 | Cristhian Muñoz 🇲🇽 @CristhianMuM @Nephro_Sparks @Stones__ @krithicism @hswapnil Thanks for this chat, was very interesting subject... i really enjoyed it. #NephJC |
| Airawat ऐरावत @Renaltubules @Nephro_Sparks @Stones__ @krithicism @hswapnil Thank you team #nephjc |
| Nephrology Journal Club @NephJC RT @MarvinGonzlez16: @CristhianMuM we tried to develop a prediction score to identify individuals at risk of CKDu. In this study, we used eGFRcr, NGAL and uACR, but we did not seen any improvement when last two markers were added to the model. https://t.co/qWKsPv1VtO #nephjc #BMC |
| Aravind Cherukuri PhD MRCP (UK) @AravindCheruku1 #nephjc thanks everyone for the great discussion. |
| Nephrology Journal Club @NephJC If you haven’t, please sign up for our weekly newsletter https://t.co/5aumn8ImwF #NephJC |
| Franklin Loachamin @FranLoachamin RT @kidney_boy: Joel Topf, clinical nephrologist. COI: Joel Topf, clinical nephrologist. COI: I think nephrology's genuflection to GFR is a big problem. GFR is only one dimension of the multidimensional disease of CKD. #NephJC |
| Nephrology Journal Club @NephJC Want yourself some #NephJC merch? Click here https://t.co/eOqYlnH0Ou |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 Great topic tonight + on a subject that interests me deeply I clearly see a role of cystatinc at a minimum as recommended by NICE #nephjc |
| Nephrology Journal Club @NephJC Join @aakash_shingada and then @AbaRenua for the Asia and EU chats tomorrow as well #NephJC (authors will probably make an appearance as well) |
| Matthew Sparks, MD @Nephro_Sparks The cystatin C numbers: 278 Tweets. 60 Participants. 2,140,606 Impressions. December 9th 2019. More #NephJC 📊 here https://t.co/MN8KsAvjZV via @symplur |
| Joel M. Topf, MD FACP @kidney_boy RT @NephJC: Apply - or ask someone to apply- to the NSMC internship, due Jan 5 2020 https://t.co/WHoAwVIVqQ #NephJC https://t.co/mab634jdij |
| Nephrology Journal Club @NephJC meanwhile - good night and happy tweeting always keep the NSMC code of conduct in mind #NephJC https://t.co/gOufNHML0Z |
| Tiffany Caza @Tiff_Caza Terrific opportunity! Besides #NephJC, consider helping out with some of the projects on Nephrology social media, while meeting some great people and having fun 🙂. |
| Matthew Sparks, MD @Nephro_Sparks RT @Tiff_Caza: Terrific opportunity! Besides #NephJC, consider helping out with some of the projects on Nephrology social media, while meeting some great people and having fun 🙂. |
| Nephrology Journal Club @NephJC and #KIDNEYCon is coming up - travel grants open, apply now! #NephJC https://t.co/RPG6PD35dY https://t.co/b2KLk9DhhB |
 | Symplur @symplur RT @Nephro_Sparks: The cystatin C numbers: The cystatin C numbers: 278 Tweets. 60 Participants. 2,140,606 Impressions. December 9th 2019. More #NephJC 📊 here https://t.co/MN8KsAvjZV via @symplur |
| Marvin Gonzalez. MD, Ph.D @MarvinGonzlez16 This was a great journal club. Many people were posting their thoughts about this topic. Thanks #NephJC for selecting this paper. |
| Joel M. Topf, MD FACP @kidney_boy My final #NephJC thought. Cys C may be (probably is?) a better creatinine but it is just another functional marker in a field that is dying for a biomarker. If we were suddenly transported to a Cystatin-C universe it wouldn't look that different than ours. |
| Tiffany Caza @Tiff_Caza RT @edgarvlermamd: Factors that limit the use of eGFR from creatinine and cystatin C #Nephpearls #NephSecrets #NephJC https://t.co/nahNyxyKDd |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @NephJC: and #KIDNEYCon is coming up - travel grants open, apply now! #NephJC https://t.co/RPG6PD35dY https://t.co/b2KLk9DhhB |
| Matthew Sparks, MD @Nephro_Sparks Paging IM Residents #KIDNEYcon apply now 👇👇 |
 | Vincent Anthony Tang @VASTangMD RT @kidney_boy: My final #NephJC thought. Cys C may be (probably is?) a better creatinine but it is just another functional marker in a field that is dying for a biomarker. If we were suddenly transported to a Cystatin-C universe it wouldn't look that different than ours. |
 | Ashwani🌱Garg 🌏🇺🇸✝️ @agargmd Nothing excites me more than Kidney Jeopardy, bowling with like minded doctors and updates in membranous nephropathy! @sjoshimd |
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