#NephJC Transcript
Healthcare social media transcript of the #NephJC hashtag.
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See #NephJC Influencers/Analytics.
| Profile | Tweet |
|---|---|
 | Sayna Norouzi, MD, FASN @SaynaNorouzi RT @MarioFunesMD: The day has arrived, the wait is almost over! Join us today at 9 PM EDT for #NephJC chat on CREDENCE trial. https://t.co/ObqgdM5zne |
 | Manuel Brockman @paging_MannyB RT @aishaikh: ๐ฅWhy is the #CREDENCE Trial such a big deal for the Nephrologists? โก๏ธIt is the first โpositiveโ trial in CKD DM pts. in two decades! 1/ @RenalFellowNtwk @VladoPerkovic @georgeinstitute #NephJC #Nephpearls |
 | Matthew Sparks, MD @Nephro_Sparks #CREDENCE on #NephJC in 40 min https://t.co/8nEHqTs49f |
 | Ariadna Polo @santa91069 RT @aishaikh: ๐ฅHow do SGLT2 Inhibitors work? ๐ฅHow does an anti-diabetic drug improve Renal & Cardiovascular outcomes? ๐ฅTo understand this letโs first review: โก๏ธRenal handling of glucose 1/ @RenalFellowNtwk #NephJC #SGLT2 #CREDENCE |
 | Kamol @KamolMU RT @aishaikh: Given the benefits of #SGLT2 Inhibitors in diabetic CKD & heart failure - will these conditions eventually become the โprimaryโ indication to use these drugs - that just happen to have mild glucose lowering as a side effect? #NephJC #CREDENCE @hswapnil https://t.co/rX7rhN3AR0 |
 | Joel M. Topf, MD FACP @kidney_boy RT @hswapnil: Just over an hour to go for next #NephJC Hope some of authors can join us? @VladoPerkovic @jardine_meg Rajiv Agarwal of @IUKidney @gbakris @DavidCWheeler2 @adeeralevin Summary here https://t.co/uai7FwTCPQ |
 | Mostapha Habib Allah @NephroMostapha RT @aishaikh: Given the benefits of #SGLT2 Inhibitors in diabetic CKD & heart failure - will these conditions eventually become the โprimaryโ indication to use these drugs - that just happen to have mild glucose lowering as a side effect? #NephJC #CREDENCE @hswapnil https://t.co/rX7rhN3AR0 |
 | Gustavo Casas @GCasasNefro_MI RT @EdoardoMelilli: |
 | Swapnil Hiremath @hswapnil@bsky.social @hswapnil @VladoPerkovic @jardine_meg @IUKidney @gbakris @DavidCWheeler2 @adeeralevin You are forgiven ๐ Hope you can make one of the chats tomorrow! #NephJC |
 | RXKEVING @KNRXRX RT @aishaikh: Given the benefits of #SGLT2 Inhibitors in diabetic CKD & heart failure - will these conditions eventually become the โprimaryโ indication to use these drugs - that just happen to have mild glucose lowering as a side effect? #NephJC #CREDENCE @hswapnil https://t.co/rX7rhN3AR0 |
 | Nephrology Journal Club @NephJC T-25 minutes #NephJC Still not too late to read @drlovygaur excellent summary https://t.co/4MdXRrwI01 |
 | Fitsum Asnakech Tilahun MD @fitse_t Waiting for the Juice #CREDENCE #NephJC @Nephro_Sparks @kidney_boy https://t.co/AsT9a4vQaZ |
 | Anna Burgner MD MEHP @anna_burgner Getting ready for tonightโs #NephJC! https://t.co/AECYgDhvNi |
 | Hector Madariaga, MD FASN ๐ฒ๐ฝ @HecmagsMD @VladoPerkovic @hswapnil @jardine_meg @IUKidney @gbakris @DavidCWheeler2 @adeeralevin Come on @AirCanada . Can you activate the Wi-Fi in the flight, please? Very important discussion in 15 minutes! #NephJC |
 | Kevin K Patel @ke6n13 Great look at SGLT2 inhibitors and trying to get the most bang for the buck, some diabetic control/BP effect/weight loss/improved CV and CKD outcomes! |
| Nephrology Journal Club @NephJC RT @hswapnil: Just over an hour to go for next #NephJC Hope some of authors can join us? @VladoPerkovic @jardine_meg Rajiv Agarwal of @IUKidney @gbakris @DavidCWheeler2 @adeeralevin Summary here https://t.co/uai7FwTCPQ |
 | Andrew Buelt @AndrewBuelt RT @aishaikh: ๐ฅWhy is the #CREDENCE Trial such a big deal for the Nephrologists? โก๏ธIt is the first โpositiveโ trial in CKD DM pts. in two decades! 1/ @RenalFellowNtwk @VladoPerkovic @georgeinstitute #NephJC #Nephpearls |
 | Sanjeev Nair @Nair_Sanj While u are waiting for today's milestone #NephJC to start, check out this quiz on SGLT2is by @ISNeducation. Didnt do too bad thanks to @aishaikh and @drlovygaur |
 | ChristosArgyropoulos MD, PhD PharmanukerInChief @ChristosArgyrop @TxPharmD @ErinMcCreary @adjamali Hey .. talking about #SGLT2i tonight at #nephjc โฆ. |
| Nephrology Journal Club @NephJC T - 7 minutes Celebrating the 5th Anniversary of #NephJC in style |
| Nephrology Journal Club @NephJC The first #NephJC summary ever https://t.co/Q7F3G4PFUk Apr 29 2014. We have come a long way - thanks to the global #NephTwitter community |
 | Mario Funes, MD @MarioFunesMD RT @NephJC: The first #NephJC summary ever https://t.co/Q7F3G4PFUk Apr 29 2014. We have come a long way - thanks to the global #NephTwitter community |
| Nephrology Journal Club @NephJC did you know: CREDENCE first author has been part of the #NephJC journey since our second chat in 2014? https://t.co/FkWTdUie4q with a video: @vladoperkovic https://t.co/PJYmH1sV6t |
| Anna Burgner MD MEHP @anna_burgner RT @NephJC: T - 7 minutes Celebrating the 5th Anniversary of #NephJC in style |
| Sanjeev Nair @Nair_Sanj RT @NephJC: The first #NephJC summary ever https://t.co/Q7F3G4PFUk Apr 29 2014. We have come a long way - thanks to the global #NephTwitter community |
 | Aakash Shingada, DNB, MRCP(UK), FASN @aakashshingada RT @divyaa24: Preparing for the big #NephJC tommorrow on #credence? Check out this quiz on the same and more about #sglt2i. @NephJC @kidney_boy @hswapnil @Nephro_Sparks |
 | Gary Singer @GarySingerMD@med-mastodon.com @GarySingerMD Gary Singer small town neph in STL no COI happy 5th birthday #NephJC https://t.co/SY2NCVFQrz |
| Fitsum Asnakech Tilahun MD @fitse_t RT @KidneyInCVD: Looking forward to the #NephJC discussing on #CREDENCE Tuesday April 23rd 9pm EST #KidneyInCVD https://t.co/DuRQprvwT4 |
| Aakash Shingada, DNB, MRCP(UK), FASN @aakashshingada RT @NephJC: The first #NephJC summary ever https://t.co/Q7F3G4PFUk Apr 29 2014. We have come a long way - thanks to the global #NephTwitter community |
| Nephrology Journal Club @NephJC 9 pm Time to rock and roll #NephJC |
| Anna Burgner MD MEHP @anna_burgner Hi #NephJC!!! Excited to be here tonight with @VUMCKidney and @_NatalieMcCall participating in tonightโs JC! https://t.co/Go34b8apMB |
| Nephrology Journal Club @NephJC Your host tonight is Swap @hswapnil from the beautiful city of Ottawa #NephJC https://t.co/ZPEgboRCRB |
 | Verner Venegas @Vernisartan Hi! Congratulations #NephJC in your 5th Year! Verner here #NSMC2019 Intern NoCOI Ready for this interesting Article |
| Hector Madariaga, MD FASN ๐ฒ๐ฝ @HecmagsMD RT @NephJC: did you know: did you know: CREDENCE first author has been part of the #NephJC journey since our second chat in 2014? https://t.co/FkWTdUie4q with a video: @vladoperkovic https://t.co/PJYmH1sV6t |
 | Samaya @TarSamMD RT @NephJC: Your host tonight is Swap @hswapnil from the beautiful city of Ottawa #NephJC https://t.co/ZPEgboRCRB |
 | Harini Sarathy @hurryknee Okay, family taking care of itself. No other CoI. What's up #NephJC ? |
| Nephrology Journal Club @NephJC Please introduce yourself (even if youโre just lurking and following along) and declare any Conflicts of Interests. Donโt forget to use the hashtag #NephJC. And hereโs the quick guide https://t.co/Fd0jkGVp6G |
 | KatieOverV @KatieKwonMD Katie Kwon private practice nephrologist in SW Michigan #NephJC |
 | Annabel Biruete ๐ฒ๐ฝ @anniebelch Annabel Biruete, postdoc @IUSMDeptMed @IUKidney. No COI. I do not prescribe, but the results and the excitement about #CREDENCE are great and contagious! Looking forward to learn. Also, happy 5th anniversary, @NephJC! #NephJC |
| Samaya @TarSamMD RT @hswapnil: Just over an hour to go for next #NephJC Hope some of authors can join us? @VladoPerkovic @jardine_meg Rajiv Agarwal of @IUKidney @gbakris @DavidCWheeler2 @adeeralevin Summary here https://t.co/uai7FwTCPQ |
| Joel M. Topf, MD FACP @kidney_boy Hello, from Huntington Woods with a CREDENCE PARTY No COI. #NephJC co-creator |
 | Pravir @Proximal_Baxi Pravir Baxi, No COI, Rush Chicago. #NephJC |
 | Harish Seethapathy @BetterCallSeeth Harish, Renal Fellow @MGHKidneys. #NSMC Intern. No COI. #NephJC Congrats to all involved with @NephJC! Big trial to mark a big achievement. |
 | Rodrigo Nunes Cal @CalZole RT @NephJC: did you know: did you know: CREDENCE first author has been part of the #NephJC journey since our second chat in 2014? https://t.co/FkWTdUie4q with a video: @vladoperkovic https://t.co/PJYmH1sV6t |
 | Abhilash Koratala @KoraAbhi Abhilash aka @NephroP reporting. No COI #NephJC |
| Anna Burgner MD MEHP @anna_burgner Two COI tonight: one: participating as a PI in DAPA-CKD and two: some of my tweets tonight are coming from the @VUMCKidney fellows!! #NephJC |
 | Dr. Divya Bajpai ๐ฎ๐ณ @divyaa24 Hi, Divya here. Nephrologist from Mumbai. Interested in this #nephjc specially because the study had 20% Asians (also big number from India). No COI |
 | Tejas Desai, MD MBA @nephondemand Tejas Desai, creator of @NODanalytics and co-creator of @NephroWorldCup here for the #CREDENCE #NephJC |
 | Anitha Vijayan @VijayanMD Anitha Vijayan from Washington University in St Louis. No COI #NephJC |
| Nephrology Journal Club @NephJC The paper we will be discussing tonight is โCanagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathyโ by Perkovic et al published in @NEJM this month. It has caused a considerable stir already #NephJC |
 | Khaled Shawwa @khaledshawwa Khaled Shawwa, Nephrology fellow. Rochester, MN. No COI #NephJC |
 | Gates Colbert, MD @DoctorGates Dallas Nephrologist. No COI. CKD treater. DM treater. HTN treater. Ready to her some opinions tonight of this big trial. #nephjc |
 | Michelle Starr MD MPH @mcstarr1 Michelle Starr, peds fellow in Seattle. No COI. Been looking forward to this one - happy birthday #nephjc!๐ |
 | Nathaniel Reisinger @nephrothaniel Nathaniel Nephrologist @CooperHospital @coopermedschool Congrats @NephJC! Happy 5th! No relevant COI #nephjc |
 | Michelle Rheault @rheault_m @NephJC @hswapnil @jpeltzer Good evening! Michelle Rheault, Ped Neph UMN. COI in bio. Perspective: There are more randomized patients in CREDENCE than there are pediatric nephrologists in the entire world. #NephJC |
 | Madhuri Ramakrishnan @madmagicdoc 5th Anniversary, a great article, a fitting host! This is exciting! Madhuri here, NSMC INtern 2019. No COI. #NephJC #NSMC |
| Verner Venegas @Vernisartan RT @NephJC: Please introduce yourself (even if youโre just lurking and following along) and declare any Conflicts of Interests. Donโt forget to use the hashtag #NephJC. And hereโs the quick guide https://t.co/Fd0jkGVp6G |
 | Pablo Garcia @PabloGarciaMD Pablo Garcia, first year nephrology fellow @StanfordNeph lurking while I write some notes. No COI. #NephJC |
| Matthew Sparks, MD @Nephro_Sparks Matt Sparks checking in to the year 5 anniversary of #NephJC for #CREDENCE so excited and can't wait to chat with everyone. No COIs |
| Nephrology Journal Club @NephJC whoah! #NephJC |
 | Jennie Lin ๐ฉ๐ปโโ๏ธ๐งฌ @jenniejlin Physician-scientist from @NU_Nephrology, celebrating CREDENCE, #NephJC anniversary, and my new apartment! No COI. Cheers! https://t.co/altmMhWTL2 |
 | Edgar V. Lerma ๐ต๐ญ @edgarvlermamd Edgar Lerma, Chicago-based Nephrologist #NephJC Photo Credit: Barry Butler Photography ๐ธ https://t.co/eWMVI6KFon https://t.co/Snu0vlPjMe |
 | Natalie McCall @_NatalieMcCall Natalie McCall. On the Vandy team. Here with the fellows! No COI. #NephJC |
 | Mya Htwe Nge @mhtwenge Hi, this is Mya from ๐ฒ๐ฒ#NephJC no COI. |
| Sanjeev Nair @Nair_Sanj Sanjeev Nair, Chennai, No CoI. Congratulations #NephJC on the 5th anniversary. Its been a wonderful learning experience. Looking fwd to this chat |
 | Steven Coca @scoca1 @NephJC Coca here. Very excited to discuss CREDENCE at #NephJC. COI: Signed a consulting contract a few years ago with Janssen for SGLT2i-associated AKI. Needless to say, I've gotten zero cases to review and I'm still in debt. ๐ฐ |
| Mario Funes, MD @MarioFunesMD Mario Funes. Internal medicine resident in New Brunswick, NJ. No COI. #NSMC 2019 intern. Congratulations on 5 years of #NephJC |
 | Pascale Khairallah @Khairallah_P Pascale, renal fellow. No COI. Very excited for tonightโs #NephJC |
 | Dr. Kelly Hyndman @DrKeeksPhD Kelly Hyndman. UAB. No coi. #NephJC |
| Samaya @TarSamMD Samaya from @BCMKidneyHealth excited for todayโs JC! #nsmc no COI other than trying to figure out how quick to change practice #NephJC |
 | Sam Krishnamoorthy @beans_sam Sam Krishnamoorthy, private practice nephrologist, #NephJC |
 | Charbel C Khoury @Charbel_Khoury Charbel, Washington Univ St Louis, Not coy about my NO COI #NephJC |
| Fitsum Asnakech Tilahun MD @fitse_t @NephJC Fitsum, 1st year nephrology fellow #NephJC |
 | Joshua Waitzman, MD PhD @Jwaitz Josh Waitzman here, Nephrology fellow and physician scientist trainee at @NU_Nephrology. No COI. Excited about #CREDENCE #NephJC https://t.co/pAJhKOFPuX |
 | Justin Davis @jbda19 @NephJC Hi! Justin #NSMC intern. In a similar way that game of thrones is released at a weird time in Aus, so is #NephJC. Weโre at work in a busy transplant clinic, so despite the awesomeness of CREDENCE Iโd better lurk for this one. |
| Aakash Shingada, DNB, MRCP(UK), FASN @aakashshingada Hi Aakash Shingada, nephrologist from Mumbai. Really excited for this discussion. congratulations #NephJC for completing 5 awesome yrs! |
 | Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @gratefull080504: COI: Protalix, Gilead, Otsuka, Bayer, Retrophin, Hansa CareDx #NephJC |
 | Anshul Bhalla @BhallaAnshul Anshul, Tx Neph fellow @hopkinsneph #NSMC2019 intern. Congrats @NephJC Excited about discussion tonight. No COI #NephJC |
 | B. Wagner, M.D. ๐บ๐ธ @Wagner_Nephro Brent Wagner, University of New Mexico. COI: Phloridzin user since 1992 #nephjc |
| Michelle Rheault @rheault_m @anna_burgner @VUMCKidney Make the fellows get their own twitter accounts! #NephJC |
 | Diana Mahbod, MD, CPE, FASN, FNKF @DiMiRenalMD Diana here, private practice nephrologist in Dallas #NephJC https://t.co/EHAZMTlqTA |
 | Alex Meraz @NephroGuy Alex from Mexico. No COI #NephJC |
| Nephrology Journal Club @NephJC @gratefull080504 glad you could make it Kevin #NephJC |
 | Majid Sikosana MD, MRCP (UK), MMED (AKU) FCP @majidsiko Majid Sikosana UofA Nephrology-lurking #NephJC |
 | Kartik Kalra MD,FNKF,FASN @kkalra_22 Hello !! Kartik Kalra @kkalra_22 , fellow at @PITTRenal . No COI. #NephJC #CREDENCE |
| Hector Madariaga, MD FASN ๐ฒ๐ฝ @HecmagsMD Hรฉctor Madariaga. No COI. From #PatriotsNation The land of the dented Lombardy trophy. Looking forward for this discussion #NephJC https://t.co/a6iNr6nRp1 |
 | Shilpa Jesudason @shilpa_jes Shilpa from Australia no CoI - first time at #NephJC |
 | Kyle Jansson @kylepjansson Kyle Jansson, soon to be nephrology fellow. Not interesting enough to have COI! Glad to be here! #nephjc |
| Michelle Rheault @rheault_m RT @NephJC: The paper we will be discussing tonight is โCanagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathyโ by Perkovic et al published in @NEJM this month. It has caused a considerable stir already #NephJC |
 | Larissa Krรผger @nephron_andon @NephJC Larissa from UConn and 2019 class of #NSMC no COI, but extremely excited #NephJC |
| Nephrology Journal Club @NephJC Didnโt have time to sift through the entire paper and supplementary material? Check out the excellent summary by @drlovygaur #NephJC https://t.co/4MdXRrwI01 |
 | Alexis Sloan @sloan_alexis Checking in from Miami! No COI and happy birthday #NephJC ! |
| Rodrigo Nunes Cal @CalZole RT @HecmagsMD: Hรฉctor Madariaga. No COI. From #PatriotsNation The land of the dented Lombardy trophy. Looking forward for this discussion #NephJC https://t.co/a6iNr6nRp1 |
| Natalie McCall @_NatalieMcCall @johnmcph @anna_burgner @VUMCKidney Yes we are! @johnmcph #NephJC |
 | James Novak, MD PhD FACP FASN FNKF @JamesNovakNeph Forgot #NephJC |
 | Helbert Rondon, MD, MS, FACP, FASN, FNKF @NephroMD This is Helbert Rondon from Pittsburgh. No COI other than I love Creedence. Just lurking today #NephJC https://t.co/DXUjlvDxGo |
| Verner Venegas @Vernisartan RT @NephJC: Didnโt have time to sift through the entire paper and supplementary material? Check out the excellent summary by @drlovygaur #NephJC https://t.co/4MdXRrwI01 |
 | Jefferson L. Triozzi, M.D. @nepherson @NephJC Jefferson, PGY2 @BCM_InternalMed no COI #NephJC |
| Nephrology Journal Club @NephJC Also check out this excellent visual abstract by @MarioFunesMD #NephJC https://t.co/BUfUuDSekT |
| Sayna Norouzi, MD, FASN @SaynaNorouzi Sayna Norouzi, first year nephrology fellow @BCMKidneyHealth. No CoI. #NephJC |
| Rodrigo Nunes Cal @CalZole RT @NephJC: The paper we will be discussing tonight is โCanagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathyโ by Perkovic et al published in @NEJM this month. It has caused a considerable stir already #NephJC |
 | Luis Perez @Lmipz @NephJC UofI PhD nutrition student here! no COI as usual... following/lurking tonight, probably won't be able to comment much. But love the topic/study! #NephJC |
 | Arshad Ali @aldorenin @NephJC Arshad Ali Clinical Nephrology No COI. Excited to learn more about CREDENCE. #Nephjc |
 | John Montford @JohnRMontford #NephJC hello from Denver CREDENCE is here! Letโs do this!!! Time to score a win for the #KidneyinCVD https://t.co/Nfl2v1vXLF |
| ChristosArgyropoulos MD, PhD PharmanukerInChief @ChristosArgyrop Christos Argyropoulos, Academic Nephrologist. No CoI with this (or any other SGLT2i). Proud SGLT2i defender of the faith and fighter of SGLT2i-denialism during the dark ages. #nephjc |
 | Mei Lin Bissonnette MD PhD FRCPC @BCRenalPath Mei Lin Bissonnette, renal pathologist in Vancouver, BC. No COI and just lurking to learn something clinical! #NephJC |
 | Sean Pickthorn @SeanPickthorn Sean, MSIV headed to Iowa IM, looking forward to the discussion tonight! #nephjc |
| Nephrology Journal Club @NephJC and another #VisualAbstract from @brendonneuen #NephJC https://t.co/Co4DXD0k67 |
| Rodrigo Nunes Cal @CalZole RT @edgarvlermamd: Edgar Lerma, Chicago-based Nephrologist #NephJC Photo Credit: Barry Butler Photography ๐ธ https://t.co/eWMVI6KFon https://t.co/Snu0vlPjMe |
 | Jeffrey William @jwilliamMD Jeff William. BIDMC Boston. No COI. Mostly lurking, because I have more clinic notes to dictate. #NephJC |
 | Lovy @drlovygaur Hi.. this is Lovy from Delhi, India. No COI except for all enthusiasm about the molecule #NephJC |
| Nathaniel Reisinger @nephrothaniel RT @NephJC: Also check out this excellent visual abstract by @MarioFunesMD #NephJC https://t.co/BUfUuDSekT |
| Nephrology Journal Club @NephJC @SeanPickthorn welcome to #NephJC |
 | Aisha Shaikh @aishaikh Hello this is Aisha from NYC, also joining the chat is my husband @kirkcampbell #NephJC |
| Dr. Kelly Hyndman @DrKeeksPhD RT @NephJC: Also check out this excellent visual abstract by @MarioFunesMD #NephJC https://t.co/BUfUuDSekT |
 | Hassan Mahmoud @hassan_mohamud RT @NephJC: Your host tonight is Swap @hswapnil from the beautiful city of Ottawa #NephJC https://t.co/ZPEgboRCRB |
 | Caitlyn Vlasschaert @DrFlashHeart Hi #nephcommunity! I'm Caitlyn, a graduating medical student/soon-to-be IM resident in Canada. First time #NephJC participant. No COI. |
| Sam Krishnamoorthy @beans_sam Great summary by @drlovygaur !! |
| Mario Funes, MD @MarioFunesMD RT @NephJC: Also check out this excellent visual abstract by @MarioFunesMD #NephJC https://t.co/BUfUuDSekT |
| Madhuri Ramakrishnan @madmagicdoc @drlovygaur Great summary @drlovygaur #NephJC #NSMC |
| Fitsum Asnakech Tilahun MD @fitse_t RT @NephJC: Also check out this excellent visual abstract by @MarioFunesMD #NephJC https://t.co/BUfUuDSekT |
| Diana Mahbod, MD, CPE, FASN, FNKF @DiMiRenalMD RT @NephJC: Also check out this excellent visual abstract by @MarioFunesMD #NephJC https://t.co/BUfUuDSekT |
| Nephrology Journal Club @NephJC A warm up T0 Twitter poll for #NephJC Do you use SGLT2i already? |
| Edgar V. Lerma ๐ต๐ญ @edgarvlermamd CREDENCE: Canagliflozin reduces the risk of kidney failure or death due to CV or kidney disease by 30% compared to current standard of care ca. 2019 from @NEJM #VisualAbstract by @brendonneuen #Nephpearls #NephJC ๐๐ผ https://t.co/NcQdXrtc3K https://t.co/dcJvZKp1N5 |
 | orion77 @orion7710 RT @aishaikh: Given the benefits of #SGLT2 Inhibitors in diabetic CKD & heart failure - will these conditions eventually become the โprimaryโ indication to use these drugs - that just happen to have mild glucose lowering as a side effect? #NephJC #CREDENCE @hswapnil https://t.co/rX7rhN3AR0 |
| Aakash Shingada, DNB, MRCP(UK), FASN @aakashshingada #isnwcn late breaking trials was the first time I witnessed first hand presentation of a clinical trial. Such an amazing experience to witness the reactions live! #NephJC https://t.co/KpFhHdRz4c |
 | Timothy Yau @Maximal_Change Tim Yau, @WUNephrology, no COI. Excited for this #NephJC, this is how people probably felt when CAPTOPRIL trial data announced 30+ years ago. |
| Tejas Desai, MD MBA @nephondemand @HecmagsMD @NODanalytics @NephroWorldCup always my friend! heading up to your neck of the woods in 1.5 weeks #nephJC |
 | Joseph Vassalotti, MD @Joe_Vassalotti First time #NephJC 25 years out of fellowship CAVH was the only CRRT No twitter & no cell phones then COI Janssen, Merck Congrats @hswapnil & @kidneyboy for #NephJC Stars seem to be aligned for a new era for nephrology and people with CKD |
| Mario Funes, MD @MarioFunesMD @c8lynv Welcome! #NephJC |
 | Heather Henderson @kidneygirl82 Heather Henderson Joint from Detroit in the gracious host Joel Topfโs @kidneyboy home. #nephjc |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 #NephJC Good to see a lot of new faces again |
| Rodrigo Nunes Cal @CalZole RT @Maximal_Change: Tim Yau, @WUNephrology, no COI. Excited for this #NephJC, this is how people probably felt when CAPTOPRIL trial data announced 30+ years ago. |
| Dr. Kelly Hyndman @DrKeeksPhD RT @NephJC: and another #VisualAbstract from @brendonneuen #NephJC https://t.co/Co4DXD0k67 |
 | Bhavnish @Buck1486 Buck from @OSUWexMed ... EMPAREG, CANVAS, DECLARE, CREDENCE. SGLT2i's work!! Talking to Nephrologists over the past 2 weeks, it seems the main concerns to be addressed tonight: 1.Risk of euglycemic DKA 2.Risk of amputation /law suit 3.Risk of UTI #NephJC |
| Sam Krishnamoorthy @beans_sam RT @edgarvlermamd: CREDENCE: CREDENCE: Canagliflozin reduces the risk of kidney failure or death due to CV or kidney disease by 30% compared to current standard of care ca. 2019 from @NEJM #VisualAbstract by @brendonneuen #Nephpearls #NephJC ๐๐ผ https://t.co/NcQdXrtc3K https://t.co/dcJvZKp1N5 |
| Michelle Rheault @rheault_m @c8lynv Welcome to #NephJC! |
| Nephrology Journal Club @NephJC check out the awesome schematic from @drlovygaur about the trials and tribulations in DM nephropathy #NephJC https://t.co/1PApkupHRt |
| Nephrology Journal Club @NephJC @Joe_Vassalotti @hswapnil @kidneyboy welcome to #NephJC Honored you could make it! |
 | Kenar Jhaveri @kdjhaveri Kenar Jhaveri, No COI #NephJC |
 | Angel Cesar Ortiz @AngelCesarOrtiz Hi everyone! Angel Ortiz from Mexico Excited for this #NEphJC no COI |
| Mya Htwe Nge @mhtwenge RT @NephJC: check out the awesome schematic from @drlovygaur about the trials and tribulations in DM nephropathy #NephJC https://t.co/1PApkupHRt |
| Joel M. Topf, MD FACP @kidney_boy #CREDENCE party #NephJC with @DoctorGates https://t.co/AatCJXSG1B |
| Rodrigo Nunes Cal @CalZole RT @kdjhaveri: Kenar Jhaveri, No COI #NephJC |
| Hector Madariaga, MD FASN ๐ฒ๐ฝ @HecmagsMD Is there an #Endocrinologist in the house? Wonder if they are also excited about #CREDENCE #Endocrine #diabetes #NephJC |
| Nephrology Journal Club @NephJC @aishaikh @kirkcampbell fab! great tweetorials on SGLT2i there #NephJC |
 | TEJAS PATEL MD, FACP, FASN @GenNextMD @ChristosArgyrop Dark ages? Well it will be sun shine by end of the hour...#enlightenment ....#nephJC |
 | Nikhil Shah MBBS DNB(IM, Neph)๐จ๐ฆ @dr_nikhilshah Nikhil Shah - Clinical Nephrologist @UAlbertaNeph No COI!#NephJC |
| Edgar V. Lerma ๐ต๐ญ @edgarvlermamd EMPA-REG: Empagliflozin, CV outcomes and mortality in Type 2 Diabetes ca. 2015 from @NEJM #VisualAbstract by @kidney_boy #Nephpearls #NephJC ๐๐ผ https://t.co/6NSu71ck43 https://t.co/VbORQXvo18 |
| Hector Madariaga, MD FASN ๐ฒ๐ฝ @HecmagsMD @c8lynv Welcome! #NephJC |
| Samaya @TarSamMD RT @NephJC: check out the awesome schematic from @drlovygaur about the trials and tribulations in DM nephropathy #NephJC https://t.co/1PApkupHRt |
| Nephrology Journal Club @NephJC SGLT2 inhibitors have increasingly drawn attention over the last decade. See this excellent ADKD blog from 2018 by Anna Burgner for an explanation of their mechanism of action #NephJC https://t.co/7mVBgGT7YQ slow-the-progression-of-diabetic-kidney-disease/ |
| Harish Seethapathy @BetterCallSeeth @NephJC @drlovygaur More sad smileys than not in recent years. #CREDENCE needs a bigger :) #NephJC |
| Mario Funes, MD @MarioFunesMD RT @NephJC: check out the awesome schematic from @drlovygaur about the trials and tribulations in DM nephropathy #NephJC https://t.co/1PApkupHRt |
| Rodrigo Nunes Cal @CalZole RT @edgarvlermamd: EMPA-REG: EMPA-REG: Empagliflozin, CV outcomes and mortality in Type 2 Diabetes ca. 2015 from @NEJM #VisualAbstract by @kidney_boy #Nephpearls #NephJC ๐๐ผ https://t.co/6NSu71ck43 https://t.co/VbORQXvo18 |
| Sanjeev Nair @Nair_Sanj This schematic by @lovygaur has its own fanbase #NephJC #Nephpearls |
| Sam Krishnamoorthy @beans_sam RT @NephJC: SGLT2 inhibitors have increasingly drawn attention over the last decade. See this excellent ADKD blog from 2018 by Anna Burgner for an explanation of their mechanism of action #NephJC https://t.co/7mVBgGT7YQ slow-the-progression-of-diabetic-kidney-disease/ |
| ChristosArgyropoulos MD, PhD PharmanukerInChief @ChristosArgyrop We had to fight right and left ... defeatism fueled denialism #SGLT2i #Nephjc |
| Nephrology Journal Club @NephJC SGLT2 inhibitors block the SGLT2 transport in the proximal tubule, resulting in glycosuria with attendant reduction in glycaemia. Their natriuretic action may hold the key to their dowsnstream kidney actions via tubuloglomerular feedback and glomerular hyperfiltration. #NephJC |
 | Vipin Varghese @vipvargh Vipin Varghese, medical student in New Orleans. First time #NephJC participant ๐ |
| Anna Burgner MD MEHP @anna_burgner @kidney_boy @DoctorGates Why are you all inside? You should be outside like we are down in beautiful Nashville! #NephJC @VUMCKidney |
 | Juan Medaura @JMedauraMD RT @NephJC: Also check out this excellent visual abstract by @MarioFunesMD #NephJC https://t.co/BUfUuDSekT |
| Rodrigo Nunes Cal @CalZole RT @HecmagsMD: Is there an #Endocrinologist in the house? Wonder if they are also excited about #CREDENCE #Endocrine #diabetes #NephJC |
| Nephrology Journal Club @NephJC RT @HecmagsMD: Is there an #Endocrinologist in the house? Wonder if they are also excited about #CREDENCE #Endocrine #diabetes #NephJC |
| Michelle Rheault @rheault_m RT @NephJC: SGLT2 inhibitors have increasingly drawn attention over the last decade. See this excellent ADKD blog from 2018 by Anna Burgner for an explanation of their mechanism of action #NephJC https://t.co/7mVBgGT7YQ slow-the-progression-of-diabetic-kidney-disease/ |
| Lovy @drlovygaur RT @aakashshingada: #isnwcn late breaking trials was the first time I witnessed first hand presentation of a clinical trial. Such an amazing experience to witness the reactions live! #NephJC https://t.co/KpFhHdRz4c |
| Hector Madariaga, MD FASN ๐ฒ๐ฝ @HecmagsMD @aakashshingada This was awesome. Great job, Aakash! #NephJC |
| Rodrigo Nunes Cal @CalZole RT @kidney_boy: #CREDENCE party #NephJC with @DoctorGates https://t.co/AatCJXSG1B |
| TEJAS PATEL MD, FACP, FASN @GenNextMD Tejas Patel, no COI #NephJC |
 | Eric Au @ericau @NephJC Hi Eric nephrologist from Sydney. Joining late and mainly lurking today #nsmc #nephjc |
 | Landmark Nephrology @landmark_neph Excited for #NephJC and the discussion of the truly Landmark #CREDENCE trial! |
| Nephrology Journal Club @NephJC @vipvargh great to see you here Vipin #NephJC |
 | Derian Lai @GlomeruLai Derian Lai. IM resident. No COI. #NephJC |
| Hector Madariaga, MD FASN ๐ฒ๐ฝ @HecmagsMD @Joe_Vassalotti @hswapnil @kidneyboy Welcome! #NephJC |
| Gates Colbert, MD @DoctorGates @kidney_boy Great to be invited to #NephJC headquarters. Midwest sector. |
 | Rima Kang @rimakang5 Rima from OSU, no COI. #NephJC |
| Dr. Kelly Hyndman @DrKeeksPhD RT @NephJC: SGLT2 inhibitors have increasingly drawn attention over the last decade. See this excellent ADKD blog from 2018 by Anna Burgner for an explanation of their mechanism of action #NephJC https://t.co/7mVBgGT7YQ slow-the-progression-of-diabetic-kidney-disease/ |
| Angel Cesar Ortiz @AngelCesarOrtiz RT @NephJC: check out the awesome schematic from @drlovygaur about the trials and tribulations in DM nephropathy #NephJC https://t.co/1PApkupHRt |
| Edgar V. Lerma ๐ต๐ญ @edgarvlermamd CANVAS: Canagliflozin and CV & Renal events in Type 2 Diabetes ca. 2017 from @NEJM #VisualAbstract by @kidney_boy #Nephpearls #NephJC ๐๐ผ https://t.co/iCmylgorUO https://t.co/KErFtyQUwN |
| Mario Funes, MD @MarioFunesMD @vipvargh Welcome to #NephJC |
| Diana Mahbod, MD, CPE, FASN, FNKF @DiMiRenalMD RT @landmark_neph: Excited for #NephJC and the discussion of the truly Landmark #CREDENCE trial! |
 | Phillip Madonia @PMNax2 Phillip Madonia. Sorry Iโm late. Private practice. Bham AL. No COI. Exciting stuff tonight. #NephJC |
| Larissa Krรผger @nephron_andon @c8lynv Welcome! #NephJC |
| Arshad Ali @aldorenin RT @NephJC: SGLT2 inhibitors block the SGLT2 transport in the proximal tubule, resulting in glycosuria with attendant reduction in glycaemia. Their natriuretic action may hold the key to their dowsnstream kidney actions via tubuloglomerular feedback and glomerular hyperfiltration. #NephJC |
| Khaled Shawwa @khaledshawwa RT @NephJC: check out the awesome schematic from @drlovygaur about the trials and tribulations in DM nephropathy #NephJC https://t.co/1PApkupHRt |
| Hector Madariaga, MD FASN ๐ฒ๐ฝ @HecmagsMD @NephJC @drlovygaur This was a great graph. Love History #NephJC |
| Samaya @TarSamMD RT @NephJC: SGLT2 inhibitors have increasingly drawn attention over the last decade. See this excellent ADKD blog from 2018 by Anna Burgner for an explanation of their mechanism of action #NephJC https://t.co/7mVBgGT7YQ slow-the-progression-of-diabetic-kidney-disease/ |
| Arshad Ali @aldorenin RT @NephJC: SGLT2 inhibitors have increasingly drawn attention over the last decade. See this excellent ADKD blog from 2018 by Anna Burgner for an explanation of their mechanism of action #NephJC https://t.co/7mVBgGT7YQ slow-the-progression-of-diabetic-kidney-disease/ |
| Nephrology Journal Club @NephJC we have had EMPAREG https://t.co/k69ARWpPrN and CANVAS http://www.nephjc. com/news/canvas #NephJC |
 | Mark Purcell @sparty_bean Mark Purcell, Greenville, SC, no COI #NephJC |
| Joshua Waitzman, MD PhD @Jwaitz Props to @SusanQuaggin for the SweetPee branding #nephjc https://t.co/tcpnaj42I7 |
| Hector Madariaga, MD FASN ๐ฒ๐ฝ @HecmagsMD @shilpa_jes Get him NOW #NephJC |
 | Kidney in Cardiovascular Disease @KidneyInCVD The AHA #KCVD #KidneyInCVD council checking in to #NephJC Welcome all |
| Nephrology Journal Club @NephJC which brings us to the CREDENCE Crescendo https://t.co/4MdXRrwI01 #NephJC |
| Alex Meraz @NephroGuy RT @NephJC: SGLT2 inhibitors have increasingly drawn attention over the last decade. See this excellent ADKD blog from 2018 by Anna Burgner for an explanation of their mechanism of action #NephJC https://t.co/7mVBgGT7YQ slow-the-progression-of-diabetic-kidney-disease/ |
 | Tiffany Caza @Tiff_Caza RT @NephJC: check out the awesome schematic from @drlovygaur about the trials and tribulations in DM nephropathy #NephJC https://t.co/1PApkupHRt |
| Alex Meraz @NephroGuy RT @edgarvlermamd: EMPA-REG: EMPA-REG: Empagliflozin, CV outcomes and mortality in Type 2 Diabetes ca. 2015 from @NEJM #VisualAbstract by @kidney_boy #Nephpearls #NephJC ๐๐ผ https://t.co/6NSu71ck43 https://t.co/VbORQXvo18 |
| Alex Meraz @NephroGuy RT @edgarvlermamd: CREDENCE: CREDENCE: Canagliflozin reduces the risk of kidney failure or death due to CV or kidney disease by 30% compared to current standard of care ca. 2019 from @NEJM #VisualAbstract by @brendonneuen #Nephpearls #NephJC ๐๐ผ https://t.co/NcQdXrtc3K https://t.co/dcJvZKp1N5 |
| Timothy Yau @Maximal_Change @vipvargh Welcome! #NephJC |
| Alex Meraz @NephroGuy RT @Nair_Sanj: This schematic by @lovygaur has its own fanbase #NephJC #Nephpearls |
 | Beje Thomas @bthomas215 Beje Thomas no coi nephrologist is AdC #nephjc |
| Nephrology Journal Club @NephJC Phew - hello to all the new peeps dont forget to vote in our poll On to methods in a minute or two #NephJC |
 | Nissreen Elfadawy MD, MS, FASN, FAST @ElfadawyN Nissreen - renal fellow. No COI. So excited to todayโs JC #NephJC |
| Edgar V. Lerma ๐ต๐ญ @edgarvlermamd Effect of SGLT2 inhibitors on CV, renal and safety outcomes in patients with type 2 diabetes mellitus and CKD: A systematic review and meta-analysis ca. 2019 #VisualAbstract by @brendonneuen #Nephpearls #NephJC ๐๐ผ https://t.co/HYQbAdsNvB https://t.co/YFeD30Txlf |
| Diana Mahbod, MD, CPE, FASN, FNKF @DiMiRenalMD RT @NephJC: SGLT2 inhibitors have increasingly drawn attention over the last decade. See this excellent ADKD blog from 2018 by Anna Burgner for an explanation of their mechanism of action #NephJC https://t.co/7mVBgGT7YQ slow-the-progression-of-diabetic-kidney-disease/ |
| Kenar Jhaveri @kdjhaveri I remember my first post on these drugs on nephronpower https://t.co/OHpFCNu89n #NephJC i had called them glucoretics |
| Alex Meraz @NephroGuy RT @NephJC: SGLT2 inhibitors block the SGLT2 transport in the proximal tubule, resulting in glycosuria with attendant reduction in glycaemia. Their natriuretic action may hold the key to their dowsnstream kidney actions via tubuloglomerular feedback and glomerular hyperfiltration. #NephJC |
| Harini Sarathy @hurryknee RT @NephJC: check out the awesome schematic from @drlovygaur about the trials and tribulations in DM nephropathy #NephJC https://t.co/1PApkupHRt |
 | Jeffrey Sparks MD MMSc @jeffsparks Jeff Sparks, @BrighamResearch Rheumatology, COI- not a nephrologist, brother of @Nephro_Sparks. Here to admire the fawning over this study #NephJC |
 | Alex Chang, MD, FASN, FAHA @alexchangmd Alex Chang, nephrologist from central Pennsylvania excited about this #NephJC chat! no COI. Putting overtired kid down |
 | Scherly Leon, MD @SLeonMD Scherly Leon, nephrologist in NYC. No COI. Happy Anniversary #NephJC! |
| Arshad Ali @aldorenin RT @edgarvlermamd: CANVAS: CANVAS: Canagliflozin and CV & Renal events in Type 2 Diabetes ca. 2017 from @NEJM #VisualAbstract by @kidney_boy #Nephpearls #NephJC ๐๐ผ https://t.co/iCmylgorUO https://t.co/KErFtyQUwN |
| Nephrology Journal Club @NephJC RT @NephJC: A warm up T0 Twitter poll for #NephJC Do you use SGLT2i already? |
| Hector Madariaga, MD FASN ๐ฒ๐ฝ @HecmagsMD @ericau @NephJC Hey, Eric #NephJC |
| James Novak, MD PhD FACP FASN FNKF @JamesNovakNeph @HecmagsMD My wife is an endocrinologist, and we're scratching our heads about the #CREDENCE craze. Similar results 3 years ago from EMPA-REG and 2 years ago from CANVAS. (Yes, somewhat dif't pop'ns and technically not "renal" trials.) #NephJC |
| Nephrology Journal Club @NephJC very few skeptics in poll Great going https://t.co/7YTLNMIbKt #NephJC |
| Matthew Sparks, MD @Nephro_Sparks @jeffsparks @BrighamResearch Whoa.... Nervous..... My brother joining #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @Joe_Vassalotti @hswapnil @kidneyboy A new era for patients is long overdue! #NephJC |
| Michelle Rheault @rheault_m @NephJC @NEJM This chat is already nuts. I can barely keep up. (And this is not my first rodeo) #NephJC |
| Matthew Sparks, MD @Nephro_Sparks RT @jeffsparks: Jeff Sparks, @BrighamResearch Rheumatology, COI- not a nephrologist, brother of @Nephro_Sparks. Here to admire the fawning over this study #NephJC |
| Nephrology Journal Club @NephJC @jeffsparks @BrighamResearch @Nephro_Sparks #SparkyPower #NephJC |
 | ajit narula @narulaas #NephJC |
 | Salt @Saltwebsite Gerren Hobby. Glad to be a part of the discussion. No COI. #NephJC |
| Hector Madariaga, MD FASN ๐ฒ๐ฝ @HecmagsMD @kdjhaveri Thatโs a nice alternate class name! #Glucoretic #nephjc |
 | L. Parker Gregg @LParkerGregg1 Late to the game today (just finished cleaning up kitchen). No COI. #NephJC |
| Verner Venegas @Vernisartan This is a great review of CREDENCE with CANVAS and EMPAREG study from the American Journal of Nephrology #NephJC https://t.co/bXWBvJJ3Oc |
| Kartik Kalra MD,FNKF,FASN @kkalra_22 RT @NephJC: check out the awesome schematic from @drlovygaur about the trials and tribulations in DM nephropathy #NephJC https://t.co/1PApkupHRt |
| Edgar V. Lerma ๐ต๐ญ @edgarvlermamd Canagliflozin and renal outcomes in type 2 diabetes: results from the CANVAS Program randomised clinical trials ca. 2018 from @TheLancet #VisualAbstract by @divyaa24 #Nephpearls #NephJC ๐๐ผ https://t.co/pKBcHebr9s https://t.co/wZLtunq7YP |
| Angel Cesar Ortiz @AngelCesarOrtiz RT @NephJC: Also check out this excellent visual abstract by @MarioFunesMD #NephJC https://t.co/BUfUuDSekT |
| James Novak, MD PhD FACP FASN FNKF @JamesNovakNeph @NephJC I don't think it's the glucosuria. It's the increased NaCl delivery to the macula densa, restoring TGF and allowing the AA to constrict. Same effect with acetazolamide, at least experimentally. #NephJC |
| ChristosArgyropoulos MD, PhD PharmanukerInChief @ChristosArgyrop @VelezNephHepato @NephJC The first paper was in JASN back in 1999 https://t.co/qxptexIc9v 4 tweets!! #wrong #nephjc |
| Nephrology Journal Club @NephJC what did we know pre-CREDENCE? See these major trials #NephJC GFR > 60 very feew with albuminuria renal outcomes secondary https://t.co/drmlYsy8Ab |
| L. Parker Gregg @LParkerGregg1 RT @NephJC: Also check out this excellent visual abstract by @MarioFunesMD #NephJC https://t.co/BUfUuDSekT |
| Aakash Shingada, DNB, MRCP(UK), FASN @aakashshingada So many #VisualAbstract s for today's paper! And I am sure more will be created for this landmark paper #NephJC @MarioFunesMD @brendonneuen @cardiotrials https://t.co/aJgJbC29es |
| Scherly Leon, MD @SLeonMD @gratefull080504 it was great to finally meet you at #KidneyCon #nephjc |
| Charbel C Khoury @Charbel_Khoury It all started with this guy: Josef von Mering who discovered glycosuric effects of phlorizin in the 1800 (right after he discovered Barbiturates, no buggy) #NephJC https://t.co/157wTBjWD3 |
 | Gonzalo Matzumura @GMatzumura Gonzalo, future neph fellow, lurking during my last set of ICU nights. No COI #Nephjc |
| Nephrology Journal Club @NephJC Point made more visually here #NephJC https://t.co/6pPwNVwLQF |
| Hector Madariaga, MD FASN ๐ฒ๐ฝ @HecmagsMD RT @JamesNovakNeph: @HecmagsMD My wife is an endocrinologist, and we're scratching our heads about the #CREDENCE craze. Similar results 3 years ago from EMPA-REG and 2 years ago from CANVAS. (Yes, somewhat dif't pop'ns and technically not "renal" trials.) #NephJC |
| Aakash Shingada, DNB, MRCP(UK), FASN @aakashshingada RT @werner02: This is a great review of CREDENCE with CANVAS and EMPAREG study from the American Journal of Nephrology #NephJC https://t.co/bXWBvJJ3Oc |
| Kenar Jhaveri @kdjhaveri @HecmagsMD They really are a proximal tubule diuretic and bp med and A1c likely a beneficial side effect #NephJC |
| Bhavnish @Buck1486 During my Journal club last week I mentioned how phlorizin was initially obtained from apple tree bark. The Nephrology community has finally infused evidence based medicine into the cliche 'An apple a day keeps the doctor away' @hswapnil #nephjc |
 | Franklin Loachamin @FranLoachamin Franklin Loachamin. Ecuador no COI . Im in love with #NephJC |
| Joel M. Topf, MD FACP @kidney_boy Lots of love for this image on #NephJC, great work. |
| Joshua Waitzman, MD PhD @Jwaitz Nothing like data to liven up the #NephJC crowd https://t.co/dc5mRXc3wX |
| Alex Meraz @NephroGuy RT @Charbel_Khoury: It all started with this guy: It all started with this guy: Josef von Mering who discovered glycosuric effects of phlorizin in the 1800 (right after he discovered Barbiturates, no buggy) #NephJC https://t.co/157wTBjWD3 |
| Aakash Shingada, DNB, MRCP(UK), FASN @aakashshingada RT @kdjhaveri: I remember my first post on these drugs on nephronpower https://t.co/OHpFCNu89n #NephJC i had called them glucoretics |
| Jennie Lin ๐ฉ๐ปโโ๏ธ๐งฌ @jenniejlin RT @Charbel_Khoury: It all started with this guy: It all started with this guy: Josef von Mering who discovered glycosuric effects of phlorizin in the 1800 (right after he discovered Barbiturates, no buggy) #NephJC https://t.co/157wTBjWD3 |
| Sam Krishnamoorthy @beans_sam RT @NephJC: what did we know pre-CREDENCE? See these major trials #NephJC GFR > 60 very feew with albuminuria renal outcomes secondary https://t.co/drmlYsy8Ab |
| Alex Meraz @NephroGuy RT @aakashshingada: So many #VisualAbstract s for today's paper! And I am sure more will be created for this landmark paper #NephJC @MarioFunesMD @brendonneuen @cardiotrials https://t.co/aJgJbC29es |
| Alex Meraz @NephroGuy RT @NephJC: Also check out this excellent visual abstract by @MarioFunesMD #NephJC https://t.co/BUfUuDSekT |
| Edgar V. Lerma ๐ต๐ญ @edgarvlermamd Ongoing trials of SGLT2 Inhibitors of interest to the Nephrology Community ca. 2019 Table by @drlovygaur #Nephpearls #NephJC https://t.co/ZbYhojEimj |
| Nephrology Journal Club @NephJC Kudos to team at @george_clinical for designing this study (planned pre-EMPAREG!) #NephJC thanks to Janssen for funding |
| Rodrigo Nunes Cal @CalZole RT @edgarvlermamd: CANVAS: CANVAS: Canagliflozin and CV & Renal events in Type 2 Diabetes ca. 2017 from @NEJM #VisualAbstract by @kidney_boy #Nephpearls #NephJC ๐๐ผ https://t.co/iCmylgorUO https://t.co/KErFtyQUwN |
| Jeffrey Sparks MD MMSc @jeffsparks @ssfarouk @BrighamResearch @Nephro_Sparks Iโm ready, able, and willing #wonderdrug #NephJC @alhkim |
 | Jung Hoon Son, M.D. @junghoon_sonMD RT @NephJC: check out the awesome schematic from @drlovygaur about the trials and tribulations in DM nephropathy #NephJC https://t.co/1PApkupHRt |
| Nephrology Journal Club @NephJC RT @Charbel_Khoury: It all started with this guy: It all started with this guy: Josef von Mering who discovered glycosuric effects of phlorizin in the 1800 (right after he discovered Barbiturates, no buggy) #NephJC https://t.co/157wTBjWD3 |
| Hector Madariaga, MD FASN ๐ฒ๐ฝ @HecmagsMD @Nephro_Sparks @jeffsparks @BrighamResearch Jeff: Can you tell us a dirty secret about Matt? LOL #NephJC |
 | Dominique Tomacruz, MD @DTomacruzMD Dominique Tomacruz from Manila, Philippines, no COI. Checking in #NephJC |
| Nissreen Elfadawy MD, MS, FASN, FAST @ElfadawyN Ok confession time. This is my first JC, how does this work?! ๐ค #NephJC |
| Aakash Shingada, DNB, MRCP(UK), FASN @aakashshingada @VelezNephHepato @rheault_m @NephJC @NEJM Today we need 2hrs #NephJC |
| Timothy Yau @Maximal_Change Just glad that someone made some subtle CCR jokes. I approve. |
| Mya Htwe Nge @mhtwenge RT @NephJC: what did we know pre-CREDENCE? See these major trials #NephJC GFR > 60 very feew with albuminuria renal outcomes secondary https://t.co/drmlYsy8Ab |
 | Jenn @Jentan7477 RT @jeffsparks: Jeff Sparks, @BrighamResearch Rheumatology, COI- not a nephrologist, brother of @Nephro_Sparks. Here to admire the fawning over this study #NephJC |
 | Samira Farouk, MD, MSCR @ssfarouk RT @jeffsparks: @ssfarouk @BrighamResearch @Nephro_Sparks Iโm ready, able, and willing #wonderdrug #NephJC @alhkim |
| Nephrology Journal Club @NephJC RT @ChristosArgyrop: @VelezNephHepato @NephJC The first paper was in JASN back in 1999 https://t.co/qxptexIc9v 4 tweets!! #wrong #nephjc |
| Scherly Leon, MD @SLeonMD @FranLoachamin great to hear! Welcome to #NephJC |
| Franklin Loachamin @FranLoachamin RT @NephJC: Point made more visually here #NephJC https://t.co/6pPwNVwLQF |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 #NephJC Let's get the conversation going |
| Lovy @drlovygaur RT @Charbel_Khoury: It all started with this guy: It all started with this guy: Josef von Mering who discovered glycosuric effects of phlorizin in the 1800 (right after he discovered Barbiturates, no buggy) #NephJC https://t.co/157wTBjWD3 |
| Jenn @Jentan7477 RT @Joe_Vassalotti: First time #NephJC 25 years out of fellowship CAVH was the only CRRT No twitter & no cell phones then COI Janssen, Merck Congrats @hswapnil & @kidneyboy for #NephJC Stars seem to be aligned for a new era for nephrology and people with CKD |
| Dr. Kelly Hyndman @DrKeeksPhD RT @NephJC: Point made more visually here #NephJC https://t.co/6pPwNVwLQF |
| Franklin Loachamin @FranLoachamin RT @Charbel_Khoury: It all started with this guy: It all started with this guy: Josef von Mering who discovered glycosuric effects of phlorizin in the 1800 (right after he discovered Barbiturates, no buggy) #NephJC https://t.co/157wTBjWD3 |
 | Dave White @kidneywarrior @kidney_boy @DoctorGates The gargantuan fruit bowl is a nice touch #CREDENCE #NephJC |
| Samaya @TarSamMD RT @NephJC: Point made more visually here #NephJC https://t.co/6pPwNVwLQF |
| Franklin Loachamin @FranLoachamin RT @aakashshingada: So many #VisualAbstract s for today's paper! And I am sure more will be created for this landmark paper #NephJC @MarioFunesMD @brendonneuen @cardiotrials https://t.co/aJgJbC29es |
 | Vanessa Lerma @VanessaLerma17 Hello everybody, Vanessa from Mexico No COI @NSMCInternship #NephJC |
| Nephrology Journal Club @NephJC T1: This was a randomised, double-blind, placebo-controlled trial conducted at 690 sites in 34 countries across North America, Latin America, South Africa and Asia Pacific. #NephJC |
 | Natasha N. Dave @NatashaNDave Hello ๐ Natasha from @NephBCM checking in for #NephJC. No COI. |
| Hector Madariaga, MD FASN ๐ฒ๐ฝ @HecmagsMD RT @Charbel_Khoury: It all started with this guy: It all started with this guy: Josef von Mering who discovered glycosuric effects of phlorizin in the 1800 (right after he discovered Barbiturates, no buggy) #NephJC https://t.co/157wTBjWD3 |
| Arshad Ali @aldorenin RT @edgarvlermamd: Ongoing trials of SGLT2 Inhibitors of interest to the Nephrology Community ca. 2019 Table by @drlovygaur #Nephpearls #NephJC https://t.co/ZbYhojEimj |
| Jennie Lin ๐ฉ๐ปโโ๏ธ๐งฌ @jenniejlin @ElfadawyN You used the hashtag - youโre good! Look out for questions from @nephjc, and follow the #nephJC hashtag on Tweetdeck. Itโs blowing up already! |
| Jenn @Jentan7477 RT @Buck1486: During my Journal club last week I mentioned how phlorizin was initially obtained from apple tree bark. The Nephrology community has finally infused evidence based medicine into the cliche 'An apple a day keeps the doctor away' @hswapnil #nephjc |
| James Novak, MD PhD FACP FASN FNKF @JamesNovakNeph @scoca1 @HecmagsMD Really? That's just mean. I'm in favor of any drug that has a meaningful mechanism of action. The really interesting therapy will be combining ACEi/ARB with SGLT2i; dilate the efferent and constrict the afferent to decrease glomerular hypertension. #NephJC |
| Fitsum Asnakech Tilahun MD @fitse_t RT @NephJC: Point made more visually here #NephJC https://t.co/6pPwNVwLQF |
| Madhuri Ramakrishnan @madmagicdoc RT @edgarvlermamd: Ongoing trials of SGLT2 Inhibitors of interest to the Nephrology Community ca. 2019 Table by @drlovygaur #Nephpearls #NephJC https://t.co/ZbYhojEimj |
| Nephrology Journal Club @NephJC Eligibility: Focus on GFR down to 30 Albuminuria #NephJC This was a Nephrology RCT #NephJC https://t.co/cyKOF1e9Nc |
| Joshua Waitzman, MD PhD @Jwaitz @NephJC Key features were that renal outcomes were secondary AND there were very few renal events of โprogression to ESRDโ. #nephjc |
| Charbel C Khoury @Charbel_Khoury #nephjc |
| Aakash Shingada, DNB, MRCP(UK), FASN @aakashshingada RT @Charbel_Khoury: It all started with this guy: It all started with this guy: Josef von Mering who discovered glycosuric effects of phlorizin in the 1800 (right after he discovered Barbiturates, no buggy) #NephJC https://t.co/157wTBjWD3 |
 | Andrew Malone @AndrewFMalone Andrew Malone, no COI #NephJC |
| Franklin Loachamin @FranLoachamin RT @NephJC: what did we know pre-CREDENCE? See these major trials #NephJC GFR > 60 very feew with albuminuria renal outcomes secondary https://t.co/drmlYsy8Ab |
 | Ross Nesbit @RossNesbit Ross Nesbit - nephrologist @utmedicalcenter Sorry to run late. Excited for all the discussion - think we might get a few UT resident lurkers from my excitement the last week. #NephJC |
 | Vlado Perkovic @VladoPerkovic @HecmagsMD @hswapnil @jardine_meg @IUKidney @gbakris @DavidCWheeler2 @adeeralevin @AirCanada Thanks @aircanada , wifi activated and I am online #NephJC |
| Kenar Jhaveri @kdjhaveri RT @NephJC: Eligibility: Focus on GFR down to 30 Albuminuria #NephJC This was a Nephrology RCT #NephJC https://t.co/cyKOF1e9Nc |
| Franklin Loachamin @FranLoachamin RT @ChristosArgyrop: @VelezNephHepato @NephJC The first paper was in JASN back in 1999 https://t.co/qxptexIc9v 4 tweets!! #wrong #nephjc |
| Nephrology Journal Club @NephJC RT @Jwaitz: @NephJC Key features were that renal outcomes were secondary AND there were very few renal events of โprogression to ESRDโ. #nephjc |
| Sanjeev Nair @Nair_Sanj RT @Buck1486: During my Journal club last week I mentioned how phlorizin was initially obtained from apple tree bark. The Nephrology community has finally infused evidence based medicine into the cliche 'An apple a day keeps the doctor away' @hswapnil #nephjc |
| Alex Meraz @NephroGuy RT @NephJC: check out the awesome schematic from @drlovygaur about the trials and tribulations in DM nephropathy #NephJC https://t.co/1PApkupHRt |
| Nephrology Journal Club @NephJC RT @Charbel_Khoury: #nephjc |
| Nephrology Journal Club @NephJC first author is in the house! #NephJC |
 | Kelly Burdge, MD, FASN @practicalkidney #NephJC Kelly Burdge, nephrologist and Bruins fan. following both tonight! |
| Vlado Perkovic @VladoPerkovic @NephJC And I am still here #NephJC ! |
| James Novak, MD PhD FACP FASN FNKF @JamesNovakNeph @Buck1486 @HecmagsMD No argument. :) #NephJC |
| Franklin Loachamin @FranLoachamin RT @edgarvlermamd: Canagliflozin and renal outcomes in type 2 diabetes: Canagliflozin and renal outcomes in type 2 diabetes: results from the CANVAS Program randomised clinical trials ca. 2018 from @TheLancet #VisualAbstract by @divyaa24 #Nephpearls #NephJC ๐๐ผ https://t.co/pKBcHebr9s https://t.co/wZLtunq7YP |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @NephJC Screened over 12,000 patients #Credence was an expensive trial and well designed #NephJC |
 | Carlos Cortรฉs, MD FACP FASN @Kidney_wiz #NephJC @Kidney_wiz, nephrologist from Puerto Rico, mostly lurking as I get the kids to sleep, no COI. Canโt wait!๐๐ |
| Alex Meraz @NephroGuy RT @NephJC: Eligibility: Focus on GFR down to 30 Albuminuria #NephJC This was a Nephrology RCT #NephJC https://t.co/cyKOF1e9Nc |
 | Joze Luis Avila MD @JozeLuis_neph RT @NephJC: check out the awesome schematic from @drlovygaur about the trials and tribulations in DM nephropathy #NephJC https://t.co/1PApkupHRt |
| Nephrology Journal Club @NephJC T1 Patients who met the eligibility criteria were enrolled in a 2-week, single-blind placebo-run in period. Patients who failed to take โฅ80% of the scheduled run-in treatment were deemed ineligible. #NephJC |
| Aakash Shingada, DNB, MRCP(UK), FASN @aakashshingada This is awesome! Author in the house! #NephJC |
| Lovy @drlovygaur RT @NephJC: Eligibility: Focus on GFR down to 30 Albuminuria #NephJC This was a Nephrology RCT #NephJC https://t.co/cyKOF1e9Nc |
| ChristosArgyropoulos MD, PhD PharmanukerInChief @ChristosArgyrop @NephJC They were all prespecified though #nephjc So the ground was solid |
| Hector Madariaga, MD FASN ๐ฒ๐ฝ @HecmagsMD @VanessaLerma17 @NSMCInternship Hi Vanessa! Hope all is well #NephJC |
| Rodrigo Nunes Cal @CalZole RT @HecmagsMD: @Nephro_Sparks @jeffsparks @BrighamResearch Jeff: @Nephro_Sparks @jeffsparks @BrighamResearch Jeff: Can you tell us a dirty secret about Matt? LOL #NephJC |
| Nephrology Journal Club @NephJC T1 Eligible patients were randomized (1:1) to receive either Canagliflozin (100mg orally once daily) or matching placebo. Randomisation was stratified according to the category of estimated GFR at the time of screening #NephJC |
| Rodrigo Nunes Cal @CalZole RT @NephJC: Eligibility: Focus on GFR down to 30 Albuminuria #NephJC This was a Nephrology RCT #NephJC https://t.co/cyKOF1e9Nc |
| Charbel C Khoury @Charbel_Khoury @JamesNovakNeph @scoca1 @HecmagsMD This trial was pretty much that as almost all patients were on ACE-ARB #NephJC |
| Jennie Lin ๐ฉ๐ปโโ๏ธ๐งฌ @jenniejlin @NephJC Well that answers my question about the purpose of a run-in :) #nephJC |
 | Gail Rae-Garwood @Slowitdownckd RT @NephJC: The paper we will be discussing tonight is โCanagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathyโ by Perkovic et al published in @NEJM this month. It has caused a considerable stir already #NephJC |
| Alex Meraz @NephroGuy @NephJC A titanic effort. It payed off #NephJC |
| Joel M. Topf, MD FACP @kidney_boy @JamesNovakNeph @scoca1 @HecmagsMD Weren't all of the patients actually on ACEi/ARB as a enrollment requirement. #NephJC |
| Pablo Garcia @PabloGarciaMD @gratefull080504 We are all like this #NephJC https://t.co/HSsKg849ML |
 | Manuel Gonzalez MD @drGnephro @NephJC Manny Gonzalez Transplant fellow! AJKD blog is just ๐ฅ golden #NephJC |
| Franklin Loachamin @FranLoachamin RT @JamesNovakNeph: @HecmagsMD My wife is an endocrinologist, and we're scratching our heads about the #CREDENCE craze. Similar results 3 years ago from EMPA-REG and 2 years ago from CANVAS. (Yes, somewhat dif't pop'ns and technically not "renal" trials.) #NephJC |
| Jennie Lin ๐ฉ๐ปโโ๏ธ๐งฌ @jenniejlin @kidney_boy @JamesNovakNeph @scoca1 @HecmagsMD Yes all on RAAS blockade #NephJC |
| Nephrology Journal Club @NephJC Any details @VladoPerkovic on dose choice? why 100 mg and no 300 mg unlike CANVAS? #NephJC |
| Kenar Jhaveri @kdjhaveri RT @NephJC: first author is in the house! #NephJC |
| Madhuri Ramakrishnan @madmagicdoc "This was a nephrology RCT" #CREDENCE #NephJC |
| Harini Sarathy @hurryknee The beauty of tubuloglomerular feedback physiology --> tested in a trial. |
| Nephrology Journal Club @NephJC RT @Charbel_Khoury: @JamesNovakNeph @scoca1 @HecmagsMD This trial was pretty much that as almost all patients were on ACE-ARB #NephJC |
| Steven Coca @scoca1 @JamesNovakNeph @HecmagsMD Ha ha, mean, no? Skeptical, yes. Healthy skepticism as @VelezNephHepato says. It was fun being the contrarian for a while. Now it's downhill. 99% were on ACEi/ARB in CREDENCE, so we have the answer. MAJOR PROTECTION. #NephJC |
| TEJAS PATEL MD, FACP, FASN @GenNextMD @JamesNovakNeph @scoca1 @HecmagsMD This trial had max ACEI or arb so ur thinking is on the spot #NephJC |
| Harish Seethapathy @BetterCallSeeth @kidney_boy @JamesNovakNeph @scoca1 @HecmagsMD On maximal tolerated dose that too #NephJC |
| Gates Colbert, MD @DoctorGates @NephJC Tough inclusion criteria, but necessary to make it relevant and applicable #whipcracked #NephJC |
| Michelle Rheault @rheault_m @JamesNovakNeph @scoca1 @HecmagsMD Are patients with isolated renal glucosuria protected from kidney disease? Is this the same mechanism? #NephJC |
| Charbel C Khoury @Charbel_Khoury @NephJC @VladoPerkovic No difference in effect in prior trials #nephjc |
| Bhavnish @Buck1486 @VelezNephHepato @JamesNovakNeph @HecmagsMD The graph showing drop in eGFR is replicated 100% from EMPAREG to CREDENCE. As you said, no head scratching...exciting part about CREDENCE is it studied our so called 'typical' CKD clinic patients. #nephjc |
| Franklin Loachamin @FranLoachamin RT @edgarvlermamd: Effect of SGLT2 inhibitors on CV, renal and safety outcomes in patients with type 2 diabetes mellitus and CKD: Effect of SGLT2 inhibitors on CV, renal and safety outcomes in patients with type 2 diabetes mellitus and CKD: A systematic review and meta-analysis ca. 2019 #VisualAbstract by @brendonneuen #Nephpearls #NephJC ๐๐ผ https://t.co/HYQbAdsNvB https://t.co/YFeD30Txlf |
| Juan Medaura @JMedauraMD Juan Medaura Nephrologist and faculty @UMMCneph. Many subjects! ~5% is Black. US NHANES CKD population ~15% Black (RENAAL trial Demographics) @Fcabezarivera concerns more than mine. โค๏ธSGLT2 inh @#NephJC |
| Joel M. Topf, MD FACP @kidney_boy Author in the house! #NephJC |
| Gail Rae-Garwood @Slowitdownckd RT @NephJC: The first #NephJC summary ever https://t.co/Q7F3G4PFUk Apr 29 2014. We have come a long way - thanks to the global #NephTwitter community |
| Nephrology Journal Club @NephJC Glycemic control was reinforced with diet, exercise counselling and also as per the discretion of the responsible physician. Patients were followed up at 3, 13 and 26 weeks, then alternated between telephone calls and out-patient visits every 13 weeks. #NephJC |
| Joshua Waitzman, MD PhD @Jwaitz @NephJC Can I put a placebo run-in phase into my clinic enrollment process? #nephjc |
| Sanjeev Nair @Nair_Sanj @ElfadawyN Follow tweets from @NephJC and responses to those. Use the #NephJC whenever u tweet. Be liberal with your opinions and the follow button. Welcome to a revolution in how you learn |
| Kenar Jhaveri @kdjhaveri RT @NephJC: Any details @VladoPerkovic on dose choice? why 100 mg and no 300 mg unlike CANVAS? #NephJC |
| ChristosArgyropoulos MD, PhD PharmanukerInChief @ChristosArgyrop @NephJC @VladoPerkovic It would make no sense to use the 300 when CANVAS (and EMPAREG) showed no dose response for the renal outcomes. Also label of the canagliflozin restricts the 300 to those with low egfrs #NephJC |
| Alex Meraz @NephroGuy @NephJC Does this affect the intention to treat analysis @hswapnil #NephJC |
| Harini Sarathy @hurryknee @NephroMD @VladoPerkovic @NephJC Probably because of focus on Type 2 DM? Average duration of DM was 16 years. #NephJC |
| Edgar V. Lerma ๐ต๐ญ @edgarvlermamd SGLT2 inhibitors: Origin ๐ #Nephpearls #NephJC ๐๐ผ https://t.co/CADHHEJaIm https://t.co/HTQJi44qKF |
| Nephrology Journal Club @NephJC @NephroGuy @hswapnil not at all #NephJC |
| Verner Venegas @Vernisartan They have other Exclusion criteria in the #RunInPeriod if they didn't adhere to the long term treatment. #NephJC Patients who Fail to take more than 80% of the scheduled run in treatment were deemed ineligible |
| Franklin Loachamin @FranLoachamin RT @edgarvlermamd: CANVAS: CANVAS: Canagliflozin and CV & Renal events in Type 2 Diabetes ca. 2017 from @NEJM #VisualAbstract by @kidney_boy #Nephpearls #NephJC ๐๐ผ https://t.co/iCmylgorUO https://t.co/KErFtyQUwN |
| Hassan Mahmoud @hassan_mohamud RT @VladoPerkovic: @HecmagsMD @hswapnil @jardine_meg @IUKidney @gbakris @DavidCWheeler2 @adeeralevin @AirCanada Thanks @aircanada , wifi activated and I am online #NephJC |
| Mario Funes, MD @MarioFunesMD @kidney_boy @JamesNovakNeph @scoca1 @HecmagsMD Yes, stable maximum tolerated dose of ACE and ARB for at least 4 weeks #NephJC |
| Angel Cesar Ortiz @AngelCesarOrtiz 1 more Reason why I love #NephJC |
| Alex Meraz @NephroGuy @kidney_boy @JamesNovakNeph @scoca1 @HecmagsMD They were. #NephJC |
| Nephrology Journal Club @NephJC See study design from the authors @AmJNephrol paper #NephJC https://t.co/54CwKPdToq |
 | Visualmedapp @medtrialsapp RT @aakashshingada: So many #VisualAbstract s for today's paper! And I am sure more will be created for this landmark paper #NephJC @MarioFunesMD @brendonneuen @cardiotrials https://t.co/aJgJbC29es |
| TEJAS PATEL MD, FACP, FASN @GenNextMD @NephJC Tough run in...Why Germany had lower A1C cut off for inclusion than the rest? 10.5% vs 12% #NephJC |
| Kenar Jhaveri @kdjhaveri @VelezNephHepato good point! but makes a point of early intervention is key #nephjc |
| Franklin Loachamin @FranLoachamin RT @NephJC: SGLT2 inhibitors block the SGLT2 transport in the proximal tubule, resulting in glycosuria with attendant reduction in glycaemia. Their natriuretic action may hold the key to their dowsnstream kidney actions via tubuloglomerular feedback and glomerular hyperfiltration. #NephJC |
| Joshua Waitzman, MD PhD @Jwaitz @Charbel_Khoury @NephJC @VladoPerkovic Based on ET-1 antagonist trials, using the lowest effective dose seems like a pretty smart move. #nephjc |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 #NephJC The screen failure rate was approximately 66% |
| Sayna Norouzi, MD, FASN @SaynaNorouzi #CREDENCE trial study design ๐ |
| Aakash Shingada, DNB, MRCP(UK), FASN @aakashshingada RT @NephJC: See study design from the authors @AmJNephrol paper #NephJC https://t.co/54CwKPdToq |
| Nephrology Journal Club @NephJC pay attention to this Prespecified stopping guidance DSMB by the steering committee of early cessation if clear evidence of benefit was observed with consideration of the overall balance of risks and benefits. #NephJC |
| Franklin Loachamin @FranLoachamin RT @NephJC: check out the awesome schematic from @drlovygaur about the trials and tribulations in DM nephropathy #NephJC https://t.co/1PApkupHRt |
| Alex Meraz @NephroGuy RT @Buck1486: @VelezNephHepato @JamesNovakNeph @HecmagsMD The graph showing drop in eGFR is replicated 100% from EMPAREG to CREDENCE. As you said, no head scratching...exciting part about CREDENCE is it studied our so called 'typical' CKD clinic patients. #nephjc |
| John Montford @JohnRMontford @NephJC @AmJNephrol #NephJC well designed Renal trial. No gripes about protocol, bout damn time! |
| Alex Meraz @NephroGuy RT @NephJC: Glycemic control was reinforced with diet, exercise counselling and also as per the discretion of the responsible physician. Patients were followed up at 3, 13 and 26 weeks, then alternated between telephone calls and out-patient visits every 13 weeks. #NephJC |
| Matthew Sparks, MD @Nephro_Sparks @VelezNephHepato @VladoPerkovic here is the eGFRs #NephJC https://t.co/80egjjXBfu |
| Alex Meraz @NephroGuy RT @Nair_Sanj: @ElfadawyN Follow tweets from @NephJC and responses to those. Use the #NephJC whenever u tweet. Be liberal with your opinions and the follow button. Welcome to a revolution in how you learn |
| James Novak, MD PhD FACP FASN FNKF @JamesNovakNeph @kidney_boy @scoca1 @HecmagsMD Yes, but I'm more interested in the converse: all patients receive SGLT2i, then test ACEi/ARB yes/no. In other words, is the addition of RAS blockade syngergistic? #CREDENCE would suggest not, as the effect sizes are similar as in EMPA-REG and CANVAS. #NephJC |
| Jennie Lin ๐ฉ๐ปโโ๏ธ๐งฌ @jenniejlin @Renaltubules Maybe, but by different and maybe synergistic mechanisms. #NephJC |
| Franklin Loachamin @FranLoachamin RT @NephJC: SGLT2 inhibitors have increasingly drawn attention over the last decade. See this excellent ADKD blog from 2018 by Anna Burgner for an explanation of their mechanism of action #NephJC https://t.co/7mVBgGT7YQ slow-the-progression-of-diabetic-kidney-disease/ |
| Nephrology Journal Club @NephJC Outcomes As we say: this was a kidney trial not a diabetes trial not a cardiology trial #NephJC https://t.co/G1K5jAD5ys |
| Aakash Shingada, DNB, MRCP(UK), FASN @aakashshingada @JaqHughes @NephJC Hi @JaqHughes. Welcome to #NephJC. Nice to see you again.. |
| KatieOverV @KatieKwonMD @VelezNephHepato @VladoPerkovic Seems to all be reported as eGFR - any reason why you want SCr instead? Just curious. #NephJC |
| Angel Cesar Ortiz @AngelCesarOrtiz @cnavadr Glad to see u! welcome to #nephjc |
| Sanjeev Nair @Nair_Sanj This is why the #CredenceCraze @JamesNovakNeph This and the fact that its a positive trial...finally!! #NephJC |
| Michelle Rheault @rheault_m RT @NephJC: See study design from the authors @AmJNephrol paper #NephJC https://t.co/54CwKPdToq |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @Renaltubules I had the same question #NephJC |
| Nephrology Journal Club @NephJC @JaqHughes welcome to #NephJC ! |
| Joel M. Topf, MD FACP @kidney_boy @GC_at_Large Welcome Joel, a true #NephJC gadfly, from the beach party to some of the great #NephJC #KidneyWk party |
| Nephrology Journal Club @NephJC RT @Nephro_Sparks: @VelezNephHepato @VladoPerkovic here is the eGFRs #NephJC https://t.co/80egjjXBfu |
| Kenar Jhaveri @kdjhaveri RT @Nephro_Sparks: @VelezNephHepato @VladoPerkovic here is the eGFRs #NephJC https://t.co/80egjjXBfu |
| Alex Meraz @NephroGuy RT @NephJC: See study design from the authors @AmJNephrol paper #NephJC https://t.co/54CwKPdToq |
| Matthew Sparks, MD @Nephro_Sparks RT @NephJC: Eligibility: Focus on GFR down to 30 Albuminuria #NephJC This was a Nephrology RCT #NephJC https://t.co/cyKOF1e9Nc |
| Steven Coca @scoca1 @VelezNephHepato I think control of multiple risk factors has gotten better as well since IDNT/RENAAL days 20 yrs ago. The avg eGFR slope in placebo was about -6 ml/min/yr in those trials (and -5 ml/min/yr in the ARB arm). Control arms of CREDENCE (and VA NEPHRON-D) less steep #NephJC |
| Landmark Nephrology @landmark_neph RT @NephJC: what did we know pre-CREDENCE? See these major trials #NephJC GFR > 60 very feew with albuminuria renal outcomes secondary https://t.co/drmlYsy8Ab |
| Natasha N. Dave @NatashaNDave For a quick SGLT2 inhibitor review check our this amazing tutorial by @aishaikh #NephJC #NephTwitter #CREDENCE https://t.co/8vWSNmpK9w |
| Sanjeev Nair @Nair_Sanj RT @VladoPerkovic: @HecmagsMD @hswapnil @jardine_meg @IUKidney @gbakris @DavidCWheeler2 @adeeralevin @AirCanada Thanks @aircanada , wifi activated and I am online #NephJC |
| Nephrology Journal Club @NephJC sorry if I am miising your question crazy credence chat today Any questions about the methods? #NephJC |
| Pravir @Proximal_Baxi RT @NatashaNDave: For a quick SGLT2 inhibitor review check our this amazing tutorial by @aishaikh #NephJC #NephTwitter #CREDENCE https://t.co/8vWSNmpK9w |
| Nephrology Journal Club @NephJC RT @scoca1: @VelezNephHepato I think control of multiple risk factors has gotten better as well since IDNT/RENAAL days 20 yrs ago. The avg eGFR slope in placebo was about -6 ml/min/yr in those trials (and -5 ml/min/yr in the ARB arm). Control arms of CREDENCE (and VA NEPHRON-D) less steep #NephJC |
| Edgar V. Lerma ๐ต๐ญ @edgarvlermamd SGLT2 inhibitors: diuretic perspective #Nephpearls #NephJC ๐๐ผ https://t.co/PmRtYs9MfO https://t.co/q3IuhBzU5k |
| Nephrology Journal Club @NephJC RT @NatashaNDave: For a quick SGLT2 inhibitor review check our this amazing tutorial by @aishaikh #NephJC #NephTwitter #CREDENCE https://t.co/8vWSNmpK9w |
| Kenar Jhaveri @kdjhaveri @Nephro_Sparks @VelezNephHepato @VladoPerkovic The problem is as "nephrologist" we will see the last two rows of GFR mostly when referred to us. The rest are usually seen at internist and endocrine docs. right? #nephjc |
| Aakash Shingada, DNB, MRCP(UK), FASN @aakashshingada We're any protocols in place to stop this drug. We're sick day rules followed or shud be followed for Sglt2i? They act like diuretics and alter intraglom dynamics. #NephJC |
| Vipin Varghese @vipvargh RT @aishaikh: ๐ฅHow do SGLT2 Inhibitors work? ๐ฅHow does an anti-diabetic drug improve Renal & Cardiovascular outcomes? ๐ฅTo understand this letโs first review: โก๏ธRenal handling of glucose 1/ @RenalFellowNtwk #NephJC #SGLT2 #CREDENCE |
| Sam Krishnamoorthy @beans_sam RT @aishaikh: ๐ฅHow do SGLT2 Inhibitors work? ๐ฅHow does an anti-diabetic drug improve Renal & Cardiovascular outcomes? ๐ฅTo understand this letโs first review: โก๏ธRenal handling of glucose 1/ @RenalFellowNtwk #NephJC #SGLT2 #CREDENCE |
| Steven Coca @scoca1 @JamesNovakNeph @kidney_boy @HecmagsMD No interactions by prevalent ACEi/ARB use in the EMPA-REG and CANVAS #NephJC |
| Natasha N. Dave @NatashaNDave RT @edgarvlermamd: SGLT2 inhibitors: SGLT2 inhibitors: diuretic perspective #Nephpearls #NephJC ๐๐ผ https://t.co/PmRtYs9MfO https://t.co/q3IuhBzU5k |
| Alex Meraz @NephroGuy RT @scoca1: @VelezNephHepato I think control of multiple risk factors has gotten better as well since IDNT/RENAAL days 20 yrs ago. The avg eGFR slope in placebo was about -6 ml/min/yr in those trials (and -5 ml/min/yr in the ARB arm). Control arms of CREDENCE (and VA NEPHRON-D) less steep #NephJC |
| Nephrology Journal Club @NephJC Q for @VladoPerkovic #NephJC |
| Joel M. Topf, MD FACP @kidney_boy @gratefull080504 @Renaltubules can't ethically do a trial that denies patients an ACEi/ARB #NephJC |
| Arshad Ali @aldorenin RT @NephJC: See study design from the authors @AmJNephrol paper #NephJC https://t.co/54CwKPdToq |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 #NephJC Less we forget the #Sglt2i were not originally designed for nephrology + #kidneydisease patients Let's maintain a modicum of humility |
| Nephrology Journal Club @NephJC On to Results #NephJC |
| TEJAS PATEL MD, FACP, FASN @GenNextMD @NephJC More of nephropathy trial? As mean albuminuria was about 1 gram and eGFR was CKD 3a...almost CKD 2 #NephJC |
| Nephrology Journal Club @NephJC RT @kidney_boy: @gratefull080504 @Renaltubules can't ethically do a trial that denies patients an ACEi/ARB #NephJC |
| Aakash Shingada, DNB, MRCP(UK), FASN @aakashshingada @NephJC https://t.co/q9FeLCGMv4 #NephJC |
| Salt @Saltwebsite it's impressive to see such a robust outcome in such a short follow up time period. renal benefit from patients with >1g proteinuria in AASK amd MDRD needed really long follow up to see a benefit #NephJC |
| Hector Madariaga, MD FASN ๐ฒ๐ฝ @HecmagsMD RT @NephJC: Outcomes As we say: this was a kidney trial not a diabetes trial not a cardiology trial #NephJC https://t.co/G1K5jAD5ys |
| Nissreen Elfadawy MD, MS, FASN, FAST @ElfadawyN @jenniejlin @NU_Nephrology #NephJC where did you get the mug from? |
| Jennie Lin ๐ฉ๐ปโโ๏ธ๐งฌ @jenniejlin @kidney_boy @gratefull080504 @Renaltubules But with CREDENCE results, would it be ethical to do head-to-head comparison with ACEI/ARB in a follow-up trial? #NephJC |
| Nephrology Journal Club @NephJC @kidney_boy @gratefull080504 @Renaltubules as @VladoPerkovic pointed out earlier in CANVAS some patients were not on RAS blocker same effect seen #NephJC |
| KatieOverV @KatieKwonMD @NatashaNDave @aishaikh This was a great thread. I did not know about the effect on arterial stiffness before reading this. #NephJC Well done @aishaikh |
| Michelle Rheault @rheault_m RT @kidney_boy: @gratefull080504 @Renaltubules can't ethically do a trial that denies patients an ACEi/ARB #NephJC |
| Matthew Sparks, MD @Nephro_Sparks @JamesNovakNeph @kidney_boy @scoca1 @HecmagsMD another caveat is that likely SGLT2is work early (and later) in disease course where as ACEi/ARB effective later. Synergy also effective later. #NephJC https://t.co/IneKRpmjjQ |
| Kenar Jhaveri @kdjhaveri @JamesNovakNeph @kidney_boy @scoca1 @HecmagsMD how come we don;t see hyperkalemia if using ACEI and SGLT-2 together? #NephJC |
| Vlado Perkovic @VladoPerkovic @VelezNephHepato Interesting that the eGFR decline rate from the placebo arm of #CREDENCE was almost identical to that in the losartan arm of RENAAL #NephJC |
| Timothy Yau @Maximal_Change RT @aishaikh: ๐ฅHow do SGLT2 Inhibitors work? ๐ฅHow does an anti-diabetic drug improve Renal & Cardiovascular outcomes? ๐ฅTo understand this letโs first review: โก๏ธRenal handling of glucose 1/ @RenalFellowNtwk #NephJC #SGLT2 #CREDENCE |
| Edgar V. Lerma ๐ต๐ญ @edgarvlermamd SGLT2 mechanism in the proximal tubule ca. 2016 from @CircAHA #Nephpearls #NephJC ๐๐ผ https://t.co/vLBA2CUkyt https://t.co/S0hgcIJURe |
| Charbel C Khoury @Charbel_Khoury RT @VladoPerkovic: @VelezNephHepato Interesting that the eGFR decline rate from the placebo arm of #CREDENCE was almost identical to that in the losartan arm of RENAAL #NephJC |
 | Saurabh kapil @foreseesaurabh RT @aakashshingada: We're any protocols in place to stop this drug. We're sick day rules followed or shud be followed for Sglt2i? They act like diuretics and alter intraglom dynamics. #NephJC |
| L. Parker Gregg @LParkerGregg1 RT @NephJC: Outcomes As we say: this was a kidney trial not a diabetes trial not a cardiology trial #NephJC https://t.co/G1K5jAD5ys |
| Alex Meraz @NephroGuy @jenniejlin @kidney_boy @gratefull080504 @Renaltubules No reason why no IMO #NephJC |
| Nephrology Journal Club @NephJC T2: In terms of baseline demographics, all patients had diabetic nephropathy with duration of diabetes ~ 15.5 years. About two-thirds were on insulin and over half on metformin. #NephJC https://t.co/T3ez7tVarh |
| Rodrigo Nunes Cal @CalZole RT @edgarvlermamd: SGLT2 inhibitors: SGLT2 inhibitors: diuretic perspective #Nephpearls #NephJC ๐๐ผ https://t.co/PmRtYs9MfO https://t.co/q3IuhBzU5k |
| Fitsum Asnakech Tilahun MD @fitse_t RT @scoca1: @VelezNephHepato I think control of multiple risk factors has gotten better as well since IDNT/RENAAL days 20 yrs ago. The avg eGFR slope in placebo was about -6 ml/min/yr in those trials (and -5 ml/min/yr in the ARB arm). Control arms of CREDENCE (and VA NEPHRON-D) less steep #NephJC |
| Rodrigo Nunes Cal @CalZole RT @edgarvlermamd: SGLT2 mechanism in the proximal tubule ca. 2016 from @CircAHA #Nephpearls #NephJC ๐๐ผ https://t.co/vLBA2CUkyt https://t.co/S0hgcIJURe |
| Samira Farouk, MD, MSCR @ssfarouk #Trending #nephjc https://t.co/hD8nb8iAAG |
| Nephrology Journal Club @NephJC RT @VladoPerkovic: @VelezNephHepato Interesting that the eGFR decline rate from the placebo arm of #CREDENCE was almost identical to that in the losartan arm of RENAAL #NephJC |
| Bhavnish @Buck1486 @gratefull080504 From a diabetic drug to a cardiologist's favorite, and now becoming a nephrology go-to drug. Interesting pathway. #NephJC |
| Sam Krishnamoorthy @beans_sam RT @edgarvlermamd: SGLT2 inhibitors: SGLT2 inhibitors: diuretic perspective #Nephpearls #NephJC ๐๐ผ https://t.co/PmRtYs9MfO https://t.co/q3IuhBzU5k |
| Vlado Perkovic @VladoPerkovic @ChristosArgyrop @NephJC To be honest, we were anxious about all the failed trials due to toxicity, and were prepared to take a risk on a slightly lower dose to minimise risk. Was a long discussion at the Steering Committee #NephJC |
| Rodrigo Nunes Cal @CalZole RT @NephJC: Outcomes As we say: this was a kidney trial not a diabetes trial not a cardiology trial #NephJC https://t.co/G1K5jAD5ys |
| ChristosArgyropoulos MD, PhD PharmanukerInChief @ChristosArgyrop @gratefull080504 @Renaltubules It is complicated. Some data from EMPAREG (left) and CANVAS (right) suggest differences according to agent. Subgroup analyses though #Nephjc https://t.co/vFnPyHAl3y |
| Edgar V. Lerma ๐ต๐ญ @edgarvlermamd SGLT2 Inhibitors: The โtubularโ hypothesis ca. 2016 from @CircAHA #Nephpearls #NephJC ๐๐ผ https://t.co/vLBA2CUkyt https://t.co/NyizIkSkr5 |
| Verner Venegas @Vernisartan RT @VladoPerkovic: @VelezNephHepato Interesting that the eGFR decline rate from the placebo arm of #CREDENCE was almost identical to that in the losartan arm of RENAAL #NephJC |
| KatieOverV @KatieKwonMD @kdjhaveri @Nephro_Sparks @VelezNephHepato @VladoPerkovic Yes - I don't know if I'm going to prescribe #canagliflozin myself, my focus right now is on getting the PCPs in my area to prescribe it more aggressively. Hence I am bookmarking images like mad tonight to use in future slide sets. #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @Buck1486 Yes it is #NephJC |
| Joshua Waitzman, MD PhD @Jwaitz @jenniejlin @kidney_boy @gratefull080504 @Renaltubules Is there a reason to think that the benefit would be greater in the absence of an ACEi/ARB? It would be helpful to see benefit magnitude in ACE/ARB intolerant patients going forward. #nephjc |
 | Jenner MG @Nefro_Jen RT @NephJC: check out the awesome schematic from @drlovygaur about the trials and tribulations in DM nephropathy #NephJC https://t.co/1PApkupHRt |
| Aakash Shingada, DNB, MRCP(UK), FASN @aakashshingada RT @ssfarouk: #Trending #nephjc https://t.co/hD8nb8iAAG |
| Nephrology Journal Club @NephJC more on albuminuria at baseline and insulin/OHA use #NephJC https://t.co/Muni9zQ2lZ |
| Alex Meraz @NephroGuy @kdjhaveri @JamesNovakNeph @kidney_boy @scoca1 @HecmagsMD More distal delivery of Na = More K excretion #NephJc. They cancel each other I think |
| John Montford @JohnRMontford @jenniejlin @kidney_boy @gratefull080504 @Renaltubules Thinking this also, may be excluding patients w hyperk hypoaldo from DM2 that might derive more benefit from SGLT2i as front line? #NephJC |
| Nephrology Journal Club @NephJC RT @VladoPerkovic: @ChristosArgyrop @NephJC To be honest, we were anxious about all the failed trials due to toxicity, and were prepared to take a risk on a slightly lower dose to minimise risk. Was a long discussion at the Steering Committee #NephJC |
| Vlado Perkovic @VladoPerkovic @JMedauraMD @UMMCneph @Fcabezarivera Fair point. We worked hard to recruit African Americans but it was hard. Please note that the trial was global, and more than 15% of US participants were Black #NephJC |
| Kenar Jhaveri @kdjhaveri @VladoPerkovic @ChristosArgyrop @NephJC makes sense #nephjc |
| Gary Singer @GarySingerMD@med-mastodon.com @GarySingerMD Who manages diabetes in your diabetic patients? #NephJC |
| Samaya @TarSamMD RT @ssfarouk: #Trending #nephjc https://t.co/hD8nb8iAAG |
| Saurabh kapil @foreseesaurabh RT @NephJC: Any details @VladoPerkovic on dose choice? why 100 mg and no 300 mg unlike CANVAS? #NephJC |
| Harini Sarathy @hurryknee RT @edgarvlermamd: SGLT2 Inhibitors: SGLT2 Inhibitors: The โtubularโ hypothesis ca. 2016 from @CircAHA #Nephpearls #NephJC ๐๐ผ https://t.co/vLBA2CUkyt https://t.co/NyizIkSkr5 |
| Kenar Jhaveri @kdjhaveri RT @NephroGuy: @kdjhaveri @JamesNovakNeph @kidney_boy @scoca1 @HecmagsMD More distal delivery of Na = More K excretion #NephJc. They cancel each other I think |
| Samira Farouk, MD, MSCR @ssfarouk RT @Nephro_Sparks: @JamesNovakNeph @kidney_boy @scoca1 @HecmagsMD another caveat is that likely SGLT2is work early (and later) in disease course where as ACEi/ARB effective later. Synergy also effective later. #NephJC https://t.co/IneKRpmjjQ |
| Nephrology Journal Club @NephJC RT @VladoPerkovic: @JMedauraMD @UMMCneph @Fcabezarivera Fair point. We worked hard to recruit African Americans but it was hard. Please note that the trial was global, and more than 15% of US participants were Black #NephJC |
| Mario Funes, MD @MarioFunesMD @NephroGuy @jenniejlin @kidney_boy @gratefull080504 @Renaltubules It was important to have ACE/ARB at baseline IMO. It has greater importance to show additive effects, not just alternative. #NephJC |
| Aakash Shingada, DNB, MRCP(UK), FASN @aakashshingada RT @VladoPerkovic: @VelezNephHepato Interesting that the eGFR decline rate from the placebo arm of #CREDENCE was almost identical to that in the losartan arm of RENAAL #NephJC |
| Nephrology Journal Club @NephJC RT @GarySingerMD: Who manages diabetes in your diabetic patients? #NephJC |
| Vanessa Lerma @VanessaLerma17 RT @Nephro_Sparks: @JamesNovakNeph @kidney_boy @scoca1 @HecmagsMD another caveat is that likely SGLT2is work early (and later) in disease course where as ACEi/ARB effective later. Synergy also effective later. #NephJC https://t.co/IneKRpmjjQ |
| Steven Coca @scoca1 @VelezNephHepato Good point @VelezNephHepato #NephJC |
| ChristosArgyropoulos MD, PhD PharmanukerInChief @ChristosArgyrop @KatieKwonMD @kdjhaveri @Nephro_Sparks @VelezNephHepato @VladoPerkovic There is a value is setting "albuminuria" / early DKD clinics as we have done locally in our comprehensive diabetes care center. Then Nephros can see the high eGFR and take an active role in prescribing #NephJC |
| Timothy Yau @Maximal_Change @NatashaNDave @aishaikh i missed this at first, but just read it and it is absolutely amazing #NephJC |
| Jennie Lin ๐ฉ๐ปโโ๏ธ๐งฌ @jenniejlin @Jwaitz @kidney_boy @gratefull080504 @Renaltubules I think the switching of energy utilization is huge. If cells are not switching to anaerobic respiration and also not being forced to undergo fatty acid oxidation, might be protective through separate mechanism of favoring ketone body fuel. #NephJC |
| Vanessa Lerma @VanessaLerma17 RT @edgarvlermamd: SGLT2 Inhibitors: SGLT2 Inhibitors: The โtubularโ hypothesis ca. 2016 from @CircAHA #Nephpearls #NephJC ๐๐ผ https://t.co/vLBA2CUkyt https://t.co/NyizIkSkr5 |
| Alex Meraz @NephroGuy @VladoPerkovic @ChristosArgyrop @NephJC Thats what I LOVE about authors being in #NephJC. |
| Vlado Perkovic @VladoPerkovic @NephJC Needed to choose a single dose for simplicity. Traded a little bit of potential efficacy to minimise safety concerns, but even when we designed the trial in 2013 we know the efficacy differences were pretty small #NephJC |
| Joshua Waitzman, MD PhD @Jwaitz I will say that the one demographic knock I have on #credence is that only 5% of patients were of African origin. I know that doesnโt look like my VA clinic. #NephJC |
 | ~~~ @DrNamkeen hopping on late, super excited for this one :), joining in from dallas, no coi #nephjc |
| Alex Meraz @NephroGuy RT @edgarvlermamd: SGLT2 Inhibitors: SGLT2 Inhibitors: The โtubularโ hypothesis ca. 2016 from @CircAHA #Nephpearls #NephJC ๐๐ผ https://t.co/vLBA2CUkyt https://t.co/NyizIkSkr5 |
| Kenar Jhaveri @kdjhaveri @kylepjansson @JamesNovakNeph @kidney_boy @scoca1 @HecmagsMD perhaps #NephJC |
| Hector Madariaga, MD FASN ๐ฒ๐ฝ @HecmagsMD @kdjhaveri @JamesNovakNeph @kidney_boy @scoca1 In #CREDENCE, patients with blood potassium level > 5.5 mmol/L at the time of screening, were excluded. #NephJC |
| Bhavnish @Buck1486 @Jwaitz @jenniejlin @kidney_boy @gratefull080504 @Renaltubules Check out the editorial by @Nephro_Sparks regarding the mechanism of action of SGLT2i's on afferent arteriole while ACE/ARBs are busy on the efferent. I believe they have synergistic effect. #nephJC @AJKDonline |
| James Novak, MD PhD FACP FASN FNKF @JamesNovakNeph @Nair_Sanj Yes, lower GFR and higher UPC, but same proof of concept. Several positive modern trials in nephrology: besides EMPA-REG, CANVAS, and DECLARE, also LEADER and SUSTAIN-6 (incretin mimetics), not to mention SHARP. #NephJC |
| Nephrology Journal Club @NephJC Early stoppage Plan was for 844 events But DSMC recommended stoppage early based on overwhelming benefit Anything you can share on that convo @VladoPerkovic ? #NephJC |
| Lovy @drlovygaur RT @jenniejlin: @Jwaitz @kidney_boy @gratefull080504 @Renaltubules I think the switching of energy utilization is huge. If cells are not switching to anaerobic respiration and also not being forced to undergo fatty acid oxidation, might be protective through separate mechanism of favoring ketone body fuel. #NephJC |
 | Katie Wang @katiemwang ๐๐ป Hi friends. Katie here, fellow at @StanfordNeph, #NSMC 2019 intern joining post-clinic. No COI. Lurking, but ready to learn ๐ค๐ Happy birthday #NephJC! ๐ |
| Vanessa Lerma @VanessaLerma17 RT @NatashaNDave: For a quick SGLT2 inhibitor review check our this amazing tutorial by @aishaikh #NephJC #NephTwitter #CREDENCE https://t.co/8vWSNmpK9w |
| Alex Meraz @NephroGuy @Jwaitz @jenniejlin @kidney_boy @gratefull080504 @Renaltubules I think their effect is additive because ofโฆ science #NephJC |
| Joel M. Topf, MD FACP @kidney_boy RT @VladoPerkovic: @NephJC Needed to choose a single dose for simplicity. Traded a little bit of potential efficacy to minimise safety concerns, but even when we designed the trial in 2013 we know the efficacy differences were pretty small #NephJC |
| Charbel C Khoury @Charbel_Khoury RT @VladoPerkovic: @ChristosArgyrop @NephJC To be honest, we were anxious about all the failed trials due to toxicity, and were prepared to take a risk on a slightly lower dose to minimise risk. Was a long discussion at the Steering Committee #NephJC |
 | Graham Abra, MD @GrahamAbra @aakashshingada Good question, they definitely mention this issue on the drug website #NephJC https://t.co/xyF7G5rrkJ |
| Kenar Jhaveri @kdjhaveri RT @NephroGuy: @VladoPerkovic @ChristosArgyrop @NephJC Thats what I LOVE about authors being in #NephJC. |
| Jennie Lin ๐ฉ๐ปโโ๏ธ๐งฌ @jenniejlin @Jwaitz @kidney_boy @gratefull080504 @Renaltubules @ksusztak showed how defective FAO promotes renal fibrosis, can SGLT2i provide a shunt to avoid pathway? #NephJC https://t.co/Eh9xNtpbys |
| Nephrology Journal Club @NephJC There was a 30% relative risk reduction in the primary composite end-point diverging as early as 12 months after randomization (event rate โ 43.2 vs 61.2 per 1000 patient-years respectively in canagliflozin vs placebo arms). #NephJC https://t.co/k5LVeQwuJN |
| Pablo Garcia @PabloGarciaMD @Jwaitz https://t.co/jTYzFtFyRE |
| KatieOverV @KatieKwonMD @GarySingerMD Does every diabetic in your area see an endocrinologist? I live in a county of 100,000 people and we have two endocrinologists. #NephJC #RuralMed |
| Sayna Norouzi, MD, FASN @SaynaNorouzi @c8lynv Hi! Welcome to #nephjc ๐ |
 | Heather L Gornik @heatherlgornik RT @edgarvlermamd: SGLT2 inhibitors: SGLT2 inhibitors: diuretic perspective #Nephpearls #NephJC ๐๐ผ https://t.co/PmRtYs9MfO https://t.co/q3IuhBzU5k |
| Nephrology Journal Club @NephJC RT @HecmagsMD: @kdjhaveri @JamesNovakNeph @kidney_boy @scoca1 In #CREDENCE, patients with blood potassium level > 5.5 mmol/L at the time of screening, were excluded. #NephJC |
| Arshad Ali @aldorenin RT @edgarvlermamd: SGLT2 Inhibitors: SGLT2 Inhibitors: The โtubularโ hypothesis ca. 2016 from @CircAHA #Nephpearls #NephJC ๐๐ผ https://t.co/vLBA2CUkyt https://t.co/NyizIkSkr5 |
| James Novak, MD PhD FACP FASN FNKF @JamesNovakNeph @kylepjansson @kdjhaveri @kidney_boy @scoca1 @HecmagsMD Almost certainly, but not noted clinically. Almost all diuretics do, based on increased distal Na delivery. #NephJC |
| TEJAS PATEL MD, FACP, FASN @GenNextMD @kdjhaveri @JamesNovakNeph @kidney_boy @scoca1 @HecmagsMD Interesting point - sglt2i not associated with k imbalance..statistically speaking https://t.co/VG5BwzNG0H #NephJC |
| Scherly Leon, MD @SLeonMD @ElfadawyN @jenniejlin @NU_Nephrology check out the store https://t.co/sw7Xvt2evp #nephjc |
| Nephrology Journal Club @NephJC RT @VladoPerkovic: @NephJC Needed to choose a single dose for simplicity. Traded a little bit of potential efficacy to minimise safety concerns, but even when we designed the trial in 2013 we know the efficacy differences were pretty small #NephJC |
| Nephrology Journal Club @NephJC RT @jenniejlin: @Jwaitz @kidney_boy @gratefull080504 @Renaltubules I think the switching of energy utilization is huge. If cells are not switching to anaerobic respiration and also not being forced to undergo fatty acid oxidation, might be protective through separate mechanism of favoring ketone body fuel. #NephJC |
| Alex Meraz @NephroGuy RT @VladoPerkovic: @NephJC Needed to choose a single dose for simplicity. Traded a little bit of potential efficacy to minimise safety concerns, but even when we designed the trial in 2013 we know the efficacy differences were pretty small #NephJC |
| Madhuri Ramakrishnan @madmagicdoc This is why #NephJC is the best! Where else can you get this kind of insight into the methods of a trial! #NephJC |
| Verner Venegas @Vernisartan Renin Angiotensin Aldosterone system blockade is currently the only treatment proven to prevent decline of kidney function until SGLT2 #NephJC #CREDENCE |
| Shilpa Jesudason @shilpa_jes @aakashshingada And peri operative cessation - vigilance for euglucaemic DKA #NephJC |
| ChristosArgyropoulos MD, PhD PharmanukerInChief @ChristosArgyrop @jenniejlin @kidney_boy @gratefull080504 @Renaltubules It would not be ethical to randomize. . the question has already been answered in the trial data: a) patients who can tolerate ACEi, use ACEI (evidence basis: CREDENCE/subgroup analysis in EMPAREG) b) patients who cannot tolerate a RAASi -> use SGLT2 monotherapy #NephJC |
 | Katalin Susztak @KSusztak RT @jenniejlin: @Jwaitz @kidney_boy @gratefull080504 @Renaltubules @ksusztak showed how defective FAO promotes renal fibrosis, can SGLT2i provide a shunt to avoid pathway? #NephJC https://t.co/Eh9xNtpbys |
| Nephrology Journal Club @NephJC RT @ChristosArgyrop: @jenniejlin @kidney_boy @gratefull080504 @Renaltubules It would not be ethical to randomize. . the question has already been answered in the trial data: a) patients who can tolerate ACEi, use ACEI (evidence basis: CREDENCE/subgroup analysis in EMPAREG) b) patients who cannot tolerate a RAASi -> use SGLT2 monotherapy #NephJC |
| ChristosArgyropoulos MD, PhD PharmanukerInChief @ChristosArgyrop RT @VladoPerkovic: @VelezNephHepato Interesting that the eGFR decline rate from the placebo arm of #CREDENCE was almost identical to that in the losartan arm of RENAAL #NephJC |
| Mario Funes, MD @MarioFunesMD It will be a powerful drug in the arsenal of internal medicine not just nephrologist. Many patient will just see IM not endo. #NephJC |
| Michelle Rheault @rheault_m RT @NephJC: There was a 30% relative risk reduction in the primary composite end-point diverging as early as 12 months after randomization (event rate โ 43.2 vs 61.2 per 1000 patient-years respectively in canagliflozin vs placebo arms). #NephJC https://t.co/k5LVeQwuJN |
| Jennie Lin ๐ฉ๐ปโโ๏ธ๐งฌ @jenniejlin @Jwaitz @kidney_boy @gratefull080504 @Renaltubules @KSusztak Switching of bioenergetics also why SGLT2i protective in diabetic and non-diabetic HF. Can SGLT2i help with cardiorenal physiology? Unifying mechanism? #NephJC |
| Matthew Sparks, MD @Nephro_Sparks @werner02 its a big day #NephJC |
| Hector Madariaga, MD FASN ๐ฒ๐ฝ @HecmagsMD @NephJC I am impressed by the median HgA1c of 8.3% across the groups. It was not an easy population and a lot of them were on insulin. This is the typical patient we encounter. #NephJC |
| Samira Farouk, MD, MSCR @ssfarouk RT @jenniejlin: @Jwaitz @kidney_boy @gratefull080504 @Renaltubules @ksusztak showed how defective FAO promotes renal fibrosis, can SGLT2i provide a shunt to avoid pathway? #NephJC https://t.co/Eh9xNtpbys |
| Joel M. Topf, MD FACP @kidney_boy @NephJC @VladoPerkovic Do we think stopping early increased the effect size? #NephJC |
| Vlado Perkovic @VladoPerkovic @aakashshingada General advice provided. Asked people to consider stopping other diuretics or BP lowering drugs first if required and try to maintain RAS blockade and randomised therapy #NephJC Interesting that these drugs appear to possibly reduce risk of AKI- should we using sick day rules??? |
| Alex Meraz @NephroGuy RT @NephJC: There was a 30% relative risk reduction in the primary composite end-point diverging as early as 12 months after randomization (event rate โ 43.2 vs 61.2 per 1000 patient-years respectively in canagliflozin vs placebo arms). #NephJC https://t.co/k5LVeQwuJN |
| Kenar Jhaveri @kdjhaveri @GenNextMD @JamesNovakNeph @kidney_boy @scoca1 @HecmagsMD nice reference #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @NephJC It appears that the Renal Composite Endpoint had the greatest separation from placebo + the separation appears to accelerate over time, correct? #NephJC |
| Michelle Rheault @rheault_m RT @madmagicdoc: This is why #NephJC is the best! Where else can you get this kind of insight into the methods of a trial! #NephJC |
| Nephrology Journal Club @NephJC 30% RRR on top of maximal RAS blockade Did anyone expect this? I did not #NephJC https://t.co/K4JHaJLP6d |
| Fitsum Asnakech Tilahun MD @fitse_t RT @VladoPerkovic: @VelezNephHepato Interesting that the eGFR decline rate from the placebo arm of #CREDENCE was almost identical to that in the losartan arm of RENAAL #NephJC |
| Natasha N. Dave @NatashaNDave RT @Nephro_Sparks: @JamesNovakNeph @kidney_boy @scoca1 @HecmagsMD another caveat is that likely SGLT2is work early (and later) in disease course where as ACEi/ARB effective later. Synergy also effective later. #NephJC https://t.co/IneKRpmjjQ |
| Nephrology Journal Club @NephJC RT @VladoPerkovic: @aakashshingada General advice provided. Asked people to consider stopping other diuretics or BP lowering drugs first if required and try to maintain RAS blockade and randomised therapy #NephJC Interesting that these drugs appear to possibly reduce risk of AKI- should we using sick day rules??? |
| Matthew Sparks, MD @Nephro_Sparks @jenniejlin @Jwaitz @kidney_boy @gratefull080504 @Renaltubules @KSusztak also direct podocyte effects #NephJC https://t.co/0WzR1imGRU |
| Khaled Shawwa @khaledshawwa @NephJC It was interesting to see from fig 2. that pts with eGFR 60-90 did not get much benefit (though interaction term did not reach statistical significance) #NephJC |
| Angel Cesar Ortiz @AngelCesarOrtiz RT @VladoPerkovic: @ChristosArgyrop @NephJC To be honest, we were anxious about all the failed trials due to toxicity, and were prepared to take a risk on a slightly lower dose to minimise risk. Was a long discussion at the Steering Committee #NephJC |
| Gary Singer @GarySingerMD@med-mastodon.com @GarySingerMD @KatieKwonMD Ditto - many diabetics managed by PCP even when taking 3+ drugs. Huge geographical variability in endocrinologist availability #NephJC |
| Aakash Shingada, DNB, MRCP(UK), FASN @aakashshingada RT @VladoPerkovic: @aakashshingada General advice provided. Asked people to consider stopping other diuretics or BP lowering drugs first if required and try to maintain RAS blockade and randomised therapy #NephJC Interesting that these drugs appear to possibly reduce risk of AKI- should we using sick day rules??? |
| Katalin Susztak @KSusztak @jenniejlin @Jwaitz @kidney_boy @gratefull080504 @Renaltubules Yes I think SGTL2i might reduce the work load of the PT so they can do a better job on less energy... (like the beta blocker of the kidney) #NephJC |
| ChristosArgyropoulos MD, PhD PharmanukerInChief @ChristosArgyrop @kdjhaveri @JamesNovakNeph @kidney_boy @scoca1 @HecmagsMD Hyperkalemia has not been seen outside the first trials in diabetes. In fact in CREDENCE SGLT2i reduced the K level and this was also seen in EMPAREG. CANVAS was an odd-ball in many aspects #NephJC |
| Hassan Mahmoud @hassan_mohamud RT @NephJC: There was a 30% relative risk reduction in the primary composite end-point diverging as early as 12 months after randomization (event rate โ 43.2 vs 61.2 per 1000 patient-years respectively in canagliflozin vs placebo arms). #NephJC https://t.co/k5LVeQwuJN |
| Nephrology Journal Club @NephJC @VladoPerkovic @aakashshingada where's @roxytonin? Indeed sick day rules have poor evidence base as we have seen https://t.co/whvMTcwYf7 #NephJC |
| Vlado Perkovic @VladoPerkovic @JamesNovakNeph @kidney_boy @scoca1 @HecmagsMD Interesting question for the future..... #NephJC |
| Matthew Sparks, MD @Nephro_Sparks nice EMs from the @JCI_insight paper of SGLT2 podocyte paper #NephJC https://t.co/ZYxucamWTJ |
| L. Parker Gregg @LParkerGregg1 RT @NephJC: There was a 30% relative risk reduction in the primary composite end-point diverging as early as 12 months after randomization (event rate โ 43.2 vs 61.2 per 1000 patient-years respectively in canagliflozin vs placebo arms). #NephJC https://t.co/k5LVeQwuJN |
| Alex Meraz @NephroGuy @KatieKwonMD @GarySingerMD In Mexico I manage both conditions. I only send patients to end if they have a difficult to control DM with the need for insulin #NephJC |
| Lovy @drlovygaur @HecmagsMD @NephJC And they dealt till those with an HbA1C of 12% (except in Germany - even there the max was 10.5%) #NephJC |
| Harini Sarathy @hurryknee RT @madmagicdoc: This is why #NephJC is the best! Where else can you get this kind of insight into the methods of a trial! #NephJC |
| Harish Seethapathy @BetterCallSeeth @kidney_boy @NephJC @VladoPerkovic Had the same question. Considering the population and the rather huge effect estimates. #NephJC |
| Kenar Jhaveri @kdjhaveri @ChristosArgyrop @JamesNovakNeph @kidney_boy @scoca1 @HecmagsMD basically a proximal tubular diuretic like effect. #NephJC |
| Fitsum Asnakech Tilahun MD @fitse_t RT @VladoPerkovic: @JMedauraMD @UMMCneph @Fcabezarivera Fair point. We worked hard to recruit African Americans but it was hard. Please note that the trial was global, and more than 15% of US participants were Black #NephJC |
| Tiffany Caza @Tiff_Caza RT @NephJC: There was a 30% relative risk reduction in the primary composite end-point diverging as early as 12 months after randomization (event rate โ 43.2 vs 61.2 per 1000 patient-years respectively in canagliflozin vs placebo arms). #NephJC https://t.co/k5LVeQwuJN |
| Sam Krishnamoorthy @beans_sam RT @NephJC: @VladoPerkovic @aakashshingada where's @roxytonin? Indeed sick day rules have poor evidence base as we have seen https://t.co/whvMTcwYf7 #NephJC |
| Nephrology Journal Club @NephJC @gratefull080504 that's right - on a relative scale its pretty constant #NephJC |
| James Novak, MD PhD FACP FASN FNKF @JamesNovakNeph @Jwaitz @jenniejlin @kidney_boy @gratefull080504 @Renaltubules Yes, I think that's how it would need to be done, as @kidney_boy rightly notes that one could not withhold ACEi/ARB otherwise. Ultimately, we'll have to guess based on retrospective comparisons of patients who were taking ACEi/ARB, SGLT2i, or both. #NephJC |
| Alex Chang, MD, FASN, FAHA @alexchangmd @scoca1 @JamesNovakNeph @HecmagsMD We as a nephrology community need to be more excited about targeting the early CKD population or even at-risk patients (e.g. EMPA-REG and CANVaS). Many seem to feel our patient population is โrealโ diabetic nephropathy (whatever that is) and glomerulonephritides #nephJC |
| Nephrology Journal Club @NephJC RT @Nephro_Sparks: nice EMs from the @JCI_insight paper of SGLT2 podocyte paper #NephJC https://t.co/ZYxucamWTJ |
 | Jack Pollack @jhpollack @kidney_boy @NephJC @VladoPerkovic As a med student, my first shortcut in any lit review is to look straight at the any cause mortality effect between treatment and placebo. Is early stoppage part of the explanation for why one isn't seen here? #nephjc |
| Alex Meraz @NephroGuy RT @ChristosArgyrop: @jenniejlin @kidney_boy @gratefull080504 @Renaltubules It would not be ethical to randomize. . the question has already been answered in the trial data: a) patients who can tolerate ACEi, use ACEI (evidence basis: CREDENCE/subgroup analysis in EMPAREG) b) patients who cannot tolerate a RAASi -> use SGLT2 monotherapy #NephJC |
| Nephrology Journal Club @NephJC RT @kdjhaveri: @ChristosArgyrop @JamesNovakNeph @kidney_boy @scoca1 @HecmagsMD basically a proximal tubular diuretic like effect. #NephJC |
| L. Parker Gregg @LParkerGregg1 RT @madmagicdoc: This is why #NephJC is the best! Where else can you get this kind of insight into the methods of a trial! #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @khaledshawwa @NephJC I believe 2/3 of the patients were in 30-60 GFR #nephJC |
| ChristosArgyropoulos MD, PhD PharmanukerInChief @ChristosArgyrop @TxPharmD @jenniejlin @kidney_boy @gratefull080504 @Renaltubules Some of us are already living the patiromer dream #NephJC |
| Jennie Lin ๐ฉ๐ปโโ๏ธ๐งฌ @jenniejlin @VelezNephHepato @Jwaitz @kidney_boy @gratefull080504 @Renaltubules @KSusztak I do like bioenergetics. :) I think both work to confer renoprotection. Would be cool to study both angles, and in terms of myocardium yes I do favor bioenergetics hypothesis. #NephJC |
| Matthew Sparks, MD @Nephro_Sparks @ElfadawyN @Buck1486 @Jwaitz @jenniejlin @kidney_boy @gratefull080504 @Renaltubules @AJKDonline this is correct. #NephJC |
| Joshua Waitzman, MD PhD @Jwaitz @khaledshawwa @NephJC Not a lot of patients in this group (the trial wasnโt really designed for them) #nephjc |
| Steven Coca @scoca1 @khaledshawwa @NephJC Because most patients had eGFR < 60. Was way underpowered to detect those interactions. Please don't ignore the overwhelming similar benefit in CANVAS and EMPA-REG where > 75% had eGFR> 60. It's a class effect and works in early and late DKD. #NephJC |
| Diana Mahbod, MD, CPE, FASN, FNKF @DiMiRenalMD RT @NephJC: See study design from the authors @AmJNephrol paper #NephJC https://t.co/54CwKPdToq |
| Samaya @TarSamMD Holy moly this chat is nuts #NephJC |
| Charbel C Khoury @Charbel_Khoury @jenniejlin @Jwaitz @kidney_boy @gratefull080504 @Renaltubules @KSusztak #nephjc https://t.co/pzjuUtvkIG |
| Graham Abra, MD @GrahamAbra @Nephro_Sparks @KatieKwonMD @GarySingerMD Palo Alto CA probably not representative of the rest of country but no, I donโt manage diabetes for most of my patients, however not going to stop me from prescribing a kidney protective proximal tubule glucosuretic ๐ #NephJC |
| TEJAS PATEL MD, FACP, FASN @GenNextMD @NephJC Soon we will protect kidneys 100% โบ๏ธ #lightermoment #nephjc |
| Vlado Perkovic @VladoPerkovic @ChristosArgyrop @kdjhaveri @JamesNovakNeph @kidney_boy @scoca1 @HecmagsMD Potassium variations in previous trials likely chance i think. WOuld expect lower K as per mechanism and that appears likely to be the case #NephJC |
| Nephrology Journal Club @NephJC @khaledshawwa exactly pay attention to interaction #NephJC |
 | Jonathan Ellison (he/him/his) @jon_ellison Dear Nephrologists, I have no clue what #CREDENCE is about. But if you donโt follow it up with a hyper-hydration trial (CLEARWATER) and a recovery after AKI study (REVIVAL), I will be disappointed. #NephJC |
| Kenar Jhaveri @kdjhaveri RT @VladoPerkovic: @ChristosArgyrop @kdjhaveri @JamesNovakNeph @kidney_boy @scoca1 @HecmagsMD Potassium variations in previous trials likely chance i think. WOuld expect lower K as per mechanism and that appears likely to be the case #NephJC |
| Sayna Norouzi, MD, FASN @SaynaNorouzi Great one by @aishaikh ๐ |
| L. Parker Gregg @LParkerGregg1 RT @NephJC: 30% RRR on top of maximal RAS blockade Did anyone expect this? I did not #NephJC https://t.co/K4JHaJLP6d |
 | Amanda Condon Martรญnez @TxPharmD Who is/when are we going to look at SGLT2i in #transplant patients? We are always afraid 2/2 infx risk, but benefit > risk? We are using in a few patients without issue.. ๐ค๐ป #nephjc |
| Jennie Lin ๐ฉ๐ปโโ๏ธ๐งฌ @jenniejlin @VelezNephHepato @Jwaitz @kidney_boy @gratefull080504 @Renaltubules @KSusztak And this is why science, cell biology, and physiology are fascinating! #NephJC |
| Gary Singer @GarySingerMD@med-mastodon.com @GarySingerMD Will your response to this question change after #CREDENCE ?#NephJC |
| Nephrology Journal Club @NephJC RT @scoca1: @khaledshawwa @NephJC Because most patients had eGFR < 60. Was way underpowered to detect those interactions. Please don't ignore the overwhelming similar benefit in CANVAS and EMPA-REG where > 75% had eGFR> 60. It's a class effect and works in early and late DKD. #NephJC |
| Mario Funes, MD @MarioFunesMD Primary care and IM should start using it more often. Even ADA diabetes care 2019 updated its recommendation this year. CREDENCE further supports this with even decrease GFR and ACE/ARB use. #NephJC https://t.co/pw9CDKwRPN |
| Matthew Sparks, MD @Nephro_Sparks here is a nice study using gomez equation on patients with SGLT2i #NephJC https://t.co/C9fvRjMNMh |
| Alex Meraz @NephroGuy @NephJC This was certainly amazing and worth of all the ovations #NephJC |
| John Montford @JohnRMontford @NephJC #NephJC would be curious to see the baseline Na excretion and any differences in response, could be underestimating the role of dietary Na in selected patients? Those that derived maximal benefit- maybe had higher intake to start? |
| Samira Farouk, MD, MSCR @ssfarouk Think we should use sick day rules to decrease euglycemic DKA risk #NephJC |
| Alex Meraz @NephroGuy RT @NephJC: 30% RRR on top of maximal RAS blockade Did anyone expect this? I did not #NephJC https://t.co/K4JHaJLP6d |
| Nephrology Journal Club @NephJC RT @VladoPerkovic: @ChristosArgyrop @kdjhaveri @JamesNovakNeph @kidney_boy @scoca1 @HecmagsMD Potassium variations in previous trials likely chance i think. WOuld expect lower K as per mechanism and that appears likely to be the case #NephJC |
| Alex Meraz @NephroGuy RT @Nephro_Sparks: @jenniejlin @Jwaitz @kidney_boy @gratefull080504 @Renaltubules @KSusztak also direct podocyte effects #NephJC https://t.co/0WzR1imGRU |
| Nephrology Journal Club @NephJC RT @jon_ellison: Dear Nephrologists, I have no clue what #CREDENCE is about. But if you donโt follow it up with a hyper-hydration trial (CLEARWATER) and a recovery after AKI study (REVIVAL), I will be disappointed. #NephJC |
| Vlado Perkovic @VladoPerkovic @Renaltubules My answer to both would be I dont think so. No evidence of dose response effect in CANVAS or EMPA-REG OUTCOMES #NephJC |
| Steven Coca @scoca1 @BetterCallSeeth @kidney_boy @NephJC @VladoPerkovic Proportional hazards assumptions should mean that early stoppage did not matter. #NephJC |
 | Deborah Verran med-mastodon.com/@VerranDeborah @VerranDeborah @kidney_boy @NephJC @VladoPerkovic Also what are the absolute risk reduction estimates here #NephJC ? Makes more sense ti us non nephrologists! |
| Aakash Shingada, DNB, MRCP(UK), FASN @aakashshingada RT @alexchangmd: @scoca1 @JamesNovakNeph @HecmagsMD We as a nephrology community need to be more excited about targeting the early CKD population or even at-risk patients (e.g. EMPA-REG and CANVaS). Many seem to feel our patient population is โrealโ diabetic nephropathy (whatever that is) and glomerulonephritides #nephJC |
| Nephrology Journal Club @NephJC RT @Nephro_Sparks: here is a nice study using gomez equation on patients with SGLT2i #NephJC https://t.co/C9fvRjMNMh |
| Kenar Jhaveri @kdjhaveri RT @Nephro_Sparks: @jenniejlin @Jwaitz @kidney_boy @gratefull080504 @Renaltubules @KSusztak also direct podocyte effects #NephJC https://t.co/0WzR1imGRU |
| Alex Meraz @NephroGuy RT @scoca1: @khaledshawwa @NephJC Because most patients had eGFR < 60. Was way underpowered to detect those interactions. Please don't ignore the overwhelming similar benefit in CANVAS and EMPA-REG where > 75% had eGFR> 60. It's a class effect and works in early and late DKD. #NephJC |
| Sam Krishnamoorthy @beans_sam RT @Nephro_Sparks: here is a nice study using gomez equation on patients with SGLT2i #NephJC https://t.co/C9fvRjMNMh |
| Vlado Perkovic @VladoPerkovic @GarySingerMD @KatieKwonMD It was fascinating to learn about differing renal referral patterns for DKD between and within countries..... #NephJC |
| Edgar V. Lerma ๐ต๐ญ @edgarvlermamd Choosing glucose lowering medication in those w/ established ASCVD or CKD #Nephpearls #NephJC ๐๐ผ https://t.co/tP3NduZZ6L https://t.co/64Dn4A7erd |
 | S a d i q J A l L a w a t i ๐ด๐ฒ @SJAllawati RT @NephJC: SGLT2 inhibitors have increasingly drawn attention over the last decade. See this excellent ADKD blog from 2018 by Anna Burgner for an explanation of their mechanism of action #NephJC https://t.co/7mVBgGT7YQ slow-the-progression-of-diabetic-kidney-disease/ |
| ChristosArgyropoulos MD, PhD PharmanukerInChief @ChristosArgyrop @VladoPerkovic @kdjhaveri @JamesNovakNeph @kidney_boy @scoca1 @HecmagsMD In total agreement - network meta-analyses of sugar lowering trials also suggest SGLT2i lower K. And if increased distal Na delivery does not lower K, then we all have to go back and rewrite the physiology textbooks The PIL/SmPC have to be redone #nephjc |
| Charbel C Khoury @Charbel_Khoury RT @scoca1: @BetterCallSeeth @kidney_boy @NephJC @VladoPerkovic Proportional hazards assumptions should mean that early stoppage did not matter. #NephJC |
| KatieOverV @KatieKwonMD @MarioFunesMD Now we just need a change in formularies and fewer prior authorizations - sad that that will be the deciding factor for some time to come. . . #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 #NephJC Isn't tonight the way that nephrology should be? Focusing on science + intervening upstream in #kidneydisease rather than rewarding #kidneyfailure Who disagrees with my premise? Anyone? |
| Nephrology Journal Club @NephJC RT @VladoPerkovic: @Renaltubules My answer to both would be I dont think so. No evidence of dose response effect in CANVAS or EMPA-REG OUTCOMES #NephJC |
| Nephrology Journal Club @NephJC subgroups see last column consistent effect in *all* subgroups #NephJC https://t.co/LYbaneEWzT |
| ~~~ @DrNamkeen RT @aishaikh: ๐ฅHow do SGLT2 Inhibitors work? ๐ฅHow does an anti-diabetic drug improve Renal & Cardiovascular outcomes? ๐ฅTo understand this letโs first review: โก๏ธRenal handling of glucose 1/ @RenalFellowNtwk #NephJC #SGLT2 #CREDENCE |
| Vlado Perkovic @VladoPerkovic @khaledshawwa @NephJC Would recommend not overinterpreting individual subgroups- previous trials strongly suggest renal benefit above eGFR 60 #NephJC |
| Harini Sarathy @hurryknee T |
| Alex Meraz @NephroGuy RT @JamesNovakNeph: @kidney_boy @scoca1 @HecmagsMD Yes, but I'm more interested in the converse: @kidney_boy @scoca1 @HecmagsMD Yes, but I'm more interested in the converse: all patients receive SGLT2i, then test ACEi/ARB yes/no. In other words, is the addition of RAS blockade syngergistic? #CREDENCE would suggest not, as the effect sizes are similar as in EMPA-REG and CANVAS. #NephJC |
| Gary Singer @GarySingerMD@med-mastodon.com @GarySingerMD @VladoPerkovic @KatieKwonMD Please share your insights #NephJC |
| Joel M. Topf, MD FACP @kidney_boy @TxPharmD @ChristosArgyrop @jenniejlin @gratefull080504 @Renaltubules Recently had a patient admitted with a potassium of 8 because the patiromer wasn't refilled when the losartan was. Oops. Patiromer dream turns to nightmare. #NephJC |
| Nephrology Journal Club @NephJC RT @scoca1: @BetterCallSeeth @kidney_boy @NephJC @VladoPerkovic Proportional hazards assumptions should mean that early stoppage did not matter. #NephJC |
| Bhavnish @Buck1486 @Nephro_Sparks Your editorial was so helpful when I presented this paper. Added meat to the data from CREDENCE. #NephJC |
| Alex Meraz @NephroGuy RT @Nephro_Sparks: nice EMs from the @JCI_insight paper of SGLT2 podocyte paper #NephJC https://t.co/ZYxucamWTJ |
| Katalin Susztak @KSusztak #NephJC I also find it very interesting that we see a clustering of GWAS hits in the kidney proximal tubules, https://t.co/BwNOeUqoTp now we have PT selective drug... I hope to understand better the role of PT in eGFR regulation |
| James Novak, MD PhD FACP FASN FNKF @JamesNovakNeph @Nephro_Sparks @JCI_insight Also, SGTL2i decreased UACR, glomerular volume, and kidney size in Akita diabetic mice. #NephJC |
| Nephrology Journal Club @NephJC RT @VladoPerkovic: @khaledshawwa @NephJC Would recommend not overinterpreting individual subgroups- previous trials strongly suggest renal benefit above eGFR 60 #NephJC |
| Vlado Perkovic @VladoPerkovic @NephJC Nor did I (in 2013 at least) #NephJC |
| ChristosArgyropoulos MD, PhD PharmanukerInChief @ChristosArgyrop @kidney_boy @TxPharmD @jenniejlin @gratefull080504 @Renaltubules Blame the #pharmacist NOT the drug #NephJC |
 | Lauren Ng, MD @lng8894 One of my concerns with the SGLT2 inhibitors is that the hazard ratio for canaglaflozin vs. placebo for DKA was 10. The study also excluded patients with a history of DKA, so if a patient had a recent history of DKA I would not prescribe SGLT2 #NephJC |
| Saurabh kapil @foreseesaurabh RT @NephJC: SGLT2 inhibitors block the SGLT2 transport in the proximal tubule, resulting in glycosuria with attendant reduction in glycaemia. Their natriuretic action may hold the key to their dowsnstream kidney actions via tubuloglomerular feedback and glomerular hyperfiltration. #NephJC |
| S a d i q J A l L a w a t i ๐ด๐ฒ @SJAllawati RT @aishaikh: ๐ฅHow do SGLT2 Inhibitors work? ๐ฅHow does an anti-diabetic drug improve Renal & Cardiovascular outcomes? ๐ฅTo understand this letโs first review: โก๏ธRenal handling of glucose 1/ @RenalFellowNtwk #NephJC #SGLT2 #CREDENCE |
| Edgar V. Lerma ๐ต๐ญ @edgarvlermamd Beneficial effects of SGLT2 inhibition on glucose homeostasis and the cardiovascular and renal systems #Nephpearls #NephJC ๐๐ผ https://t.co/Tnu8SsiZhq https://t.co/PFK8ylNIJ1 |
| Nephrology Journal Club @NephJC change in albuminuria? Here we go #NephJC https://t.co/HtByIv61Zo |
| Jennie Lin ๐ฉ๐ปโโ๏ธ๐งฌ @jenniejlin @NephJC But what about race? Was African ancestry subgroup underpowered? I did notice vast majority of participants were European ancestry. #NephJC |
| Salt @Saltwebsite @Buck1486 the rates of amputation in this trial were similar b/w canagliflozin and placebo which is nice. maybe we can prescribe this with a little more ease of mind than previously thought? #NephJC |
| Mario Funes, MD @MarioFunesMD @GarySingerMD @VladoPerkovic @KatieKwonMD Iโm hopeful that in the future prescription assistance program will be available. This will give more options for IM residents, IM physicians and primary care who manage this patients in underserved areas. #NephJC |
| Joel M. Topf, MD FACP @kidney_boy This is why this study is so exciting because we all want to prevent kidney failure. Cut it off at his needs. #NephJC |
| Alex Meraz @NephroGuy @Nephro_Sparks @ElfadawyN @Buck1486 @Jwaitz @jenniejlin @kidney_boy @gratefull080504 @Renaltubules @AJKDonline In Mice? #NephJC |
| Kenar Jhaveri @kdjhaveri @ssfarouk usually i had thought the ones that get euglycemic DKA with the glucoretics are the ones that have a low fasting C peptide. If there is a normal C peptide, less likely to get DKA #NephJC |
| Nephrology Journal Club @NephJC @lng8894 indded - that was an exclusion #NephJC (and large HR but small absolute risk increase) |
| Graham Abra, MD @GrahamAbra @ssfarouk Iโm going to add it on to my sick day med list. Drug website says to consider. though nihilists will say no evidence for the sick day list in first place - *waits for nihilist to tweet recent sick day study data* #NephJC https://t.co/YaOxoun2xv |
| Katalin Susztak @KSusztak @VelezNephHepato @jenniejlin @Jwaitz @kidney_boy @gratefull080504 @Renaltubules True the hyperfiltration seems to be a very consistent theme... however we do not know whether this only protects the glom/podocyte or also the tubules #NephJC |
| Nephrology Journal Club @NephJC RT @gratefull080504: #NephJC Isn't tonight the way that nephrology should be? Focusing on science + intervening upstream in #kidneydisease rather than rewarding #kidneyfailure Who disagrees with my premise? Anyone? |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @VladoPerkovic @NephJC This truly excites me Thank you @VladoPerkovic for a superb study that I hope will accelerate policy change #NephJC |
| ChristosArgyropoulos MD, PhD PharmanukerInChief @ChristosArgyrop @NephJC #boring #nephjc I know of no proteinuric patient who is on dialysis because the proteinuria and eGFR are high |
| Charbel C Khoury @Charbel_Khoury RT @VladoPerkovic: @aakashshingada General advice provided. Asked people to consider stopping other diuretics or BP lowering drugs first if required and try to maintain RAS blockade and randomised therapy #NephJC Interesting that these drugs appear to possibly reduce risk of AKI- should we using sick day rules??? |
| Kenar Jhaveri @kdjhaveri RT @ChristosArgyrop: @kdjhaveri @JamesNovakNeph @kidney_boy @scoca1 @HecmagsMD Hyperkalemia has not been seen outside the first trials in diabetes. In fact in CREDENCE SGLT2i reduced the K level and this was also seen in EMPAREG. CANVAS was an odd-ball in many aspects #NephJC |
| Alex Meraz @NephroGuy RT @VladoPerkovic: @ChristosArgyrop @kdjhaveri @JamesNovakNeph @kidney_boy @scoca1 @HecmagsMD Potassium variations in previous trials likely chance i think. WOuld expect lower K as per mechanism and that appears likely to be the case #NephJC |
| TEJAS PATEL MD, FACP, FASN @GenNextMD @lng8894 Yeh..itโs like pancreatitis for dpp4i #NephJC |
| Nissreen Elfadawy MD, MS, FASN, FAST @ElfadawyN I have not seen this strong positive data for years. Itโs a dream came true #nephJC #CREDENCE |
| Nephrology Journal Club @NephJC @ChristosArgyrop hahaha whwre's Scott @s_brimble and @lp7777777 #NephJC |
| Alex Meraz @NephroGuy RT @TxPharmD: Who is/when are we going to look at SGLT2i in #transplant patients? We are always afraid 2/2 infx risk, but benefit > risk? We are using in a few patients without issue.. ๐ค๐ป #nephjc |
| Jeffrey Sparks MD MMSc @jeffsparks @gratefull080504 can we define a new term for #kidneysuccess ? @alhkim @Nephro_Sparks @kidney_boy @edgarvlermamd #NephJC |
| Tiffany Caza @Tiff_Caza @jenniejlin @Jwaitz @kidney_boy @gratefull080504 @Renaltubules @KSusztak Interesting concepts and mechanisms. Perhaps increased VEGF may play a role too, as seen with reduced renal fibrosis by SGLT2 inhibitors in rodent models? #NephJC https://t.co/n2rfirepkv |
| Jefferson L. Triozzi, M.D. @nepherson @Saltwebsite @Buck1486 The study wasn't powered for adverse events. Let alone adverse events that are not common. Interpret with caution. #NephJC |
| ChristosArgyropoulos MD, PhD PharmanukerInChief @ChristosArgyrop RT @GrahamAbra: @ssfarouk Iโm going to add it on to my sick day med list. Drug website says to consider. though nihilists will say no evidence for the sick day list in first place - *waits for nihilist to tweet recent sick day study data* #NephJC https://t.co/YaOxoun2xv |
| Harini Sarathy @hurryknee RT @VladoPerkovic: @aakashshingada General advice provided. Asked people to consider stopping other diuretics or BP lowering drugs first if required and try to maintain RAS blockade and randomised therapy #NephJC Interesting that these drugs appear to possibly reduce risk of AKI- should we using sick day rules??? |
| Alex Meraz @NephroGuy RT @MarioFunesMD: Primary care and IM should start using it more often. Even ADA diabetes care 2019 updated its recommendation this year. CREDENCE further supports this with even decrease GFR and ACE/ARB use. #NephJC https://t.co/pw9CDKwRPN |
| Nephrology Journal Club @NephJC Change in GFR: voila Boom: don't worry about early GFR drop #NephJC https://t.co/X1MJ72hYa1 |
| Samaya @TarSamMD Anyone concerned about UTI risk? #NephJC |
| Alex Chang, MD, FASN, FAHA @alexchangmd RT @jenniejlin: @Jwaitz @kidney_boy @gratefull080504 @Renaltubules @ksusztak showed how defective FAO promotes renal fibrosis, can SGLT2i provide a shunt to avoid pathway? #NephJC https://t.co/Eh9xNtpbys |
| Vlado Perkovic @VladoPerkovic @NephJC Just that there was no real debate- very clear advice and decision #NephJC |
| Salt @Saltwebsite @NephJC so now we have ACE/ARBs, low sodium diet and SGLT-2 inhibitors to reduce proteinuria. does this mean we can finally test the hypothesis that targeting a certain % reduction in proteinuria has true renal benefits? #NephJC |
| Nephrology Journal Club @NephJC @TRIOZZIJL @Saltwebsite @Buck1486 No RCT is powered for adverse effects Ahem #NephJC |
| Gary Singer @GarySingerMD@med-mastodon.com @GarySingerMD Comments? #NephJC |
| Verner Venegas @Vernisartan RT @NephJC: Change in GFR: voila Boom: don't worry about early GFR drop #NephJC https://t.co/X1MJ72hYa1 |
| Kelly Burdge, MD, FASN @practicalkidney #NephJC Perhaps I missed this but besides DKA patients who should not get an SGLT2? |
| TEJAS PATEL MD, FACP, FASN @GenNextMD @kdjhaveri @ssfarouk Check c-peptide before starting? #nephrondetective #NephJC @ASNKidney |
| Bhavnish @Buck1486 @Saltwebsite Plus we can always assess abnormal physical findings during office visit. Need for amputation does not happen overnight. Euglycemic DKA is another story though. HR of 10 from CREDENCE. That was the only cringing point. Unless stat expert can say otherwise. #NephJC |
| Nissreen Elfadawy MD, MS, FASN, FAST @ElfadawyN @Nephro_Sparks @NephroGuy @Buck1486 @Jwaitz @jenniejlin @kidney_boy @gratefull080504 @Renaltubules @AJKDonline #NephJC that means the combination between ACEi/ARBs and SGL2i is a disaster to GFR. Who much expected drop in GFR? |
| Nephrology Journal Club @NephJC @TarSamMD not UTI itself it was genital mycotic infection (also shown before by @FralickMike et al i think?) #NephJC |
| Nephrology Journal Club @NephJC RT @VladoPerkovic: @NephJC Just that there was no real debate- very clear advice and decision #NephJC |
| Alex Meraz @NephroGuy RT @VladoPerkovic: @Renaltubules My answer to both would be I dont think so. No evidence of dose response effect in CANVAS or EMPA-REG OUTCOMES #NephJC |
| Joshua Waitzman, MD PhD @Jwaitz Strongest piece of data in my mind is the rate of progression to ESRD. Bardaxolone (among others) can improve a creatinine, but ESRD is a pretty solid and clinically meaningful outcome. #NephJC |
| Salt @Saltwebsite @TRIOZZIJL @Buck1486 good call. thanks. #NephJC |
| Nephrology Journal Club @NephJC @VladoPerkovic wise decision We need to start using them now and preventing ESKD rather than 2 years from now #NephJC |
| TEJAS PATEL MD, FACP, FASN @GenNextMD @practicalkidney Still I would be cautious with PVD pt..IMO #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 For all of my #nephJC friends The policy implications of #credence are enormous + have a chance to shape the future delivery of #kidneycare Thank you @VladoPerkovic + others for demonstrating the value of science + improved patient care |
| Mario Funes, MD @MarioFunesMD @LTummalapalli Yes. Image by @drlovygaur #NephJC https://t.co/Ux9gxgb0fm |
| Alex Meraz @NephroGuy RT @edgarvlermamd: Choosing glucose lowering medication in those w/ established ASCVD or CKD #Nephpearls #NephJC ๐๐ผ https://t.co/tP3NduZZ6L https://t.co/64Dn4A7erd |
 | Cassie Kovach, MD @CKovachMD RT @jon_ellison: Dear Nephrologists, I have no clue what #CREDENCE is about. But if you donโt follow it up with a hyper-hydration trial (CLEARWATER) and a recovery after AKI study (REVIVAL), I will be disappointed. #NephJC |
| Dr. Divya Bajpai ๐ฎ๐ณ @divyaa24 @TxPharmD There r small studies looking at #sglt2i in transplant One from Mumbai https://t.co/pBufoZPq7l And https://t.co/QvweYHeQsA #NephJC |
| Matthew Sparks, MD @Nephro_Sparks @Jwaitz I have shown this paper to anyone who will take 5 min to listen to me talk. Which is not many people. but at least I am trying #NephJC |
| KatieOverV @KatieKwonMD @TxPharmD @MarioFunesMD But if we're trying to broadly change practice patterns, appeals and P2P are huge barriers. And if it's still Tier 3 and glipizide is Tier 1, the copays are also going to push towards less effective therapies. #NephJC |
| Timothy Yau @Maximal_Change @VerranDeborah @kidney_boy @NephJC @VladoPerkovic NNT for primary outcome was 21, was 42 for the kidney-specific outcome. #NephJC |
| Kenar Jhaveri @kdjhaveri RT @NephJC: @VladoPerkovic wise decision We need to start using them now and preventing ESKD rather than 2 years from now #NephJC |
| Tiffany Caza @Tiff_Caza @NephJC So exciting .. especially given that patients with more advanced CKD were included and still benefited. This rocks! #NephJC |
| ChristosArgyropoulos MD, PhD PharmanukerInChief @ChristosArgyrop @KSusztak @VelezNephHepato @jenniejlin @Jwaitz @kidney_boy @gratefull080504 @Renaltubules #NephJC This paper makes for a very provocative read. Knock out SGLT2 (by definition 100% SGLT2i) and one does not fully prevent experimental DKD. SGLT2i are the end of the beginning for #diabetic #kidney #disease https://t.co/uRXg48SaUG |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @jeffsparks @alhkim @Nephro_Sparks @kidney_boy @edgarvlermamd Yes @jeffsparks enabling #kidneydisease patients to retain their native kidneys #NephJC |
| Larissa Krรผger @nephron_andon @TarSamMD I know from a patient perspective is definitely uncomfortable and we should always have shared decision making with our patients - my value system may not be the same as them. Personally, DKA was the most worrisome risk #NephJC |
| Hector Madariaga, MD FASN ๐ฒ๐ฝ @HecmagsMD @gratefull080504 We hate #KidneyFailure #NephJC |
| Steven Coca @scoca1 @ElfadawyN @Nephro_Sparks @NephroGuy @Buck1486 @Jwaitz @jenniejlin @kidney_boy @gratefull080504 @Renaltubules @AJKDonline Disaster? How about hang in there with a little "permissive hypercreatinemia" for a year and then the turtle will win the long-term marathon #NephJC |
| Alex Meraz @NephroGuy @NephJC #NephJC BOOOM! |
| Charbel C Khoury @Charbel_Khoury @ssfarouk https://t.co/AZVem3AOI7 #nephjc STITCH cards for DKA prevention |
| Mario Funes, MD @MarioFunesMD @KatieKwonMD @TxPharmD Yes, I agree. #NephJC |
| Kenar Jhaveri @kdjhaveri @GenNextMD @ssfarouk @ASNKidney i think so, some of my endocrine colleagues recommended that. I don't think there is data for that though #NephJC |
| Jennie Lin ๐ฉ๐ปโโ๏ธ๐งฌ @jenniejlin @S_brimble @NephJC @ChristosArgyrop @lp7777777 My Tweetdeck is whizzing by too fast! #NephJC |
| Edgar V. Lerma ๐ต๐ญ @edgarvlermamd Renal Outcomes in the CANVAS, DECLARE-TIMI 58, and EMPA-REG OUTCOME Trials: A Systematic Review ca. 2019 #Nephpearls #NephJC ๐๐ผ https://t.co/C58YAozDKB https://t.co/2WVR0yiCpX |
| Nephrology Journal Club @NephJC adverse effects Euglycemic DKA Genital mycotic infections No increase in amputations Unliek CANVAS #NephJC https://t.co/oDhDgZ7DCy |
| L. Parker Gregg @LParkerGregg1 RT @NephJC: subgroups see last column consistent effect in *all* subgroups #NephJC https://t.co/LYbaneEWzT |
| Joshua Waitzman, MD PhD @Jwaitz @VladoPerkovic @NephJC Data Safety Monitoring Committees be like: #nephjc https://t.co/e2KsVZgpx9 |
| Alex Meraz @NephroGuy RT @VladoPerkovic: @khaledshawwa @NephJC Would recommend not overinterpreting individual subgroups- previous trials strongly suggest renal benefit above eGFR 60 #NephJC |
| Bhavnish @Buck1486 @ElfadawyN @Nephro_Sparks @NephroGuy @Jwaitz @jenniejlin @kidney_boy @gratefull080504 @Renaltubules @AJKDonline The drop in eGFR equalizes in both groups at 1 year and after that its SGLT2i for the win all the way! #NephJC |
| Jennie Lin ๐ฉ๐ปโโ๏ธ๐งฌ @jenniejlin @NephJC OK any thoughts on the differences in amputation rates in CANVAS and CREDENCE? Did protocol adjustment play a role? #NephJC |
| Larissa Krรผger @nephron_andon @Buck1486 @Saltwebsite Agree! The euglicemic DKA is also what worries me #NephJC |
| Alex Meraz @NephroGuy RT @lng8894: One of my concerns with the SGLT2 inhibitors is that the hazard ratio for canaglaflozin vs. placebo for DKA was 10. The study also excluded patients with a history of DKA, so if a patient had a recent history of DKA I would not prescribe SGLT2 #NephJC |
| Nephrology Journal Club @NephJC @nephron_andon @TarSamMD True - but 11 cases in 2200 patients comapre with magnitude of ESKD and mortality benefit? #NephJC https://t.co/vBmEb98y3n |
| Alex Meraz @NephroGuy RT @edgarvlermamd: Beneficial effects of SGLT2 inhibition on glucose homeostasis and the cardiovascular and renal systems #Nephpearls #NephJC ๐๐ผ https://t.co/Tnu8SsiZhq https://t.co/PFK8ylNIJ1 |
| Joel M. Topf, MD FACP @kidney_boy @GarySingerMD @US_FDA I don't think the FDA will back off the black box warning. In addition to CANVAS a lot of observational data showing amputations. #NephJC https://t.co/DZWa8Qgoye |
| Alex Meraz @NephroGuy RT @NephJC: change in albuminuria? Here we go #NephJC https://t.co/HtByIv61Zo |
 | Tired & Sakit ๐ฒ๐พ @tulunsokit @aakashshingada Yes . Should be subject to sick day rule #SGLT2 #NephJc |
| Hector Madariaga, MD FASN ๐ฒ๐ฝ @HecmagsMD @NephJC Not at all. One of a kind! #NephJC |
| Nephrology Journal Club @NephJC RT @Maximal_Change: @VerranDeborah @kidney_boy @NephJC @VladoPerkovic NNT for primary outcome was 21, was 42 for the kidney-specific outcome. #NephJC |
| Graham Abra, MD @GrahamAbra @VelezNephHepato @KSusztak @jenniejlin @Jwaitz @kidney_boy @gratefull080504 @Renaltubules RIP Roland #NephJC https://t.co/2Ud4QAZzrD |
| ChristosArgyropoulos MD, PhD PharmanukerInChief @ChristosArgyrop @TarSamMD Hmm... the incidence vary among SGLT2i and doses of them #NephJC |
| Alex Meraz @NephroGuy RT @Saltwebsite: @Buck1486 the rates of amputation in this trial were similar b/w canagliflozin and placebo which is nice. maybe we can prescribe this with a little more ease of mind than previously thought? #NephJC |
| Joshua Waitzman, MD PhD @Jwaitz @scoca1 @ElfadawyN @Nephro_Sparks @NephroGuy @Buck1486 @jenniejlin @kidney_boy @gratefull080504 @Renaltubules @AJKDonline How much do I love โpermissive hypercreatininemiaโ?! Can I use this for diuresis induced โAKIโ consults?? #nephjc |
| Nephrology Journal Club @NephJC RT @scoca1: @ElfadawyN @Nephro_Sparks @NephroGuy @Buck1486 @Jwaitz @jenniejlin @kidney_boy @gratefull080504 @Renaltubules @AJKDonline Disaster? How about hang in there with a little "permissive hypercreatinemia" for a year and then the turtle will win the long-term marathon #NephJC |
| Nissreen Elfadawy MD, MS, FASN, FAST @ElfadawyN How much drop in GFR is Ok? Before you decide to stop either ACEi or SGL2i #nephJC @scoca1 |
| Nephrology Journal Club @NephJC RT @Jwaitz: @VladoPerkovic @NephJC Data Safety Monitoring Committees be like: @VladoPerkovic @NephJC Data Safety Monitoring Committees be like: #nephjc https://t.co/e2KsVZgpx9 |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @Buck1486 @ElfadawyN @Nephro_Sparks @NephroGuy @Jwaitz @jenniejlin @kidney_boy @Renaltubules @AJKDonline Amen to the renoprotective benefit appears to grow over time #NephJC |
| Angel Cesar Ortiz @AngelCesarOrtiz RT @NephJC: subgroups see last column consistent effect in *all* subgroups #NephJC https://t.co/LYbaneEWzT |
| Jennie Lin ๐ฉ๐ปโโ๏ธ๐งฌ @jenniejlin @kidney_boy @GarySingerMD @US_FDA Is there a physiological explanation for the connection? #NephJC |
| Khaled Shawwa @khaledshawwa @VladoPerkovic @NephJC would you expect the overall mortality to be different had there been a long-term follow-up (or a different study)? #NephJC |
| ChristosArgyropoulos MD, PhD PharmanukerInChief @ChristosArgyrop @Saltwebsite @NephJC #Nephjc #proteinuria is a marker, not a target |
| Vlado Perkovic @VladoPerkovic @VerranDeborah @kidney_boy @NephJC About 2% per year for primary outcome #NephJC |
| Kelly Burdge, MD, FASN @practicalkidney Utiโs as well...#Nephjc |
| Alex Meraz @NephroGuy RT @kdjhaveri: @ssfarouk usually i had thought the ones that get euglycemic DKA with the glucoretics are the ones that have a low fasting C peptide. If there is a normal C peptide, less likely to get DKA #NephJC |
| Nephrology Journal Club @NephJC Other outcomes too All good? #NephJC https://t.co/rsAEQ5029x |
| Harini Sarathy @hurryknee Adding to my ever-burgeoning reading list |
| Vlado Perkovic @VladoPerkovic @ssfarouk That is a good point #NephJC |
| Jennie Lin ๐ฉ๐ปโโ๏ธ๐งฌ @jenniejlin @Jwaitz @scoca1 @ElfadawyN @Nephro_Sparks @NephroGuy @Buck1486 @kidney_boy @gratefull080504 @Renaltubules @AJKDonline Yale and Coca say yes #NephJC |
| Mario Funes, MD @MarioFunesMD @jenniejlin @S_brimble @NephJC @ChristosArgyrop @lp7777777 Hard to keep up! #NephJC https://t.co/77CwRB3ccw |
| Nephrology Journal Club @NephJC RT @ChristosArgyrop: @Saltwebsite @NephJC #Nephjc #proteinuria is a marker, not a target |
| Larissa Krรผger @nephron_andon @NephJC @TarSamMD True story. #perspective , maybe we just need to educate physicians of the need for early suspicion of DKA in patients using the drug #NephJC |
| Charbel C Khoury @Charbel_Khoury @NephJC @TarSamMD @FralickMike The impression from litterature is that Genital mycotic inf can be treated with a single dose of an oral antifungal drug (e.g. fluconazole) or application of an antifungal cream (e.g. miconazole, clotrimazole). #nephjc not a life threatening side effect, @VladoPerkovic ? |
| Joshua Waitzman, MD PhD @Jwaitz @Nephro_Sparks Talk shorter. โDo you want your patients on dialysis? No? #CREDENCEโ #thankunext #nephjc |
 | Mario Alamilla-Sรกnchez @MarioAlamilla RT @lng8894: One of my concerns with the SGLT2 inhibitors is that the hazard ratio for canaglaflozin vs. placebo for DKA was 10. The study also excluded patients with a history of DKA, so if a patient had a recent history of DKA I would not prescribe SGLT2 #NephJC |
| Edgar V. Lerma ๐ต๐ญ @edgarvlermamd Pump, pipes, and filter: do SGLT2 inhibitors cover it all โ๏ธ ca. 2018 from @TheLancet #Nephpearls #NephJC ๐๐ผ https://t.co/yXCZNoew2e https://t.co/WzmTBvInZO |
| Jeffrey William @jwilliamMD @scoca1 @ElfadawyN @Nephro_Sparks @NephroGuy @Buck1486 @Jwaitz @jenniejlin @kidney_boy @gratefull080504 @Renaltubules @AJKDonline #NephJC Maybe we might be able to restrain ourselves (...maybe), but guaranteed everything will be stopped when the patient is admitted with some other issues and Cr is above baseline. And then you'll need to reset the clock! |
| ChristosArgyropoulos MD, PhD PharmanukerInChief @ChristosArgyrop @KSusztak @VelezNephHepato @jenniejlin @Jwaitz @kidney_boy @gratefull080504 @Renaltubules There are huge differences to be sure, but unfortunately it is a cheap model to play with #NephJC |
| Vlado Perkovic @VladoPerkovic @TxPharmD Important population to study. Will be important to learn whether infection risks similar or increased if SGLT2i used after transplant. No data currently available to my knowledge #NephJC |
| L. Parker Gregg @LParkerGregg1 RT @NephJC: @VladoPerkovic wise decision We need to start using them now and preventing ESKD rather than 2 years from now #NephJC |
| TEJAS PATEL MD, FACP, FASN @GenNextMD @VelezNephHepato @kdjhaveri @ssfarouk @ASNKidney Interesting..But Med would be held too...no? #nephjc |
| Gary Singer @GarySingerMD@med-mastodon.com @GarySingerMD @VladoPerkovic @KatieKwonMD See huge variability in referral patterns in ๐บ๐ธ depending on PCP expertise, payor/insurance, MD vs AP/NP/PA, other #NephJC |
| Harish Seethapathy @BetterCallSeeth @NephJC Mycotic infections and DKA I get why that would happen. Always wondered why amputation stood out. No real mechanism. Hopefully it plays out to be a non-drug (and hence random) effect in the previous trials. DAPA-CKD and EMPA-Kidney to come #NephJC |
| Aisha Shaikh @aishaikh @NephJC @nephron_andon @TarSamMD Any suggestions for early detection of DKA - such as using a capillary blood ketone monitor to detect ketonemia as hyperglycemia is usually not present in the DKA seen with SGLTi #NephJC |
| Nephrology Journal Club @NephJC wow only 12 minutes left No major red flags Early stoppage is legit - and ouctomes consistent with EMPAREG/CANVAS results #NephJC |
| Gates Colbert, MD @DoctorGates Currently at #MidwestHeadquarters are discussing why we need to watch out out for euglycemic DKA in SGLTi patients. Consensus is that it is the lack of insulin (from DM Type II) in setting of hypoglycemia from the drug, resulting in ketosis. #nephjc |
| Alex Meraz @NephroGuy RT @scoca1: @ElfadawyN @Nephro_Sparks @NephroGuy @Buck1486 @Jwaitz @jenniejlin @kidney_boy @gratefull080504 @Renaltubules @AJKDonline Disaster? How about hang in there with a little "permissive hypercreatinemia" for a year and then the turtle will win the long-term marathon #NephJC |
| Steven Coca @scoca1 @ElfadawyN Depends, prob < 20%. Each case is different have to evaluate all conditions and precipitants. #NephJC |
| Anna Burgner MD MEHP @anna_burgner Do you think the SGLT1 vs SGLT2 selectivity is going to matter with renal outcomes with these drugs? #NephJC |
| Sam Krishnamoorthy @beans_sam RT @MarioFunesMD: Primary care and IM should start using it more often. Even ADA diabetes care 2019 updated its recommendation this year. CREDENCE further supports this with even decrease GFR and ACE/ARB use. #NephJC https://t.co/pw9CDKwRPN |
| Hector Madariaga, MD FASN ๐ฒ๐ฝ @HecmagsMD @practicalkidney Patients at risk of amputation, PVD, perhaps T1DM, peripheral neuropathy.. Any others? #NephJC |
| Samira Farouk, MD, MSCR @ssfarouk RT @VladoPerkovic: @TxPharmD Important population to study. Will be important to learn whether infection risks similar or increased if SGLT2i used after transplant. No data currently available to my knowledge #NephJC |
| Tiffany Caza @Tiff_Caza @Nephro_Sparks @NephJC @JCI_insight Looks like we should pay close attention to podocytes from patients on SGLT2 inhibitors. Hopefully the same protection plays out in treated patients as seen in the rodent models. #NephJC |
| ChristosArgyropoulos MD, PhD PharmanukerInChief @ChristosArgyrop RT @scoca1: @ElfadawyN @Nephro_Sparks @NephroGuy @Buck1486 @Jwaitz @jenniejlin @kidney_boy @gratefull080504 @Renaltubules @AJKDonline Disaster? How about hang in there with a little "permissive hypercreatinemia" for a year and then the turtle will win the long-term marathon #NephJC |
| Nephrology Journal Club @NephJC FOr DKA: as @ssfarouk said, sick day kind of rules makes some sense for amputation: watch the legs every visit? Avoid if established PAD? #NEPHJC |
 | Juan Carlos Q Velez @VelezNephHepato @kdjhaveri @GenNextMD @ssfarouk @ASNKidney Anybody tempted to prescribe it OFF LABEL in an albuminuric (UACR>1g/g) T2DM-CKD 3B with h/o life-threatening angioedema with ACEI/ARB? #NephJC |
| Nephrology Journal Club @NephJC RT @aishaikh: @NephJC @nephron_andon @TarSamMD Any suggestions for early detection of DKA - such as using a capillary blood ketone monitor to detect ketonemia as hyperglycemia is usually not present in the DKA seen with SGLTi #NephJC |
 | Jason Prosek @JasonProsek @Saltwebsite @NephJC In this case the reduction in proteinuria simply informs us of the mechanism of this drugโs action. But I wouldnโt read into it anymore than that. If youโve got a primary outcome, you donโt need a surrogate. #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 #NephJC This is my suggestion: We must develop a strategy to engage people with color to participate in trials like the #credence rather than have them on #dialysis disproportionately It is long overdue |
| Alex Meraz @NephroGuy @ElfadawyN @Nephro_Sparks @Buck1486 @Jwaitz @jenniejlin @kidney_boy @gratefull080504 @Renaltubules @AJKDonline Not a disaster, is an acute kidney success! #NephJC |
| Verner Venegas @Vernisartan @NephJC Are the amputations related to the increase of Nitric Oxide due to Canaglifozin ? #nephjc |
| Vlado Perkovic @VladoPerkovic @gratefull080504 Such an important point @gratefull080504 - this is our next challenge. We dont even get RAS blockade to all who might benefit today...... #NephJC |
| Gary Singer @GarySingerMD@med-mastodon.com @GarySingerMD @kidney_boy @US_FDA What will tell your patients when you start them on canagliflozin? #NephJC |
| Joel M. Topf, MD FACP @kidney_boy This! #NephJC |
| KatieOverV @KatieKwonMD @Jwaitz @Nephro_Sparks So it bothered me a little that "ESRD" was defined as dialysis OR a sustained eGFR <15. I have lots of CKD 5 patients not on dialysis. Dialysis dependent renal failure is a much bigger deal to prevent IMO and I didn't like the two lumped together. (((ducks))) #NephJC |
| Anna Burgner MD MEHP @anna_burgner I.e will there potentially be a best drug in this class of medications because it has more SGLT1 or SGLT 2 selectivity? #NephJC |
| Kenar Jhaveri @kdjhaveri @VelezNephHepato @GenNextMD @ssfarouk @ASNKidney i am tempted to try in so many scenerios- CHF, diuretic resistant edema, nephrotic syndrome, etc.. #nephjc |
| Jefferson L. Triozzi, M.D. @nepherson @NephJC @nephron_andon @TarSamMD History of DKA was in exclusion criteria but history of UTI was not. Maybe these patients had a previous history or were otherwise predisposed to infection. #NephJC |
| Nephrology Journal Club @NephJC @gratefull080504 yes but partly where this RCT was conducted: Australia, China etc #NephJC |
| Alex Meraz @NephroGuy @Charbel_Khoury @NephJC @TarSamMD @FralickMike @VladoPerkovic Not just your impression, is a common practice. #NephJC |
| L. Parker Gregg @LParkerGregg1 RT @JasonProsek: @Saltwebsite @NephJC In this case the reduction in proteinuria simply informs us of the mechanism of this drugโs action. But I wouldnโt read into it anymore than that. If youโve got a primary outcome, you donโt need a surrogate. #NephJC |
| Matthew Sparks, MD @Nephro_Sparks and no hyperkalemia #NephJC |
| Nephrology Journal Club @NephJC RT @anna_burgner: I.e will there potentially be a best drug in this class of medications because it has more SGLT1 or SGLT 2 selectivity? #NephJC |
| ChristosArgyropoulos MD, PhD PharmanukerInChief @ChristosArgyrop @KatieKwonMD @TxPharmD @MarioFunesMD #nephjc Do it as a pro: use the CV indication when you prescribe SGLT2i , because insurance cannot really block |
| Madhuri Ramakrishnan @madmagicdoc @jenniejlin @NephJC Yes, have the same question. Can we really put the question of risk for amputation to rest? #NephJC |
| Jenn @Jentan7477 RT @Nephro_Sparks: and no hyperkalemia #NephJC |
| Scherly Leon, MD @SLeonMD @NephJC @Joe_Vassalotti @hswapnil @kidneyboy Thank you for joining us! #nephjc |
| Alex Meraz @NephroGuy RT @MarioFunesMD: @LTummalapalli Yes. Image by @drlovygaur #NephJC https://t.co/Ux9gxgb0fm |
| Harini Sarathy @hurryknee @anna_burgner Wasn't GI tolerability to SGLT1 a big issue? #NephJC |
| KatieOverV @KatieKwonMD @ChristosArgyrop @TxPharmD @MarioFunesMD That $50 copay tho #NephJC |
| James Novak, MD PhD FACP FASN FNKF @JamesNovakNeph @nephron_andon @NephJC @TarSamMD Euglycemic DKA is the most worrisome complication. I'll be presenting #CREDENCE at a bi-divisional journal club with Endocrinology next week. Prescriptions must be collaborative until we have nephrology guidelines and more experience. #NephJC |
| Harini Sarathy @hurryknee RT @Charbel_Khoury: @NephJC @TarSamMD @FralickMike The impression from litterature is that Genital mycotic inf can be treated with a single dose of an oral antifungal drug (e.g. fluconazole) or application of an antifungal cream (e.g. miconazole, clotrimazole). #nephjc not a life threatening side effect, @VladoPerkovic ? |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @VladoPerkovic @VladoPerkovic : We can do it if we make it a priority Think about how much just our society would be + we all benefit from a just society Count me in #nephJC |
| Hector Madariaga, MD FASN ๐ฒ๐ฝ @HecmagsMD @ElfadawyN @scoca1 Where is that 20% drop in eGFR coming from? #AskingForAFriend #NephJC |
| Nephrology Journal Club @NephJC @KatieKwonMD @Jwaitz @Nephro_Sparks but even dialysis/Tx/renal death was significant RR 0.72 #NephJC https://t.co/YH2G8Ia9TE |
| Katalin Susztak @KSusztak @scoca1 @ElfadawyN @Nephro_Sparks @NephroGuy @Buck1486 @Jwaitz @jenniejlin @kidney_boy @gratefull080504 @Renaltubules @AJKDonline Yes, tubule markers would be useful as we seem to excessively rely on filtration as the only function of the kidney #NephJC |
| Nephrology Journal Club @NephJC RT @JasonProsek: @Saltwebsite @NephJC In this case the reduction in proteinuria simply informs us of the mechanism of this drugโs action. But I wouldnโt read into it anymore than that. If youโve got a primary outcome, you donโt need a surrogate. #NephJC |
| Alex Meraz @NephroGuy @jdmd262 I had used EMPA before, now moving to CANA #NephJC |
| ChristosArgyropoulos MD, PhD PharmanukerInChief @ChristosArgyrop @VelezNephHepato @kdjhaveri @GenNextMD @ssfarouk @ASNKidney There is nothing in the label that says they have to be combined with RAASi. Play with the CV risk factor and use the non-glycemic indication when prescribing #NephJC |
| Lovy @drlovygaur @nephron_andon @NephJC @TarSamMD I wonder if that should be warning for all the antihyperglycemics except insulin secretagogues- going by the mechanism that the altered insulin:glucagon ratio the underlying mechanism for DKA. #nephjc |
| ChristosArgyropoulos MD, PhD PharmanukerInChief @ChristosArgyrop RT @gratefull080504: #NephJC This is my suggestion: #NephJC This is my suggestion: We must develop a strategy to engage people with color to participate in trials like the #credence rather than have them on #dialysis disproportionately It is long overdue |
 | Tina Zhou @TinaSJZhou I love this so much. |
| Jeffrey William @jwilliamMD #nephJC #rookiemove |
| Nissreen Elfadawy MD, MS, FASN, FAST @ElfadawyN @HecmagsMD @scoca1 #nephJC please show figures |
| TEJAS PATEL MD, FACP, FASN @GenNextMD @kdjhaveri @VelezNephHepato @ssfarouk @ASNKidney I had patients with stage 4 ckd call this pst week to be put on sglt2i...#NephJC #nodata |
| Samira Farouk, MD, MSCR @ssfarouk RT @kdjhaveri: @VelezNephHepato @GenNextMD @ssfarouk @ASNKidney i am tempted to try in so many scenerios- CHF, diuretic resistant edema, nephrotic syndrome, etc.. #nephjc |
| Alex Meraz @NephroGuy RT @kidney_boy: @GarySingerMD @US_FDA I don't think the FDA will back off the black box warning. In addition to CANVAS a lot of observational data showing amputations. #NephJC https://t.co/DZWa8Qgoye |
| Nephrology Journal Club @NephJC @HecmagsMD @ElfadawyN @scoca1 haha The TGF effect but no evidence for the Bakris rule right @CharlieTomson #NephJC |
| Joshua Waitzman, MD PhD @Jwaitz Great pointโI missed this. Would be nice to know the breakdown of GFR <15 v dialysis dependence within this CKD5/ESRD group. #nephjc |
| Kenar Jhaveri @kdjhaveri RT @GenNextMD: @kdjhaveri @VelezNephHepato @ssfarouk @ASNKidney I had patients with stage 4 ckd call this pst week to be put on sglt2i...#NephJC #nodata |
| ChristosArgyropoulos MD, PhD PharmanukerInChief @ChristosArgyrop @KatieKwonMD @TxPharmD @MarioFunesMD Huge reduction in insulin requirements may offset for some. Assistance programs for others. Ertugliflozin (50% less expensive) since renoprotection seems a class effect #tipsForNewSGLT2iUsers #NephJC |
| Nephrology Journal Club @NephJC 5 minutes left See major trials coming out in next few years #NephJC https://t.co/Qk7CCfXDDv |
| Matthew Sparks, MD @Nephro_Sparks RT @kdjhaveri: @VelezNephHepato @GenNextMD @ssfarouk @ASNKidney i am tempted to try in so many scenerios- CHF, diuretic resistant edema, nephrotic syndrome, etc.. #nephjc |
| Bhavnish @Buck1486 Not sure how long we have tonight so I'll throw this out there #nephjc 1. If we take ownership of SGLT2i, how do you intend to coordinate with PCP/Endo? 2. Is this a drug we can give in non diabetic CKD patients with macro-albuminuria? |
| Verner Venegas @Vernisartan RT @NephJC: 5 minutes left See major trials coming out in next few years #NephJC https://t.co/Qk7CCfXDDv |
| Harini Sarathy @hurryknee RT @TRIOZZIJL: @Saltwebsite @Buck1486 The study wasn't powered for adverse events. Let alone adverse events that are not common. Interpret with caution. #NephJC |
 | Kosuru Srinivas @drksrinivas RT @aishaikh: ๐ฅWhy is the #CREDENCE Trial such a big deal for the Nephrologists? โก๏ธIt is the first โpositiveโ trial in CKD DM pts. in two decades! 1/ @RenalFellowNtwk @VladoPerkovic @georgeinstitute #NephJC #Nephpearls |
| Mario Funes, MD @MarioFunesMD How about side effects of hyperkalemia, angioedema with ACE/ARB? If patient understands possible side effects and 30% reduction on ESRD I believe the choice may be clear. #NephJC |
| Vipin Varghese @vipvargh RT @NephJC: 5 minutes left See major trials coming out in next few years #NephJC https://t.co/Qk7CCfXDDv |
| Steven Coca @scoca1 @Jwaitz eGFR < 15 is more objective than the practice variation in the start of HD/PD for ESRD-related symptoms. Don't you think? #NephJC |
| Fitsum Asnakech Tilahun MD @fitse_t @NephJC @ssfarouk Avoid for PAD? You will be left with few patients to treat. #nephjc |
| Samaya @TarSamMD RT @NephJC: 5 minutes left See major trials coming out in next few years #NephJC https://t.co/Qk7CCfXDDv |
| Michelle Rheault @rheault_m RT @NephJC: 5 minutes left See major trials coming out in next few years #NephJC https://t.co/Qk7CCfXDDv |
| Kosuru Srinivas @drksrinivas RT @kidneydoc101: |
| Edgar V. Lerma ๐ต๐ญ @edgarvlermamd Pre-CREDENCE Diabetic Kidney Disease trials and CKD ca. 2015 from @NDTsocial #Nephpearls #NephJC ๐๐ผ https://t.co/GxHnBro7Z2 https://t.co/wtUVKwsKLg |
| Charbel C Khoury @Charbel_Khoury @NephJC @ssfarouk STITCH cards have been suggested for DKA, hold when PO intake decreases #NephJC https://t.co/vpxJWl5gnn |
| Nephrology Journal Club @NephJC @Jwaitz not really see this again #NephJC @KatieKwonMD https://t.co/tFzT5wEbhz |
| James Novak, MD PhD FACP FASN FNKF @JamesNovakNeph @VladoPerkovic @gratefull080504 It's frontier medicine right now. Different insurance companies cover different SGLT2 inhibitors. On average, it takes 17 years for clinical evidence to percolate into practice. #NephJC |
| Gates Colbert, MD @DoctorGates @KatieKwonMD @ChristosArgyrop @TxPharmD @MarioFunesMD Cost (high) is temporary, but the benefits can last a lifetime. Costs will change as it is adopted and time moves forward #NephJC |
| KatieOverV @KatieKwonMD @NephJC @Jwaitz @Nephro_Sparks True. And eGFR <15 can get a preemptive transplant. It's just when we talk about avoiding dialysis (because that's truly meaningful to patients) then I would have liked to have seen he data on just that endpoint. Prespecified of course! #NephJC |
| Nephrology Journal Club @NephJC RT @fitse_t: @NephJC @ssfarouk Avoid for PAD? You will be left with few patients to treat. #nephjc |
| Dr. Divya Bajpai ๐ฎ๐ณ @divyaa24 @aishaikh @NephJC @nephron_andon @TarSamMD Will giving them urine ketosticks and regular home monitoring help? Also we can train them to identify symptoms of ketoacidosis and come back early #NephJC |
| Jennie Lin ๐ฉ๐ปโโ๏ธ๐งฌ @jenniejlin @NephJC Looking forward to non-DM CKD results! #NephJC |
| Jenn @Jentan7477 RT @Buck1486: Not sure how long we have tonight so I'll throw this out there #nephjc 1. If we take ownership of SGLT2i, how do you intend to coordinate with PCP/Endo? 2. Is this a drug we can give in non diabetic CKD patients with macro-albuminuria? |
| ChristosArgyropoulos MD, PhD PharmanukerInChief @ChristosArgyrop @TxPharmD @KatieKwonMD @MarioFunesMD Amanda just shot herself in her foot. Guess who will be sweetening the pee of her transplant patients in clinic in mid May? #nephjc |
| Alex Meraz @NephroGuy @VelezNephHepato @kdjhaveri @GenNextMD @ssfarouk @ASNKidney I would definitely #NephJC |
| Jeffrey William @jwilliamMD @GenNextMD @kdjhaveri @VelezNephHepato @ssfarouk @ASNKidney And you obliged...right? #patientreportedoutcomes #NephJC |
| Hector Madariaga, MD FASN ๐ฒ๐ฝ @HecmagsMD @BetterCallSeeth @NephJC Volume depletion (as well as DKA) is a speculation, but I still donโt get it. I think the mechanism is still unknown. #NephJC |
| Joel M. Topf, MD FACP @kidney_boy @jenniejlin @NephJC yes! #NephJC |
| Verner Venegas @Vernisartan @NephJC what about FIGARO and FIDELIO #NephJC |
| Nephrology Journal Club @NephJC for DKA see supp table 6 #NephJC https://t.co/JyXsYFQozY |
| Nissreen Elfadawy MD, MS, FASN, FAST @ElfadawyN ADA diabetic care 2019. Spot the HERO! #ADA #nephJC #Credence |
| Matthew Sparks, MD @Nephro_Sparks the next several years will teach us alot about SGLT2i inpatients with CKD. We need to keep our antennae up and ensure we safely prescribe and adapt to new knowledge about problems that might occur. the eugly DKA is scary. #NephJC |
| Joseph Vassalotti, MD @Joe_Vassalotti #NephJC #CREDENCE No sig increase amputations but protocol amendment May 2016: Investigators: examine pts feet each trial visit & temporarily hold drug for any concerns. How often did this happen? Any comments on generalizability of this amendment? @VladoPerkovic |
| Nephrology Journal Club @NephJC RT @Nephro_Sparks: the next several years will teach us alot about SGLT2i inpatients with CKD. We need to keep our antennae up and ensure we safely prescribe and adapt to new knowledge about problems that might occur. the eugly DKA is scary. #NephJC |
| Harish Seethapathy @BetterCallSeeth Prescription rates of SGLT2 inhibitors by specialty: Endocrinology (40%) Primary care physicians (PCPs) (23.1%) Cardiologists 5%. Can't wait to see nephrology domination of this soon enough. #NephJC https://t.co/Zy4SSrvlAK |
| Samaya @TarSamMD I havenโt bookmarked so much in my twitter life #nephJC |
 | Luis Enrique Alvarez @LuisAlvarezRa Hi everyone, Luis Alvarez from Mexico City, No COI!!!! #NephJC |
| KatieOverV @KatieKwonMD @DoctorGates @ChristosArgyrop @TxPharmD @MarioFunesMD I think this highlights a problem with commercial insurance through a job - when people change jobs every few years, is it worth it to BCBS or Humana to spend $$$ to avoid an endpoint many years down the road? #NephJC |
| Verner Venegas @Vernisartan RT @BetterCallSeeth: Prescription rates of SGLT2 inhibitors by specialty: Prescription rates of SGLT2 inhibitors by specialty: Endocrinology (40%) Primary care physicians (PCPs) (23.1%) Cardiologists 5%. Can't wait to see nephrology domination of this soon enough. #NephJC https://t.co/Zy4SSrvlAK |
| Joshua Waitzman, MD PhD @Jwaitz @scoca1 Yes, more objective. QOL damage from starting dialysis is pretty significant though. #nephjc |
| Alex Meraz @NephroGuy @werner02 @NephJC I dont see how, it is a vasodilator #NephJC |
| Fitsum Asnakech Tilahun MD @fitse_t RT @NephJC: 5 minutes left See major trials coming out in next few years #NephJC https://t.co/Qk7CCfXDDv |
| Nephrology Journal Club @NephJC 3 minutes left final thoughts? Any holdouts still reluctant to Rx SGLT2i for eligible patients? #NephJC |
| Vlado Perkovic @VladoPerkovic @Charbel_Khoury @NephJC @TarSamMD @FralickMike Yes, mycotic infections rarely lead to problems and mostly treated topically without a need to stop the drug. But do be careful in uncircumcised men as some cases of phimosis have been reported #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @LTummalapalli This is pennies compared to #dialysis #NephJC |
| Hassan Mahmoud @hassan_mohamud RT @NephJC: 5 minutes left See major trials coming out in next few years #NephJC https://t.co/Qk7CCfXDDv |
| Nephrology Journal Club @NephJC Thanks again to @VladoPerkovic for joining chat tonight on board @AirCanada #NephJC |
 | Erin Vaughan @erin_vaughan_ RT @NephJC: check out the awesome schematic from @drlovygaur about the trials and tribulations in DM nephropathy #NephJC https://t.co/1PApkupHRt |
| Gary Singer @GarySingerMD@med-mastodon.com @GarySingerMD @DoctorGates @KatieKwonMD @ChristosArgyrop @TxPharmD @MarioFunesMD Would be nice to see pharmacoeconomic data to persuade @CMSGov and commercial payers to cover SGLT2i #NephJC |
| Juan Medaura @JMedauraMD @NephJC @nephron_andon @TarSamMD B cells in the pancreases have SGLT1 channels #NephJC |
| Nephrology Journal Club @NephJC RT @VladoPerkovic: @Charbel_Khoury @NephJC @TarSamMD @FralickMike Yes, mycotic infections rarely lead to problems and mostly treated topically without a need to stop the drug. But do be careful in uncircumcised men as some cases of phimosis have been reported #NephJC |
| ChristosArgyropoulos MD, PhD PharmanukerInChief @ChristosArgyrop @LTummalapalli This question has been looked into the UK. About 16% of all patients with diabetes would have fulfilled the criteria for the CV safety trials (population overlapping with CREDENCE) #NephJC https://t.co/jlDJvHujEa |
| Steven Coca @scoca1 @werner02 @NephJC Too bad from here on out it will be BCE (Before CREDENCE) and CE (Common Era; i.e., post-CREDENCE). #NephJC |
| Samaya @TarSamMD RT @VladoPerkovic: @Charbel_Khoury @NephJC @TarSamMD @FralickMike Yes, mycotic infections rarely lead to problems and mostly treated topically without a need to stop the drug. But do be careful in uncircumcised men as some cases of phimosis have been reported #NephJC |
| Nissreen Elfadawy MD, MS, FASN, FAST @ElfadawyN Nephrology Journal Club- no kidding #nephJC #CREDENCE |
| Deborah Verran med-mastodon.com/@VerranDeborah @VerranDeborah @VladoPerkovic @kidney_boy @NephJC Thanks โฆ.. that is very useful !!! #Nephjc |
| Dominique Tomacruz, MD @DTomacruzMD Looking forward to these too! #NephJC |
| Erin Vaughan @erin_vaughan_ Erin, Sydney. Late & lurking. No COI #NephJC |
| Samaya @TarSamMD RT @NephJC: Thanks again to @VladoPerkovic for joining chat tonight on board @AirCanada #NephJC |
| Tiffany Caza @Tiff_Caza @ChristosArgyrop @Saltwebsite @NephJC Sorry for the ignorant question (I'm not a nephrologist, but trying to learn ๐), but can albuminuria predict progression in DN, or are you suggesting it occurs with advanced disease but isn't responsible for the progression? #NephJC |
| Hector Madariaga, MD FASN ๐ฒ๐ฝ @HecmagsMD @aishaikh @NephJC @nephron_andon @TarSamMD Yes, keto screening makes sense, particularly during sick days. #NephJC |
| Charbel C Khoury @Charbel_Khoury RT @BetterCallSeeth: Prescription rates of SGLT2 inhibitors by specialty: Prescription rates of SGLT2 inhibitors by specialty: Endocrinology (40%) Primary care physicians (PCPs) (23.1%) Cardiologists 5%. Can't wait to see nephrology domination of this soon enough. #NephJC https://t.co/Zy4SSrvlAK |
| Alex Meraz @NephroGuy This ๐๐ฝ#NephJC |
 | Motib AlAbdulwahhab @stronghold222 RT @edgarvlermamd: CREDENCE: CREDENCE: Canagliflozin reduces the risk of kidney failure or death due to CV or kidney disease by 30% compared to current standard of care ca. 2019 from @NEJM #VisualAbstract by @brendonneuen #Nephpearls #NephJC ๐๐ผ https://t.co/NcQdXrtc3K https://t.co/dcJvZKp1N5 |
| Nephrology Journal Club @NephJC RT @BetterCallSeeth: Prescription rates of SGLT2 inhibitors by specialty: Prescription rates of SGLT2 inhibitors by specialty: Endocrinology (40%) Primary care physicians (PCPs) (23.1%) Cardiologists 5%. Can't wait to see nephrology domination of this soon enough. #NephJC https://t.co/Zy4SSrvlAK |
| Charbel C Khoury @Charbel_Khoury RT @VladoPerkovic: @Charbel_Khoury @NephJC @TarSamMD @FralickMike Yes, mycotic infections rarely lead to problems and mostly treated topically without a need to stop the drug. But do be careful in uncircumcised men as some cases of phimosis have been reported #NephJC |
 | Ernesto LopezAlmaraz @kidney_doctor RT @edgarvlermamd: SGLT2 Inhibitors: SGLT2 Inhibitors: The โtubularโ hypothesis ca. 2016 from @CircAHA #Nephpearls #NephJC ๐๐ผ https://t.co/vLBA2CUkyt https://t.co/NyizIkSkr5 |
| Nephrology Journal Club @NephJC RT @Joe_Vassalotti: #NephJC #CREDENCE No sig increase amputations but protocol amendment May 2016: Investigators: examine pts feet each trial visit & temporarily hold drug for any concerns. How often did this happen? Any comments on generalizability of this amendment? @VladoPerkovic |
| Hector Madariaga, MD FASN ๐ฒ๐ฝ @HecmagsMD #NephJC |
| Khaled Shawwa @khaledshawwa @KatieKwonMD @Jwaitz @Nephro_Sparks might be hard to demonstrate.. median follow-up 2.6 years (but K-M curves go up to 3.5 years). #NephJC |
| Vlado Perkovic @VladoPerkovic @Joe_Vassalotti I think holding drug in people with active foot lesions is sensible with all SGLT2 inhibitors. #NephJC |
| ChristosArgyropoulos MD, PhD PharmanukerInChief @ChristosArgyrop @GarySingerMD @DoctorGates @KatieKwonMD @TxPharmD @MarioFunesMD @CMSGov A couple of European countries have done the calculations. Drugs are extremely cost effective assuming European prices for drugs (and dialysis) #nephjc |
| Nephrology Journal Club @NephJC @Joe_Vassalotti @VladoPerkovic and good practice to do if we Rx SGLT2i #NephJC |
| Nephrology Journal Club @NephJC RT @VladoPerkovic: @Joe_Vassalotti I think holding drug in people with active foot lesions is sensible with all SGLT2 inhibitors. #NephJC |
| Charbel C Khoury @Charbel_Khoury RT @ChristosArgyrop: @LTummalapalli This question has been looked into the UK. About 16% of all patients with diabetes would have fulfilled the criteria for the CV safety trials (population overlapping with CREDENCE) #NephJC https://t.co/jlDJvHujEa |
 | Dr. Ivรกn @MedMedIvan RT @edgarvlermamd: SGLT2 inhibitors: SGLT2 inhibitors: diuretic perspective #Nephpearls #NephJC ๐๐ผ https://t.co/PmRtYs9MfO https://t.co/q3IuhBzU5k |
| Matthew Sparks, MD @Nephro_Sparks Final Thought. It is amazing to see these results (and earlier ones) for SGLT2i. From mechanism to function. Makes me invigorated to stay in the lab and test new ideas. I hope @NIH is watching and funding studies on vascular hemodynamics of the kidney/ tubular function. #NephJC |
| Tiffany Caza @Tiff_Caza @ChristosArgyrop @Saltwebsite @NephJC I've seen curves like this and assumed they were related. But perhaps a bad assumption? #NephJC https://t.co/fH6RegNfY9 |
| Saurabh kapil @foreseesaurabh RT @BetterCallSeeth: Prescription rates of SGLT2 inhibitors by specialty: Prescription rates of SGLT2 inhibitors by specialty: Endocrinology (40%) Primary care physicians (PCPs) (23.1%) Cardiologists 5%. Can't wait to see nephrology domination of this soon enough. #NephJC https://t.co/Zy4SSrvlAK |
| Joseph Vassalotti, MD @Joe_Vassalotti RT @VladoPerkovic: @Joe_Vassalotti I think holding drug in people with active foot lesions is sensible with all SGLT2 inhibitors. #NephJC |
| ChristosArgyropoulos MD, PhD PharmanukerInChief @ChristosArgyrop @Tiff_Caza @Saltwebsite @NephJC The former ; I don't buy the argument that 800mg of protein kills #nephjc |
| Nissreen Elfadawy MD, MS, FASN, FAST @ElfadawyN @Peralta_KHRC You can still catch up. A lot of study to do tonight #NephJC |
| Nephrology Journal Club @NephJC Thanks again to @drlovygaur for the summary and @MarioFunesMD and @brendonneuen for the VAs #NephJC |
| Gary Singer @GarySingerMD@med-mastodon.com @GarySingerMD @ChristosArgyrop @DoctorGates @KatieKwonMD @TxPharmD @MarioFunesMD @CMSGov Wish we had European prices here ๐ #NephJC |
| Saurabh kapil @foreseesaurabh RT @VladoPerkovic: @TxPharmD Important population to study. Will be important to learn whether infection risks similar or increased if SGLT2i used after transplant. No data currently available to my knowledge #NephJC |
| Alex Meraz @NephroGuy @madmagicdoc @jenniejlin @NephJC There are a lot of signs out there from observational data as well. IMO it is a little bit premature to put it to rest. #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @NephJC Pivotal study that will shift the field of #nephrology in the right direction + move the field away from #kidneyfailure as an acceptable outcome Superb study by @VladoPerkovic #NephJC |
| Fitsum Asnakech Tilahun MD @fitse_t @NephJC If we start using #SGLT2 , how soon you recommend follow up? What other things to watch out in next visit apart from K, ? Ketones? UTI? #NephJC |
| Nephrology Journal Club @NephJC Please also sign up for our weekly newsletter at https://t.co/5aumn8qL85 #NephJC |
| Matthew Sparks, MD @Nephro_Sparks The #CREDENCE numbers: 1,215 Tweets. 334 Participants. 3,641,848 Impressions. April 23rd 2019. More #NephJC ๐ here https://t.co/N6Ck4aw62r via @symplur |
| Nephrology Journal Club @NephJC RT @gratefull080504: @NephJC Pivotal study that will shift the field of #nephrology in the right direction + move the field away from #kidneyfailure as an acceptable outcome Superb study by @VladoPerkovic #NephJC |
 | Warren DeMontague #GoBirds @professor_Ape RT @aishaikh: ๐ฅHow do SGLT2 Inhibitors work? ๐ฅHow does an anti-diabetic drug improve Renal & Cardiovascular outcomes? ๐ฅTo understand this letโs first review: โก๏ธRenal handling of glucose 1/ @RenalFellowNtwk #NephJC #SGLT2 #CREDENCE |
| Alex Meraz @NephroGuy RT @JamesNovakNeph: @nephron_andon @NephJC @TarSamMD Euglycemic DKA is the most worrisome complication. I'll be presenting #CREDENCE at a bi-divisional journal club with Endocrinology next week. Prescriptions must be collaborative until we have nephrology guidelines and more experience. #NephJC |
| Samaya @TarSamMD Awesome job with the craziest #NephJC @hswapnil thank you! |
| Fitsum Asnakech Tilahun MD @fitse_t RT @VladoPerkovic: @Charbel_Khoury @NephJC @TarSamMD @FralickMike Yes, mycotic infections rarely lead to problems and mostly treated topically without a need to stop the drug. But do be careful in uncircumcised men as some cases of phimosis have been reported #NephJC |
| Nephrology Journal Club @NephJC Looking for some #NephJC swag? Order it here https://t.co/eTUrZY27Qo |
 | Bharat Sachdeva MD @Kidneylsu RT @NephJC: 5 minutes left See major trials coming out in next few years #NephJC https://t.co/Qk7CCfXDDv |
 | Marcelo Barrios @marcerbg RT @Joe_Vassalotti: First time #NephJC 25 years out of fellowship CAVH was the only CRRT No twitter & no cell phones then COI Janssen, Merck Congrats @hswapnil & @kidneyboy for #NephJC Stars seem to be aligned for a new era for nephrology and people with CKD |
| Annabel Biruete ๐ฒ๐ฝ @anniebelch @Nephro_Sparks @symplur Wow! 334 participants! #NephJC |
 | Doreen Rabi, M.D. @doreen_rabi @JamesNovakNeph @nephron_andon @NephJC @TarSamMD In the trials examining glycemic benefits of SGLT2 in type 1 patients, DKA was much higher in women. Is there any signal of SAE*sex interaction in CREDENCE? #NephJC . Important for counselling and DKA risk assessment. |
| KatieOverV @KatieKwonMD @khaledshawwa @Jwaitz @Nephro_Sparks I assumed that was why they did it - makes the trial too long or big otherwise. Not a huge criticism, I just try not to overstate benefits. #NephJC |
| Joel M. Topf, MD FACP @kidney_boy @Tiff_Caza @ChristosArgyrop @Saltwebsite @NephJC albuminuria does predict progression to diabetic nephropathy. #NephJC |
| Nephrology Journal Club @NephJC @Nephro_Sparks @symplur what? 334 for a single chat <mind blown> #Unprecedented #NephJC |
| Nephrology Journal Club @NephJC RT @doreen_rabi: @JamesNovakNeph @nephron_andon @NephJC @TarSamMD In the trials examining glycemic benefits of SGLT2 in type 1 patients, DKA was much higher in women. Is there any signal of SAE*sex interaction in CREDENCE? #NephJC . Important for counselling and DKA risk assessment. |
| Bharat Sachdeva MD @Kidneylsu RT @NephJC: FOr DKA: FOr DKA: as @ssfarouk said, sick day kind of rules makes some sense for amputation: watch the legs every visit? Avoid if established PAD? #NEPHJC |
| Scherly Leon, MD @SLeonMD RT @NephJC: Please also sign up for our weekly newsletter at https://t.co/5aumn8qL85 #NephJC |
| Alex Meraz @NephroGuy RT @Charbel_Khoury: @NephJC @ssfarouk STITCH cards have been suggested for DKA, hold when PO intake decreases #NephJC https://t.co/vpxJWl5gnn |
| Joshua Waitzman, MD PhD @Jwaitz At the end of the day, Iโm drinking the (sugar-free) kool aid on this one. #CREDENCE. Thanks #NephJC for a great discussion! https://t.co/9SJIekYCyL |
| Fitsum Asnakech Tilahun MD @fitse_t @BetterCallSeeth @NephJC Nephrologist coming to dominate this graph #NephJC https://t.co/PYFmhK05Y4 |
| Madhuri Ramakrishnan @madmagicdoc RT @Nephro_Sparks: the next several years will teach us alot about SGLT2i inpatients with CKD. We need to keep our antennae up and ensure we safely prescribe and adapt to new knowledge about problems that might occur. the eugly DKA is scary. #NephJC |
| Mario Funes, MD @MarioFunesMD Great chat! Thank you @hswapnil for hosting #NephJC 5 year anniversary chat. |
| Alex Meraz @NephroGuy RT @VladoPerkovic: @Charbel_Khoury @NephJC @TarSamMD @FralickMike Yes, mycotic infections rarely lead to problems and mostly treated topically without a need to stop the drug. But do be careful in uncircumcised men as some cases of phimosis have been reported #NephJC |
| Diana Mahbod, MD, CPE, FASN, FNKF @DiMiRenalMD #NephJC |
| Katalin Susztak @KSusztak #NephJC Thanks for the fascinating discussion. The >20 drought in DKD clinical trials is over...This is massive and practice changing for patients with diabetic kidney disease. Thanks Credence team and @VladoPerkovic |
| Nephrology Journal Club @NephJC @kidney_boy @Tiff_Caza @ChristosArgyrop @Saltwebsite have you seen @lp7777777 thread? https://t.co/DgCu9yaCqL #NephJC |
| James Novak, MD PhD FACP FASN FNKF @JamesNovakNeph @Charbel_Khoury Phlorizin is a non-selective SGLT (1 and 2) blocker, which may also be making a clinical appearance soon, if safe. #NephJC |
| Verner Venegas @Vernisartan RT @JamesNovakNeph: @Charbel_Khoury Phlorizin is a non-selective SGLT (1 and 2) blocker, which may also be making a clinical appearance soon, if safe. #NephJC |
| Phillip Madonia @PMNax2 RT @NephJC: @Nephro_Sparks @symplur what? 334 for a single chat <mind blown> #Unprecedented #NephJC |
| Alex Meraz @NephroGuy RT @HecmagsMD: @aishaikh @NephJC @nephron_andon @TarSamMD Yes, keto screening makes sense, particularly during sick days. #NephJC |
| Angel Cesar Ortiz @AngelCesarOrtiz @Nephro_Sparks @symplur I need more columns in my Tweetdeck! Amazing numbers #NephJC |
| Hassan Mahmoud @hassan_mohamud RT @Nephro_Sparks: The #CREDENCE numbers: The #CREDENCE numbers: 1,215 Tweets. 334 Participants. 3,641,848 Impressions. April 23rd 2019. More #NephJC ๐ here https://t.co/N6Ck4aw62r via @symplur |
| Alex Meraz @NephroGuy RT @VladoPerkovic: @Joe_Vassalotti I think holding drug in people with active foot lesions is sensible with all SGLT2 inhibitors. #NephJC |
| Tiffany Caza @Tiff_Caza @Nephro_Sparks @NephJC Will be an exciting new era! Is there any increase in pyelonephritis from glycosuria from SGLT2? #NephJC |
| Nephrology Journal Club @NephJC @tulunsokit hey Tulun! and what was your advice? Wash your ....#NephJC |
| Vlado Perkovic @VladoPerkovic @fitse_t @NephJC In #CREDENCE, we brought patients back after 3 weeks. Check volume, BP, sugars and adjust other meds if required #NephJC |
| Nephrology Journal Club @NephJC RT @KSusztak: #NephJC Thanks for the fascinating discussion. The >20 drought in DKD clinical trials is over...This is massive and practice changing for patients with diabetic kidney disease. Thanks Credence team and @VladoPerkovic |
| Madhuri Ramakrishnan @madmagicdoc RT @NephJC: 5 minutes left See major trials coming out in next few years #NephJC https://t.co/Qk7CCfXDDv |
| ChristosArgyropoulos MD, PhD PharmanukerInChief @ChristosArgyrop @Tiff_Caza @Saltwebsite @NephJC Proteinuria - > marker of kidney damage: the greater the damage the faster one progresses. Does not mean that proteinuria cases progression. 50% of all patients are now non-proteinuric. #NephJC |
 | Arjang Djamali @adjamali @TxPharmD @ChristosArgyrop I have seen UTIs and also had to biopsy KTRs on SGLT2 inhibitors because of a rise in Scr so I am shying away from their broad use after renal Tx pending more published data ๐ |
| Alex Meraz @NephroGuy RT @Nephro_Sparks: The #CREDENCE numbers: The #CREDENCE numbers: 1,215 Tweets. 334 Participants. 3,641,848 Impressions. April 23rd 2019. More #NephJC ๐ here https://t.co/N6Ck4aw62r via @symplur |
| Harish Seethapathy @BetterCallSeeth What other renal diseases do you see SGLT2 inhibitors being used? I predict a slew of anecdotal cases and small case series in diseases like IgA Nephropathy in the next few years. Or maybe they already exist #NephJC |
| Alex Meraz @NephroGuy RT @kidney_boy: @Tiff_Caza @ChristosArgyrop @Saltwebsite @NephJC albuminuria does predict progression to diabetic nephropathy. #NephJC |
| Diana Mahbod, MD, CPE, FASN, FNKF @DiMiRenalMD @SaynaNorouzi @Nephro_Sparks @symplur #NephJC https://t.co/omGLw70hVw |
| Fitsum Asnakech Tilahun MD @fitse_t RT @VladoPerkovic: @fitse_t @NephJC In #CREDENCE, we brought patients back after 3 weeks. Check volume, BP, sugars and adjust other meds if required #NephJC |
| Charbel C Khoury @Charbel_Khoury RT @VladoPerkovic: @fitse_t @NephJC In #CREDENCE, we brought patients back after 3 weeks. Check volume, BP, sugars and adjust other meds if required #NephJC |
| Nephrology Journal Club @NephJC @JamesNovakNeph @Charbel_Khoury but 'phlorizin is not an effective drug because when orally consumed, it is nearly entirely converted into phloretin by hydrolytic enzymes in the small intestine' per @Wikipedia #NephJC |
| Alex Meraz @NephroGuy RT @NephJC: @kidney_boy @Tiff_Caza @ChristosArgyrop @Saltwebsite have you seen @lp7777777 thread? https://t.co/DgCu9yaCqL #NephJC |
| Nephrology Journal Club @NephJC RT @VladoPerkovic: @fitse_t @NephJC In #CREDENCE, we brought patients back after 3 weeks. Check volume, BP, sugars and adjust other meds if required #NephJC |
| Alex Meraz @NephroGuy RT @VladoPerkovic: @fitse_t @NephJC In #CREDENCE, we brought patients back after 3 weeks. Check volume, BP, sugars and adjust other meds if required #NephJC |
| Matthew Sparks, MD @Nephro_Sparks Has been a time honored tradition to post the chat stats at the end... this one particularly gratifying #NephJC #PostCredenceEra |
| Nephrology Journal Club @NephJC @BetterCallSeeth wait for EMPAKidney and DAPACKD latter will b e out soon #NephJC https://t.co/MGyA99qRLv |
| Dominique Tomacruz, MD @DTomacruzMD On Following up patients #NephJC |
| Nissreen Elfadawy MD, MS, FASN, FAST @ElfadawyN We- nephrologist - will take care of it ๐ช๐๐ป #NephJC #CREDENCE |
| Alex Meraz @NephroGuy @Nephro_Sparks Any records broken #NephJC ? |
| Nephrology Journal Club @NephJC @NephroGuy @Nephro_Sparks all of them #NephJC |
| Alex Meraz @NephroGuy RT @ElfadawyN: We- nephrologist - will take care of it ๐ช๐๐ป #NephJC #CREDENCE |
| Hector Madariaga, MD FASN ๐ฒ๐ฝ @HecmagsMD Crazy #NephJC chat. Itโs going to take a while to recover from this chat ๐ . Lots of great and valuable information/tweets. Happy 5th anniversary!!! @NephJC https://t.co/hyVI6vwoSs |
| Harini Sarathy @hurryknee Like a diuretic. Or ACEI/ARB. This is so fantastic. |
| Diana Mahbod, MD, CPE, FASN, FNKF @DiMiRenalMD RT @VladoPerkovic: @fitse_t @NephJC In #CREDENCE, we brought patients back after 3 weeks. Check volume, BP, sugars and adjust other meds if required #NephJC |
| Nephrology Journal Club @NephJC OK this is @hswapnil signing off Join @aakashshingada and then @Slatts_1 for next 2 chats in a few hours #NephJC |
| James Novak, MD PhD FACP FASN FNKF @JamesNovakNeph @NephJC @Charbel_Khoury @Wikipedia I know. I've used both phlorizin and phloretin experimentally, to block myo-inositol efflux from human CNS neurons in cell culture. They're fairly toxic, since SGLT1 is much more widely expressed in numerous tissues. #NephJC |
| Bhavnish @Buck1486 NephJC was trending above Avengers Endgame tonight. Mindblown! #nephjc |
| Jack Pollack @jhpollack Great #nephjc. Do other specialties do this kind of thing on twitter? Following along on here was a great rec from @bthomas215 and @thecurbsiders, looking for other places that are having similar (although maybe not 334 participants!) conversations |
| Kyle Jansson @kylepjansson RT @NephJC: @BetterCallSeeth wait for EMPAKidney and DAPACKD latter will b e out soon #NephJC https://t.co/MGyA99qRLv |
| ChristosArgyropoulos MD, PhD PharmanukerInChief @ChristosArgyrop @kidney_boy @Tiff_Caza @Saltwebsite @NephJC Provocative data suggest that DKD in the 21st century is not the same as DKD when we were residents/fellows #nephjc https://t.co/LdivlAOogJ https://t.co/YTSUDvucLZ |
| Samaya @TarSamMD RT @HecmagsMD: Crazy #NephJC chat. Itโs going to take a while to recover from this chat ๐ . Lots of great and valuable information/tweets. Happy 5th anniversary!!! @NephJC https://t.co/hyVI6vwoSs |
| Marcelo Barrios @marcerbg RT @Nephro_Sparks: Has been a time honored tradition to post the chat stats at the end... this one particularly gratifying #NephJC #PostCredenceEra |
| Alex Meraz @NephroGuy #NephJC |
| Nephrology Journal Club @NephJC we will have an #AskASN with @jenniejlin next tuesday https://t.co/JHDOehnWoH #NephJC |
| Fitsum Asnakech Tilahun MD @fitse_t @NephJC @hswapnil @aakashshingada @Slatts_1 Thank you. #nephjc #CREDENCE |
| Alex Meraz @NephroGuy @HecmagsMD @TarSamMD @NephJC I need a rest after all the new info! #NephJC |
| Nissreen Elfadawy MD, MS, FASN, FAST @ElfadawyN Looool! BCE and CE eras - thanks #CREDENCE #NephJC |
| Scherly Leon, MD @SLeonMD @Nephro_Sparks we were also trending! #NephJC https://t.co/5S0RsVRMVs |
| Jeffrey Sparks MD MMSc @jeffsparks Thank you #NephJC for allowing a rheumatologist to witness this great event! |
| Sam Krishnamoorthy @beans_sam @NephJC @hswapnil @aakashshingada @Slatts_1 Thank you so much... my eyes are watering from how the tweetdeck blew up today... #NephJC |
| Arshad Ali @aldorenin RT @hswapnil: Rabbit hole search Some ๐ Apples might contain Phlorizin ....obliquely relevant for tonightโs #NephJC right @ChristosArgyrop ? https://t.co/wgZRDOSfsK |
| Bhavnish @Buck1486 @BetterCallSeeth And FSGS, or any other non diabetic glomerular diseases with indolent proteinuria. Alport's maybe? #NephJC |
| Alex Chang, MD, FASN, FAHA @alexchangmd Any data on outcomes after euglycemic DKA events with SGLT2 inhibitors? @VladoPerkovic #nephJC |
| Charbel C Khoury @Charbel_Khoury @NephJC @JamesNovakNeph @Wikipedia Correct, and Homer smith Showed that oral doses were very variable in effect, and experimentally it was being used IV https://t.co/0jiYaBzxJv #nephjc |
| Aisha Shaikh @aishaikh @NephJC @hswapnil @aakashshingada @Slatts_1 Thank you so much for hosting @hswapnil #nephjc |
| ChristosArgyropoulos MD, PhD PharmanukerInChief @ChristosArgyrop My take of CREDENCE/CANVAS/EMPAREG/DECLARE-TIMI An SGLT2i to rule them all #LordOfThePees #Nephjc , but note that CV risk reduction not uniform among SGLT2i (compare DECLARE-TIMI with the others) #NephJC https://t.co/C83ek7tTq4 |
| Alex Meraz @NephroGuy What a ride #NephJC. Thank you all, specially to @VladoPerkovic. Your insight made all the difference!!!! |
| Nissreen Elfadawy MD, MS, FASN, FAST @ElfadawyN @BetterCallSeeth This will open the gates for us to do more research, case reports, case series in this area #NephJC |
| Alex Meraz @NephroGuy RT @ChristosArgyrop: My take of CREDENCE/CANVAS/EMPAREG/DECLARE-TIMI An SGLT2i to rule them all #LordOfThePees #Nephjc , but note that CV risk reduction not uniform among SGLT2i (compare DECLARE-TIMI with the others) #NephJC https://t.co/C83ek7tTq4 |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @VladoPerkovic: @Charbel_Khoury @NephJC @TarSamMD @FralickMike Yes, mycotic infections rarely lead to problems and mostly treated topically without a need to stop the drug. But do be careful in uncircumcised men as some cases of phimosis have been reported #NephJC |
| Hector Madariaga, MD FASN ๐ฒ๐ฝ @HecmagsMD I felt palpitations. I was going through one-two tweets, and realized that I was missing like 20 other tweets at the same time ๐ Feed was like ๐ฅ #Nephjc |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @VladoPerkovic: @TxPharmD Important population to study. Will be important to learn whether infection risks similar or increased if SGLT2i used after transplant. No data currently available to my knowledge #NephJC |
| Alex Meraz @NephroGuy @VelezNephHepato @GlassockJ @Nephro_Sparks Excellent pointโฆ now what? #NephJC |
| Matthew Sparks, MD @Nephro_Sparks @VelezNephHepato @GlassockJ We still donโt know precisely how ACEI and ARBs work in DKD. After many decades of investigation. We are scratching the surface. All should head to lab and ask these questions #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @Nephro_Sparks: The #CREDENCE numbers: The #CREDENCE numbers: 1,215 Tweets. 334 Participants. 3,641,848 Impressions. April 23rd 2019. More #NephJC ๐ here https://t.co/N6Ck4aw62r via @symplur |
| Alex Meraz @NephroGuy RT @Nephro_Sparks: @VelezNephHepato @GlassockJ We still donโt know precisely how ACEI and ARBs work in DKD. After many decades of investigation. We are scratching the surface. All should head to lab and ask these questions #NephJC |
| Hassan Mahmoud @hassan_mohamud Great discussion #nephjc |
| Charbel C Khoury @Charbel_Khoury @NephJC @JamesNovakNeph @Wikipedia However Sotagliflozin is currently in trials and it has more SGLT1 inhibition then the other drugs, FDA ruling on it was split #NephJC |
| Alex Meraz @NephroGuy RT @Charbel_Khoury: @NephJC @JamesNovakNeph @Wikipedia However Sotagliflozin is currently in trials and it has more SGLT1 inhibition then the other drugs, FDA ruling on it was split #NephJC |
| Verner Venegas @Vernisartan RT @Charbel_Khoury: @NephJC @JamesNovakNeph @Wikipedia However Sotagliflozin is currently in trials and it has more SGLT1 inhibition then the other drugs, FDA ruling on it was split #NephJC |
| Matthew Sparks, MD @Nephro_Sparks @VelezNephHepato @GlassockJ I, for one, like to think broadly but then use tools to isolate in different cell lineages/tissue compartments. Then we can exploit the positive effects. #NephJC |
| Samaya @TarSamMD RT @NephroGuy: What a ride #NephJC. Thank you all, specially to @VladoPerkovic. Your insight made all the difference!!!! |
| Verner Venegas @Vernisartan RT @Buck1486: NephJC was trending above Avengers Endgame tonight. Mindblown! #nephjc |
| Aakash Shingada, DNB, MRCP(UK), FASN @aakashshingada RT @KSusztak: #NephJC Thanks for the fascinating discussion. The >20 drought in DKD clinical trials is over...This is massive and practice changing for patients with diabetic kidney disease. Thanks Credence team and @VladoPerkovic |
| Joseph Vassalotti, MD @Joe_Vassalotti Thanks for great discussion! #NephJC After over 1 year of using all 3 FDA approved SGLT-2i, the major barrier is prior authorization & out of pocket patient $. Although this is a huge excitement for nephrology there is work to be done to ensure access to SGLT-2i. |
| Jenn @Jentan7477 RT @Joe_Vassalotti: Thanks for great discussion! #NephJC After over 1 year of using all 3 FDA approved SGLT-2i, the major barrier is prior authorization & out of pocket patient $. Although this is a huge excitement for nephrology there is work to be done to ensure access to SGLT-2i. |
| ChristosArgyropoulos MD, PhD PharmanukerInChief @ChristosArgyrop @VelezNephHepato @GlassockJ @Nephro_Sparks #nephjc The group which highlighted the potential for SGLT2i have looked into acute and chronic inhibition and TGF effects. The data are not clear (IMHO) about the chronic effects https://t.co/KqOdl1kEIZ https://t.co/KXKTM83W1d |
| Aakash Shingada, DNB, MRCP(UK), FASN @aakashshingada RT @Nephro_Sparks: The #CREDENCE numbers: The #CREDENCE numbers: 1,215 Tweets. 334 Participants. 3,641,848 Impressions. April 23rd 2019. More #NephJC ๐ here https://t.co/N6Ck4aw62r via @symplur |
| Tired & Sakit ๐ฒ๐พ @tulunsokit RT @edgarvlermamd: Renal Outcomes in the CANVAS, DECLARE-TIMI 58, and EMPA-REG OUTCOME Trials: Renal Outcomes in the CANVAS, DECLARE-TIMI 58, and EMPA-REG OUTCOME Trials: A Systematic Review ca. 2019 #Nephpearls #NephJC ๐๐ผ https://t.co/C58YAozDKB https://t.co/2WVR0yiCpX |
| Matthew Sparks, MD @Nephro_Sparks @VelezNephHepato @GlassockJ A few years back tried to summarize all known effects through years of research with the @DukeKidney group #NephJC #RAS https://t.co/ws3lgXARiR |
| Charbel C Khoury @Charbel_Khoury RT @ChristosArgyrop: My take of CREDENCE/CANVAS/EMPAREG/DECLARE-TIMI An SGLT2i to rule them all #LordOfThePees #Nephjc , but note that CV risk reduction not uniform among SGLT2i (compare DECLARE-TIMI with the others) #NephJC https://t.co/C83ek7tTq4 |
| Alex Meraz @NephroGuy RT @aishaikh: @NephJC @nephron_andon @TarSamMD Any suggestions for early detection of DKA - such as using a capillary blood ketone monitor to detect ketonemia as hyperglycemia is usually not present in the DKA seen with SGLTi #NephJC |
| Alex Meraz @NephroGuy RT @Buck1486: During my Journal club last week I mentioned how phlorizin was initially obtained from apple tree bark. The Nephrology community has finally infused evidence based medicine into the cliche 'An apple a day keeps the doctor away' @hswapnil #nephjc |
| Matthew Sparks, MD @Nephro_Sparks @VelezNephHepato @NephroGuy @GlassockJ I donโt think it is a settle. But ignoring intraglom hemodynamics not good either. SGLT2i will be multifactoral just like RAS blockade. AT1 receptor sodium retention effects are just as much prox tubule as vascular . But vessels get all the press #NephJC |
 | Chi Chu @cdchu RT @KSusztak: @scoca1 @ElfadawyN @Nephro_Sparks @NephroGuy @Buck1486 @Jwaitz @jenniejlin @kidney_boy @gratefull080504 @Renaltubules @AJKDonline Yes, tubule markers would be useful as we seem to excessively rely on filtration as the only function of the kidney #NephJC |
| Alex Meraz @NephroGuy RT @Nephro_Sparks: @VelezNephHepato @NephroGuy @GlassockJ I donโt think it is a settle. But ignoring intraglom hemodynamics not good either. SGLT2i will be multifactoral just like RAS blockade. AT1 receptor sodium retention effects are just as much prox tubule as vascular . But vessels get all the press #NephJC |
| Harini Sarathy @hurryknee RT @Joe_Vassalotti: Thanks for great discussion! #NephJC After over 1 year of using all 3 FDA approved SGLT-2i, the major barrier is prior authorization & out of pocket patient $. Although this is a huge excitement for nephrology there is work to be done to ensure access to SGLT-2i. |
| Nissreen Elfadawy MD, MS, FASN, FAST @ElfadawyN Wonderful night and one of a kind chat #CREDENCE #NephJC thanks @hswapnil for hosting and thanks @Nephro_Sparks @kidney_boy for the #NEPHJC. A lot of study to do and people to follow tonight https://t.co/G9h5WOjKDF |
| Aisha Shaikh @aishaikh When will FDA lower the eGFR limit to 30 mlโs/min for the use of SGLT2 inhibitors? #NephJC @US_FDA |
| Harini Sarathy @hurryknee RT @Charbel_Khoury: It all started with this guy: It all started with this guy: Josef von Mering who discovered glycosuric effects of phlorizin in the 1800 (right after he discovered Barbiturates, no buggy) #NephJC https://t.co/157wTBjWD3 |
| Matthew Sparks, MD @Nephro_Sparks Gnite all. 5 yrs of #NephJC in the books https://t.co/nH9PxQNHTh |
| James Novak, MD PhD FACP FASN FNKF @JamesNovakNeph @hurryknee @Charbel_Khoury Plus, SGLT1 expression is more ubiquitous. #NephJC |
| Nissreen Elfadawy MD, MS, FASN, FAST @ElfadawyN Top Influencers of #NephJC ๐ @NephJC @aishaikh @kidney_boy @VladoPerkovic @RenalFellowNtwk @hswapnil https://t.co/L9BOsjGH2L via @symplur. The winner tonight is @aishaikh. You Rock girl! |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @aishaikh: When will FDA lower the eGFR limit to 30 mlโs/min for the use of SGLT2 inhibitors? #NephJC @US_FDA |
| Matthew Sparks, MD @Nephro_Sparks Can stop Tweeting #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil @zena_barakat Ah. We just finished the chat...feel free to check the #NephJC timeline though and comment |
 | samuel @Samuel02181722 RT @NephJC: @kidney_boy @Tiff_Caza @ChristosArgyrop @Saltwebsite have you seen @lp7777777 thread? https://t.co/DgCu9yaCqL #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @Joe_Vassalotti: Thanks for great discussion! #NephJC After over 1 year of using all 3 FDA approved SGLT-2i, the major barrier is prior authorization & out of pocket patient $. Although this is a huge excitement for nephrology there is work to be done to ensure access to SGLT-2i. |
| Tiffany Caza @Tiff_Caza The CREDENCE #NephJC chat was awesome tonight! Next week's #askASN chat should be fantastic too!! Join in next week and rock on ๐ธ! |
| Hector Madariaga, MD FASN ๐ฒ๐ฝ @HecmagsMD @doreen_rabi Is it time to think that a #SGLT2i should be considered first-line agent in T2DM, instead of metformin? Does that make sense? Or too soon? #NephJC |
| Franklin Loachamin @FranLoachamin RT @HecmagsMD: @doreen_rabi Is it time to think that a #SGLT2i should be considered first-line agent in T2DM, instead of metformin? Does that make sense? Or too soon? #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil @deepakjadhav Probably lots of effects See @aishaikh thread https://t.co/zXQT86h97H #NephJC After all TGF canโt explain CHF reduction .... |
| Joshua Waitzman, MD PhD @Jwaitz @NephJC @KatieKwonMD I see the table, but itโs actually a composite of: -dialysis -transplant (which can be preemptive) -and โrenal deathโ. How accurate are we at filling out death certificates? (answer: not very. 40% wrong when we are โcompletely certainโ) https://t.co/N5i3w1f6z3 #nephjc |
| Harini Sarathy @hurryknee RT @DoctorGates: Currently at #MidwestHeadquarters are discussing why we need to watch out out for euglycemic DKA in SGLTi patients. Consensus is that it is the lack of insulin (from DM Type II) in setting of hypoglycemia from the drug, resulting in ketosis. #nephjc |
| Luis Enrique Alvarez @LuisAlvarezRa RT @Nephro_Sparks: nice EMs from the @JCI_insight paper of SGLT2 podocyte paper #NephJC https://t.co/ZYxucamWTJ |
 | Eduardo Vega @Lalo_le_medecin RT @jon_ellison: Dear Nephrologists, I have no clue what #CREDENCE is about. But if you donโt follow it up with a hyper-hydration trial (CLEARWATER) and a recovery after AKI study (REVIVAL), I will be disappointed. #NephJC |
| Luis Enrique Alvarez @LuisAlvarezRa RT @MarioFunesMD: @LTummalapalli Yes. Image by @drlovygaur #NephJC https://t.co/Ux9gxgb0fm |
 | Alvin Thomas @alvinthomas13 RT @Nephro_Sparks: The #CREDENCE numbers: The #CREDENCE numbers: 1,215 Tweets. 334 Participants. 3,641,848 Impressions. April 23rd 2019. More #NephJC ๐ here https://t.co/N6Ck4aw62r via @symplur |
| Nephrology Journal Club @NephJC Also, #NephJC peeps - did you know we have a podcast? Check out the latest episode here https://t.co/Zva3nfrDrK https://t.co/75u378590y |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @NephJC: Also, #NephJC peeps - did you know we have a podcast? Check out the latest episode here https://t.co/Zva3nfrDrK https://t.co/75u378590y |
 | Lauren E. Woodard @LEWoodardPhD RT @aishaikh: ๐ฅHow do SGLT2 Inhibitors work? ๐ฅHow does an anti-diabetic drug improve Renal & Cardiovascular outcomes? ๐ฅTo understand this letโs first review: โก๏ธRenal handling of glucose 1/ @RenalFellowNtwk #NephJC #SGLT2 #CREDENCE |
 | Cory C. Heck, PharmD, BCCCP @Cory_naryCareRx RT @aishaikh: ๐ฅHow do SGLT2 Inhibitors work? ๐ฅHow does an anti-diabetic drug improve Renal & Cardiovascular outcomes? ๐ฅTo understand this letโs first review: โก๏ธRenal handling of glucose 1/ @RenalFellowNtwk #NephJC #SGLT2 #CREDENCE |
| Matthew Sparks, MD @Nephro_Sparks RT @NephJC: Also, #NephJC peeps - did you know we have a podcast? Check out the latest episode here https://t.co/Zva3nfrDrK https://t.co/75u378590y |
| Joshua Waitzman, MD PhD @Jwaitz RT @Charbel_Khoury: It all started with this guy: It all started with this guy: Josef von Mering who discovered glycosuric effects of phlorizin in the 1800 (right after he discovered Barbiturates, no buggy) #NephJC https://t.co/157wTBjWD3 |
 | Tiffany โท @TiffanyAndLupus RT @NephJC: Also, #NephJC peeps - did you know we have a podcast? Check out the latest episode here https://t.co/Zva3nfrDrK https://t.co/75u378590y |
| Natasha N. Dave @NatashaNDave RT @NephJC: Also, #NephJC peeps - did you know we have a podcast? Check out the latest episode here https://t.co/Zva3nfrDrK https://t.co/75u378590y |
| Aisha Shaikh @aishaikh @ElfadawyN @NephJC @kidney_boy @VladoPerkovic @RenalFellowNtwk @hswapnil @symplur Thanks! Not sure what this means. But the real influencers r the people who conducted & participated in the #CREDENCE trial @VladoPerkovic. And the @NephJC crew @hswapnil @kidney_boy @drlovygaur who managed to put together this insanely amazing JC #NephJC |
 | Dr Benil @hafeeq_benil RT @NephJC: There was a 30% relative risk reduction in the primary composite end-point diverging as early as 12 months after randomization (event rate โ 43.2 vs 61.2 per 1000 patient-years respectively in canagliflozin vs placebo arms). #NephJC https://t.co/k5LVeQwuJN |
| Dr Benil @hafeeq_benil RT @NephJC: SGLT2 inhibitors have increasingly drawn attention over the last decade. See this excellent ADKD blog from 2018 by Anna Burgner for an explanation of their mechanism of action #NephJC https://t.co/7mVBgGT7YQ slow-the-progression-of-diabetic-kidney-disease/ |
| Dr Benil @hafeeq_benil RT @landmark_neph: Excited for #NephJC and the discussion of the truly Landmark #CREDENCE trial! |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @shilpa_jes @pauldlawton @NephJC Completely agree #NEPHJC |
| Arshad Ali @aldorenin RT @edgarvlermamd: CREDENCE: CREDENCE: Canagliflozin reduces the risk of kidney failure or death due to CV or kidney disease by 30% compared to current standard of care ca. 2019 from @NEJM #VisualAbstract by @brendonneuen #Nephpearls #NephJC ๐๐ผ https://t.co/NcQdXrtc3K https://t.co/dcJvZKp1N5 |
 | Josuรฉ Ruiz @JosueRuizmd RT @edgarvlermamd: Choosing glucose lowering medication in those w/ established ASCVD or CKD #Nephpearls #NephJC ๐๐ผ https://t.co/tP3NduZZ6L https://t.co/64Dn4A7erd |
| Josuรฉ Ruiz @JosueRuizmd RT @edgarvlermamd: Ongoing trials of SGLT2 Inhibitors of interest to the Nephrology Community ca. 2019 Table by @drlovygaur #Nephpearls #NephJC https://t.co/ZbYhojEimj |
| Jenn @Jentan7477 RT @Nephro_Sparks: Matt Sparks checking in to the year 5 anniversary of #NephJC for #CREDENCE so excited and can't wait to chat with everyone. No COIs |
| Graham Abra, MD @GrahamAbra @Joe_Vassalotti @aishaikh @US_FDA Getting ready to send any insurance medical director CREDENCE if they try a denial #NephJC https://t.co/kLnCfeZQpQ |
| Ernesto LopezAlmaraz @kidney_doctor RT @edgarvlermamd: CREDENCE: CREDENCE: Canagliflozin reduces the risk of kidney failure or death due to CV or kidney disease by 30% compared to current standard of care ca. 2019 from @NEJM #VisualAbstract by @brendonneuen #Nephpearls #NephJC ๐๐ผ https://t.co/NcQdXrtc3K https://t.co/dcJvZKp1N5 |
| Ernesto LopezAlmaraz @kidney_doctor RT @edgarvlermamd: EMPA-REG: EMPA-REG: Empagliflozin, CV outcomes and mortality in Type 2 Diabetes ca. 2015 from @NEJM #VisualAbstract by @kidney_boy #Nephpearls #NephJC ๐๐ผ https://t.co/6NSu71ck43 https://t.co/VbORQXvo18 |
| KatieOverV @KatieKwonMD @GrahamAbra @Joe_Vassalotti @aishaikh @US_FDA They donโt read the charts, you think they might read a paper? Send the visual abstract. #NephJC |
| Ernesto LopezAlmaraz @kidney_doctor RT @edgarvlermamd: CANVAS: CANVAS: Canagliflozin and CV & Renal events in Type 2 Diabetes ca. 2017 from @NEJM #VisualAbstract by @kidney_boy #Nephpearls #NephJC ๐๐ผ https://t.co/iCmylgorUO https://t.co/KErFtyQUwN |
| Ernesto LopezAlmaraz @kidney_doctor RT @edgarvlermamd: Effect of SGLT2 inhibitors on CV, renal and safety outcomes in patients with type 2 diabetes mellitus and CKD: Effect of SGLT2 inhibitors on CV, renal and safety outcomes in patients with type 2 diabetes mellitus and CKD: A systematic review and meta-analysis ca. 2019 #VisualAbstract by @brendonneuen #Nephpearls #NephJC ๐๐ผ https://t.co/HYQbAdsNvB https://t.co/YFeD30Txlf |
| Ernesto LopezAlmaraz @kidney_doctor RT @edgarvlermamd: Canagliflozin and renal outcomes in type 2 diabetes: Canagliflozin and renal outcomes in type 2 diabetes: results from the CANVAS Program randomised clinical trials ca. 2018 from @TheLancet #VisualAbstract by @divyaa24 #Nephpearls #NephJC ๐๐ผ https://t.co/pKBcHebr9s https://t.co/wZLtunq7YP |
| Ernesto LopezAlmaraz @kidney_doctor RT @edgarvlermamd: Ongoing trials of SGLT2 Inhibitors of interest to the Nephrology Community ca. 2019 Table by @drlovygaur #Nephpearls #NephJC https://t.co/ZbYhojEimj |
| Samira Farouk, MD, MSCR @ssfarouk RT @NephJC: Also, #NephJC peeps - did you know we have a podcast? Check out the latest episode here https://t.co/Zva3nfrDrK https://t.co/75u378590y |
 | Kevin Roe @KCR_DO RT @edgarvlermamd: Choosing glucose lowering medication in those w/ established ASCVD or CKD #Nephpearls #NephJC ๐๐ผ https://t.co/tP3NduZZ6L https://t.co/64Dn4A7erd |
#NephJC content from Twitter.