#NephJC Transcript
Healthcare social media transcript of the #NephJC hashtag.
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See #NephJC Influencers/Analytics.
| Profile | Tweet |
|---|---|
 | Nephrology Journal Club @NephJC T-1 hour to the European #NephJC on the CREDENCE trialβCanagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy. Hoping some of the authors can join us (again!) @VladoPerkovic @jardine_meg Rajiv Agarwal of @IUKidney @gbakris @DavidCWheeler2 @adeeralevin https://t.co/hkS4PEp9mh |
 | Laura Slattery @Slatts_1 RT @NephJC: T-1 hour to the European #NephJC on the CREDENCE trialβCanagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy. Hoping some of the authors can join us (again!) @VladoPerkovic @jardine_meg Rajiv Agarwal of @IUKidney @gbakris @DavidCWheeler2 @adeeralevin https://t.co/hkS4PEp9mh |
 | Aakash Shingada, DNB, MRCP(UK), FASN @aakashshingada RT @hswapnil: Asian #NephJC numbers: Asian #NephJC numbers: 398 Tweets. 92 Participants. 1,545,404 Impressions. April 24th 2019. More #NephJC π here https://t.co/1LXEaUW79N via @symplur Well done @aakashshingada and team! |
 | Lovy @drlovygaur @NephJC With this large a cohort, it is definitely reassuring wrt amputation risk.. and probably this will make us look at the patientsβ feet more frequently; which anyways we must do irrespective of the drug used #NephJC |
 | Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @drlovygaur: @NephJC With this large a cohort, it is definitely reassuring wrt amputation risk.. and probably this will make us look at the patientsβ feet more frequently; which anyways we must do irrespective of the drug used #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @NephJC: T-1 hour to the European #NephJC on the CREDENCE trialβCanagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy. Hoping some of the authors can join us (again!) @VladoPerkovic @jardine_meg Rajiv Agarwal of @IUKidney @gbakris @DavidCWheeler2 @adeeralevin https://t.co/hkS4PEp9mh |
| Aakash Shingada, DNB, MRCP(UK), FASN @aakashshingada RT @drlovygaur: @NephJC With this large a cohort, it is definitely reassuring wrt amputation risk.. and probably this will make us look at the patientsβ feet more frequently; which anyways we must do irrespective of the drug used #NephJC |
| Aakash Shingada, DNB, MRCP(UK), FASN @aakashshingada RT @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 |
 | julio caro valerio @carovalerio6 RT @NephJC: T-1 hour to the European #NephJC on the CREDENCE trialβCanagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy. Hoping some of the authors can join us (again!) @VladoPerkovic @jardine_meg Rajiv Agarwal of @IUKidney @gbakris @DavidCWheeler2 @adeeralevin https://t.co/hkS4PEp9mh |
 | Helbert Rondon, MD, MS, FACP, FASN, FNKF @NephroMD RT @hswapnil: Key aspect! No need to stop SGLT2i if GFR drops below 30 while on RX #NephJC |
| Lovy @drlovygaur This thread is a gem #NephJC #CREDENCE |
 | Walaa Saweirs @WalaaSaweirs RT @NephJC: check out the awesome schematic from @drlovygaur about the trials and tribulations in DM nephropathy #NephJC https://t.co/1PApkupHRt |
 | Kamel Hatahet @kamel_hatahet RT @aishaikh: The #CREDENCE Trial was discussed @NephJC last night. We were fortunate to have the lead author of the paper @VladoPerkovic join in. He took questions from the participants. Here is the summary of his responses ππ½ #CREDENCE #NephJC @hswapnil @kidney_boy |
 | Mana @manasigh 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 |
| Mana @manasigh RT @hswapnil: Key aspect! No need to stop SGLT2i if GFR drops below 30 while on RX #NephJC |
 | Jim Moriarty @HotKidneyAction RT @NephJC: check out the awesome schematic from @drlovygaur about the trials and tribulations in DM nephropathy #NephJC https://t.co/1PApkupHRt |
 | Tushar Dhakate @tushar_dhakate RT @hswapnil: Key aspect! No need to stop SGLT2i if GFR drops below 30 while on RX #NephJC |
| Jim Moriarty @HotKidneyAction @JTollitt @landmark_neph No chance of early termination if it hits a prespecified endpoint by half time, I suppose? #nephjc |
| Tushar Dhakate @tushar_dhakate 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 |
| Tushar Dhakate @tushar_dhakate RT @landmark_neph: Excited for #NephJC and the discussion of the truly Landmark #CREDENCE trial! |
 | Rob Peelπ³οΈβπππ¬π§π΄σ §σ ’σ ³σ £σ ΄σ Ώ @rabpeel nearly time #nephjc |
 | Alicia Yepez @YepezDra RT @NephJC: check out the awesome schematic from @drlovygaur about the trials and tribulations in DM nephropathy #NephJC https://t.co/1PApkupHRt |
 | Arshad Ali @aldorenin RT @hswapnil: Key aspect! No need to stop SGLT2i if GFR drops below 30 while on RX #NephJC |
 | Nathaniel Reisinger @nephrothaniel 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 |
 | Shelley Zieroth @ShelleyZieroth RT @aishaikh: The #CREDENCE Trial was discussed @NephJC last night. We were fortunate to have the lead author of the paper @VladoPerkovic join in. He took questions from the participants. Here is the summary of his responses ππ½ #CREDENCE #NephJC @hswapnil @kidney_boy |
 | Melanie @halpern_melanie 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 Good evening everyone! Itβs 08:00PM which means it is time for the European #NephJC. Welcome to tonightβs discussion. |
 | manuel macia heras @mmacia25 RT @NephJC: T-1 hour to the European #NephJC on the CREDENCE trialβCanagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy. Hoping some of the authors can join us (again!) @VladoPerkovic @jardine_meg Rajiv Agarwal of @IUKidney @gbakris @DavidCWheeler2 @adeeralevin https://t.co/hkS4PEp9mh |
 | Alex Meraz @NephroGuy RT @VladoPerkovic: @divyaa24 I think the results for the 30-45mls/min eGFR subgroup mean that the drug is promising for lower eGFR levels. But risks could be higher so wouldnt start below 30 until more data. Note that patients who had eGFR drop below 30 during #CREDENCE continued study treatment #NephJC |
| Nephrology Journal Club @NephJC Iβm Ted Fitzgerald @Ted_FitzG and Iβll be your co-host with Laura Slattery @ Slatts_1 tonight as we discuss this paper. Weβre both adult Nephrology trainee working in University Hospital Waterford, Ireland #NSMCunite #NephJC. https://t.co/pe0dfteC9T |
| Jim Moriarty @HotKidneyAction RT @NephJC: Good evening everyone! Itβs 08:00PM which means it is time for the European #NephJC. Welcome to tonightβs discussion. |
| Jim Moriarty @HotKidneyAction Evening all. Jim Moriarty, nephrologist from Gloucestershire. No direct COI; part of our trial team for #EMPAKIDNEY. Greatest ever #NephJC followed by Endgame? Why not... https://t.co/wUzh9PfyBu |
| Nephrology Journal Club @NephJC Please introduce yourself (even if youβre just lurking and following along) and declare any Conflicts of Interests. Donβt forget to use the hashtag #NephJC. And hereβs the quick guide on βHow to #NephJC. https://t.co/LPybW9CFtY |
| Rob Peelπ³οΈβπππ¬π§π΄σ §σ ’σ ³σ £σ ΄σ Ώ @rabpeel Rab in the Sunny Highlands of Scotland@nhshrenal no coi #nephjc |
| Mana @manasigh 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 |
 | Colin Geddes @geddescc #NephJC colin Geddes Glasgow. No COI |
 | Richard Fish @Rsfish190 Evening. Richard. North Midlands. #NephJC |
| Nephrology Journal Club @NephJC The paper we will be discussing is βCanagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathyβ by Perkovic et al published in NEJM this month. It has caused a considerable stir in the #NephTwitter community since its release which makes it an excellent #NephJC choice. |
| Nephrology Journal Club @NephJC Happy 5th Birthday to #NephJC! |
 | Diego Coronel @DIERCO1 RT @edgarvlermamd: Beneficial effects of SGLT2 inhibition on glucose homeostasis and the cardiovascular and renal systems #Nephpearls #NephJC ππΌ https://t.co/Tnu8SsiZhq https://t.co/PFK8ylNIJ1 |
| Laura Slattery @Slatts_1 @_ajhamilton Welcome Alex #NephJC |
| Laura Slattery @Slatts_1 @rabpeel Welcome @rabpeel #NephJC |
 | Mohamed E. Elrggal @M_Elraggal Hi, I am Mohamed E Elrggal, from Alexandria, Egypt. No COI, #NephJC |
| Laura Slattery @Slatts_1 @RidingAlex Welcome Alex #NephJC |
| Nephrology Journal Club @NephJC Didnβt have time to sift through the entire paper and supplementary material? Check out the excellent summary by @drlovygaur #NephJC https://t.co/4MdXRrf78t |
| Laura Slattery @Slatts_1 @Ashidotic Welcome Neil, we're likewise excited! #NephJC |
| Laura Slattery @Slatts_1 @logiebear111 @NephJC Welcome Ian #NephJC |
| Laura Slattery @Slatts_1 @HotKidneyAction Welcome @HotKidneyAction #NephJC |
| Nephrology Journal Club @NephJC Check out these brilliant visual abstracts by @MarioFunesMD created for #NephJC and @brendonneuen created for @georgeinstitute https://t.co/F5mLyfTdDC |
| Diego Coronel @DIERCO1 RT @edgarvlermamd: SGLT2 inhibitors: SGLT2 inhibitors: Origin π #Nephpearls #NephJC ππΌ https://t.co/CADHHEJaIm https://t.co/HTQJi44qKF |
| Nephrology Journal Club @NephJC Without further adoβ¦let us move onto T0 and the background #NephJC |
| Jim Moriarty @HotKidneyAction @rupertbright This is brilliant, isn't it? #NephJC |
| Laura Slattery @Slatts_1 @FionaCLoud Welcome @FionaCLoud #NephJC |
| Laura Slattery @Slatts_1 @caioqualunque Welcome Francesco! #NephJC |
| Laura Slattery @Slatts_1 @sarah_gleeson_ Welcome Sarah! #NephJC |
| Nephrology Journal Club @NephJC T0: To say that diabetes and its complications are an epidemic would be an understatement. Given that 30-40% of people with diabetes ultimately develop diabetic kidney disease, renal physicians are likely to be treating these individuals with ever increasing frequency #NephJC |
| Laura Slattery @Slatts_1 @EdoardoMelilli Welcome Edoardo! #NephJC |
| Laura Slattery @Slatts_1 @HDiniz_ Welcome Hugo, great birthday party! #NephJC |
| Jim Moriarty @HotKidneyAction @toates_19 @_ajhamilton They're more Biggie and Tupac. #nephjc |
| Laura Slattery @Slatts_1 @unicipa Welcome Zoran #NephJC |
| Nephrology Journal Club @NephJC T0: Unsurprisingly, this has resulted in a dearth of clinical trials investigating pharmacotherapies to halt or slow the progression of diabetic kidney disease. See the salient trials summarised excellently by @drlovygaur #NephJC https://t.co/aZKzTnNOKg |
| Laura Slattery @Slatts_1 @M_Elraggal Welcome Mohamed! #nephjc |
| Laura Slattery @Slatts_1 @johnasayer Welcome John #NephJC |
| Laura Slattery @Slatts_1 @Stones__ Welcome Sinead! #NephJC |
| Nephrology Journal Club @NephJC T0: RAS blockade has remained the cornerstone of treatment to delay the progression of diabetic nephropathy. However, despite maximal RAS blockade, proteinuria does not completely regress and a significant proportion of patients progress to kidney failure. #NephJC |
| Nephrology Journal Club @NephJC @johnholian Welcome, Dr Holian #NephJC |
| Laura Slattery @Slatts_1 @toates_19 Welcome Tom! #NephJC |
| Jim Moriarty @HotKidneyAction @DrDeano Dean Wallace, creator of the best #CREDENCE pun so far? https://t.co/r101eYeYdD #nephjc |
| Laura Slattery @Slatts_1 @Rsfish190 Welcome @Rsfish190 #NephJC |
| Laura Slattery @Slatts_1 @geddescc Welcome @geddescc #NephJC |
| Jim Moriarty @HotKidneyAction RT @NephJC: T0: T0: Unsurprisingly, this has resulted in a dearth of clinical trials investigating pharmacotherapies to halt or slow the progression of diabetic kidney disease. See the salient trials summarised excellently by @drlovygaur #NephJC https://t.co/aZKzTnNOKg |
| Nephrology Journal Club @NephJC T0: While there have been many new hypoglycaemic agents introduced in the last 2 decades, few of them have shown effect in altering disease progression. #NephJC |
| Nephrology Journal Club @NephJC T0: Linagliptin was renoprotective in animal models, this has not been replicated in human studies. CARMELINA did not demonstrate evidence of renoprotection. GLP-1 analogues have shown a modest effect on albuminuria, but no effect on GFR or tangible clinical outcomes #NephJC |
| Nephrology Journal Club @NephJC RT @RidingAlex: |
| Richard Fish @Rsfish190 @DrDeano Also use the #NephJC summary? |
| Nephrology Journal Club @NephJC T0: SGLT2 inhibitors have increasingly drawn attention over the last decade. See this excellent AJKD blog from 2018 by Anna Burgner for an explanation of their mechanism of action #NephJC https://t.co/vYAJm8ozxF |
| Nephrology Journal Club @NephJC RT @FionaCLoud: |
| Nephrology Journal Club @NephJC T0: In the EMPA-REG trial, use of empagliflozin decreased risk of doubling of creatinine (44%) and ESRD (55%) without any difference in albuminuria. We covered the renal results on #NephJC here. https://t.co/n7hAxa6WEf |
| Nephrology Journal Club @NephJC RT @HotKidneyAction: @DrDeano Dean Wallace, creator of the best #CREDENCE pun so far? https://t.co/r101eYeYdD #nephjc |
| Laura Slattery @Slatts_1 @toates_19 @VickiSandys1 Welcome Vicki! #NephJC |
| Nephrology Journal Club @NephJC T0: In CANVAS, canagliflozin reduced the risk of sustained and adjudicated major kidney outcomes. On the basis of the pre-specified hypothesis testing sequence, the renal outcomes were not viewed as statistically significant. #NephJC https://t.co/9NYPdzNoV7 |
| Jim Moriarty @HotKidneyAction @toates_19 Ramipril/Losartan local to us, probably down to historical formulary reasons #nephjc |
| Mohamed E. Elrggal @M_Elraggal @toates_19 Team Irbesartan #NephJC |
| Nephrology Journal Club @NephJC T0: They did show a possible benefit of canagliflozin with respect to the progression of albuminuria (HR 0.73) and the composite outcome of a sustained 40% reduction in the eGFR, the need for RRT, or death from renal causes (HR 0.60). #NephJC https://t.co/4J1MT3ZVFv |
| Nephrology Journal Club @NephJC T0 See the below table summary of EMPA-REG, CANVAS and DECLARE #NephJC https://t.co/Qcap9l5b1b |
| Mohamed E. Elrggal @M_Elraggal @ThePeanutKidney Welcome John #NephJC |
| Nephrology Journal Club @NephJC T0 One of the significant concerns has been the signal of higher amputations reported in CANVAS - and then reinforced by observational data from elsewhere. #NephJC https://t.co/XbSjFVc8aW |
| Laura Slattery @Slatts_1 RT @DrDeano: |
| Colin Geddes @geddescc @toates_19 #nephjc based on trials I think purist would go for captopril for Type 1 and Irbesartan for type 2 but I suspect not much in it? Personally use ramipril first line for both types but if they are on another RAASi donβt change it. If need ARB then irbesartan or losartan |
 | Verner Venegas @Vernisartan Verner. Mexico City fellow. #NSMC intern 2019 No COI. Just Lurking today #NephJC #Credence |
 | Paul Murray @drpjmurray Paul Murray, Nephrologist, Dorchester. No COI and a complete #NephJC novice |
 | Amanda KirwanπΊπ¦πͺπΊππͺπΊπΊπ¦ @AJKD RT @NephJC: T0: T0: To say that diabetes and its complications are an epidemic would be an understatement. Given that 30-40% of people with diabetes ultimately develop diabetic kidney disease, renal physicians are likely to be treating these individuals with ever increasing frequency #NephJC |
| Laura Slattery @Slatts_1 @werner02 Welcome @werner02 #NephJC |
| Nephrology Journal Club @NephJC T0 CREDENCE (Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation) was designed to assess the effects of canagliflozin on primarily the renal outcomes in patients with established nephropathy. #NephJC |
| Rob Peelπ³οΈβπππ¬π§π΄σ §σ ’σ ³σ £σ ΄σ Ώ @rabpeel @ThePeanutKidney we'll be telling our grand children of the time NephJC did Credence! #nephjc |
 | Bernadette @BouncyB101 RT @aishaikh: Q3: Q3: Why was only 5% of the CREDENCE trial population black? VP: Fair point. We worked really hard to recruit them but it was hard. Please note that the trial was global, and more than 15% of the participants from the US were African American #NephJC |
| Laura Slattery @Slatts_1 @M_Elraggal @ThePeanutKidney Welcome @ThePeanutKidney, definitely, one not to miss! #NephJC |
| Nephrology Journal Club @NephJC T0: Of note, CREDENCE was initiated in 2014, before the results of EMPA-REG came out. Another important point to note was that previous trials tended to enrol patients with preserved GFR due to a theory that efficacy of these agents decreased with decreasing GFR #NephJC |
| Colin Geddes @geddescc @daniyal_jafree @NephJC RAASi pretty effective at slowing it down though #nephjc |
| Nephrology Journal Club @NephJC T0: Have you much experience with using these agents in your clinical practice? If so, do you find them beneficial? Any experience with adverse events? #NephJC |
| Jim Moriarty @HotKidneyAction PAUL MURRAY!! #NephJC |
 | Sally Johnson @docsallyj @logiebear111 @toates_19 Iβm joining, better late than never. Paed nephrologist in Newcastle. No COI #nephjc |
| Laura Slattery @Slatts_1 @calvapo @NephJC Welcome Tomas! #NephJC |
| Nephrology Journal Club @NephJC T0: See the poll below #NephJC https://t.co/7xH1NUMCjf |
| 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 https://t.co/SYT3DIiO5S |
| Colin Geddes @geddescc @rabpeel @toates_19 #nephjc over-rated I reckon. Not to say I havenβt tried it! |
| Mohamed E. Elrggal @M_Elraggal @logiebear111 @NephJC Used Dapagliflozin in some patients, with really very good results, A1C, proteinuria, edema and HTN. All improved. #NephJC |
| Nephrology Journal Club @NephJC T1 Because the trial was designed to study the impact of Canagliflozin on the progression of CKD, the intent was that at least 60% of the patient population have CKD stage 3 (rather than stage 2), with an eGFR of 30-60 ml/min/1.73m2. #NephJC https://t.co/0OPh2afP5l |
 | Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 #NephJC @gratefull080504 : COI: @OtsukaUS Gilead, Bayer, Protalix, Retrophin, CareDx Hansa |
| Nephrology Journal Club @NephJC T1 Patients who met the eligibility criteria were enrolled in a 2-week, single-blind placebo-run in period. Those who failed to take β₯80% of the scheduled run-in treatment were deemed ineligible. #NephJC |
| Mohamed E. Elrggal @M_Elraggal @NephJC this is what makes this study important, we usually see our patients at that stage #NephJC |
| Nephrology Journal Club @NephJC @EdoardoMelilli And Europe indeed #NephJC |
| Jim Moriarty @HotKidneyAction @NephJC Used in a handful with eGFR down to 45 (so far) - well tolerated and effective, haven't run in to loads of urogenital side effects (yet). Suspect wider experience of GP/endo will be different in this regard... #nephjc |
| Nephrology Journal Club @NephJC RT @ThePeanutKidney: |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @NephJC Screened 12,000 patients #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 https://t.co/5ECnuUP5dR |
| Nephrology Journal Club @NephJC RT @HotKidneyAction: @NephJC Used in a handful with eGFR down to 45 (so far) - well tolerated and effective, haven't run in to loads of urogenital side effects (yet). Suspect wider experience of GP/endo will be different in this regard... #nephjc |
| Rob Peelπ³οΈβπππ¬π§π΄σ §σ ’σ ³σ £σ ΄σ Ώ @rabpeel T0 the lower eGFRs is the best bit about this trial set up for me #nephjc |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @FionaCLoud @NephJC ?????? #nephJC |
| Nephrology Journal Club @NephJC T1 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 and then alternated between telephone calls and out-patient visits every 13 weeks. #NephJC https://t.co/ttwagcFzZM |
| Nephrology Journal Club @NephJC RT @rabpeel: T0 the lower eGFRs is the best bit about this trial set up for me #nephjc |
| Nephrology Journal Club @NephJC T1 Pre-specified guidance recommended early cessation if benefit was observed for the primary outcome (p<0.01) and the composite of ESKD or death from renal or cardiovascular causes (p<0.025), with consideration of the overall balance of risks and benefits. #NephJC https://t.co/AsjyO9VQun |
| Nephrology Journal Club @NephJC RT @_ajhamilton: |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @rabpeel In section B the renal benefit was the most striking positive aspect of the trial #nephJC |
| Jim Moriarty @HotKidneyAction RT @rabpeel: T0 the lower eGFRs is the best bit about this trial set up for me #nephjc |
| Mohamed E. Elrggal @M_Elraggal @NephJC What are the general recommendation or advises one should give to patients on both RAASi and SGLT2i ? #NephJC |
| Nephrology Journal Club @NephJC Onto T2 and the results #NephJC |
| Verner Venegas @Vernisartan @NephJC I love the Run in period #NephJC |
| Rob Peelπ³οΈβπππ¬π§π΄σ §σ ’σ ³σ £σ ΄σ Ώ @rabpeel @gratefull080504 @rabpeel but the lower eGFRs were not in the previous studies so we never found out- so set up crucial #nephjc |
| Nephrology Journal Club @NephJC T2: In terms of baseline demographics, all patients had diabetic nephropathy with duration of diabetes of mean 15.5 years. About two-thirds were on insulin and over half on metformin. #NephJC https://t.co/mUeuALgxmE |
| Richard Fish @Rsfish190 @NephJC This is quite an important point - there were mild improvements in HbA1c, weight, BP and ACR in placebo group (the 'trial effect') - a reminder that 'simply'recruiting patients to a trial can be beneficial to health #NephJC |
 | Wei Ling Lau, MD @Kidneys1st RT @rupertbright: |
| Nephrology Journal Club @NephJC T2 Despite the 30 ml/min GFR floor, about 170 participants with GFR 15-30 were included. 10% had nephrotic range proteinuria and another three-quarters were non-nephrotic, but had macroalbuminuria. #NephJC https://t.co/gdoSveebzg |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @Rsfish190 @NephJC Yes it is It least patients will receive good patient care #nephJC |
| Rob Peelπ³οΈβπππ¬π§π΄σ §σ ’σ ³σ £σ ΄σ Ώ @rabpeel @toates_19 I prescribe and re prescribe more MF than de-prescribe! #nephjc |
| Nephrology Journal Club @NephJC RT @Rsfish190: @NephJC This is quite an important point - there were mild improvements in HbA1c, weight, BP and ACR in placebo group (the 'trial effect') - a reminder that 'simply'recruiting patients to a trial can be beneficial to health #NephJC |
| Nephrology Journal Club @NephJC T2 Anti-hyperglycaemic therapy summarised below #NephJC https://t.co/DEZl6YC2s7 |
 | Shivani Misra @ShivaniM_KC @RidingAlex @toates_19 @NephJC Yes, not uncommon. Studies show risk in unwell /catabolic type 2 patients and when used off licence in type 1 (not in UK). (ps hello! diabetes consultant lurking on #nephjc as interested in renal take on CREDENCE) |
| Laura Slattery @Slatts_1 @Rsfish190 @NephJC Makes a solid case for the importance of MDT, community and hospital input #NephJC |
| Nephrology Journal Club @NephJC T2 By the time all events were adjudicated and recorded ~ 500 primary outcome events had occurred. #NephJC |
| Mohamed E. Elrggal @M_Elraggal @NephJC would love to know how these (advanced CKD) patients performed #NephJC |
| Rob Peelπ³οΈβπππ¬π§π΄σ §σ ’σ ³σ £σ ΄σ Ώ @rabpeel @toates_19 thank you #nephjc |
| Nephrology Journal Club @NephJC T2:There was a 30% relative risk reduction in the primary composite endpoint of ESKD, doubling of sCr and renal or CV death; line segments diverged as early as 1 yr after randomisation (event rate 43.2 vs 61.2/1000 patient-years respectively in canagliflozin vs placebo)#NephJC |
| Nephrology Journal Club @NephJC @ShivaniM_KC @RidingAlex @toates_19 Happy to get an endocrinologist's view! #NephJC |
| Nephrology Journal Club @NephJC RT @Sarah_Finer: |
| Nephrology Journal Club @NephJC T2 The relative risks of ESKD, doubling of serum creatinine and death due to cardiovascular cause were reduced by 32%, 40% and 22% respectively. #NephJC https://t.co/yabRTl64PI |
| Mohamed E. Elrggal @M_Elraggal @EdoardoMelilli important, would have stopped it myself #NephJC |
| Nephrology Journal Club @NephJC T2 With respect to relative risk reduction in the primary outcomes, the effect was consistent across all subgroups on subgroup analysis #NephJC https://t.co/vlyla3geIV |
 | Gabriela Morataya @EGMorataya RT @NefroHUVmaca: |
| Nephrology Journal Club @NephJC T2: There was no significant difference in the risk of CV death therefore subsequently listed outcomes in the hierarchy were not formally evaluated #NephJC |
| Nephrology Journal Club @NephJC T2: With secondary outcomes, patients in the canagliflozin arm had a lower risk for most secondary outcomes (statistically significant for outcomes 1st-4th). #NephJC https://t.co/CgaXOGXIyc |
| Richard Fish @Rsfish190 I may have missed - was there a difference in the achieved dose of RAAS blockade between groups? #NephJC |
| Nephrology Journal Club @NephJC @EdoardoMelilli Doesn't specify class but Table S1 in Supplements says 1026 patients in the Cana grp were on diuretic and 1031 in the placebo grp were on diuretic at time of trial entry (~46% of each pop) #NephJC |
| Mana @manasigh RT @NephJC: T1 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 and then alternated between telephone calls and out-patient visits every 13 weeks. #NephJC https://t.co/ttwagcFzZM |
| Nephrology Journal Club @NephJC T2: The degree of albuminuria was 31% lower compared with placebo. This difference appears almost immediately, suggesting an early hemodynamic mechanism probably mediated by reduced intraglomerular pressure. #NephJC https://t.co/XJqzWaQkLw |
| Jim Moriarty @HotKidneyAction @Sarah_Finer Are the 10% who stop people with multiple other treatment options to try, maybe relatively low CVS risk, no protenuria? How many will persist with SGLT2i if we can be clear this is the best drug for a whole raft of outcomes? #NephJC |
| Mohamed E. Elrggal @M_Elraggal @Rsfish190 as far as i read, all patients were on maximum tolerated dose of RAASi 4 weeks before enrollment #NephJC |
| Nephrology Journal Club @NephJC T2: This may be supported by early GFR decline seen in the first few weeks of initiation of Canagliflozin; thereafter the decline in eGFR remains gentler for Canagliflozin, for a difference of 2.74 ml/min/1.73m2. #NephJC https://t.co/qavWY02qS7 |
| Colin Geddes @geddescc @Roxytonin @logiebear111 @toates_19 #nephjc but this paper was at initiation of type 2 DM. Presumably prevalence less for patients median 15 years from diagnosis? |
| Richard Fish @Rsfish190 @M_Elraggal Yes but that doesn't necessarily mean the achieved doses were the same #NephJC |
| Nephrology Journal Club @NephJC T2: Baseline mean HbA1C across both the groups was 8.3%. While the mean levels were lower in Canagliflozin arm the difference was marginal (mean being 0.25% and end of study difference being just 0.11%). #NephJC https://t.co/QUf722mw8V |
| Nephrology Journal Club @NephJC T2: The mean difference in systolic and diastolic BP were 3.30 and 0.95 mmHg, lower in the Canagliflozin arm. Again, this is too small a difference to result in such a large nephroprotective effect. #NephJC |
| Verner Venegas @Vernisartan @M_Elraggal @NephJC I concur #NephJC |
| Jim Moriarty @HotKidneyAction For the ace clinical triallists out there - how do you stop a trial early because you've hit endpoints, then find you have missed a key endpoint? Asking for a friend. #NephJC |
| Nephrology Journal Club @NephJC T2: In terms of adverse events, lower limb amputation and fracture rates were similar across both groups (in stark contrast with CANVAS). #NephJC https://t.co/NJmChSnTA8 |
| Nephrology Journal Club @NephJC T2: A protocol amendment asked investigators to examine patientsβ feet at each trial visit and temporarily interrupt the assigned treatment in patients with any active condition that might lead to amputation. #NephJC |
| Nephrology Journal Club @NephJC @Rsfish190 Supplementary material states maximum approved labelled dose for DN/HTN unless side effects limit use of maximum dose. Investigators had to document why higher dose wasn't used. Both groups had to be established for minimum 4 weeks on this dose. >99% in both on RAAS #NephJC |
| Nephrology Journal Club @NephJC T2: Ketoacidosis was detected with greater frequency in the canagliflozin arm than the placebo. #NephJC https://t.co/3pPhofN9uB |
| Nephrology Journal Club @NephJC T2: Overall, urinary tract infections occurred at similar frequencies in both the arms (48 vs 45 episodes per 1000 patient-years). However, genital mycotic infections occurred more commonly in patients receiving canagliflozin. #NephJC https://t.co/Q0PsW9KvTf |
 | Ayanfe Obilana @AyanfeObilana Ayanfe, Irish Nephrology SpR, late to the CREDENCE party and lurking, looking forward to learning. No COI #nephjc |
| Nephrology Journal Club @NephJC RT @HotKidneyAction: For the ace clinical triallists out there - how do you stop a trial early because you've hit endpoints, then find you have missed a key endpoint? Asking for a friend. #NephJC |
| Jim Moriarty @HotKidneyAction @RidingAlex @DrDeano @Sarah_Finer And lactate (see #NephJC passim) https://t.co/3tXNweu9QV |
 | Anace Pastor β¨οΈ Renalis π·@Anace710 @anace710 RT @c8lynv: Visual summary of the epic CREDENCE #NephJC hosted last night by @hswapnil. https://t.co/txC3JJto5S |
 | Vlado Perkovic @VladoPerkovic Hi all, I am back #NephJC |
| Nephrology Journal Club @NephJC T2: Any thoughts on the results? #NephJC |
| Vlado Perkovic @VladoPerkovic @logiebear111 @NephJC Right, important evidence that the effects are glucose independent #NephJC |
| Verner Venegas @Vernisartan @NephJC The OR for DKA is really High. More than the one for Amputations. #NephJC |
| Jim Moriarty @HotKidneyAction @VladoPerkovic We decided the paper was deeply flawed and have reverted to gliclazide. #NephJC |
| Nephrology Journal Club @NephJC Onto T3 and the discussion #NephJC |
| Rob Peelπ³οΈβπππ¬π§π΄σ §σ ’σ ³σ £σ ΄σ Ώ @rabpeel T2 it is a shame they stopped it early all the same! #nephjc |
| Richard Fish @Rsfish190 #NephJC |
| Mohamed E. Elrggal @M_Elraggal @NephJC weird, with better glycemic control, suspected less DKA. may be it is infection induced #NephJC |
| Nephrology Journal Club @NephJC T3: The authors conclude that in patients with T2DM and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years #NephJC |
| Nephrology Journal Club @NephJC First author in the house! Welcome @VladoPerkovic #NephJC |
| Nephrology Journal Club @NephJC RT @VladoPerkovic: @logiebear111 @NephJC Right, important evidence that the effects are glucose independent #NephJC |
| Nephrology Journal Club @NephJC T3: Is it time to get excited about these medications? Will they be part of our prescribing armamentarium? #NephJC |
| Nephrology Journal Club @NephJC T3: Strengths of the study include 1. The primacy given to renal outcomes 2. Benefit over and above RAS blockade was examined 3. Large clinical trial population #NephJC |
| Jim Moriarty @HotKidneyAction This is why I love having lead authors at #NephJC - thanks @VladoPerkovic |
| Rob Peelπ³οΈβπππ¬π§π΄σ §σ ’σ ³σ £σ ΄σ Ώ @rabpeel @logiebear111 @NephJC T3 Fire and forget, like the statins? #nephjc |
| Vlado Perkovic @VladoPerkovic @Rsfish190 @HDiniz_ @NephJC I think we looked at this and was similar but will need to check. Not straightforward as max labelled dose varies by country and multiple drugs used. Either way, hard to believe it explains results..... #NephJC |
| Nephrology Journal Club @NephJC T3: Limitations include 1. Premature termination of the trial limited the power for at least some secondary outcomes 2. As with most trials, those with advanced kidney disease (GFR < 30) were excluded from the study, though a few patients with GFR 15-30 did make it in. #NephJC |
| Nephrology Journal Club @NephJC T3: This raises a question of generalisability and to consider at what GFR (if any) would one not use or stop an SGLT2i. #NephJC |
| Richard Fish @Rsfish190 @VladoPerkovic @HDiniz_ @NephJC Thank you #NephJC |
| Verner Venegas @Vernisartan @NephJC I want to see other Results of these Two: FIGARO and FIDELIO not SGLT2i, but also interesting #NephJC |
| Vlado Perkovic @VladoPerkovic @HotKidneyAction Wow, that went downhill fast. Then again, from the country that chose Brexit.......... πΒ #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 I hope so especially that upstream interventions can be initiated + slow down the progression of #KidneyDisease When I was diagnosed with #adokd I would have loved to have an option to slow down profession of #adpkd What is the downside? I donβt see one #nephJC |
| Mohamed E. Elrggal @M_Elraggal @johnasayer @NephJC and EMPA-kidney with DM excluded ! #NephJC |
| Nephrology Journal Club @NephJC T3 Are you reassured by the safety data, particularly that relating to amputations? #NephJC |
| Nephrology Journal Club @NephJC @EdoardoMelilli Patients with renal transplant (and those on immunosuppressive therapy) were excluded from the trial #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @logiebear111 @NephJC Nephrologists! #nephJC |
| Rob Peelπ³οΈβπππ¬π§π΄σ §σ ’σ ³σ £σ ΄σ Ώ @rabpeel @NephJC well how long to know when to stop ACE /ARBs just keep it going? #nephjc |
| Richard Fish @Rsfish190 Am pleased EMPAkidney is going down to eGFR 25 #NephJC |
| Vlado Perkovic @VladoPerkovic @werner02 @NephJC Yes, we need to learn more about how to watch for and manage DKA. But note 11 cases out of 5000 patient years of follow up in the cana arm so uncommon, but important #NephJC |
| Nephrology Journal Club @NephJC T3: Any other thoughts on the strengths and limitations? #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @NephJC In addition the number of patients , 645 sites, global study etc #nephJC |
| Nephrology Journal Club @NephJC RT @Sarah_Finer: |
| Nephrology Journal Club @NephJC T3 How do you envisage these results will change your clinical practice? #NephJC |
| Sally Johnson @docsallyj @logiebear111 I'm learning loads tonight. First irbesartan is an anagram of Serbian art and now how to prevent athletes foot. Thank you #nephjc |
| Vlado Perkovic @VladoPerkovic @ThePeanutKidney @daviesmd3 @logiebear111 @NephJC Lots of speculation about mechanisms. TGF looks promising but not clearcut and many other potential pathways to benefit #NephJC |
| Jim Moriarty @HotKidneyAction RT @VladoPerkovic: @werner02 @NephJC Yes, we need to learn more about how to watch for and manage DKA. But note 11 cases out of 5000 patient years of follow up in the cana arm so uncommon, but important #NephJC |
| Nephrology Journal Club @NephJC Final few minutes: what are your take-home points? #NephJC |
| Rob Peelπ³οΈβπππ¬π§π΄σ §σ ’σ ³σ £σ ΄σ Ώ @rabpeel T3 I will be more confident to ignore the eGFR<60 rules with SLGT2i #nephjc |
| Jim Moriarty @HotKidneyAction @Roxytonin @NephJC How long to we give NICE to respond? Evidence is there now, patients are asking, drug is available... #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 Can someone tell me why you would not be excited? In most situations #dialysis robs you of your life + dignity #nephJC |
| Mohamed E. Elrggal @M_Elraggal @caioqualunque as far as i remeber, it was 0.8 kg difference between both groups #NephJC |
| Jim Moriarty @HotKidneyAction @VladoPerkovic We deserve it #NephJC |
| Shivani Misra @ShivaniM_KC @Ashidotic @toates_19 Primary care using it for type 2 diabetes a lot. From diabetes perspective whatβs lacking is firm guidance re when to initiate and in whom, as NICE type 2 diabetes guidelines need update to incorporate recent SGLT-2 trials. #NephJC |
| Rob Peelπ³οΈβπππ¬π§π΄σ §σ ’σ ³σ £σ ΄σ Ώ @rabpeel @ThePeanutKidney @NephJC I can't imagine for long though #nephjc |
| Laura Slattery @Slatts_1 RT @HotKidneyAction: This is why I love having lead authors at #NephJC - thanks @VladoPerkovic |
| Vlado Perkovic @VladoPerkovic @HDiniz_ @logiebear111 @ThePeanutKidney @daviesmd3 @NephJC Funnily enough, I have been pushing for a trial of SGLT2i in IgAN for years- no bites....... YET #NephJC |
| Nephrology Journal Club @NephJC Thanks for joining us tonight and for contributing to the discussion. #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 This is no different than current #diabetic #kidneydisease trials #nephJC |
| Nephrology Journal Club @NephJC RT @VladoPerkovic: @werner02 @NephJC Yes, we need to learn more about how to watch for and manage DKA. But note 11 cases out of 5000 patient years of follow up in the cana arm so uncommon, but important #NephJC |
| Colin Geddes @geddescc @logiebear111 @NephJC #nephjc seems strange that nephrologists wonβt be the experts at prescribing a drug that acts only on the kidney. But agree at present appropriate most of the prescribing in UK done in primary care |
| Nephrology Journal Club @NephJC Thanks again to @drlovygaur for the summary and @MarioFunesMD for the VA. #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @RidingAlex @Sarah_Finer @Ashidotic Thank you! An infection can easily be managed compared to #dialysis #NephJC |
| Vlado Perkovic @VladoPerkovic @unicipa @werner02 @NephJC Certainly intense interest and lots of studies ongoing. Preventing/managing DKA will be key #NephJC |
| Rob Peelπ³οΈβπππ¬π§π΄σ §σ ’σ ³σ £σ ΄σ Ώ @rabpeel and don't forget the fabulous Credence sweet water revival! #nephjc |
| Verner Venegas @Vernisartan RT @VladoPerkovic: @HDiniz_ @logiebear111 @ThePeanutKidney @daviesmd3 @NephJC Funnily enough, I have been pushing for a trial of SGLT2i in IgAN for years- no bites....... YET #NephJC |
| Vlado Perkovic @VladoPerkovic @johnasayer @NephJC Pretty sure reduced intraglom pressure is involved as evidenced by early eGFR and albuminuria changes- how we get there is much more controversial #NephJC |
| Nephrology Journal Club @NephJC Please also sign up for our weekly newsletter at https://t.co/5aumn8ImwF #NephJC Looking for some #NephJC swag? Order it here https://t.co/eTUrZYjJeY |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 I think there will be a place with #kidneytransplant recipients We can have kidneys last longer #NephJC |
| Rob Peelπ³οΈβπππ¬π§π΄σ §σ ’σ ³σ £σ ΄σ Ώ @rabpeel Thank you and goodnight #nephjc |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @VladoPerkovic: @HDiniz_ @logiebear111 @ThePeanutKidney @daviesmd3 @NephJC Funnily enough, I have been pushing for a trial of SGLT2i in IgAN for years- no bites....... YET #NephJC |
 | J. Brian Byrd Lab @thebyrdlab #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @geddescc @logiebear111 @NephJC Good grief! If #nephrologists want a future profession you take the lead + change the way patient care is practiced Leaders need to appear #nephJC |
 | Kartik Kalra MD,FNKF,FASN @kkalra_22 Amazing Thread @aishaikh for people who missed the #NephJC !! @AravindCheruku1 @siddverma96 @ripudamanmunjal |
| Nephrology Journal Club @NephJC Until next timeβ¦thank you and good night! #NephJC |
| Nephrology Journal Club @NephJC RT @Sarah_Finer: |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @VladoPerkovic: @johnasayer @NephJC Pretty sure reduced intraglom pressure is involved as evidenced by early eGFR and albuminuria changes- how we get there is much more controversial #NephJC |
| Richard Fish @Rsfish190 @Roxytonin @ukkw Excellent. Look forward to hearing! #NephJC |
| Jim Moriarty @HotKidneyAction One for @ukrtn? #nephjc |
 | Hector Madariaga, MD FASN π²π½ @HecmagsMD RT @VladoPerkovic: @HDiniz_ @logiebear111 @ThePeanutKidney @daviesmd3 @NephJC Funnily enough, I have been pushing for a trial of SGLT2i in IgAN for years- no bites....... YET #NephJC |
| Jim Moriarty @HotKidneyAction @NephJC Thank you hosts #NephJC |
| Nephrology Journal Club @NephJC RT @johnholian: |
| Richard Fish @Rsfish190 @NephJC Excellent discussion - thanks #NephJC |
 | Dumont Audrey @DumontAudrey6 RT @NephJC: Also check out this excellent visual abstract by @MarioFunesMD #NephJC https://t.co/BUfUuDSekT |
| Dumont Audrey @DumontAudrey6 RT @NephJC: 5 minutes left See major trials coming out in next few years #NephJC https://t.co/Qk7CCfXDDv |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @Sarah_Finer: |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @Sarah_Finer: |
| Mana @manasigh RT @NephJC: T1 Pre-specified guidance recommended early cessation if benefit was observed for the primary outcome (p<0.01) and the composite of ESKD or death from renal or cardiovascular causes (p<0.025), with consideration of the overall balance of risks and benefits. #NephJC https://t.co/AsjyO9VQun |
| Dumont Audrey @DumontAudrey6 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/ |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @Sarah_Finer: |
| J. Brian Byrd Lab @thebyrdlab RT @rupertbright: |
| Colin Geddes @geddescc @johnholian @Sarah_Finer #nephjc beneficial in both is my bet |
 | Aravind Cherukuri PhD MRCP (UK) @AravindCheruku1 @nephrologistsan @SunilDaga23 |
| J. Brian Byrd Lab @thebyrdlab @toates_19 @rupertbright What I see in the list: Certain olmesartan, candesartan, valsartan & telmisartan products are on the list of 40 US-marketed ARB products FDA knows to be impurity-free Other products containing these ARBs & all products containing other ARBs are still being evaluated #NephJC |
 | Max Benjamin MD @mmaxbenji RT @aishaikh: The #CREDENCE Trial was discussed @NephJC last night. We were fortunate to have the lead author of the paper @VladoPerkovic join in. He took questions from the participants. Here is the summary of his responses ππ½ #CREDENCE #NephJC @hswapnil @kidney_boy |
| Shivani Misra @ShivaniM_KC @_ajhamilton @Sarah_Finer Thanks for being so welcoming #nephjc π Canβt rule out future lurking π |
 | Valerie Luyckx @valerie_luyckx RT @NephJC: check out the awesome schematic from @drlovygaur about the trials and tribulations in DM nephropathy #NephJC https://t.co/1PApkupHRt |
 | Ammar Saati ΨΉΩ
Ψ§Ψ± Ψ³Ψ§ΨΉΨ§ΨͺΩ @AmmarSaati RT @c8lynv: Visual summary of the epic CREDENCE #NephJC hosted last night by @hswapnil. https://t.co/txC3JJto5S |
| Alex Meraz @NephroGuy RT @VladoPerkovic: @HDiniz_ @logiebear111 @ThePeanutKidney @daviesmd3 @NephJC Funnily enough, I have been pushing for a trial of SGLT2i in IgAN for years- no bites....... YET #NephJC |
 | Steven Coca @scoca1 @aishaikh with another DOMINANT neph twitter performance!! En fuego!! π₯π₯π₯ ππππΌπͺπΌπͺπΌπͺπΌ |
 | ChristosArgyropoulos MD, PhD PharmanukerInChief @ChristosArgyrop RT @HDiniz_: |
 | Matthew Sparks, MD @Nephro_Sparks The #CREDENCE numbers: 2,554 Tweets. 482 Participants. 7,721,839 Impressions. April 23rd 2019. More #NephJC π here https://t.co/Yof2L1ytEj via @symplur |
 | Paul Snelling @camusfallen RT @aishaikh: The #CREDENCE Trial was discussed @NephJC last night. We were fortunate to have the lead author of the paper @VladoPerkovic join in. He took questions from the participants. Here is the summary of his responses ππ½ #CREDENCE #NephJC @hswapnil @kidney_boy |
 | Sarah Moran @sarah_m_moran RT @VladoPerkovic: @HDiniz_ @logiebear111 @ThePeanutKidney @daviesmd3 @NephJC Funnily enough, I have been pushing for a trial of SGLT2i in IgAN for years- no bites....... YET #NephJC |
| Arshad Ali @aldorenin RT @aishaikh: The #CREDENCE Trial was discussed @NephJC last night. We were fortunate to have the lead author of the paper @VladoPerkovic join in. He took questions from the participants. Here is the summary of his responses ππ½ #CREDENCE #NephJC @hswapnil @kidney_boy |
 | madree @madrees007 RT @NephJC: T2: T2: The degree of albuminuria was 31% lower compared with placebo. This difference appears almost immediately, suggesting an early hemodynamic mechanism probably mediated by reduced intraglomerular pressure. #NephJC https://t.co/XJqzWaQkLw |
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