Isn’t this just a set up for selection bias by indication? How do you retrospectively “target trial” emulate a contrast CT? Patients who got contrast post AKI could have unmeasurable illness. Patients who didn’t get it were obviously doing ok. @kidneyboy.bsky.social @hswapnil.medsky.social

American Journal of Kidney Diseases@ajkd.bsky.social · 13h ago

Kidney Outcomes After Contrast Exposure in Patients Recovering From Dialysis-Requiring Acute Kidney Injury: A Target Trial Emulation Study bit.ly/4wsFue2

Any experience with generic budesonide versus Tarpeyo(targeted release budesonide) for IgA nephropathy? All I can find are proteinuria studies and increased risk of systemic side effects. Blue Cross wants patient to fail generic budesonide for 3 months before approving Tarpeyo. #askrenal

Crescentic IgA on biopsy. Blue Cross Blue Shield says patient has to fail ACE inhibitors alone for 3 months before trying Tarpeyo. This will be overturned on appeal but why-oh-why do we do this dance every time? Nephrologists start hating GN clinics because the paperwork burns everyone out

Stan Marsh Asks: Why Do We Do This?

ALT: Stan Marsh Asks: Why Do We Do This?

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Critical need for control group reform in RCTs. If you are seeking FDA approval by comparing to placebo or a weak control, your drug should be subject to price controls at 1.5x the current Rx. If you want premium pricing, pony up $$$ and do a comparative effectiveness trial against a strong control

LLMs really impress the nephrologists who like to make a diagnosis of hypertension as the most common cause of ESRD. Or propagate the myth of widespread “hypertensive nephrosclerosis”

Anchorage Man@sethpartnow.bsky.social · 2mo ago

So, @edzitron.com ate his Wheatties this morning

AI is absolutely amazing at coming up with rhyming hints for scavenger hunts. Remind me again how profitable that business is.

Man Thinking Deeply with Math Equations

ALT: Man Thinking Deeply with Math Equations

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No one could afford #flozin for years but 3 patients today have told me they are buying shilajit or some BS supplement that costs $200 “to help my kidneys”. The supplement industry brainwashing is ridiculous. Kudos to the affordable dapagliflozin now! I hope @costplusdrugs.com never run out of it.

Sparsentan in FSGS: pay us a million dollars over 8 years in drug cost. Your EGFR will be 34 instead of 30!!! Nephrology is becoming the new oncology. Surrogate outcomes and pricey meds galore without real progress. We are winning the war on kidney disease, just as we won the war on cancer.

a man in a plaid jacket says " no i don t think so "

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a man with a surprised look on his face is asking what would i tell them

ALT: a man with a surprised look on his face is asking what would i tell them

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National Kidney Foundation@kidney.org · 5mo ago

Kick up your #hydration game! 🚰 Staying hydrated is a great way to support your kidney health. If you have kidney disease, speak to your doctor about how much you should be drinking to protect your kidney function. Love, Kenny the Kidney! 🧡 #heartyourkidneys

Not sure about the conclusion. It’s not a randomized study so only patients with clinical equipoise would have undergone a biopsy. The results just show nephrologists’ pre-test intuitions are quite good.

ASN Publications@asnpublications.bsky.social · 5mo ago

This #ASNKidney360 study evaluated the concordance of pre-biopsy clinical diagnosis with post-biopsy final diagnosis among patients with clinical AKI. Read the article here: kidney.pub/KID1151 Steve Coca

Not the best marketing strategy unfortunately. Nephrologists’ professional growth pathways are not as convoluted as pretzel word-finding exercises.

ASNKidney@asnkidney.bsky.social · 7mo ago

🧩 All the words fit together, connected by one idea. Take a closer look and see what you find. ASN membership supports professional growth at every stage, with benefits designed to move your career forward. Join or renew today: http://asn.kdny.info/mJ6R50XWkWj

And my conscience says that a drug costing $600,000 a year should be ashamed of doing a trial with only protenuria as an outcome. They should get a 50% price cut just for cutting corners.

Nephrology Times@nephtimes.bsky.social · 7mo ago

The phase 3 APPEAR-C3G study showed iptacopan significantly reduced proteinuria at 6 months in people with C3 glomerulopathy. #nephrology #nephsky #C3G www.docwirenews.com/post/iptacop...

Not just a huge vulnerability in medical stuff. This should affect every major corporate application of LLMs. The question is why did the stock market not fall with this study?

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F. Perry Wilson, MD@fperrywilson.bsky.social · 8mo ago

You can get ChatGPT to recommend thalidomide to a pregnant woman. It's not even hard. A new study in JAMA Network Open shows just how vulnerable medical AI is to manipulation. 🧵

What type of fish oil commercially available in the US most closely approximates the PISCES study formulation? Not an expert but I think not every fish oil being sold is equivalent. #askrenal #nephjc #nephsky

And why did finerenone get away with it? Kerendia is being prescribed right and left now because they had the RCT data and FDA approval. But it’s very clear to me that old MRAs r just as protective, just lacked the RCT data for non medical circumstances. An unpopular opinion, but I own it.

NSAIDs leading to extinction of vital species in India www.nature.com/articles/d44...

Diclofenac endangers vultures even in protected areas

DNA metabarcoding reveals what vultures eat, and where

nature.com

My initial thoughts about aldosterone synthase inhibitors: why spend $$$$ to achieve what $4 of spironolactone can also achieve? Am I missing something? #askrenal

IgA is pronounced eye-gee-ay The reason the disease should be called "eye-gee-ay nephropathy" is because IgA is central to the pathogenic mechanism. Moving to eye-gan is moving away from describing the disease by its pathogenic mechanism.

Is calling “I-G-A nephropathy” “Eye-GAN” mainstream now? I am really struggling to accept that. #askrenal

‘Booty’ and ‘butt’ are synonyms. ‘Call’ and ‘dial’ are synonyms. But, a ‘booty call’ and a ‘butt dial’ are VERY different things.

Mother: I have twins. Doctor: Oh, so they were born on the same day? Mother: No, they were born with the same propensity score.

Funny highlight of today’s road trip

Time to make a polypill for CKD? Telmisartan+ #flozin + finerinone + statin+ oral semaglutide? Call it Tel-em-fine-at-tide Telemfinatide? At least for countries with affordable pharma price negotiations.

Lately, I don’t enjoy @nkf-professionals.bsky.social or @asnkidney.bsky.social meetings as much as @renalphysicians.bsky.social First 2 are about “cool drugs that cost a million and improve 1% of patients by 30%” rather than “How to survive & thrive as a burnt out specialty no one wants to join”

Funny that tool looks familiar… downloaded from the RPA store

“If you have abdominal pain on the right, upper or lower, around belly button or lower, severe, throbbing, in one spot or moving around, go to the ER (not PCP or urgent care)”- HuffPost Next article coming soon: “Crisis: How ER visits drive up healthcare costs” www.huffpost.com/entry/stomac...

If Your Stomach Pain Feels Like This, It's Time To Go To The ER

Don't dismiss these red flags — they could warrant medical attention.

huffpost.com

“officials regularly ignore the rankings, leapfrogging over hundreds or even thousands of people when they give out kidneys, livers, lungs and hearts. These organs often go to recipients who are not as sick, have not been waiting nearly as long…” www.nytimes.com/interactive/...

Adult nephrologists, with your hospital administration and state malpractice environment, would you feel comfortable dialyzing a kid coming in with toxic ingestion if asked to? Why/ why not? #askrenal

Michelle Rheault, MD@rheaultm.bsky.social · last yr.

Comparison of children receiving extracorporeal treatments for poisoning at United States centers with and without a pediatric nephrologist pubmed.ncbi.nlm.nih.gov/39911112/

Once upon a time, some villagers came across a large, ornate wooden box in the local woods. On the side of the box was a message: “Whatever money you put in this box will, in future, grow to become 2.5 times larger.” 1/

Interesting thread by James Heather about the indirect rate caps by the #NIH . It is not the first time this comes up e.g. both the Obama and the 1st DJT admin tried to cap them (with fierce discussions on Twitter back in 2017).