Joel M. Topf, MD FACP retweeted
@kidney_boy @ASNKidney I have personally served on the ASN Council nomination committee as a private practice nephrologist. I do think if we can rally behind a private practice physician- we will reach our goals quickly! @kidney_boy I hope we can achieve that goal soon!
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RT @MaxJordan_N: The first Democrat physician in the senate. And she’s a pediatrician. Love this for us bc we’ve had enough doctors in high…
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Joel M. Topf, MD FACP retweeted
FIRST VOTES from DETROIT
🔵 Abdul El-Sayed 25,397 (93%)
🔴 Mike Rogers 1,261 (5%)
🔵 Abdul El-Sayed 25,397 (93%)
🔴 Mike Rogers 1,261 (5%)
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Joel M. Topf, MD FACP retweeted
11/10 #NephJC Poll
In your ICU, which RRT modality is most commonly used for hemodynamically unstable patients with AKI?
In your ICU, which RRT modality is most commonly used for hemodynamically unstable patients with AKI?
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"The opposite could never be published"
I believe this to be absolutely true. But that is not a methodologic flaw in the study.
This is not the first time this has been found. I suspect it is true. It must merely be an association with gender. What is it that actually translates into better outcomes and how can we teach capture that for patients?
I believe this to be absolutely true. But that is not a methodologic flaw in the study.
This is not the first time this has been found. I suspect it is true. It must merely be an association with gender. What is it that actually translates into better outcomes and how can we teach capture that for patients?
Even conceding these identity studies are true, which given quasi randomization here I do believe, I still don't care for these studies
Scores political and cultural points of the time but advances little else. The opposite could never be published
You can't modify the exposure in practice except through discrimination
There will be more variation within men and women than between. Yes there are amazing male doctors and lousy female ones, and vice versa
And it leaves the elusive question of what is good doctoring unmeasured, which is the core implications of this line of work. Skip the gender part and let's figure that out
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What's more of a placebo, the remember tick box on NEJM or the close door button on an elevator?
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Joel M. Topf, MD FACP retweeted
Forget the afterparties. The coolest #KidneyWk gathering is still #NephJC 🎤
Being there for a live @FreelyFiltered recording was a whole different vibe. Be honest... which LBCT already has a half-written draft sitting in your notes?
+ @jenniejlin @Jwaitz @NephCrit_NM
Being there for a live @FreelyFiltered recording was a whole different vibe. Be honest... which LBCT already has a half-written draft sitting in your notes?
+ @jenniejlin @Jwaitz @NephCrit_NM
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This is great
@kidney_boy @ASNKidney Council membership is not the same as representation. Anyone can apply to participate in committees and self nominate for leadership roles.
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It is time for private practice physicians to participate more in running ASN.
Send a request to join a committee to operations@asn-online.org
asn-online.org/about/committe…
Send a request to join a committee to operations@asn-online.org
asn-online.org/about/committe…
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Joel M. Topf, MD FACP retweeted
IHD vs CRRT again. ICRAKI was stopped early due to higher mortality with IHD. Real signal or truncation artifact? And was IHD given the way we'd give it to a patient on vasopressors? #NephJC #nephtwitter
✍️ By @rn_flex @DivyaveerSSNeph
nephjc.com/news/icraki111…
✍️ By @rn_flex @DivyaveerSSNeph
nephjc.com/news/icraki111…
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Along the same line, anyone know where the RCT of dialysis access in the elderly is going to be published?
x.com/kidney_boy/sta…
Arteriovenous Fistulas, Grafts, or Central Venous Catheters as Vascular Access for Older Adults Starting Hemodialysis: A Randomized Controlled n, Koen E.A. van der Bogf, Friedo W. Dekker, Michiel Willem de Haant, Marc
H. Hemmelder, Magda Van Loon, Joris I.
Rotmans, Geert Willem H. Schurink, Jan Tordoir, Maarten G. Snoeijs
Background
Elderly patients starting hemodialysis have an increased risk of early arteriovenous fistula (AVF) complications due to maturation failure, while the long-term durability benefit may be limited by short life expectancy. We hypothesized that arteriovenous grafts (AVG) or central venous catheters (CVC) would result in better outcomes than AVFs.
Methods
In this multicenter randomized controlled trial, we enrolled patients ≥70 years with life expectancy <2 years (Dusseux risk score ≥4) who were expected to start hemodialysis within 6 months or had started within the previous 6 months with a CVC.
Patients had to be eligible for all access types based on ultrasound vessel mapping. Participants were randomized to AVF, AVG, or CVC strategies and followed until study closeout at 1 year after the last enrollment. The primary endpoint was the rate of access-related interventions per patient-year. Safety endpoints were mortality, access-related serious adverse events (SAEs), and vascular access infections. Intervention groups were compared with the AVF group using negative binomial and Cox regression models.
Results
A total of 165 patients were enrolled: 52 AVF, 57 AVG, and 56 CVC. Mean age was 78 years; 27% had started hemodialysis at enrollment. Median follow-up was 2.0 years. The allocated vascular access type was changed in 9 AVF, 24 AVG, and 4 CVC patients during follow-up (P=0.002). The rate of access-related interventions was 1.12/year with AVF, 1.53/year with AVG (P=0.082), and 0.76/year with CVC (P=0.018). Mortality did not differ significantly. The rate of access-related SAEs was 0.08/year with AVF, 0.27/year with AVG (P=0.012), and 0.11/year with CVC (P=0.418). Access-related infection rates did not differ significantly; the overall catheter-related bloodstream infection rate was 0.37/1000 catheter days.
Conclusion
In elderly patients with limited life expectancy, CVCs required fewer access-related interventions than AVFs, without excess mortality or infection. AVGs are more often abandoned and result in more access-related SAEs than AVFs.
x.com/kidney_boy/sta…
Arteriovenous Fistulas, Grafts, or Central Venous Catheters as Vascular Access for Older Adults Starting Hemodialysis: A Randomized Controlled n, Koen E.A. van der Bogf, Friedo W. Dekker, Michiel Willem de Haant, Marc
H. Hemmelder, Magda Van Loon, Joris I.
Rotmans, Geert Willem H. Schurink, Jan Tordoir, Maarten G. Snoeijs
Background
Elderly patients starting hemodialysis have an increased risk of early arteriovenous fistula (AVF) complications due to maturation failure, while the long-term durability benefit may be limited by short life expectancy. We hypothesized that arteriovenous grafts (AVG) or central venous catheters (CVC) would result in better outcomes than AVFs.
Methods
In this multicenter randomized controlled trial, we enrolled patients ≥70 years with life expectancy <2 years (Dusseux risk score ≥4) who were expected to start hemodialysis within 6 months or had started within the previous 6 months with a CVC.
Patients had to be eligible for all access types based on ultrasound vessel mapping. Participants were randomized to AVF, AVG, or CVC strategies and followed until study closeout at 1 year after the last enrollment. The primary endpoint was the rate of access-related interventions per patient-year. Safety endpoints were mortality, access-related serious adverse events (SAEs), and vascular access infections. Intervention groups were compared with the AVF group using negative binomial and Cox regression models.
Results
A total of 165 patients were enrolled: 52 AVF, 57 AVG, and 56 CVC. Mean age was 78 years; 27% had started hemodialysis at enrollment. Median follow-up was 2.0 years. The allocated vascular access type was changed in 9 AVF, 24 AVG, and 4 CVC patients during follow-up (P=0.002). The rate of access-related interventions was 1.12/year with AVF, 1.53/year with AVG (P=0.082), and 0.76/year with CVC (P=0.018). Mortality did not differ significantly. The rate of access-related SAEs was 0.08/year with AVF, 0.27/year with AVG (P=0.012), and 0.11/year with CVC (P=0.418). Access-related infection rates did not differ significantly; the overall catheter-related bloodstream infection rate was 0.37/1000 catheter days.
Conclusion
In elderly patients with limited life expectancy, CVCs required fewer access-related interventions than AVFs, without excess mortality or infection. AVGs are more often abandoned and result in more access-related SAEs than AVFs.
Has the Telitacicept data presented at the plenary session at #KidneyWk been published?
I can only find the 39 week data from last spring
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