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nepherson.bsky.social
nephrology
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Standard metformin practice is: GFR 45+. No changes GfR 30-45. Decrease dose (but don’t initiate new therapy) GFR <30. Discontinue But maybe some low risk patients with CKD IV are losing a benefit by discontinuing their metformin?

submitted 5 days ago • 2 comments

We often stop metformin when eGFR < 30 (CKD stage 4). In this observational study of 4,278 patients with type 2 diabetes and CKD stage 4, stopping metformin (40.1% of patients) was associated with lower 3-year survival (63.7% vs 70.5%). Time for an RCT? #MedSky #NephSky www.ajkd.org/article/S027...

submitted 5 days ago • 1 comment

NIH lawyer arguing that slashing indirect costs will allow for more direct costs for research. Do you believe him?

submitted 5 days ago • 1 comment

Cardio 🔗 Kidney 🔗 Metabolic Learning lots at WCIRDC in Los Angeles!

submitted 75 days ago • 1 comment

Going a bit bro-science here:🏋️‍♂️🏋️‍♂️ a study reports gym supplements as gateway to anabolic steroids with an 8x higher odds. BUT: low cases (n=18), wide CI (2.6 -26.7), mixed definitions (protein shakes are a gateway drug?) & potential confounders. Observation ≠ causation #criticalreading Link below:👇

submitted 75 days ago • 1 comment

#CKM

submitted 75 days ago • 0 comments

Higher metal in your urine associated with lower cognitive function. In #JAMA @jama.com 🧠 A pee test for brain health? Models adjusted for age, sex, race, location, edu, eGFR, smoking, BMI Interesting association but studies like this are subject to residual confounding! jamanetwork.com/2827187

submitted 77 days ago • 1 comment

In #JAMA: a randomized trial shows daily procalcitonin measurements in sepsis to guide antibiotic discontinuation was safe and effective. (And CRP didn’t help…) @jama.com jamanetwork.com/journals/jama/fullarticle/2828036 #antibiotics #sepsis #biomarkers

submitted 77 days ago • 0 comments

Very simplistic explanation and it's MUCH more complicated than this, but a nice way to think about creatinine dilution with decompensated heart failure and convince people that a creatinine rise with decongestion is not actual kidney injury #nephsky #cardsksy

submitted 106 days ago • 3 comments

SGLT2 inhibitors will be subject to Medicare price negotiations www.nytimes.com/2023/08/29/u...

submitted 547 days ago • 0 comments