Discover and read the best of Twitter Threads about #CREDENCE
Most recents (12)
1) Welcome to this new #accredited #tweetorial on “Strategies to Apply Current Clinical Trial Data for SGLT2i to Reduce the Progression of CKD,” authored by our ⭐️tweetorialist Edgar V. Lerma 🇵🇭 @edgarvlermamd 
2) This program is #accredited for CE/#CME #physicians #physicianassociates #nurses #pharmacists #nursepractitioners & is supported by an educational grant from the Boehringer Ingelheim Pharmaceuticals Inc and Eli Lilly Company. It is intended for healthcare professionals.
3) Faculty disclosures and statement of accreditation are provided at ckd-ce.com/disclosures/. Please FOLLOW @ckd_ce (& @cardiomet_CE!) so you don't miss ANY of our unique serialized #tweetorials, always 🆓, always from expert authors! Prior programs at ckd-ce.com/category/dkd/ .
1a) Welcome to one of our favorite events on the @academiccme #accredited #tweetorial feeds: a takeover of our programming from @GoggleDocs! The focus of this tweetorial is data from #ADA2022 on #SGLT2i beyond cardiac disease. Our expert author is @GoggleDocs' @drpatrickholmes.
1b) Check out our other #ADA2022 recap #tweetorial by new @GoggleDocs family member @Ines_VFonseca who focused on the cardiac data presented: ckd-ce.com/dkd13_ada22a/
2) This program is #accredited for CE/#CME #physicians #physicianassociates #nurses #pharmacists #nursepractitioners & is supported by an educational grant from the Boehringer Ingelheim Pharmaceuticals Inc and Eli Lilly Company. It is intended for healthcare professionals.
1) Welcome to our new #accredited #tweetorial which is Part 2 of a 2-part "highlights" program on new #SGLT2i & #DKD data presented at @ERAkidney #ERA22. #Physicians #nurses #pharmacists #PAs and #NPs can all earn 0.5h CE/#CME by following this 🧵!
2a) @ERAkidney #ERA22 is a primary international scientific symposium for interaction and exchange among basic scientists and clinicians working in #Nephrology. Our expert author is Dr. Clara García Carro (@ClaraGCarro) from San Carlos Clinical Hospital (Madrid, Spain).
2b) Be sure to check out the first half of this #ERA22 recap from my colleague @shbermejo, and get MORE 🆓CE/#CME at ckd-ce.com/dkd12_ERA22a/. Join me in following @ckd_ce for the BEST in #cardiorenal education delivered entirely by #tweetorial!
1) Welcome to our new #accredited #tweetorial which is Part 1 of a 2-part "highlights" program on new #SGLT2i & #DKD data presented at @ERAkidney #ERA22. #Physicians #nurses #pharmacists #PAs and #NPs can all earn 0.5h CE/#CME by following this thread!
2) @ERAkidney #ERA22 is a primary international scientific symposium for interaction and exchange among basic scientists and clinicians working in #Nephrology. It was held in May. Our expert author is Dr. Sheila Bermejo (@shbermejo) from @vallhebron in Barcelona, Spain.
3) This program is #accredited for CE/#CME & is supported by an independent educational grant from the Boehringer Ingelheim/Lilly Alliance. It is not intended for US- or UK-based based HCPs. Accreditation statement & faculty disclosures at ckd-ce.com/disclosures/.
💡Zététique ou Autodéfense intellectuelle ? (thread)
Lors de mon enseignement des bases de la #PenséeCritique, la « #zététique » et l'#AutodéfenseIntellectuelle m'ont été présentées de façon confondue : il m'a été longtemps difficile de faire la part des choses entre les deux.👇
Lors de mon enseignement des bases de la #PenséeCritique, la « #zététique » et l'#AutodéfenseIntellectuelle m'ont été présentées de façon confondue : il m'a été longtemps difficile de faire la part des choses entre les deux.👇
De plus, sans même parler d'#AutodéfenseIntellectuelle, la définition du terme #Zététique elle-même semble être différente d'une personne à l'autre.
Je vais ici vous en exposer ma compréhension depuis les cours de @RichMonvoisin à son utilisation dans la communauté des #SceptiquesRationnel·les française et parler brièvement des idéologies associées comme l'#AutodéfenseIntellectuelle afin d'éviter les épouvantails.
1) Welcome to a new #accredited #tweetorial from our good friends and #diabetes experts @GoggleDocs, specifically @drkevinfernando, @drpatrickholmes, & @AmarPut. They have put their 🗣️s together to provide us with a summary of the first-ever consensus statement from ...
2) ... @AmDiabetesAssn & @goKDIGO, which were discussed at the recently concluded #isnwcn congress in Kuala Lumpur. This joint document nicely summarizes important recent advances and practice-changing data for the management of diabetic #kidneydisease #DKD.
3) This program is #accredited for CE/#CME #physicians #physicianassociates #nurses #pharmacists #nursepractitioners & is supported by an independent educational grant from the Boehringer Ingelheim/Lilly Alliance. It is not intended for US based healthcare professionals.
A tweetorial.
Here's an intriguing analysis just published in Diabetes Care by the great folks at @AmDiabetesAssn and @ADA_Journals. We examined concentrations of insulin-like growth factor binding protein-7 (IGFBP7) at BL and 1Y in the CANVAS study.
care.diabetesjournals.org/content/early/…
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Here's an intriguing analysis just published in Diabetes Care by the great folks at @AmDiabetesAssn and @ADA_Journals. We examined concentrations of insulin-like growth factor binding protein-7 (IGFBP7) at BL and 1Y in the CANVAS study.
care.diabetesjournals.org/content/early/…
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Why IGFBP7? Good question.
Though IGFBP7 "looks like" an IGF binder, it is lousy at this job. But IGFBP7 has other roles: it is a cell cycle arrest biomarker in the 'senescence associated secretory phenotype'.
When cells are exposed to IGFBP7 in excess, fibrosis follows.
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Though IGFBP7 "looks like" an IGF binder, it is lousy at this job. But IGFBP7 has other roles: it is a cell cycle arrest biomarker in the 'senescence associated secretory phenotype'.
When cells are exposed to IGFBP7 in excess, fibrosis follows.
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We previously found IGFBP7 was associated with cardiac structural and functional abnormalities and outcome in patients with heart failure, but we were interested to see how it would act in patients with #T2D, such as those in CANVAS.
Why?
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Why?
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The big picture of #DKD worldwide
Meda Pavkov @CDCgov
Long term improvements for diabetes and ESKD stalled after 2010
@nkf workshop SGLT2 in glucose homeostasis & kidney disease
Meda Pavkov @CDCgov
Long term improvements for diabetes and ESKD stalled after 2010
@nkf workshop SGLT2 in glucose homeostasis & kidney disease
Prevention & Treatment of #DKD
@cellotonelli
Health in All Policies (HiAP)
Systematically considering the health effects of all policies.
Big problems need big solutions.
SGLT2i are a part of the solution that we need 5 lenses:
Benefits
Harms
Utilization
Value
Access
@cellotonelli
Health in All Policies (HiAP)
Systematically considering the health effects of all policies.
Big problems need big solutions.
SGLT2i are a part of the solution that we need 5 lenses:
Benefits
Harms
Utilization
Value
Access
Changing Landscape: Advances in Understanding DKD Pathophysiology
Kathy Tuttle
Dual specialist who sees more people with diabetes in the nephrology clinic than in the endocrine clinic!
SGLT2i of course &
GLP1 receptor antagonists kidney outcomes data reviewed
Kathy Tuttle
Dual specialist who sees more people with diabetes in the nephrology clinic than in the endocrine clinic!
SGLT2i of course &
GLP1 receptor antagonists kidney outcomes data reviewed
@NephroGuy @GlassockJ @hswapnil @cdchu Need clinical context +/- biomarkers? I can't even fathom the amount of "harm" by physicians and patients overreacting to small changes in creatinine instead of continuing the meds needed for their CV and Kidney Protection.
Examples of why we need to split and not lump:
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Examples of why we need to split and not lump:
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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 👇🏽
#CREDENCE
#NephJC
@hswapnil
@kidney_boy
#CREDENCE
#NephJC
@hswapnil
@kidney_boy
Q1: Why was the 100 mg dose of Canagliflozin used in #CREDENCE and not the 300 mg dose?
VP: We were anxious about the toxicity as seen in some previous trials, & we wanted to minimize that risk
#NephJC
VP: We were anxious about the toxicity as seen in some previous trials, & we wanted to minimize that risk
#NephJC
Q2: Why did centers from Germany have a lower HbA1C cut off for inclusion in the study compared to the centers from other parts of the world - 10.5% vs. 12%?
VP: That was a regulatory request from Germany 🇩🇪
#NephJC
VP: That was a regulatory request from Germany 🇩🇪
#NephJC
💥How do SGLT2 Inhibitors work?
💥How does an anti-diabetic drug improve Renal & Cardiovascular outcomes?
💥To understand this let’s first review:
⚡️Renal handling of glucose
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@RenalFellowNtwk
#NephJC
#SGLT2
#CREDENCE
💥How does an anti-diabetic drug improve Renal & Cardiovascular outcomes?
💥To understand this let’s first review:
⚡️Renal handling of glucose
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@RenalFellowNtwk
#NephJC
#SGLT2
#CREDENCE
💥Renal handling of glucose:
⚡️180 g of glucose is filtered thru the glomeruli every day
(180 L x 100mg/dL)
⚡️But all the glucose is completely reabsorbed
⚡️Renal reabsorption of glucose occurs thru transporters in the proximal tubule called SGLT
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⚡️180 g of glucose is filtered thru the glomeruli every day
(180 L x 100mg/dL)
⚡️But all the glucose is completely reabsorbed
⚡️Renal reabsorption of glucose occurs thru transporters in the proximal tubule called SGLT
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💥Sodium-Glucose Co-transporters (SGLT)
⚡️There are many 👇🏽
⚡️Not all of them are located in the kidney👇🏽
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⚡️There are many 👇🏽
⚡️Not all of them are located in the kidney👇🏽
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💥Why is the #CREDENCE Trial such a big deal for the Nephrologists?
⚡️It is the first ‘positive’ trial in CKD DM pts. in two decades!
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@RenalFellowNtwk
@VladoPerkovic
@georgeinstitute
#NephJC
#Nephpearls
⚡️It is the first ‘positive’ trial in CKD DM pts. in two decades!
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@RenalFellowNtwk
@VladoPerkovic
@georgeinstitute
#NephJC
#Nephpearls
The last positive RCTs in CKD-T2DM were RENAAL & IDNT & those were published in 2001....19 years ago!
💥RENAAL Trial: Losartan ⬇️ CKD progression & ⬇️ risk of ESRD by 28% compared to placebo, but it did not lower CV mortality
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💥RENAAL Trial: Losartan ⬇️ CKD progression & ⬇️ risk of ESRD by 28% compared to placebo, but it did not lower CV mortality
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💥IDNT Trial: Irbesartan ⬇️ CKD progression & risk of ESRD by 23% compared to the Amlodipine and Placebo, but it did not lower CV mortality
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