Tag: KidneyCON

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KIDNEYcon 2019 was awesome

KIDNEYcon is the answer to my post about how ASN’s Kidney Week is facing an existential crisis. John Arthur, Shree Sharma, and Matt Sparks have put together a brilliant two-day conference that offers hands-on work shops, an inspirational keynote, trainee Jeopardy, and state of the art clinical lectures.

The night before the conference a bunch of people met for bowling. Very fun. One of many events organized by Samira Farouk.

You can see the entire schedule here.

This was my third year participating in KIDNEYcon and this year I was invited to re-run the acid-base, fluid, and electrolyte workshop from last year. This year I teamed up with Roger Rodby of Rush (do more people anyone identify Rodby with Rush or ASN Communities, Twitter, ASN Board Review Course, or #NephMadness Blue Ribbon Panel?).

The workshop started with my favorite electrolyte gimmick, the IV fluid tasting party.

University of Arkansas provided 0.9% NS, 3% saline, lactated ringers, and D5W for our gustatory enjoyment. I then presented three cases:

  1. A case of toluene toxicity and how it looks like a distal RTA (non-anion gap metabolic acidosis), smells like a distal RTA (hypokalemia), and quacks like a distal RTA (positive urinary anion gap), but it’s not a distal RTA (lots of urinary ammonium).

Then I went over a case of hypernatremia and drilled down on how to calculate a water prescription that will actually correct hypernatremia.

And then a case of hypotonic hyperosmolar hyponatremia.

My slides, including a case of hyperkalemia that we didn’t use, are here:

Keynote | Powerpoint | PDF

(I include the Powerpoint for the unenlightened who still use that ancient technology. I do not check if the transitions, animations or images look decent. Use at your own risk)

Then Roger took over and went through a case of MDMA induced hyponatremia.

Then he went through a case of cerebral injury and polyuria. No, it was not a case of cerebral salt wasting. He then presented a really practical case of hyponatremia. Too many electrolyte problems are made up and you can feel the fiction when you hear them. This case of hyponatremia had integrity. Loved it.

Which was a great entry for Ure-Na tasting.

This led to a totally off label discussion of buying food-grade urea from Amazon and making home UreNa. This is not standard of care. Your mileage may vary. Talk to your lawyer before proceeding.

Roger concluded with a great discussion of DKA in an anuric dialysis patient.

After that I finished the workshop by presenting an unknown case of hypokalemia. And then then we tried to simulate those findings by drinking a sample of sodium zirconium cyclosilicate, Lokelma.

After lunch (dosed with extra mentoring, again thanks to Samira Farouk), Roger and I ran it all again.

That night was a dinner. There was an entertaining game of Jeopardy for the trainees. Jeopardy was put together by Samira Farouk (who, if you haven’t noticed is building a compelling case for NephJC Kidney MVP). Steven Coca found a mistake in the otherwise brilliant Jeopardy board.

Then Michelle Rheault gave an inspiring keynote speech about her journey through academic medicine. It was really good.

Saturday was a day of didactic sessions. The best way to catch up on all the tweets is to take a look at the amazing live tweeting by Brent Wagner…

It started with a review of social media and medicine by Sayna Norouzi and Sri Lekha. It was a breakfast session so it was called Hashtags and Hash-browns. Unfortunately no hash-browns were available.

This was followed by a session on hypertension put together by Swapnil which was amazing. Four lectures:

  • Office, Automated, Home, or Ambulatory? Which One and Why? by Mathew Luther
  • BP Variability: What is It and Why Should We Care? by Jordana Cohen
  • Drugs and Devices That Lower BP: A 2019 Update by Steven Coca
  • Debate: BP in CKD: How Low Should We Go? Tara Chang and Scott Brimble

The debate might have been the best medical debate I have ever seen. Dr. Chang’s slides were gorgeous and Scott did a beautiful, funny and humble job poking holes in the generalizability of SPRINT.

It was followed by a session on AKI

  • Urine Sediment Microscopy to Diagnose and Phenotype AKI: Should We Bother? by Juan Carlos Velez
  • TIMP2/IGFBP7 as a Predictor of AKI Outcomes: Are We There Yet? by Nithin Karakala
  • Genomic Predictors in AKI by Kevin Rogers
  • Using Proteomics to Identify AKI Biomarkers by John Arthur

After lunch there was a session on pediatrics

  • C3GN: Pathogenesis and Treatment by Carla Nester
  • Pediatric Kidney Stone Disease, Including Genetic Forms by David Sas
  • Kidney Development and APOL1 by Kimberly Reidy
  • Non-Adherence in Pediatric Kidney Transplant-Practical Strategies for the Pediatric and Adult Nephrologist by Vikas Dharnidharka
Love this on brand pic of Vikas!

The last session of the weekend was on clinical research.

  • Fellow Case Report on euglycemic DKA from an SGLT2i
  • A Telehealth Study to Improve Outcomes in Patients with CKD by Manisha Singh
  • Perplexed About Pragmatic Trials? The Ins and Outs of Different Trial Designs in Clinical Research by Swapnil Hiremath (who has generously made his presentation available)
  • SGLT2 Inhibitors: Discovering Their Role in Slowing Progression of Diabetic Nephropathy by myself
  • Tolvaptan for ADPKD: From Mechanisms to Treatment by Frederic Rahbari Oskoul

Here is the presentation I gave:

Keynote | Powerpoint | PDF

(I include the powerpoint for the unenlightened who still use that ancient technology. I do not check if the transitions, animations or images look decent. Use at your own risk)

After the lecture the conference moved to John Arthur’s house for a party with delicious hand crafted martinis and gourmet meatballs.

KIDNEYcon is a special conference. It is a great place for trainees. The workshops allow hand-on experiential learning that you can’t get from YouTube. It gives people the opportunity to really drill down and develop biopsy skills, pathology skills, early career development. In the past they have done point of care ultrasound and cooking classes. It is amazing. If you haven’t been it’s time to make a trip to Little Rock.

Here is a sharp top ten list from KIDNEYcon

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The mentor keynote

Matt Sparks gave KidneyCON keynote on Friday night. It was an amazing talk.

Things you don’t see at #KidneyWK

John Arthur asked Matt to talk about his career and how he navigated medicine to become an accomplished scientist, clinician, and educator.  Matt organized his talk around the mentors that guided him. The theme was that the way he made his way forward was by finding the best mentors available and learning as much as he could from them. It started with Wynton Marsalis

Though he went to the University of Arkansas to play trumpet he transitioned to biomedical science and found Dr Jeannine Durdik, an inspiring basic science professor, who taught him the scientific method.

After flirting with a career in basic science he went medical school at the University of Arkansas and matched at Arkansas where also did a chief resident year. The chair of medicine was Dr. Andreoli. I never knew Andreoli, but he sounds like the type of physician they don’t make any more…and you are simultaneously saddened and relieved by that fact. Andreoli was a giant in nephrology and Sparks worked close with him as a resident and closer during his chief year.

Andreoli directed Matt to Duke where he mentored by Tom Coffman. Coffman taught Matt how to write and directed him on his scientific career.

Then Matt talked about going to Mount Desert Island and meeting Nate Hellman. Matt was already an avid reader of the Renal Fellow Network, and Nate invited Matt to contribute. Matt really didn’t get involved until after Nate passed away and this ignited his desire to contribute to the Renal Fellow Network. This is how Matt got involved in and ultimately helped forge what would eventually become our online tribe of nephrologists.

It was fascinating to see the people that mentored Matt, because he is a mentor to so many right now.

Matt seems to know every nephrology fellow in the country and he takes an interest in promoting them and getting them involved. He is a strong advocate for fellows, both in and outside of Duke.

Even though Matt is younger than me, he is one of my important mentors. He has a wisdom that I don’t have and I often go to him with questions. I also trace my success with social media to his reaching out to me back in 2010. He guided me and really transformed my efforts from a solo project to one that recognizes that we can go further and do better by working together. Its a simple lesson but it has been critical to all of the successes we have found in social media.

Matt,

Congratulations on the Keynote.

Congratulations on putting together an amazing conference.

I am honored to be your friend and mentee.

Joel

 

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#KidneyCON Fluid, Electrolyte, and Acid-Base Workshop

David Goldfarb (@weddellite) and I put on a fluid, electrolyte and acid-base variety show at KidneyCON. The itinerary:

  1. IV fluid taste test
  2. Hypernatremia
  3. Management of calcium phosphate stones: to K-Citrate or not?
  4. Management of chronic hyponatremia, use of DDAVP
  5. Aspirin toxicity
  6. Hyperkalemia

Both of us had a bunch of additional cases that we didn’t get to so be sure to go deep into the presentation files.

Here are the presentation files: