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?
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?
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...
Stopping Versus Continuing Metformin in Patients With Advanced CKD: A Nationwide Scottish Target Trial Emulation Study
Despite a lack of supporting evidence, current guidance recommends against the use
of metformin in people with advanced kidney impairment. This observational study compared
the outcomes of patients wi...
www.ajkd.org
February 21, 2025 at 6:14 PM
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?
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?
Reposted by jefferson triozzi
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...
Stopping Versus Continuing Metformin in Patients With Advanced CKD: A Nationwide Scottish Target Trial Emulation Study
Despite a lack of supporting evidence, current guidance recommends against the use
of metformin in people with advanced kidney impairment. This observational study compared
the outcomes of patients wi...
www.ajkd.org
February 21, 2025 at 4:55 PM
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...
NIH lawyer arguing that slashing indirect costs will allow for more direct costs for research.
Do you believe him?
Do you believe him?
BL: The way it would work, guidance said crucial to ? direct costs.
Money "saved" will be taken from indirect costs and plowed into new grants, using the same funding formula. It's being plowed back into other research to best serve public health.
Money "saved" will be taken from indirect costs and plowed into new grants, using the same funding formula. It's being plowed back into other research to best serve public health.
February 21, 2025 at 4:19 PM
NIH lawyer arguing that slashing indirect costs will allow for more direct costs for research.
Do you believe him?
Do you believe him?
Reposted by jefferson triozzi
Cardio 🔗 Kidney 🔗 Metabolic
Learning lots at WCIRDC in Los Angeles!
Learning lots at WCIRDC in Los Angeles!
December 13, 2024 at 9:25 PM
Cardio 🔗 Kidney 🔗 Metabolic
Learning lots at WCIRDC in Los Angeles!
Learning lots at WCIRDC in Los Angeles!
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:👇
Link below:👇
December 13, 2024 at 9:35 PM
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:👇
Link below:👇
Cardio 🔗 Kidney 🔗 Metabolic
Learning lots at WCIRDC in Los Angeles!
Learning lots at WCIRDC in Los Angeles!
December 13, 2024 at 9:28 PM
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
🧠 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
December 12, 2024 at 1:31 AM
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
🧠 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
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
jamanetwork.com/journals/jama/fullarticle/2828036
#antibiotics #sepsis #biomarkers
December 12, 2024 at 1:16 AM
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
jamanetwork.com/journals/jama/fullarticle/2828036
#antibiotics #sepsis #biomarkers
Reposted by jefferson triozzi
In conclusion:
💥I don't use albumin/diuretic combinations because the literature doesn't support the practice
💥I think the overfill hypothesis predominates
💥An exception may be minimal change disease (particularly children) which is typically an abrupt presentation
💥I don't use albumin/diuretic combinations because the literature doesn't support the practice
💥I think the overfill hypothesis predominates
💥An exception may be minimal change disease (particularly children) which is typically an abrupt presentation
November 17, 2024 at 2:56 AM
In conclusion:
💥I don't use albumin/diuretic combinations because the literature doesn't support the practice
💥I think the overfill hypothesis predominates
💥An exception may be minimal change disease (particularly children) which is typically an abrupt presentation
💥I don't use albumin/diuretic combinations because the literature doesn't support the practice
💥I think the overfill hypothesis predominates
💥An exception may be minimal change disease (particularly children) which is typically an abrupt presentation
Reposted by jefferson triozzi
August 29, 2023 at 12:16 PM