Saturday, August 18, 2012

eJournal Club

CJASN eJC Article of the Month, 2012-08-15
Prevalence and Factors Associated with Hyperkalemia in Predialysis Patients Followed in a Low-Clearance Clinic
"Pantelis A. Sarafidis, Rochelle Blacklock, Eleri Wood, Adam Rumjon, Shanique Simmonds, Jessica Fletcher-Rogers, Rachel Ariyanayagam, Aziza Al-Yassin, Claire Sharpe, Katie Vinen"
©American Society of Nephrology

A few months ago, CJASN introduced a new feature called eJournal Club. This is a means by which fellows (and others) can review papers and communicate directly with the authors. The idea is that perhaps these papers could be discussed in local journal clubs and then any questions or concerns that arise could be answered by the authors. It's an interesting idea that to my mind is a big improvement on the traditional model of letters to the editor. At the moment, the paper is chosen by the editors each month but the plan may be for this to change in the future if there is sufficient interest.

This month's paper is a study of the factors that are associated with hyperkalemia in patients attending a low clearance clinic in the UK. The main finding of the paper is that eGFR is the best predictor of the likelihood of being hyperkalemic. In the univariate analysis, patients with hyperkalemia were more likely to have a low serum bicarbonate or be on sodium bicarbonate treatment. However, in the multivariate analysis these were not significant. Looking at the analysis, the cut-off for bicarbonate in the LR was greater than or less than 25 mmol/L while the mean values in both groups were lower. I wonder, if they had run this as a continuous variable in the LR or chosen a lower cut-off for bicarbonate, if it wouldn't have been significant. This is a question that I can now ask the authors. This is free to all - you do not need to be an ASN member or a subscriber but you do need to register your email address with the ASN. The PDFs of the article and accompanying editorial are provided also.

I think this is a great use of new media and we will be referring to it monthly.

1 comment:

David S. Goldfarb MD said...

Thanks Gearoid. One of our NYU fellows did select the eJC for her journal club and then posted a summary of the main points of the discussion at the site. I had in mind a national journal club, sort of the way Oprah has a book club. I posted some comments there tonight to seed the discussion and we hope you'll all find the papers interesting and the comments stimulating.