CJASN eJournalClub: Patient/Provider Characteristics and timing of dialysis start

CJASN’s eJournal Club has recently been revamped with host institutions presenting a chosen article at their hospital on a rotational basis and feeback gathered by the host center. This month’s journal club was hosted by the Division of Nephrology at Duke and concerns a topical and I feel somewhat controversial article. The paper is entitled ‘Provider and Care Characteristics Associated with Timing of Dialysis Initiation’ by Slinin et al. Check out the editorial by RFN’s Andrew Malone at the CJASN website. There will be an ongoing discussion of the paper including author replies to questions posed by the online community. There is a login page but remember registration is free to all (including non-ASN members). The eJournal Club can be a great addition to our online nephrology resources but it requires the participation of the community. Interaction is paramount for its success so your comments are more than welcome.

Dream RCT in Nephrology: what would you choose?

The DreamRCT initiative, driven by Jordan Weinstein of UKidney & Joel Topf of PBFluids, has gone live. The project can be seen as an online reaction to the dearth of clinical trials in nephrology. It has been supported by the nephrology blogging community and features some great ideas to answer burning questions in our specialty. Some dream RCTs are more doable than others but all topics stimulate interest.

RFN has contributed with my IMAGINE & IMAGINARY studies in tranpslant immunosuppression and Andrews DREAM-CARD study of diuretic management after cardiac surgey.



The other enteries are:
O-My Study by Pascale Lane
CA-HIL study by Kenar Jhaveri
URIC ACID-CKD study by Joel Topf
International Glomerular Disease trial network by Matt Sparks
PHANTOM-1 Study by Ed El Sayed
Prevent DeaDD by Swapnil Hiremath
PhosFATE Trial by Jordan Weinstein

Check out the contenders on the impressive UKidney website and vote now. Dream it, do it!

New Cases Site from the UK RA

The UK Renal Association (RA); the professional body for UK nephrologists and renal scientists, has recently started a website to foster discussion of interesting cases (There is also a link in the sidebar). The site remains embryonic whilst a development strategy is debated, but the RA would be very gratfeul for feedback and some comments/discussion of the cases.

Urine Microscopy and the Camera Phone

I had a breakthrough with my iPhone 3G camera. I've tried unsuccessfully several times in the past to take pictures of urine microscopy fields through the lens of the microscope and had just about given up until I came across this NEJM letter to the editor that claimed it was doable.

The trick is to hold the lens of the camera phone about half a centimeter to a centimeter away from the eye piece. I found I needed to turn the intensity of the microscope light source down quite a bit to avoid whiting out the image. It's a little tricky getting the field into focus but with a little practice is completely doable.

Above is an image I took of a granular cast in a sea of non-dysmorphic rbcs from a patient with ATN and foley trauma. As pointed out by the letter to editor one can take video to scroll around the slide so you can show your attending, housestaff or primary team who weren't there with you what the urine microscopy looked like.

Journals as ranked by nephrology fellows

RFN wanted to know which journals were most helpful for nephrology fellows in training. As a busy nephrology fellow it can be difficult to find time to sift through the vast plethora of neprhology related journals. Interestingly, CJASN was chosen by 53% of the respondents as being most helpful. This is quite a feat in that CJASN's inception date was January of 2006!! A recent podcast by ASN Kidney News discusses the transition of editors from founding editor-in-chief William Bennett to new editor-in-chief Gary Curhan. NEJM came in at a close second at 40%. This was followed by JASN, KI, AJKD and NDT.