#69 CKD: Prescribing Do’s and Dont’s with @kidney_boy, Joel Topf

The Curbsiders Internal Medicine Podcast

Health & Fitness, Medicine, Science, Higher Education, Education

4.8 • 3.1K Ratings

🗓️ 27 November 2017

⏱️ 41 minutes

🔗️ Recording | iTunes | RSS

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Summary

Making all your nephrology dreams come true with part 2 of our interview with @kidney_boy, Joel Topf, MD Salt Whisperer and Chief of Nephrology at Kashlak Memorial Hospital. Flush away your bad prescribing habits when it comes to nephrotoxic drugs in this fast paced run down of the medications which must stay on or off Santa’s naughty-list, backed up with a sack full of memorable research studies. Special thanks to Annie Medina, Justin Berk and Kate Grant for writing/producing this show and to physician artist, Kate Grant for her lovely/hilarious artwork (more at paintscientific.com).

Full show notes available at http://thecurbsiders.com/podcast

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Time Stamps

00:00 Intro
03:00 Which medications should we exercise caution over in CKD?
03:31 Bactrim (Trimethoprim+Sulfamethoxazole)
07:00 NSAIDS
08:29 NSAIDS and the ‘Precision’ Trial NEJM 2016 looking at cardiovascular safety
12:50 The Male Physician Study JAMA 2001
13:50 Discussion about Nurses Health Study and use of analgesia, and CKD
15:15 Acute Interstitial Nephritis, Beta Lactam Antibiotics, and the risk of Acute kidney injury +/- CKD with Proton Pump Inhibitors
18:20 Advice for co-prescribing NSAIDS,ACE inhibitors and diuretics
20:39 Creatinine levels and ACE/ARB prescribing. How High can you go?
24:55 Facebook question from listener: measures to reduce proteinuria in hypertensive patients
27:20 Empagliflozin and renal protection in diabetic patients
32:00 Contrast Induced Nephropathy, the AMACING trial 2016.
38:00 Take Home Points
39:57 Outro

Tags: chronic, kidney, disease, nephrology, renal, glomerular, filtration, crcl, gfr, creatinine, medications, pharmacology, bactrim, nsaid

Transcript

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0:00.0	Welcome back to the Curbsiders.
0:09.0	Oh, yeah, that's right Stuart.
0:12.0	That's surprising.
0:13.0	I didn't know we're going to set it up.
0:14.0	That's right, we are doing the second one.
0:16.0	Like you said, Stuart, this like you've said.
0:18.0	Oh no, where did you come from?
0:31.0	Stuart, like you said before, this episode was so chock-a-full that we had to spill over into another episode.
0:43.0	This is the Curbsiders, the internal medicine podcast that uses expert interviews to bring you critical pearls and practice changing knowledge.
0:52.0	I'm Dr. Matthew Wato.
0:54.0	Here with my co-host, Dr. Stuart Brigham and Dr. Pyl Williams.
1:00.0	Stuart, you're so surprised that we were recording tonight.
1:06.0	You literally just went right into it.
1:09.0	Two hours of recording, it's just a little chock.
1:13.0	Well, we're back for part two with Dr. Joel Topf.
1:18.0	On this episode, we talk about kind of medication management, which medications to avoid during chronic kidney disease and also trying to dispel some myths.
1:28.0	We get into talking about contrast and doust nephropathy.
1:31.0	Does it really exist?
1:33.0	We talk about aces and arbs, what to do when the creatinine bumps and also talking about back-dramed SGLT2 inhibitors.
1:42.0	A lot of interesting discussion here with Dr. Joel Topf.
1:46.0	Just to remind you, Dr. Joel Topf is best known as AtkiniBoy on Twitter.
1:53.0	He is one of the creators of the Nephrology Journal Club and is well known for his blog, Precious Bodily Fluids, Mewsings of a Salt Whisperer.
	...

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