Patrick Pun, MD MHS FASN

103,000+ Americans wait for transplants. 25% of living donors face insurance discrimination. Solution? Living Donor Protection Act (S.1552/HR 4582 & 4583). Bipartisan, zero cost, saves lives. Pls @fousheefornc cosponsor #LDPA #OrganDonation #Congress

13 people die daily waiting for organs while heroes willing to donate face insurance discrimination & job loss. @fousheefornc pls cosponsor the Living Donor Protection Act S. 1552/ HR4582 & 4583 #LDPA #OrganDonation #SaveLives

So excited to celebrate @VUMChealth @WesElyMD & Brenda Pun for their Pioneering Spirit Award at #NTI2023 @AACNme

Brenda Pun and @WesElyMD receiving the Pioneering Spirit from @AACNme! #NTI2023

Signal for sudden cardiac death (SCD) with azithro and with levofloxacin. #BestofNephJC #KidneyWk

@JeromeAdamsMD @kidney_boy Wholeheartedly agree. Awareness of the problem is the first step. We also need standardized protocols for dialysis unit CPR.

@kidney_boy Collecting and showing people the data is an incredibly important first step. People often clean up the room themselves when you turn the lights on, and everyone can see how dirty the room actually is. But admittedly that’s not enough for everyone.

Black dialysis patients with cardiac arrest are less likely to receive CPR than white patients. OR 0.4! W.T.F. #KidneyWk

@MentaculusMap @kidney_boy Thanks for this thought. This was addressed in our study and it was indeed true white cardiac arrest patients dialyzed in better resourced clinics. However, accounting for these differences only increased the magnitude of the disparity

@kidney_boy Certainly wouldn’t rule it out. Would be nice to see some controls. Dialysis centers w/ predominantly white pts probably better trained staff. Economics a big factor and economics is not de facto evidence of racism.

Why $950 per cancer patient Why $560 per Alzheimer’s patient Why $18 per kidney patient #KidneyWk

.@shofacker @virtualpun and colleagues in Nephrology Nursing Journal Barriers and Facilitators to Performing Cardiopulmonary Resuscitation During Treatment in Outpatient Hemodialysis Clinics: A Qualitative Study pubmed.ncbi.nlm.nih.gov/33107712/

Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes | NEJM. When it 🌧 sometimes it pours in the most positive way!! Another #win for the kidney community! can’t wait to check out the late breakers ⁦@ASNKidney⁩ #KidneyWk nejm.org/doi/full/10.10…

.@virtualpun @DCRINews and colleagues in @CJASN Trends in Use and In-Hospital Outcomes of Subcutaneous Implantable Cardioverter Defibrillators in Patients Undergoing Long-Term Dialysis cjasn.asnjournals.org/content/early/…

Hi #Medtwitter, #Nephtwitter! I’ve wanted to put together a tweetorial for a while, and now that my first manuscript is published, here are a few things I’ve learned about cardiac arrest in patients on dialysis, our resuscitative response, and #healthequity. Thread:

@DrDeidraCrews @Nephro_Sparks @Cervantes_Lily1 @AmakaEMD @MarlenaCFisher @JHUNursing Thanks much @DrDeidraCrews @AmakaEM @Cervantes_Lily1 for discussion! In a recent qualitative study with HD staff, uncertainty about code status wasn't cited as major barrier to CPR, whereas uncertainty about how to best do CPR during HD was. NKF poster here.

New research led by former @DukeMedSchool student @shofacker / @MGHMedicine intern Important racial disparities in CPR initiation observed in US dialysis clinics "Of all forms of inequality, injustice in health is most shocking and inhuman" Dr MLK Jr resuscitationjournal.com/article/S0300-…

@VUMCKidney @VUMChealth @VUMC_MD @VUMC_Medicine @VUMCMedicineRes Very sad news. It was a privilege to train under Dr Stone and his love for medicine and learners will always be an inspiration!

But If we have stopped using gadolinium in ckd due to risk of nsf, how can we have any data that risk in ckd is “sufficiently low or nonexistent”? Do we need more evidence specifically in ckd pts before we subject our patients to gadolinium without informed consent?

The 2017 American College of Radiology guidelines on contrast say that the risk of NSF with class II gadolinium agents is "sufficiently low or possibly non-existent" and recommend that no informed consent is needed for CKD pts. Does absence of evidence= absence of risk? #AskASN

@nephrothaniel @kidney_boy I think RCTs now made possible by new tools including implantable loop monitors and wearable patches to use as proof of concept. Stay tuned

@jddneary @hswapnil Agree but perhaps an opportunity. In gen pop, pacemaker detected subclinical AF increas CVA risk 2.5x-- who knows in our patients? #AskASN