John Kellum

Listen to "Code Green or Code Greed? Dr John Kellum" by The Critical Care Commute Podcast creators.spotify.com/pod/show/the-c…

How is possible that ICU physicians still believe that serum creatinine quantifies kidney function when nephrology adopted eGFR 20 years ago? How is it OK that a woman must lose 2.5x as much kidney function as a man just to get 1 SOFA point for renal? jamanetwork.com/journals/jama/…

Another tripute to a giant in our field. Rest in peace dear brother. sciencedirect.com/science/articl…

TIMP-2 and IGFBP7 are stress markers for the kidney, no stress, no protection. Now the stage is set to do a large trial of RIPC using sevoflurane anesthesia and better yet we can also titrate RIPC to biomarker response. Precision medicine at its finest!

...It turns out that the big trials used propofol and there is body of evidence showing that this agent blocks the protective effect of RIPC. Now with this paper we show how. Propofol interferes with the release of TIMP-2 and IGFBP7 from the kidney in response to RIPC...

Impact of propofol or sevoflurane on the renoprotective effect of remo... sciencedirect.com/science/articl… --This is a fascinating story. RIPC seems to work in some trials but not at all in others. Two big trials were negative so that's the end of story right? Not so fast. . .

@Tubulocentric Good thoughts. The kidney stress question we addressed by measuring TIMP-2*IGFBP7. We used a very high threshold so no question that these patients all had very high stress. The greater functional nephron mass is harder... all we can say is that the cohort was the same age.

@kellumja Could it be less about “nephrons of steel” and more about greater functional nephron mass and lower acute kidney stress?

Funny thing. . . 7% of patients with sepsis have "Nephrons of Steel" and don't develop Acute Kidney Injury when by all accounts they should. These "AKI-resistant" humans may hold the key to AKI prevention and therapy. doi.org/10.1186/s13054…

@pkguru10 @VicenzaCourse Some news today.. . globenewswire.com/news-release/2…

Is Endotoxin is the Exemplar/Poster Child for Extracoporeal Effectiveness?? 💡 Seems Yes! @kellumja @VicenzaCourse 🧭 Wait for #TIGRIS Trial 📍43rd AKI-CRRT-EBPT #VicenzaCourse #Endotoxin #MedEd #Sepsis #Extracorporeal #ECMO

After more than 5 years and nearly 15,000 patients screened, main results from Tigris are out! Precision medicine isn’t for the faint of heart! PMX Hemoadsorption to remove endotoxin is highly effective in this very select population globenewswire.com/news-release/2…

Learn why sepsis criteria are grossly inadequate for capturing Kidney dysfunction. rdcu.be/eqH2N

As seen in other studies, about half of all patients admitted to the ICU develop AKI with about 2/3 stage 2-3. However only 12% of stage 2-3 are have persistent severe kidney dysfunction. Outcomes for these pts are far worse. Endpoint for drug trials? rdcu.be/eebnP

Check out table 4. AKI rates were not different across study arms with the exception of DAPA-HF trial in which serious kidney events were actually less common with dapagliflozin compared to placebo (P=0.009). The claim that SGLT2 inhibitors cause AKI is demonstrably FALSE.

doi.org/10.1016/j.jacc… FACTCHECK “SGLT2 inhibitors result in “AKI” using KDIGO definitions yet confer undisputable benefits across a variety of settings.” FALSE

See et al. Makes a compelling Argument for Clinician Autonomy, and Individualized Care in the ICU. journals.lww.com/ccmjournal/abs…

We will never achieve our aspirations for a truly equitable society until those born into privilege see progress in absolute terms not just relative to people they believe they are superior to.

Kicking off Critical Care Nephrology precourse @ASNKidney week with Michael Connor. Thanks to course directors Ashita Tolwani and Mark Perazella

@ORCID_Org Ok so let me get this straight if I want to add a paper I had nothing to do with to my works I could? and there would be no verification as to the accuracy? And furthermore no one could remove it except me? Is this what you're telling me?

@kellumja This way, we can hold our member organizations accountable for adding only true and valid data to the ORCID records they have been granted permission to by the record holder. Data that you have added yourself can never be removed by third parties.

Anyone else getting notices from ORCID of papers being removed from your account? Papers you've written. Contacting ORCID isn't helpful--they say they can't do anything. I guess @ORCID_Org is run like social media. No accountability.