Jefferson Peeples

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Jefferson Peeples

Jefferson Peeples

@NephroPeeps

Christian. Husband. Dad. Friend. Literature Enthusiast. Former heavy metal guitarist/vocalist. Nephrologist in NC. Opinions are my own. @jpeeples.bsky.social

เข้าร่วม Temmuz 2009
452 กำลังติดตาม584 ผู้ติดตาม
Jefferson Peeples
Jefferson Peeples@NephroPeeps·
Twitter sucks and has sucked since it was sold. 3 days on @bluesky and I feel like I have my #Nephtwitter community back. I’m not pummeled with senseless BS. So refreshing and excited for the move to that platform. ✌️
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Jefferson Peeples
Jefferson Peeples@NephroPeeps·
@SPuro88 Same… I’m always tempted to wear a Christmas sweater when I work on the holidays. But having GOC conversations in a goofy sweater is so off putting.
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Sravan Panuganti, DO, FACOS
My wife told me when she was in residency, staff in the ED would wear Halloween costumes. One year a kid came in and had to be coded by a clown, witch, etc. and how bad the optics were. So I refuse to wear a costume at work because I’m terrified of delivering bad news in costume.
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Jefferson Peeples รีทวีตแล้ว
Adam Bruggeman, MD
Adam Bruggeman, MD@DrBruggeman·
Physician conversion factors: 2000: $36.6173 2003: $36.7856 2006: $37.8975 2009: $36.0666 2012: $34.0376 2015: $35.7547 2018: $35.9996 2021: $34.8931 2024: $32.7442 UHC stock up 8,556% Insurance premiums up 342% Inflation up 86% Physician pay down 10% We should keep cutting physician pay so families have more money in their pockets through reduced costs and reduced premiums based on the last 25 years of experience.
Adam Bruggeman, MD tweet media
Charlie Bilello@charliebilello

Average US family health insurance premium... 2000: $6k 2003: $9k 2006: $11k 2009: $13k 2012: $16k 2015: $18k 2018: $20k 2021: $22k 2024: $26k That's a 342% increase since 1999 (6.1% per year). (Note: US CPI inflation has increased 2.5%/year) youtube.com/channel/UCRoWR…

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Jefferson Peeples
Jefferson Peeples@NephroPeeps·
@kidney_boy So I think we need more data in heart failure/decongestion/cardiorenal syndrome before we can let kidney injury biomarkers inform us on how to make clinical decisions for these patients Until then…. DECONGEST
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Jefferson Peeples
Jefferson Peeples@NephroPeeps·
@kidney_boy Supporting the idea that decongestion is king whether biomarkers rise or not. One caveat these studies say is that the biomarkers are validated to assess tubular injury in ATN but haven’t been well studied in other types of AKI
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Joel M. Topf, MD FACP
Joel M. Topf, MD FACP@kidney_boy·
One of the common criticisms of NephroCheck and other biomarkers of AKI is that since we don't have a treatment for AKI, checking these do not change what we do. But I think this view isn't thoughtful. Given that most of the contrast associated nephropathy we see after cardiac cath has been shown to be meaningless hemodynamic changes in creatinine and not actual tubular damage, we could have avoided scaring a generation of doctors in to believing in contrast nephropathy had we evolved from creatinine to biomarkers. Similarly, how many heart failure patients have gotten inadequate diuresis because of panic over a bump in creatinine? I suspect, had we transitioned to biomarkers of kidney injury, cardiologists and nephrologists would have been more confident in pressing forward with needed diuresis. Better diagnosis would allow better management despite not having an AKI pill (yet).
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