“What is the role of vasopressin?”
A nephrologist will talk about osmolality and aquaporins.
An intensivist might talk about its use as a pressor.
But, ask an evolutionary or social scientist and you might be surprised by the answer…
#MedTwitter
#NephTwitter
#NSMC
So, what is the role of vasopressin?
An evolutionary scientist will say its adaptations helped our transition from water to land.
A social scientist might say it helps us socialize.
I’d say: vasopressin has allowed us to become human.
✨Introducing: A 1-minute review of lupus nephritis
As a trainee, I've found it hard to wrap my head around the many classes and emerging treatment options in LN.
Mithu (
@MithuRheum
) and I created this short audiovisual primer on LN. 🐺
#NephTwitter
Thanks in part to ADH, kidneys can effectively concentrate urine to meet a range of homeostatic needs.
Or, in the words of Homer W. Smith…
(Read a reprint of his classic text here: )
Our paper demonstrating an approach to CHIP curation in large datasets is now out in Blood (
@BloodJournal
)! 🩸
We identify CHIP in >500,000 individuals and show how common challenges such as sequencing artifacts and germline variants can be addressed.
Passed my PhD defence [while 7.5 months pregnant!] ✅
Thankful to the mentors and collaborators who helped me reach this milestone, including Mike (
@QMyPath
), Matt (
@MattLanktree
), Alex (
@AlexBickMDPhD
), Cassy (
@CassyRCohen
) and many others!
SGLT2 inhibitors in CKD and heart failure: ready for prime time in patients without diabetes
New review article written by Drs. Sam Silver (
@drsamsilver
), Bikrampal Sidhu (
@bsidhu28
) and I for an upcoming issue of CONH.
#NephTwitter
#flozination
Passed my PhD defence [while 7.5 months pregnant!] ✅
Thankful to the mentors and collaborators who helped me reach this milestone, including Mike (
@QMyPath
), Matt (
@MattLanktree
), Alex (
@AlexBickMDPhD
), Cassy (
@CassyRCohen
) and many others!
Nope: it’s oxytocin.
Oxytocin & vasopressin are evolutionary cousins located side-by-side on human chromosome 20. Invertebrates have one hybrid copy. Tandem duplication in the common jawed vertebrate ancestor gave rise to our two gene copies.
Image from .
Unlike most other animals, humans cannot convert uric acid into a more soluble compound.
Precipitated uric acid can cause a host of problems like gout and kidney stones.
What happened to our uricase?: a brief Tweetorial.
Fig. from
#NephJC
#NephTwitter
Vasopressin and oxytocin signalling in the brain regulates social behaviour in many species.
In humans, genetic variants in these receptors (particularly in the V1a receptor, AVPR1A) appear to contribute to sociobehavioral diversity.
More on this here:
Last week, I shared how we derived CHIP calls in the UK Biobank (N ~450k).
In a study out today in Circulation (
@CircAHA
), we use these CHIP calls to contribute to an ongoing debate regarding IL-6 signaling mediating the association between CHIP & CAD.
⚠️ New podcast episode on phosphate disorders ⚠️
A
#FOAMed
primer on:
- What regulates phosphate balance
- How to treat the highs and lows
Written by
@MattLanktree
,
@StevenMontague
, Dr. Rachel Holden and I.
What's up with the phosphate? Today's episode "Heating the Log Cabin - Phosphate Disorders" covers everything you need to know about phosphate disorders - hypo & hyper!
Written by Dr. Caitlyn Vlasschaert
@DrFlashHeart
(IM Resident) from
@queensuim
Today was my last clinical day for a while. It wrapped up in the best way:
@moorman_neph
&
@sarah_m_moran
helped me find my first RBC cast.
Tomorrow, I start a PhD with
@QMyPath
, where I’ll be looking at how mutant myeloid cells affect our kidneys.
Exciting times!
Thrilled to share the first original research paper from my PhD work.
We examined the associations of clonal hematopoiesis of indeterminate potential (CHIP) in two 🇨🇦 cohorts of individuals with CKD stage 3-5.
A quick thread 🧵:
This study of 172 patients with advanced CKD found that 25% had clonal hematopoiesis of indeterminate potential (CHIP), and that those with this common inflammatory condition had an increased risk of kidney function decline and CKD-associated anemia
Shortly after this gene duplication, the vasopressin system began to take shape and refine its specialized function: osmoregulation.
Transition of early life from sea to freshwater to land came with significant changes in osmotic stress.
Image from .
To adapt to terrestrialization, kidneys developed more sophisticated urine concentrating systems.
The amphibian urothelium (analogous to mammalian kidney collecting ducts) became sensitive to ADH. This allows them to live in wet or dry habitats.
Fig. from
Arginine vasopressin (AVP), also known as antidiuretic hormone (ADH), is a short peptide hormone coded by ⒸⓎⒻⓆⓃⒸⓅⓇⒼ.
We have a similar peptide, ⒸⓎⒾⓆⓃⒸⓅⓁⒼ, floating around in our bodies.
Is this AVP, too?
Kidney homeostasis is highly dependent upon the correct functioning of myeloid cells. This review provides an overview of current knowledge regarding the interactions between myeloid cells and native kidneys
We typically think of oxytocin and vasopressin as having pretty distinct roles.
Vasopressin:
free water absorption in the kidney via V2R
vasoconstriction via V1aR & V1bR
Oxytocin:
myometrial contraction
milk letdown
Did you know they both also have roles in socialization?
Over the past few years, I’ve spent a lot of time thinking about how CHIP – a common, acquired blood cell condition – might affect the kidneys.
Our review in
@NatRevNeph
discusses the current state of knowledge. 🫘 🧬
I would like to nominate
@Nephro_Sparks
for
#NephJCKidneys
MVP.
Without him, reckless holding of RAASi in COVID or Rx’ing of baclofen in ESKD might be commonplace.
More seriously: Dr. Sparks is a steadfast mentor who many trainees look to for guidance & support.
#TheRealMVP
Sharing exciting new work led by Adriana Hung, Alex Bick (
@AlexBickMDPhD
) and Eric Green (
@ercgrn
):
Genetic inhibition of APOL1 Pore Forming Function Prevents APOL1-Mediated Kidney Disease
A brief 🧵:
Proudly sharing our work on CHIP in kidney disease, presented as a poster at ASN
#KidneyWk
.
PO1899 — 2021:
Clonal Hematopoiesis of Indeterminate Potential Is Associated with Worse Kidney Function and Anemia in a Cohort of Patients with Advanced CKD
A short thread 🧵 (1/6):
Our report on CHIP and infection risk in the UK Biobank is out now
@LeukemiaJnl
.
We illustrate the importance of accounting for incident myeloid cancer development in observational studies of CHIP, particularly when the observation period is very long.
One can learn so much about humans by studying how a system of interest has been adapted & co-opted in different animals.
Really looking forward to "Kidneys at the Zoo: What Can We Learn from Comparative Renal Physiology?" starting now at
#KidneyWk
.
“What is the role of vasopressin?”
A nephrologist will talk about osmolality and aquaporins.
An intensivist might talk about its use as a pressor.
But, ask an evolutionary or social scientist and you might be surprised by the answer…
#MedTwitter
#NephTwitter
#NSMC
Feeling honoured to find myself on this list.
Thank you to my nominators, Drs. Rob Hegele and Ray Harris!
Congratulations to the other awardees including Dr. Jordan Nestor (
@JNPrecisionNeph
) who I look up to so much. 🫘 🧬
Congratulations to
@DrFlashHeart
for being selected as a 2023
@the_asci
Emerging Generation Awardee! Caitlyn is a leader in
#CHIP
and kidney genetics. We are lucky to have her as part of our extended research group!
The Intern At Work (
@InternAtWork
) is an excellent resource created by 🇨🇦residents for residents.
Here is a selection of medical infographics created by our infographic team:
@ShannonYGui
,
@rachelahlle
, Lucy Lan and myself.
Check us out!
#iMED2021
Air pollution is a recently recognized driver of lung cancer among never-smokers.
In a new preprint, we show that clonal hematopoiesis of indeterminate potential (CHIP) and PM2.5 form a novel gene × environment interaction promoting NSCLC tumorigenesis.
Hi
#NephJC
! This is Caitlyn – IM resident & PhD student from 🇨🇦.
Thank you for discussing our paper tonight.
I'm tuning in from Nashville, where I'm working to better define the relationship between CHIP and kidneys with
@CassyRCohen
@AlexBickMDPhD
@rharrisneph
& others.
COVID-19 is changing how we communicate science.
How has the pandemic shaped communication via journals, preprints, traditional media and social media?
In our latest paper,
@kidneyboy
,
@hswapnil
and I review what's changed in the kidney world.
Sharing a preprint of our latest work:
"Clonal Hematopoiesis of Indeterminate Potential is Associated with Acute Kidney Injury"
where we study four prospective cohorts and conduct mouse model experiments to identify a new link between CHIP and AKI.
Ever wonder how new emoji are added to your keyboard?
Every year,
@unicode
reviews proposals for new emoji.
Our team is submitting proposals for 10 new emoji this year.
Join our campaign () and tell us:
Why are these
#medicalemoji
important to you?
A year ago, I attended my first
#NephJC
.
Tonight, I’ll be hosting. Surreal!
Thankful for all of the great opportunities provided through
#NSMC
2020.
See you all at 9pm!
Experimental RCTs are not the only way to assess causality.
Mendelian randomization studies can also help distinguish causation (⇒) from correlation (∝).
👉 A short Tweetorial & walk-through of 2 MR studies that looked at whether urate ⇒ CKD.
#NephJC
You know those teaching moments where things *click* and you finally understand a topic?
The urine microscopy talk by
@jrseltzer
at
#KidneyWk
was one of those moments for me.
Highly recommend for all trainees!
For those w/o access, a similar talk:
Hi
@NephJC
- I'm Caitlyn, budding kidney clinician-scientist from 🇨🇦 and
#NSMC
intern.
Tonight I'd like to welcome my colleague
@JawaTasha
to her first
#NephJC
. She's a brilliant MD/PhD trainee studying cognitive function in dialysis. Give her a follow!
Thrilled to launch a project some colleagues and I have been working on: a webcast called Let’s LIME (
@LetsLimeWith
).
For our first episode, we interviewed Dr. Kimberly Manning (
@gradydoctor
).
Watch the full episode here:
Incredible Grand Rounds this morning by Dr. Gord Boyd
@jgordonboyd
this morning.
The bottom line: Cognitive dysfunction is common in patients with CKD, particularly those who are on HD, as well as after AKI.
Some details in this short thread:🧵
#NephTwitter
The third edition of the Dictionary of Moose Cree is now available.
It has >25k entries including extensive medical terminology.
So proud of my colleague Kevin (family medicine resident and Cree linguist) for putting this together.
In X-linked Alport syndrome, the onset of ESKD is significantly delayed with RAASi regardless of whether the type IV collagen mutation is truncating or missense.
ACEi/ARBs recommended for all patients with Alport Syndrome + proteinuria.
#Nephrogenetics
#KidneyWk
@rheault_m
CHIP is common and associated with an increased risk of disease across several organ systems (not just 🫀).
My PhD goal is to try and figure out if and how CHIP affects the kidneys so that when treatments become available, kidney patients will be considered.
#NephJC
Sure the visual abstracts are great, but the best part of the cardiorenal write-up is this anatomically correct kidney by Meera Sparks. 🤩
#NephMadness
@Nephro_Sparks
Applications for the Nephrology Social Media Collective Class of 2021 are now open.
It's *the best* structured e-mentorship experience out there, led by
@kidney_boy
and
@Nephro_Sparks
.
Take a look at the content I created this past year:
⚡️ NSMC 2020
Hyperuricemia is common in CKD, but there is debate about whether this is cause or effect.
This week in
#NephJC
, we're covering 2 new RCTs that study whether allopurinol helps stymie CKD.
Follow
@NephJC
& join us for the chat!
Four months at Vanderbilt went by in the blink of an eye.
Very grateful that Alex Bick and Cassy Robinson-Cohen agreed to host me in their labs.
I will miss every single person in this picture so much. A very special and close-knit bunch.
My brilliant former
@queensuim
co-resident Cam Giles (
@cameron_giles8
) was recognized as having one of the Top Trainee posters at ASN
#KidneyWk
.
This comes as no surprise to those who know him! Go Cam!
Full house at the “Integrating Kidney Genetics into Clinical Practice” session at
#KidneyWk
. 🧬
First up is Dr. Anthony Bleyer telling us about variants of unknown significance (VUS). A main challenge is that so many variants are not previously reported or well-characterized.
Physicians are trained to take a medical history before seeing patients; should we similarly receive formal training in social media?
Shout out to
@NSMCInternship
and other social media internships that fill this gap at
@QueensuDOM
Grand Rounds this morning by
@tdswan1991
.
Welcome 🙏 the 8th class of NSMC Interns
36 Interns representing 6 continents and 15 Countries
#NephForward
#NSMC2022
Read about the entire class here ⬇️
My friend, a general surgery resident, said she liked one of the NephMadness Tweets earlier this month and her whole timeline became kidney content for a few days.
The power of
#NephMadness
. The Twitter algorithm knows. 😉
#NephJC
Today marks 6 months since my aunt Dr. Janet McElhaney died.
She was a superstar who changed the world of geriatric medicine. Among her many achievements, she led one of the largest clinical trials ever published (PMID: 23518156).
Her absence is felt.
Graphical communication is the future! 🖌️🎨
Members of
@InternAtWork
and
@JournalofGME
have teamed up to walk you through your own visual abstract and/or infographic at ICRE 2021 (
@ICREConf
).
Be sure to check out our workshop this Thursday starting at 1pm ET. 🕐
Another
#nephrogenetic
disorder: APRT deficiency, characterized by argyrophillic (silver-loving) DHA crystals on biopsy.
✨ rare but typically diagnosed in adulthood with no extrarenal manifestations and can recur after kidney transplant.
@arkanalabs
Transplant patients have thus far been excluded from SGLT2i RCTs like DAPA-CKD.
What evidence exists for
#flozination
in patients with kidney transplant?
Dr. Shuster and her team review by body of literature for us.
#NephTwitter
The use of SGLT2-i in kidney transplant patients with diabetes: A literature review.
Here is our poster from
#ENDO2021
.
Proud to share this collaborative work by Endocrinology (
@saraawad87
, Sarah Moore) and Nephrology (Dr. Shamseddin, Dr. Al-Hadhrami) at
@QueensuDOM
.
I think I speak for all of us who participated in
#NephMadness
when I say:
A big thank you to Alina Foo and the rest of the
@AJKDonline
team for providing the platform and all of the support! ☺️
Dr. Manning is widely admired on
#MedTwitter
for her refreshing perspective and candour in sharing her experiences as a physician and human being.
Here is one of my favourite moments from our chat: a question stemming from her time on
@ETSshow
podcast.
#LetsLIMEwithDrManning
Hi everyone online for
#NephJC
tonight!
I'm Caitlyn- IM resident/PhD student from 🇨🇦. No COI.
Really grateful for my
#NSMC
colleagues
@Kidneymedic
&
@iheartkidneys
who prepared summary material to help me get up to speed this week!