Brian Rifkin

a cartoon penguin is fishing in a small boat ALT: a cartoon penguin is fishing in a small boat

Are you fishing for an answer?

a dog wearing glasses and a hoodie is sleeping on the floor reading a book ALT: a dog wearing glasses and a hoodie is sleeping on the floor reading a book

Man, you’re everywhere! I’m getting tired just reading your articles

a cartoon character with the words rule 1076 no more constipation on the bottom ALT: a cartoon character with the words rule 1076 no more constipation on the bottom

You’re full of $h!t

🎥 ASDIN TV! 🎥
@Kidneylsu shares insights on dialysis access and patient outcomes in this exclusive clip from his full interview—now available online!
 
🔗 Watch it here: youtu.be/TnhvKK6hrAA?...

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Last #NephJC we discussed HiLo: Hi vs Lo phos targets in HD patients #TenPostNephJC

Can restricted diets & loading patients full of phos binders be filed under “Things We Do For No Reason,” or do we finally have proof these measures save lives?

pubmed.ncbi.nlm.nih.gov/40638247/

Could interleukin-6 have the potential to lead to treatments for calciphylaxis? The rare and life-threatening complication takes center stage in a new study described by Aarushi Varshney and Matthew Sparks. kidney.pub/KN1707-20 #ASNKidneyNews

@nephrosparks.bsky.social

a statue of yoda is smoking a cigarette and says `` study you must '' . ALT: a statue of yoda is smoking a cigarette and says `` study you must '' .

Studies are hard. If they were easy…we’d already have all the answers #NephJC

a cartoon man with a mustache is sitting in a chair and the word seconded is written below him ALT: a cartoon man with a mustache is sitting in a chair and the word seconded is written below him

#NephJC I’m (overly) critical, but I appreciate any and all authors insight into the challenges of study design and evaluation 🍻

a man sitting in a chair talking to another man with the words you 've got tuberculosis on the screen ALT: a man sitting in a chair talking to another man with the words you 've got tuberculosis on the screen

Read da book #NephJC

a poster for the great shows a woman with blonde hair ALT: a poster for the great shows a woman with blonde hair

I don’t feel like I’ve changed my goals, but I probably have limited the upper amount of binders I prescribe since starting practice (due to patient reluctance) #NephJC

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Agreed, again I’m impressed they went to publication rather than abandon ship #NephJC

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#NephJC

a man in a suit and tie is running down a street while saying `` i need answers ! '' ALT: a man in a suit and tie is running down a street while saying `` i need answers ! ''

So after another “meh” phos trial, will we ever get the answer? #NephJC

a little girl is jumping into a muddy puddle .. ALT: a little girl is jumping into a muddy puddle ..

Muddy and slippery #NephJC

a man in a gold dress with the words " even magic has it 's limit " ALT: a man in a gold dress with the words " even magic has it 's limit "

Lots of limitations (so did we learn anything?) #NephJC

a cat standing next to a row of coca cola bottles . ALT: a cat standing next to a row of coca cola bottles .

Nice! #NephJC

a man with a beard and a hood says this is not the strategy you 're looking for . ALT: a man with a beard and a hood says this is not the strategy you 're looking for .

But is this study really the answers you’re looking for ? #NephJC

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#NephJC Phos never asked to be the villian

a black and white photo of a man and a woman with the words and away we go ALT: a black and white photo of a man and a woman with the words and away we go

Just tell the Hi group: cheese, milk and Coke … #NephJC

a woman in a purple shirt is sitting in a chair and says amen and hallelujah to that ! ALT: a woman in a purple shirt is sitting in a chair and says amen and hallelujah to that !

So this part of the design I like. Outcomes over numbers #NephJC

a man with a beard and glasses is talking about somebody 's gotta win might as well be me . ALT: a man with a beard and glasses is talking about somebody 's gotta win might as well be me .

Surprising. I want to see more “win” ratios too (maybe it’s the gambler in me). #NephJC

a police officer is sitting on a couch and says i just want you to get some separation ALT: a police officer is sitting on a couch and says i just want you to get some separation

I mean if you stopped all binders in Hi group and continued/added in Lo group…I feel like 1 mg/dl separation is feasible #NephJC

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#NephJC I’m confused why they continued knowing that the result would be significantly underpowered

It is not a design flaw per se. But the outcomes of deaths and admissions are so facility dependent that one would need a huge number of dialysis units, some sort of adjustment for baseline *facility* covariates and hierarchical models to estimate treatment effects with precision.
#nephjc

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#NephJC

a close up of a cat with the words hello jack can i have my hilo back below it ALT: a close up of a cat with the words hello jack can i have my hilo back below it

Seems easy in theory to get good separation given our current medical treatments #NephJC

a woman in a red dress is holding a microphone and screaming . ALT: a woman in a red dress is holding a microphone and screaming .

Yes, the treatment of hyperphosphatemia is without a doubt worse than the disease (and never ending) #NephJC

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Again small but meaningful #NephJC

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I would have gladly taken that outcome difference #NephJC

a football is sitting on top of a lush green field with the words deflategate written on it . ALT: a football is sitting on top of a lush green field with the words deflategate written on it .

We waited so long for the answer, and this design felt deflating #NephJC