Sumit Mohan

Long-Term Exposure to Uranium and Arsenic in Community Drinking Water and CKD Risk Among California Women

bit.ly/Medgyesi25OI

Some of the biggest successes of public health are being re-litigated in 2025

By a bunch of incompetent idiots

And people are going to die as a consequence

Defend Public Broadcasting! Public broadcasting provides Americans with access to local news, educational programming, and independent journalism without corporate and political influence. Public broadcasters like PBS and NPR ar...

This cause is close to my heart - please sign: sign.moveon.org/petitions/de...

The 8 largest Dow Jones drops in history
1. Trump 3/16/20 -2,997.10
2. Trump 3/12/20 -2,352.60
3. Trump 4/4/25 -2,231.07
4. Trump 3/9/20 -2,013.76
5. Trump 6/11/20 -1,861.82
6. Trump 4/3/25 -1,679.39
7. Trump 3/11/20 -1,464.94
8. Trump 3/18/20 -1,338.46
Tired of winning yet?

Thanks to all of the NIHers and their friends who reached out to me. I am still here (DM me or Signal jeremymberg.78)

I still have a very incomplete picture but based on what I have been told, the damage to NIH and to many wonderful people who work(ed) there is/was impossible for me to imagine

1/n

Major Variation across Local Transplant Centers in... : Journal of the American Society of Nephrology probability of receiving a deceased donor kidney transplant within 3 years of waiting list placement across centers. For the average patient, probability of transplant varied 16-fold between different...

There were real geographic disparities- not just rural vs urban but as we showed - the differences were more to do with organ offer acceptance than anything else. journals.lww.com/jasn/abstrac... …. Also multi listing benefits pts with higher SES largely

Association Between Declined Offers of Deceased Donor Kidney Allograft and Outcomes in Kidney Transplant Candidates - PubMed This study found that transplant candidates appeared to receive a large number of viable deceased donor kidney offers that were refused on their behalf by transplant centers, potentially exacerbating ...

Yes - non utilization is a discard. Terminology changes that a few insist on. There can be good reasons to say no to an organ and often not. See table 3 in our paper above - or the variation here pubmed.ncbi.nlm.nih.gov/31469394/

Outcomes for patients with a deceased donor kidney offer in the new allocation system In the United States, disparities in access to kidney transplantation exist for waitlisted candidates with end-stage kidney disease. Meanwhile, changes in kidney allocation policy have been associated...

www.kireports.org/article/S246...

In 2022, we did fewer than 20,000 kidney transplants and discarded thousands more…. and it took nearly 30 million offers. Kidneys that reached patients were turned down twice as often compared to 2 years prior. #broken #kidney #allocation

Another way to think about this… how often does a kidney actually go to the person at the top of the allocation match run … well… not very often, it turns out

How inefficient is the new kidney allocation system in the US? the number of offers increased so rapidly that some centers were receiving > 100,000 offers per year. Is it any surprise that no one is paying close attention anymore?
www.kireports.org/article/S246...

And yet folks continue to defend the status quo… our allocation system is broken and those responsible for regulation are asleep at the wheel…

Congratulations!

Happens in any 24 hr urine collection with a UTI or bacteriuria. The urea clearance is much higher than the creatinine clearance rather it being the other way around…. leads to a falsely low CrCl that gets incorrectly blamed on an incomplete collection.

Given the challenges around organ utilization and discards, figuring out reliable estimates of organ quality are a big piece of the puzzle if we are going to make real improvements and increase access to transplant.

Outcomes of #Living Kidney #Donors Following Donor #Nephrectomy in Aotearoa New Zealand

#VisualAbstract by @krishnadoctor1

www.kireports.org/ar...

This has been an inspiring conference so far with so many patient voices and the broad engagement of so many professionals

NEXT WEEK: Join us for ‘#ClinicalGenetics in #KidneyTransplantation’ - a virtual conference on Friday, December 13, 2024 – 7.25 ACCME Credits.
www.eventleaf.com/e/ClinicalGe...

#Genomics #Genetics #MedicalGenetics #Kidney #Nephrology #NephPearls #CKD

Legend for the Altmetric chart

Legend:

Altmetric cumulative attention shown by day in the Altmetric Explorers. The Sky Blue section from Bluesky is growing over time.

The Rise of Skywalkers

New federal model for increasing kidney transplants begins July 1 CMS and HHS finalized a federal rule aimed at increasing the number of kidney transplants and addressing disparities among potential organ recipients, according to a CMS press release. “The goa...

Great to see the final Increasing Organ Transplant Access (IOTA) model rule from the Centers for Medicare and Medicaid Innovation released.

@asnkidney.bsky.social @nkf-professionals.bsky.social
www.healio.com/news/nephrol...

For many the low hanging fruit is expanding their living donor program

The secret sauce here is going to good waitlist management - eliminate internal holds, inactivate folks that aren’t ready, implement filters well. This coupled with review of offers that are declined but accepted by others.

Deceased donor kidneys allocated out of sequence by Organ Procurement Organizations Deceased donor kidney allocation follows a ranked match-run of potential recipients. Organ procurement organizations (OPOs) are permitted to deviate from the mandated match-run in exceptional circumst...

In the interim, here is the first paper that was written on this pmc.ncbi.nlm.nih.gov/articles/PMC... - this has gone from a niche rare event to something that encompasses nearly 20% of all deceased donor kidneys in the US

There should be a few papers coming … if we can make it past the reviewers 😂 … it’s been more of a challenge than usual

Perhaps the biggest challenge with #IOTA is continued inclusion of out-of-sequence (OOS) deceased donor kidneys in center volume. This means that centers that are randomized are essentially incentivized to increase OOS placements to meet volume goals and inflate their organ offer acceptance rates

The full 595 pages of the #IOTA rule - public-inspection.federalregister.gov/2024-27841.pdf is excellent bedtime reading but the easier to read model website is at www.cms.gov/priorities/i...

#IOTA a MAJOR win for patients. Centers need to grow if we want to improve access to the best treatment option for ESRD and lower the discard rate in a more efficient system that holds centers accountable for their organ and patient selection choices

Improved information about waitlisting practices is a good first step on the transparency front and will likely benefit from the new pre-waitlisting data requirements from HRSA that are out for public comment now from OMB. #IOTA

But a center that excels at organ offer acceptance and period prevalence graft outcomes will get the max incentive with slightly slower growth too. Unfortunately, the graft survival metric is unadjusted.