#NephMadness is back

Last Sunday we launched NephMadness

for the third time. This began as a last minute Hail Mary by the crew at AJKDblog to commemorate World Kidney Day in 2013. The response was so overwhelming that despite initially thinking this would be a one-and-done we decided to come back and improve the idea.

We have steadily improved the execution of NephMadness.

Last year we introduced a system to allow online bracket submissions. We found a company that provides white labelled online tournament brackets. This gave us streamlined registration and allowed for automatic scoring. Participation sky rocketed. Last year we also brought in content experts to act as our selection committee to make sure we had the best field possible.

This year, we have a number of further improvements. The primary complaint last year was seemingly arbitrary way the winners of each match up were determined, basically it was a system we called "Matt and Joel decide." Not surprisingly people were not enamored with this system and this year we have deputized a blue ribbon panel of nephrology experts to make the decisions.

We are also getting better at producing the brackets themselves and filling out the field. We now have written on 192 concepts since we started NephMadness. We have seen that the best match-ups pit related concepts up against each other and we have really increased the use of that technique in this year's brackets. In addition we have themed the entire tournament as nephrology's interaction with other specialties.

Download a PDF of the brackets

We have also changed the schedule. The first two years we tried to track the schedule of March Madness as closely as possible. This meant we opened the brackets on Selection Sunday and closed them a week later. This year we opened the brackets on March 1 and accept submissions for 3 weeks, until March 22. This will, hopefully, increase participation.

Another area of improvement is in the Tourneytopia rollover descriptions. Last year we just copied the scouting reports from AJKDblog and pasted them in to the roll overs. They had a bunch of links and were really long. This resulted in really long descriptions that were difficult to read in the rollovers. This year we have a short 2-3 sentence description for the rollovers written solely for that purpose. Oh and a picture.

Go to Tourneytopia to submit your brackets for NephMadness

Last year we had a confusing collection of three sites, Tourneytopia, NephMadness.com and AJKDblog. This year we jettisoned NephMadness.com and completely redesigned AJKDblog to be a much more effective container for NephMadness. The editorial staff at AJKD really did an outstanding job with the redesign.

This year the journal, AJKD, is really behind the contest. The Feb and March issues of AJKD had pack ins to promote the contest.

This months AJKD! #NephMadness

A photo posted by @jtopf on Feb 6, 2015 at 6:38pm PST

And the journal website has two high profile ads for NephMadness.

The last change is we are partnering with MedScape, a long time partner with the NKF and AJKD to promote NephMadness. Medscape is republishing all the content from the scouting reports and e-mailing their audience.

At St John Hospital and Medical Center we are having all of our fellows and faculty complete their own brackets and then we will have a consensus conference and build a collective entry to see if we can do better as a pit crew or as lone cowboys (and cowgirls).

Twitter Chat Tonight, Tuesday Feb 24 about World Kidney Day

I have been involved in Nephrology social media for years now, and it has been rewarding seeing the global community of nephrologists connect and develop a voice over that time.

While social media in general and Twitter in particular was once thought of as a time waster, it is now recognized as critical communication channel that allows back and forth communication as well as side to side communication.

First order communication: traditional top down

Second order communication: back and forth

Third order communication: back and forth and side to side

The side to side communication is what builds the community and is what twitter excels at. Imagine how boring the NephJC chats wold be if the only communication you saw was from the NephJC host? The whole point of the chat is to leverage the diversity of expertise in the crowd. 

Tonight will be a first in social media. Representatives from the International Society of Nephrology, The American Society of Nephrology and the National Kidney Foundation will be convening to discuss the upcoming World Kidney Day. It should be a great discussion. Please join us in (dare I say?) this historic moment. The discussion starts at 9PM EST and the hashtag is:

#WorldKidneyDay

More information, including who the representatives are, is available on Medium.

Must know facts about albumin! Number seven will blow you away!

Albumin is made in hepatocytes at a rate of 200 mg/kg/day - Created with Haiku Deck, presentation software that inspires

Improving albumin levels among hemodialysis patients

1. Albumin is made in hepatocytes at a rate of 200 mg/kg/day 
1. or 14 g in 70 kg person
2. Total body albumin is 4-5 g/kg
3. 40-45% of albumin is in the intravascular space
4. Normal albumin concentration in the interstitial space is 
1. 0.7 in fat and 
2. 1.3 in skeletal muscle
5. Albumin has a half life of 2 to 3 weeks
6. The drop in albumin with inflammation is due to: 
1. reduced synthesis and 
2. increased fractional catabolic rate (FCR)
7. Intradialytic weight gain of 2.8 liters (4% in a 70 kg man) will dilute the albumin down 0.8 g/dL 

Refs

Improving albumin levels among hemodialysis patients (PubMed)

Measurement of interstitial albumin in human skeletal muscle and adipose tissue by open-flow micro perfusion (PubMed)

Potassium Wars, The Grand Rounds Presentation.

Last week I delivered my grand rounds to both St John Hospital and Providence Hospital. This grand rounds on Kayexalate and the new therapies to increase colonic potassium clearance. Take a look. I hope you enjoy. I have more to say about this talk, and hopefully I will do a directors commentary of the presentation. I have 99 problems but have no for that time now.

Potassium Wars, The Native Keynote file (431 mb) Alternative link.zip (307 mb)
Potassium Wars, The PDF of the Keynote (184 mb)
Potassium Wars, The Movie, It's almost like being there (1.05 gb)

Or stream it:

K wars, The Movie from joel topf on Vimeo.