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Round Four, Forming the Final Four. This is the most important round, because it determined the champion of each individual region.

Toxin versus Hypertension

2 JNC8: 44
1 ACEi ARBs combo: 41
3 Systolic BP: 34
5 Chlorthalidone: 34
1 Aristolochic Acid: 21
7 KDIGO BP in CKD: 13
7 Osmolar Gap: 12
8 Hemoperfusion: 10
8 Renal Artery Tx: 9
6 Diastolic BP: 8

The Game Makers also had a final four matchup of Aristolochic Acid versus JNC8 and the people agreed with the Game Makers and had JNC8 advance. Perfect agreement.

Renal Replacement versus Regeneration

2 Bioartificial Kidney: 61
6 Residual Renal Function: 49
14 Urgent PD: 30
5 Fistula First: 27
2 DreamRCT: ESRD: 19
1 Convective Clearance: 16
4 Resident Stem Cells: 15
7 DreamRCT: AKI: 13
1 Parietal Epithelial: 12
3 Buttonhole Technique: 5

Bioartificial kidney continued to be the People’s Choice, but Urgent PD, the Game Makers choice, did finish a respectable third. EMT has the first goose egg in the tournament.

Acute Kidney Injury versus Electrolytes

7 Bicarb in CKD: 33
1 Contrast Nephropathy: 31
2 KDIGO AKI: 29
6 AKI Biomarkers: 26
3 U/A and Indices: 22
4 Normal Saline: 21
5 Balanced Solutions: 19
3 Serum Anion Gap: 16
8 Vaptans: 12
1 Hypertonic Saline: 9

The popular vote pitted Contrast Nephropathy against Bicarb in CKD rather than the Game Makers, Balanced Solutions against Bicarb in CKD. The people wanted Bicarb in CKD, we picked Balanced solutions. Both of them are waiting for definitive studies to decide their actual fate.

Kidney Stones versus Biologics

1 Rituximab: 107
5 Eculizumab: 23
8 Medical Acute Care: 22
6 Belatacept: 16
1 Surgical Acute Care: 15
2 Oxalobacter: 12
3 CT Scan: 9
7 ACTHAR Gel: 9
7 Bariatric Surgery: 9
4 Dr. Fred Coe: 8
2 Abatacept: 8

Round 5, the Final Four

Toxin v HTN v RRT v Regen

2 Bioartificial Kidney: 40
6 Residual Renal Function: 31
1 ACEi ARBs combo: 24
2 JNC8: 19
4 Urgent PD: 18
3 Systolic BP: 18
5 Fistula First: 15
4 Resident Stem Cells: 12
5 Chlorthalidone: 12
2 DreamRCT: ESRD: 10
1 Aristolochic Acid: 10

Bioartificial kidney continued to be the People’s Choice, but JNC8, the Game Makers choice, did finish third.

AKI v lytes v Stones v Biologics

1 Rituximab: 59
6 AKI Biomarkers: 19
1 Contrast Nephropathy: 18
3 U/A and Indices: 15
5 Eculizumab: 14
2 KDIGO AKI: 14
4 Normal Saline: 13
5 ZS-9: 12
7 Bicarb in CKD: 12
3 Serum Anion Gap: 10
5 Balanced Solutions: 5
6 Belatacept: 7

The crowd loves Rituximab, the most popular winner in the final four.

Round 6, The finals

1 Rituximab 26
2 Bioartificial Kidney 25
6 Residual Renal Function 18
1 ACEi ARBs combo 17
5 Fistula First 12
2 JNC8 12
4 Urgent PD 11
2 KDIGO AKI 11
3 Systolic BP 10
2 DreamRCT: ESRD 8

Rituximab wins the popularity contest over Bioartificial kidney.

Here is how the brackets would have looked if we had used popularity as the judge:

Toxin versus Hypertension

Renal Replacement versus Regeneration

Acute Kidney Injury versus Electrolytes

Kidney Stones versus Biologics

The Final Four

The leader board in this alternative universe also looks completely different with Susana Hong crushing the competition with 84 points (the actual contest winner, Carlos Machado, accrued only 63 points).

Click here to view all eAJKD content about NephMadness 2014!