In the week since introducing the brackets and seeds, #NephMadness has created a lot of nephrology-related excitement. Medical students, residents, fellows, nephrologists, and even patients from around the world are filling out brackets, learning, and debating the wide scope of nephrology achievements.

The First Round results and summarized below. The results for the first round were determined by considering submitted brackets, online votes, and the editors’ thoughtful consensus.

Four underdogs (by seeding) rose above their seeding and advanced to the round of 32.  The Cinderella of the field was PD First.  PD First was a 14 seed and took on the formidable number 3 seed, Fistula First. A Harvard versus New Mexico matchup. Online voting was overwhelmingly in favor of PD First. Reversing the long term trend of decreased peritoneal dialysis in the U.S. is going to take a concerted effort on multiple fronts. PD First plays a central role in that important initiative.

The next big upset was the eleventh seeded Citrate who HIT heparin hard. Citrate has many advantages over heparin described here and won in double overtime.

Tenth seeded tolvaptan has had a great run recently. It established itself as a highly effective drug in hyponatremia erasing the nightmare options of demeclocycline and lithium. And it was the darling of ASN Kidney Week with a big win in polycystic kidney disease. It comes into the tournament a bit bruised with the recent FDA warnings of liver damage but it was still able to hold off long-time juggernaut (7) cyclosporin.

Lastly, the 9 seed, Renal Fellow Network, rocked the 8 seed HDCN.com. Both sites are popular and informative, but the fellows have an open approach and the use of text rather than video dramatically increases the on-the-fly usability of web-based information.

Down load the updated brackets as PDF or PPT

Glomerular region, Podocyte group

• (1) Medicare Entitlement defunded (16) Transplant Chains
• (14) PD First ultrafiltered (3) Fistula First
• (5) KDIGO rejected (12) K/DOQI
• (7) USRDS retrospectively defeats (10) DOPPS

Glomerular region Mesangium group

• (8) Epigenetics expressed victory over (9) Whole Exome Sequencing
• (6) Propensity Scores outweighed (11) Cox Proportional Hazards (P=0.003)
• (4) Real Time PCR quantified (13) Western Blot
• (2) RCT had a landslide over (15) Meta Analysis. No publication bias was detected in the funnel plot.

Proximal tubule region, S1 Segment group

• (1) HEMO Trial destroyed the previously unquestioned truth of the (16) NCDS
• (3) TREAT trashed (14) EMERALD
• (5) ALLHAT nocturnally dipped (12) ACCOMPLISH
• (7) IDEAL defeats (10) MDRD

Proximal tubule region, Vasa recta group

• (8) FGF23 crushed (9) cystatin C
• (6) Anti PLA(2)R focally sclerosed (11) suPAR
• (13) HIVAN collapsed on  (4) MPGN Reclassification
• (2) APOL1 was the favorite gene, not (15) MYH9

Loop of Henle region, Thick ascending limb group

• (1) Captopril had a victory choir against (16) Epotein alfa
• (3) Mycophenolate sclerosed (14) Cyclophosphamide
• (5) Eculizumab delivered the win over (12) Rituximab
  
• (10) Tolvaptan rejected (7) Cyclosporin

Loop of Henle region, thin ascending limb group

• (9) Renal Fellow Network outblogged (8) HDCN
• (6) UpToDate rose above (11) Wikipedia
• (4) ASN Kidney Week out conferenced (13) Burton Rose’s Clinical Physiology…
• (2) NephSAP out questioned (15) NKF Spring Clinical Meetings

Collecting tubule region, principal cell group

• (1) MDRD Equation creatinized (16) CKD-EPI Equation
• (3) 24-hour CrCl collected more than (14) Cockcroft-Gault Equation
• (5) Winter’s formula left a gap with (12) TTKG
• (7) FeNa flushed FeUrea (10)

Collecting tubule region, intercalated cell group

• (8) Kidney Biopsy diagnosed (9) Urinalysis
• (11) Citrate HIT (6) Heparin
• (4) Scribner Shunt bled (13) Direct Potentiometry
• (2) Kidney Transplantation immunocompromised  (15) Plasmapheresis

We will present the players for the next round.  Final 16 to be presented on March 26th.