#NephMadness 2022: The Filtered Four

The Championship Matchup is nearing! How is your Bracket doing? How has the Blue Ribbon Panel done? Check out the Current Standings and tweet your reactions with #NephMadness!

We present the Filtered Four:

Current Standings Match Results#NephMadness | #FilteredFour

Lupus Region vs Animal House Region

Team Bear went back into hibernation mode for this game. Family Planning in Lupus Nephritis hit all their shots and stopped most of Bear’s shots for the easy win.

Family Planning in Lupus Nephritis wins 16-5

Comments from the BRP:

Patient-centered care will drive medicine in the future, and there is nothing more patient-centered than family planning (other than maybe getting eaten by a bear).”

“Tough choice but I think we need to pay more attention to the family planning needs of our patients and return them to their best health possible.”

“Bear will have to go back to hibernation.”

“My dear ursine category advances! Grin and bear it. When I was a medical student at University of Illinois one of the real pioneers in Bear Hibernation research was a professor (celebrity on campus), Ralph Nelson, and we all knew about his fame in this field. I knew nothing about water generation and urea recycling at that time, but it is ironic this all comes back to me 100 years later.”

“Hibernation is an amazing phenomenon. Maybe we will figure out how CKD patients can reutilize their urea.”

“Glad to see the family planning getting cut through; hope and realism – and some shared decision-making!!”

“People with ‘full house’ kidney pathology, also deserve a full house of children!”

“This region busted my bracket! Going with Family Planning.”

“Arrgh! As much as I love the Bear (and have waited patiently for them to be included in NephMadness and get the respect they deserve) I have to go with family planning. Definitely will have a larger impact on my day-to-day practice. Sorry, Bears!”

“Am I a broken record! Sickest patient you will ever save-hopefully-is a woman who is pregnant and has recurrent lupus. We do not do enough to prevent such awful situations.


Hemodialysis Region vs Inequities Region

If after the first match up in this region you thought it wasn’t possible for there to be an even larger blowout win for a team to make it to the Filtered Four, you’d be wrong!  Intradialytic Hypotension’s low energy and syncopal spells finally caught up with them right as Social Determinants of Health started to pick up steam both on the offensive and defensive ends of the court. 

Social Determinants of Health wins 19-2

Comments from the BRP:

Patients need more medicine – they need food, housing, employment, safe water/air – and until we address these we will fail in our care.”

“If we fix this, maybe dialysis becomes more infrequent.”

“Intradialytic hypotension has been on the agenda for only 40 years.”

“Any category that has ‘Social’ in it always goes far in NephMadness but I have to vote with my Dr. hat on. Forgive me for using this cliche but if “Access is the Achilles’ heel of dialysis,” intradialytic hypotension is the Achilles’ heel of finishing dialysis.

“Intradialytic hypotension may be the most common dialysis complication, but ameliorating the inequities in the social determinants of health could decrease the number of patients on dialysis.”

“A huge but vital pick for our community where there is too much inequity.”

“This is a strange match-up like smoking among high school students vs. climate change. Both are important problems but one is LARGER in scope than the other. Given the past two years, I’m headed for Social Determinants of Health.


Parasites Region vs Cardiorenal Region

The Cinderella run of Diuretic Resistance Treatments continues. Malaria proved to be no match for Diuretic Resistance Treatments strong offense. 

Diuretic Resistance Treatments Wins 14-7

Comments from the BRP:

“Malaria has the flashy star, but diuretic resistance has a long, deep bench that keeps coming back, and back, and back, and back.”

“If we’re talking about global inequities, we have to put malaria at the top.”

“Ugh, treatment wins over pathophysiology, that should never happen, besides I’m just tired of flozinmania”. “Black water fever” best AKI-related name ever, Malaria for the win here, but it won’t advance.

“The Emperor of all parasites.”

“Malaria is fighting a tough battle in the US, going with Cardiorenal treatments.”

“Using your magic wand to manage patients with difficult diuretic resistance is when nephrologists get to shine – people realize just how marvelous and smart we are!”


Neonatal Region vs Nephropath Region

Other Membranous Antigens fought valiantly till the end but they were just no match for the new kid on the block, Novel Devices for Neonatal HD

Novel Devices wins 13-8

Comments from the BRP:

“Molecular science is taking medicine to a whole new level with moves we have never before seen in Nephrology.”

“Novel devices advances? Seriously?”

“Taking other membranous with this, but no question I would pick novel devices if I were in pediatric nephrology.”

“We need innovation, so let’s push for it.”

“For the longest time, we had no idea what ‘the’ antigen was for membranous. Finding so many of them reinforces the growing recognition that we have to move away from histopathologic pattern recognition when we approach and treat glomerular diseases.”

“Antigens – makes me think of my vacuum cleaner – it’s just dirt – as viewed by the B cells.”

“Fascinating topic which I knew little about. Thank you to NephMadness for educating myself and my fellow Adult Nephrologists! Much respect to our pediatric colleagues. The level of complexity they encounter everyday is amazing.”

Huge thanks to Omar Taco @ErrantNephron for the scoreboard graphics!

Current Standings | Match Results | Saturated 16 | Effluent 8 #NephMadness | @NephMadness


US-based physicians can earn 1.0 CME credit and 1.0 MOC per region through NKF PERC (detailed instructions here). The CME and MOC activity will expire on June 1, 2022.

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