#NephMadness 2023: The Effluent Eight

In this round, the region champions are named. Did the Blue Ribbon Panel keep you alive or break your heart and your bracket after just the first round? Check out the Current Standings and tweet your reaction and score with the hashtag: #NephMadness

We present the Effluent Eight:

Current Standings Match Results#NephMadness | #EffluentEight

And before we begin, special thanks to Omar Taco @ErrantNephron for the scoreboard graphics!

Access to Kidney Transplantation

Two strong teams were forced to play each other in the first round. Organ Pool showed that coming in with an inventive game plan can make all the difference. Easy win for Organ Pool over Journey to the Waitlist

Organ Pool wins 7-2

Comments from the BRP:

Both of these options had elements that were very US-centric.”

“While the waitlist journey is long and arduous, there still remains a dearth of available organs for those who are currently listed. Working on the current organ pool with expanded-criteria kidney donation and including hepatitis C kidneys have already had a significant impact on transplantation. Solving the organ shortage (perfecting xenotransplantation or an artificial kidney) would probably have effects upstream at making waitlist requirements less stringent.”

“Both teams have essential strengths and strategies. It was a tough choice. However, in the end, you need the available organs, i.e. the organ pool players, to win the access to transplant game!”

“Very close decision. My choice was swayed with the organ pool inclusion of Xenotransplantation, which I’m not (yet) ready to receive as a treatment.


Heart Failure Devices

Team Cardiac Devices in ESKD proved no match for the endurance of Team Cardiac Devices in AKI.  Team Cardiac Devices in AKI with the easy win!

Cardiac Devices in AKI wins 7-2

Comments from the BRP:

The ESKD examples seem likely to be financially restricted, as much as anything else.”

“Drs. Bergeron and Triozzi wrote a phenomenal summary. The use of cardiac-assist devices is ever increasing – and patients who we’ll encounter with AKI from infection/hemolysis/GN will follow. How do we best manage their care with outpatient RRT if they reach the point of needing dialysis – especially when it’s so challenging inpatient?


Thrombotic Microangiopathy

Team Secondary TMA’s deep bench proved no match for Team Primary TMA. Team Secondary TMA with the regulation win!

Secondary TMA wins 6-3

Comments from the BRP:

Much more excitement in the secondary forms!”

“To eculizumab or not to eculizumab? That is the question.”

“The secondary thrombotic microangiopathy players have street smarts and make a lot of gutsy and surprising moves. However, the primary thrombotic microangiopathy are a bit more practiced and disciplined in their game.


IGA Nephropathy

The firepower of Immunosuppression in IgAN proved no match for the methodical, steady play of Non-Immunosuppression in IgAN. Non-Immunosuppression in IgAN with the big win!

Non-Immunosuppresive Therapy for IgAN wins 7-2

Comments from the BRP:

Hopefully a step forward for IgAN (Immunosuppression for IgAN).”

“IgA nephropathy? I’m definitely cheering for the team on steroids!


Mineralocorticoid Receptor Antagonists

The newcomer Nonsteroidal MRA’s energy on the court proved no match for the older team of Steroidal MRA. The question is, can Nonsteroidal MRA be stopped?

Nonsteroidal MRA wins 9-0

Comments from the BRP:

“Something new is always more enticing.”

“MRAs? I’m voting for the team not on steroids this time.”

“Nonsteroidal MRA players are the new kids on the block. They bring ability without as many distractions as the steroidal MRA players.”



Team Chemotherapy-Associated HypoMg might as well not have even come out of the locker room. Team ICI-Associated AKI rolled over them for the easy win.

ICI-Associated AKI Wins 9-0

Comments from the BRP:

“ICPIs are becoming standard of care for many cancers and are generally less toxic than conventional chemotherapy. ICPI-associated AKI events are going to be something that every nephrologist and oncologist have to be comfortable managing because ICPIs are going nowhere.”

Transitions of Care

Supportive Care for Kidney Failure’s skills on the court proved no match for Pediatric to Adult Care. Easy win for team Supportive Care for Kidney Failure!

Supportive Care for Kidney Failure wins 7-2

Comments from the BRP:

“Weight of numbers (Supportive Care for Kidney Failure)”

“You can give and receive to a larger overall community (Supportive Care for Kidney Failure).”

Transgender Health

These two strong teams made for an exciting tournament game. Evenly matched, these two teams kept the score close till the very end when Kidney Care for the Transgender Patient was able to pull away with the win against Gender-Affirming Care!

Kidney Care for the Transgender Patient wins 6-3

Comments from the BRP:

“This is a relatively new set of players. It was an extremely tough choice and I vacillated in which set of players to choose. However, as this team is building, one needs to start with an excellent set of basic players that represent the principles of the team. Have strong transgender kidney care is the starting point and baseline. So at this point in building the team, I chose Transgender Kidney Care, with the anticipation of adding Gender-Affirming Care players in future drafts.”

“Same as with transitions of care – you can give and receive to a larger overall community. (Gender-Affirming Care)”

Current Standings | Match Results
#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, 2023.

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