KIReports
@KIReports · New York, USA · joined 27 Sep 2017
Kidney International Reports | Official journal of @ISNkidneycare | Tweets by KI Reports Social Media team | 👀https://t.co/I6LNofZoQ2
14 278Followers
350Following
8 567Posts total
7.3KViews on collected posts
Ultimi post
Cerchiamo nuovi post…
@KIReports @AgavriloaeiB @assad_sm @DrAkshayaJ @ISNkidneycare @ISNeducation @sophia_kidney @MChanMD @brian_rifkin @CristinaDeReins I’m curious whether the vascular effect tracks citrate exposure itself or the transient drop in ionized Ca—does the study separate those mechanisms?
16 views · 0 likes
· 0 reposts · 0 replies
Open on X →
18/ Thank you for reading!
This paper is a reminder that dialysis prescriptions can have biological effects we may not predict from short-term biochemical markers.
Read the full KI Reports paper and keep questioning the mechanism.
🧵@DrAkshayaJ
https://t.co/0Kf2DgxL4i https:
143 views · 2 likes
· 0 reposts · 0 replies
Open on X →
16/ So, should we stop citrate dialysate? No.
This is a small, single-center study with a selected population and surrogate endpoint. But the signal is striking enough to justify larger studies with robust exposure assignment, imaging and clinical outcomes. https://t.co/3IOe0mXT
251 views · 4 likes
· 2 reposts · 1 replies
Open on X →
15/ The study also challenges an interesting disconnect: citrate dialysate can improve short-term serum calcification propensity, yet this study found faster progression of vascular calcification.
A better biomarker does not automatically mean a better tissue-level outcome.
23 views · 3 likes
· 0 reposts · 1 replies
Open on X →
14/ Limitations
5 patients may have had dialysate errors, based on unexpectedly ⬆️ citrate levels during the acetate arm
BAC is a surrogate
This study did not measure coronary/aortic Ca, calciphylaxis, CV events or mortality. We cannot conclude that citrate dialysate⬆️ CV risk
22 views · 2 likes
· 0 reposts · 1 replies
Open on X →
13/ Why is this surprising?
Citrate is a calcium chelator and can inhibit calcium phosphate crystallization. But citrate is also abundant in bone and participates in biomineralization. So its biological effect may depend on context, concentration and tissue environment.
98 views · 4 likes
· 1 reposts · 1 replies
Open on X →
12/ Then came the intriguing tissue finding. Citrate was detected in calcified human arterial segments. Citrate content correlated strongly with the amount of calcification (r=0.91). Estimated citrate content was ~0.8% of calcified tissue.
101 views · 3 likes
· 2 reposts · 1 replies
Open on X →
11/ The striking biochemical difference was citrate itself.
Pre-HD citrate was similar, but post-HD citrate rose to 383 vs 187 μM with citrate vs acetate. That >3-fold rise makes citrate a plausible contributor, but does not prove causality. https://t.co/LqhRvWfsmO
99 views · 3 likes
· 1 reposts · 1 replies
Open on X →
10/ Could Ca, phosphate or dialysis adequacy explain it?
Not really.
Pre-HD Ca and phosphate, dialysis time, Kt/V and dialysate Ca were similar. Citrate did lower post-HD ionized Ca and Mg, while HCO3 and PTH were slightly higher. https://t.co/wsGXACaW4O
103 views · 4 likes
· 1 reposts · 1 replies
Open on X →
9/ The finding was also seen as % change from baseline: 40%/yr with citrate vs 21%/yr with acetate.
The effect was significant whether patients started with citrate or acetate, supporting consistency within the crossover design. https://t.co/1CN138vDKC
92 views · 3 likes
· 1 reposts · 1 replies
Open on X →
8/ The headline result: BAC progressed much faster with citrate.
Median progression was 47 mm/yr with citrate vs 9 mm/yr with acetate. (P=0.0005)
22 of 28 patients had greater progression during citrate exposure. https://t.co/QYP9VmfrMI
30 views · 2 likes
· 0 reposts · 1 replies
Open on X →
7/ The cohort was small and highly selected: all 28 were women and African American.
Of 54 who started, only 29 completed the protocol, and 28 had usable BAC progression data.
The attrition matters when interpreting the magnitude of the finding. https://t.co/m0I1ZKNAuS
25 views · 4 likes
· 0 reposts · 1 replies
Open on X →
6/ Study design : This was a crossover study. 28 women on chronic HD with pre-existing BAC received citrate or acetate dialysate for ~1 year each, with mammograms at 6-month intervals.
Each patient therefore served as her own control. https://t.co/M6fbu3CNjf
26 views · 2 likes
· 0 reposts · 1 replies
Open on X →
5/ The study used breast arterial calcification (BAC) as a marker of medial vascular calcification, answer “A”.
BAC is visible on routine mammography and reflects medial rather than atherosclerotic intimal calcification. https://t.co/rwJRUGFYWb
100 views · 4 likes
· 2 reposts · 1 replies
Open on X →
4/ Poll : What is breast arterial calcification (BAC) most reflective of?
34 views · 2 likes
· 1 reposts · 1 replies
Open on X →
3/ Our #Xtorial is by Akshaya J @DrAkshayaJ, adult nephrologist from @CMCNephrology - No COI
#MedTwitter
@ISNkidneycare
Check out #KIReportsCommunity educational #blogposts at https://t.co/AgY6mXQU75.
FOLLOW US at @KIReports https://t.co/jdjZqH5pw1
210 views · 6 likes
· 2 reposts · 1 replies
Open on X →
2/ A new KI Reports study asks a provocative question : does citrate-containing dialysate affect vascular calcification in HD?
https://t.co/0Kf2DgxL4i
The answer was unexpected. Let’s look at the study, the signal, and what we should make of it. https://t.co/9lu2VmH0BO
206 views · 3 likes
· 0 reposts · 1 replies
Open on X →
1/ Hey #NephX! 👋
We’re back with a fresh #Xtorial from KIReports
Citrate dialysate is often viewed as a friend in dialysis : it chelates Ca, and inhibits Ca/Phos crystallization, But what if the effect on the vessel wall is not so simple?
https://t.co/0Kf2DgxL4i https://t.co/R
1.6K views · 22 likes
· 13 reposts · 2 replies
Open on X →
19/ We hope this #tweetorial improved your understanding of donor & recipient diabetes in KT. Please share! Thanks to @ManoleaA for authoring & @sophia_kidney for great feedback! @ISNkidneycare @KIReports
🔗https://t.co/V4jQZ0foqK
196 views · 2 likes
· 1 reposts · 0 replies
Open on X →
18/ Based on this evidence, does this change your perspective on using kidneys from donors with diabetes for transplantation? Please comment!
142 views · 1 likes
· 0 reposts · 1 replies
Open on X →
16/ Summary
⚡ Donor diabetes status alone did not worsen graft or patient survival
⚡ D+/R+ had the poorest graft and patient survival
⚡ eGFR was only slightly lower, with no difference in rejection
27 views · 0 likes
· 0 reposts · 1 replies
Open on X →
17/ Limitations
👎 Observational registry study, with potential residual confounding
👎 Relatively small D+/R+ group (n=189)
👎 No data on diabetes severity, duration, treatment or HbA1c
👎 Lack of kidney biopsy data to assess diabetic kidney changes
25 views · 1 likes
· 0 reposts · 1 replies
Open on X →
15/ Results: 2° Outcomes
⚕️ No significant difference in rejection between groups
⚕️ Diabetic donor kidneys were associated with only a minor reduction in eGFR
📉 The difference was small during the first 5 years post-transplant
📈 D−/R− recipients had the best eGFR over time https
28 views · 1 likes
· 0 reposts · 1 replies
Open on X →
14b/ Results: Graft Survival
👤 Diabetic recipients had reduced overall graft survival
📊 D+/R+: aHR 1.52 (95% CI 1.16–1.98)
📊 D−/R+: aHR 1.19 (95% CI 1.03–1.36) https://t.co/7GsxJebN3i
20 views · 1 likes
· 0 reposts · 1 replies
Open on X →
14a/ Results: Patient Survival
🫘 Death-censored graft survival was similar for most donor–recipient combinations
🫘 D+/R+ had significantly worse patient survival
📊 aHR 1.70 (95% CI 1.15–2.51)
🫘 D−/R+ had reduced patient survival
📊 aHR 1.38 (95% CI 1.18–1.61) https://t.co/rtkYEGur
23 views · 1 likes
· 0 reposts · 1 replies
Open on X →
13/ Results: Cohort & Follow-up
💊 11,343 kidney transplant recipients included
💊 Median follow-up: 6.16 years
💊 3,427 graft losses and 2,532 deaths
💊 Only 124 patients were lost to follow-up
24 views · 1 likes
· 0 reposts · 1 replies
Open on X →
12/ Results: Clinical Characteristics
The D+/R+ group was:
🔬 Older
🔬 More often male
🔬 Higher BMI
🔬 More cardiovascular & peripheral vascular disease
🔬 Mostly T2DM
For diabetic donors:
🫘 Older and higher BMI
🫘 More hypertension
🫘Similar terminal creatinine https://t.co/GlDCuRZh9
26 views · 1 likes
· 0 reposts · 1 replies
Open on X →
11/ Outcomes
🎯Primary: Death-censored graft survival
➕ Secondary: Patient survival, overall graft survival, acute rejection at 12 months, and post-transplant eGFR over time
29 views · 1 likes
· 0 reposts · 1 replies
Open on X →
10b/ Methods
🎗️ Inclusion: First-time adult (≥18 years) recipients of a deceased-donor kidney transplant
❌ Exclusion: Living-donor, repeat, and multi-organ transplants; missing donor or recipient diabetes status
30 views · 1 likes
· 0 reposts · 1 replies
Open on X →
10a/ Methods
💽 Data: Australia and New Zealand Dialysis and Transplant Registry (ANZDATA)
🕐2003–2022
🫘 11,343 first-time adult recipients of deceased-donor kidney transplants
🔄 Compared 4 donor–recipient diabetes combinations: D−/R−, D−/R+, D+/R−, D+/R+
34 views · 2 likes
· 0 reposts · 1 replies
Open on X →
Rispetto ad account della stessa dimensione
41 post degli ultimi 90 giorni, accanto alla fascia di 10K–100K follower. raggiunge meno persone dei pari, ma le coinvolge molto di più.
Visualizzazioni mediane61questo account950mediana per 10K–100K
Copertura, %0.43%questo account3.31%mediana per 10K–100K
Interazione, %6.12%questo account1.88%mediana per 10K–100K
| Metrica | Questo account | Mediana per 10K–100K | Rapporto |
|---|---|---|---|
| Visualizzazioni mediane per post | 61 | 950 | 0.06× |
| Copertura (visualizzazioni ÷ follower) | 0.43% | 3.31% | 0.13× |
| Tasso di interazione | 6.12% | 1.88% | 3.27× |
Altri account di questa fascia → Confronta con un altro account → Come sono costruiti questi parametri →
Growth & engagement
How the posts we collected actually performed: views and reaction rate post by post, what the audience did with them, and where the follower count goes.
Views per post
1006 Sep
26
25
30
92
103
99
101
98
22
23
251
143
16
Last 14 collected posts, oldest on the left. The scale is logarithmic: one post can outrun the rest a hundred times over.
Engagement rate per post
7.00%6 Sep
11.54%
20.00%
10.00%
5.43%
5.83%
5.05%
5.94%
6.12%
13.64%
17.39%
2.79%
1.40%
0.00%
Reactions — likes, reposts, replies and quotes — divided by views. Median for 10K–100K accounts is 1.88%.
What the audience does
Likes58.1%86 in total
Reposts18.2%27 in total
Replies18.9%28 in total
Quotes2.7%4 in total
Bookmarks2.0%3 in total
Share of every reaction we collected for this account. Replies mean argument, reposts mean endorsement, bookmarks mean the post was worth keeping.
The follower curve appears once this account has two daily snapshots — we take one a day, and this one is on its first.
Account simili
danış ✓
@birgencinumidi
28.6K followers
· 34.9K posts
NΞO ✓
@NeoCallss
28.6K followers
· 6K posts
MakeHerEatAPlanB
@BvndoGxd
28.6K followers
· 96.3K posts
Mutant Hounds
@MutantHounds
28.6K followers
· 3.2K posts
Zara baloch ✓
@Zara_Baloch26
28.6K followers
· 15.7K posts
Twitched News ✓
@TwitchedNews
28.6K followers
· 2.5K posts
The Politics Hour with Kojo Nnamdi
@politicshour
28.6K followers
· 54.6K posts
VerityAI ✓
@BuildOnVerity
28.6K followers
· 216 posts