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Get inside the black box of transplant medicine as we discuss: Kidney transplant for the internist. Join Dr. Cyrus Askin, @askins_razor, one of our Curbsiders Correspondents, as he teams up with the fine folks from freely Filtered in this NephMadness episode exploring topics in kidney transplant! On this show, the gang turns to Dr. Samira Farouq, @ssfarouk, a Mount Sinai transplant nephrologist, to take the reins during this guided tour of concepts in transplant medicine that internists should be familiar with. During this episode, you’ll learn about indications for kidney transplant, immunosuppressive agents, what to watch out for in your post-transplant patients and so much more! And of course, we will talk a little NephMadness as we wrap things up. So maybe you need to learn about kidney transplant or perhaps you’re still mourning the loss of March Madness 2020 - either way, we encourage you to take a listen and hope you’ll enjoy!

Listeners can claim free CE credit for this episode at curbsiders.vcuhealth.org (goes live at 1200 ET on the episode’s release date). 

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It's time for NephMadness 2020! Fill out your bracket before the April 30, 2020 deadline and be sure to list The Curbsiders as your team. 

1. Read this year’s region posts here.
2. Submit an individual or team bracket here.
3. Discuss your picks with #NephTwitter!

• Written and Produced by: Cyrus Askin MD, Matthew Watto MD and the Freely Filtered Crew
• Infographic: Cyrus Askin MD
• Cover Art: Kate Grant MBChB DipGUMed
• Hosts: Cyrus Askin MD, Joel Topf MD, Samira Farouk MD, Swapnil Hiremath MD, Jennie Lin MD & Matt Sparks MD
• Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com

We are excited to announce that the Curbsiders are now partnering with VCU Health Continuing Education to offer continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org for more information.

• 00:00 Announcement, Intro to Freely Filtered and NephMadness
• 04:00 Case of advanced CKD; Who/when to refer for transplant
• 12:05 Benefits of renal transplant
• 16:22 Counseling patients with advanced CKD about transplant and a bit on living donors
• 20:40 Medications after transplant; Drug-drug interactions
• 25:50 Dr. Sparks’ 30 second exam for the transplant patient; Diarrheal illness
• 32:07 Calcineurin inhibitor levels
• 36:42 Prophylaxis for long term complications
• 40:21 Allograft rejection; BAMF criteria
• 50:40 Cardiovascular risk; Statins
• 56:11 Malignancy after kidney transplant
• 60:00 NephMadness Transplant Region: Biomarkers vs Biopsy
• 72:23 Outro

Listeners will learn valuable skills to assist in the management and counseling of pre- and post- kidney transplant patients.

After listening to this episode listeners will…  

1. Recognize the criteria for kidney transplant referral and evaluation, as well as the importance of referring a patient as soon as they are eligible. 
2. Be able to counsel a patient regarding what to expect before, during and after the transplant process.
3. Know the main classes of medication used after patients have received transplants, to include their side effects and any relevant monitoring. 
4. Be familiar with the different types of rejection, the clinical signs/symptoms of rejection and the utility / limitations of kidney biopsy.
5. Be able to discuss the post-transplant complications of kidney transplantation (cardiovascular, malignancy, etc.) as well as what type of prophylactic medications should be considered in these patients.

Drs. Cyrus Askin MD, Samira Farouk MD, Swapnil Hiremath MD, Jennie Lin MD & Matt Sparks MD report no relevant financial disclosures. Dr. Topf has received honoraria from Astra Zeneca and Cara Therapeutics. He is joint venture partner in Davita Dialysis centers receiving dividends. The Curbsiders report no relevant financial disclosures. 

Cyrus A, Topf J, Farouk S, Swapnil H, Lin J, Sparks M, Watto MF. “#210 NephMadness: Kidney Transplant for the Internist”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. April 27, 2020