#NephMadness Choosing Wisely Campaign (#NCWC) –Women’s Health Region (#WomensHealthRegion)

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From ‘Prematurity’ to ‘Menopause’, life completes a full cycle in the Women’s Health region of Nephmadness 2018. Let it be the glomerular disease (preeclampsia) or dialysis & transplant (reproductive planning) or endocrine disturbances, this region has something for everyone, including our pediatric colleagues. The fact that all of the players in this region are of vital importance makes the choice even more difficult. 

For me, all are champions in their own way, but let’s try to peep into minds of #Blueribbonpanel (BRP) who will have the final word in crowning the champion. The fact that we have 6 wonderful ladies (out of 9 members) on the BRP is a testimony to the fact that this region is going to make it big.

Reproductive planning Vs Menopause in CKD

None of the BRP members have leaked any clues about how they might vote on the Twitter just yet. Therefore, we decided to do a deep dive and search the #WorldkidneyDay chat. This gives us some important clues. Fiona Loud (@FionaCLoud), Policy Director at Kidney Care UK, who is a kidney transplant recipient herself, has talked about Pregnancy in CKD.

She has actively advocated for the patient’s perspective related to pregnancy in CKD during the World Kidney Day chat (#WKDChat).

So it will be not a surprise if she votes for ‘Reproductive Planning’. Also, Eleanor Lederer (@EleanorLederer) had actively participated in the #askASN Chat and discussed reproductive issues in CKD

And she surely advocates pregnancy in glomerular diseases.

Quotes by Roger Rodby (@NephRodby) on reproductive planning are so famous that he was quoted in a presentation in India.

After reading his paper on “Disease-specific patient reported outcome tools for SLE” we are confident that he will favor reproductive planning. A Twitter and PubMed search for Deidra Crews (@DrDeidraCrews) didn’t reveal any clue directly related to these regions, however she has done some commendable work in the field of disparities in Chronic kidney disease and transplant which makes me believe that she will support reproductive planning in CKD as well.

Thus 4/9 votes for reproductive planning.

None of the PubMed/Twitter accounts of other BRP members had any other clues however, this post by Mark Reid (@medicalaxioms) might be the best clue we can get and is “right” to the point.

Menopause in CKD is an equally important topic addressing harmful effects on cardiovascular risk, bone health and on patients’ quality of life. But we expect ‘reproductive planning’ to be much more popular amongst the BRP. Also, Selection committee member Michelle Hladunewich (@mhladunewich) will try to persuade the BRP in the favour of Reproductive Planning as is evident in her important review on pregnancy in CKD and recently in ESKD.

A battle for the larger Global Impact: Preeclampsia Vs Prematurity

Two of the BRP members Fiona Loud and Mark Reid have a shared their experience with Preeclampsia in these tweets.

Eleanor Lederer has elegantly explained urinary findings is preeclampsia in this paper and she has also addressed this issue on twitter.

Tazeen Jafar’s work on young prehypertensives, on hypertension and cardiovascular health,  and on coronary artery disease in women is likely to make her inclined towards preeclampsia.

This makes it again 4/9 votes for preeclampsia.

The only BRP member who may lean towards ‘Prematurity’ is  Sarah Faubel (@doc_faubel) by the virtue of her work AKI in neonates. Bryan Carmody (@jbcarmody) has made an excellent argument in favor of prematurity in AJKD blog mentioning the long-term kidney outcomes, but unfortunately, he is not on the Blue Ribbon Panel.

Preeclampsia seems to be very popular amongst those who have already filled their brackets.

And that’s my poll for the Women’s Health Region

Bottomline – Women’s health region is here to win. Choose your pick wisely.

Follow #NCWC for daily region updates.

Read the full AJKD blog (and check out the full scouting report for the #Women’s healthregion here).

Submit your NephMadness brackets here.

Do let us know about your choices in the comments.

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