Patrick Pun, MD MHS FASN

Nephrologist and Clinical Researcher at Duke University School of Medicine/Durham VA Medical Center

[Patrick Pun, MD MHS FASN @virtualpun]

103,000+ Americans wait for transplants. 25% of living donors face insurance discrimination. Solution? Living Donor Protection Act (S.1552/HR 4582 & 4583). Bipartisan, zero cost, saves lives. Pls @fousheefornc cosponsor #LDPA #OrganDonation #Congress

[Patrick Pun, MD MHS FASN @virtualpun]

13 people die daily waiting for organs while heroes willing to donate face insurance discrimination & job loss. @fousheefornc pls cosponsor the Living Donor Protection Act S. 1552/ HR4582 & 4583 #LDPA #OrganDonation #SaveLives

[Alvin Jeffery @Nurse_Alvin]

So excited to celebrate @VUMChealth @WesElyMD & Brenda Pun for their Pioneering Spirit Award at #NTI2023 @AACNme

[Chris Carroll MD @ChrisCarrollMD]

Brenda Pun and @WesElyMD receiving the Pioneering Spirit from @AACNme! #NTI2023

[Joel M. Topf, MD FACP @kidney_boy]

Signal for sudden cardiac death (SCD) with azithro and with levofloxacin. #BestofNephJC #KidneyWk

[Patrick Pun, MD MHS FASN @virtualpun]

@JeromeAdamsMD @kidney_boy Wholeheartedly agree. Awareness of the problem is the first step. We also need standardized protocols for dialysis unit CPR.

[Patrick Pun, MD MHS FASN @virtualpun]

@MentaculusMap @kidney_boy Thanks for this thought. This was addressed in our study and it was indeed true white cardiac arrest patients dialyzed in better resourced clinics. However, accounting for these differences only increased the magnitude of the disparity

[Joel M. Topf, MD FACP @kidney_boy]

Black dialysis patients with cardiac arrest are less likely to receive CPR than white patients. OR 0.4!

W.T.F.

#KidneyWk

[Joel M. Topf, MD FACP @kidney_boy]

Why $950 per cancer patient
Why $560 per Alzheimer’s patient
Why $18 per kidney patient

#KidneyWk

[Duke Kidney @DukeKidney]

.@shofacker @virtualpun and colleagues in Nephrology Nursing Journal

Barriers and Facilitators to Performing Cardiopulmonary Resuscitation During Treatment in Outpatient Hemodialysis Clinics: A Qualitative Study

https://t.co/Teo0uVkYhg

[Susan Quaggin @SusanQuaggin]

Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes | NEJM. When it 🌧 sometimes it pours in the most positive way!! Another #win for the kidney community! can’t wait to check out the late breakers ⁦@ASNKidney⁩ #KidneyWk https://t.co/UBEUjo6u18

[Duke Kidney @DukeKidney]

.@virtualpun @DCRINews and colleagues in @CJASN

Trends in Use and In-Hospital Outcomes of Subcutaneous Implantable Cardioverter Defibrillators in Patients Undergoing Long-Term Dialysis

https://t.co/rdsDHV8xCJ

[Sam Hofacker @shofacker]

Hi #Medtwitter, #Nephtwitter! I’ve wanted to put together a tweetorial for a while, and now that my first manuscript is published, here are a few things I’ve learned about cardiac arrest in patients on dialysis, our resuscitative response, and #healthequity. Thread:

[Patrick Pun, MD MHS FASN @virtualpun]

@DrDeidraCrews @Nephro_Sparks @Cervantes_Lily1 @AmakaEMD @MarlenaCFisher @JHUNursing Thanks much @DrDeidraCrews @AmakaEM @Cervantes_Lily1 for discussion! In a recent qualitative study with HD staff, uncertainty about code status wasn't cited as major barrier to CPR, whereas uncertainty about how to best do CPR during HD was. NKF poster here.

[Patrick Pun, MD MHS FASN @virtualpun]

New research led by former @DukeMedSchool student @shofacker / @MGHMedicine intern

Important racial disparities in CPR initiation observed in US dialysis clinics

"Of all forms of inequality, injustice in health is most shocking and inhuman" Dr MLK Jr

https://t.co/CqRoPafL3g

[Patrick Pun, MD MHS FASN @virtualpun]

@VUMCKidney @VUMChealth @VUMC_MD @VUMC_Medicine @VUMCMedicineRes Very sad news. It was a privilege to train under Dr Stone and his love for medicine and learners will always be an inspiration!

[Patrick Pun, MD MHS FASN @virtualpun]

But If we have stopped using gadolinium in ckd due to risk of nsf, how can we have any data that risk in ckd is “sufficiently low or nonexistent”? Do we need more evidence specifically in ckd pts before we subject our patients to gadolinium without informed consent?

[Patrick Pun, MD MHS FASN @virtualpun]

The 2017 American College of Radiology guidelines on contrast say that the risk of NSF with class II gadolinium agents is "sufficiently low or possibly non-existent" and recommend that no informed consent is needed for CKD pts. Does absence of evidence= absence of risk? #AskASN

[Patrick Pun, MD MHS FASN @virtualpun]

@nephrothaniel @kidney_boy I think RCTs now made possible by new tools including implantable loop monitors and wearable patches to use as proof of concept. Stay tuned

[Patrick Pun, MD MHS FASN @virtualpun]

@jddneary @hswapnil Agree but perhaps an opportunity. In gen pop, pacemaker detected subclinical AF increas CVA risk 2.5x-- who knows in our patients? #AskASN