My NCAA Bracket has now moved beyond dead. None of the Final Four show up in my picks. I can almost hear taps playing softly in the background as I write this post.
However, I am kicking butt in Nephmadness! The votes came in and we are down to 8 teams, 7 of which I picked (and 6 of which show up in my original brackets). Let's go over the remaining Elite Eight and my picks for the Final Four.
- Glomerular Regional pits a classic 1-2 match-up with the Medicare ESRD Benefit taking on Randomized Clinical Trial. I am going with the favorite here, because payment for ESRD treatment makes nephrology possible. While RCT remains the gold standard for medical research, its significance to nephrology just cannot hold a candle to the benefit.
- Proximal Tubular Regional also features a 1-2 match-up with the HEMO trial taking on the APOL1 gene. This match could go either way, but I pick the HEMO Trial which guides treatment every minute of every day in the US. The APOL1 gene explains the excess burden of kidney disease in African Americans, but we cannot yet use it for treatment improvement. The edge thus goes to HEMO!
- Loop of Henle Regional includes the champion Captopril (1) taking on upstart UpToDate (6) after its minor upset of ASN Kidney Week. No question in my mind; the most important non-dialysis treatment for most chronic kidney disease patients is captopril (as a representative of the ACE inhibitors) and I expect it to squash UpToDate. The latter is a valuable reference, but an electronic text cannot delay the onset of end-stage kidney disease unless it tells you to prescribe Captopril.
- Collecting Tubule Regional once again features a 1-2 match-up between MDRD eGFR Equation and Kidney Transplant. The former is useful (although I predicted a second-round exit for it), but Kidney Transplant is the closest thing we have to a cure right now.