Andrew J Sauer MD

@AndrewJSauer

Cardiologist @MidAmericaHeart, building programs to implement therapies, advance discovery, and foster innovation for patients suffering from heart disease.

Kansas City, MO

pubmed.ncbi.nlm.nih.gov/?term=Sauer+An…

Born July 26

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Andrew J Sauer MD
@AndrewJSauer
Jun 27, 2021
My top ten tips for graduating fellows and faculty entering and continuing “early career” as I am transitioning into “mid-career”. A thread:
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Andrew J Sauer MD
@AndrewJSauer
Sep 8
Loop diuretics are threshold drugs, not direct nephrotoxins. In congested HF, underdosing can be worse than aggressively getting above the natriuretic threshold. Testani and colleagues have prospectively tested 1,000 mg/day furosemide-equivalent loop dosing, producing
Andrew J Sauer MD
@AndrewJSauer
Sep 8
You can load the kidneys with a gram of Lasix and still not hurt the kidneys directly. What hurts the kidneys is hemodynamic derangements like congestion or prerenal state plus other real nephrotoxins not loop diuretics
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Andrew J Sauer MD
@AndrewJSauer
Sep 8
You can load the kidneys with a gram of Lasix and still not hurt the kidneys directly. What hurts the kidneys is hemodynamic derangements like congestion or prerenal state plus other real nephrotoxins not loop diuretics
Jeffrey Wilson, MD
@jl35wilsonMD
Sep 7
Tale as old as time. Lasix nephrotoxicity: the Bigfoot of inpatient medicine. Too many fear it. Nobody’s actually seen it. Meanwhile the kidneys are drowning in venous congestion wondering why nobody will just give the F* Lasix. LASIX IS NOT NEPHROTOXIC. CIN doesn’t exist.
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Andrew J Sauer MD
@AndrewJSauer
Sep 2
The argument for studies needing to be finerenone vs “active comparator” falls flat when the so-called active comparator has not been shown to be better than placebo in these populations. The argument makes more sense for ASI vs nsMRA than it does for nsMRA vs sMRA.
Muthu Vaduganathan
@mvaduganathan
Sep 2
Spironolactone Outcomes RCTs in the Last 20y #TOPCAT (HFpEF) ❓❌ #SPIRITHF (HFpEF) ❓❌ #CLEAR (Post-MI) ❌ #BARACKD (CKD) ❌ #ALCHEMIST (ESKD) ❌ #ACHIEVE (ESKD) ❌ One day we will hopefully have a positive RCT to elevate eminence based medicine to evidence based medicine!
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Andrew J Sauer MD
@AndrewJSauer
Sep 2
I’m sorry but how does @escardio give MRA (without differentiating sMRA from nsMRA) a Class I for HFpEF? Where is the evidence for steroidal MRA? And even if we base on nsMRA, we have one study (FINEARTS-HF) and we somehow end up with a Class I? Make it make sense.
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