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Sunday, January 6, 2019

Use Caution When Reading Medical Blogs for Medical Truth

"If it is published (or in print), it must be true."

I received an email from a primary care provider asking me about a YouTube video I made years ago regarding the topic of aquapheresis to remove excess fluid in patients with heart failure. The provider wanted to offer this modality of care to her patient to help remove the excess fluid the patient was carrying in her legs. The patient found the video after Google searching for ways to remove fluid when diuretics failed -- so-called diuretic resistance.

My response was guarded. Although at the time aquapheresis was a great way to remove 50 pounds of fluid from a patient without affecting kidney function, it turned out, after a trial was performed, there was no difference using aquapheresis compared with diuretics (water pills). Why was there no difference? Patients ended up regaining the fluid lost during the expensive, invasive procedure. I wrote back that the best approach was to consult nephrology, and we could go through possible causes and suggested treatment options.

I was embarrassed that the video existed for so long, was still available, and requested it be removed. Why? Because it falsely implied that this method of fluid removal is an option that will work for patients with fluid overload when in fact it will not. Time proved that aquapheresis is not a good option; and my smiling face was up there, out there, suggesting otherwise!

This example of incorrect medical information available on the internet is just one of many that demonstrates the slippery slope of using medical blogs, YouTube, etc. to find the answers to medical questions. I'm sure the offering of incorrect information is not deliberate. But if not updated, incorrect data remains, even from sources you might otherwise trust.

What is the best way to get up to date medical information? Ask your doctor. With respect to the patient above, I consulted and found out the patient was ingesting a tremendous amount of salt which was contributing to fluid overload. The patient had chronic kidney disease and was diuretic-resistant secondary to dietary indiscretion. After following up with our ckd coordinator who helped educate the patient on proper foods to eat and with some water pill tweaks, we were able to decrease the patient's swelling while maintaining the kidney function.

The moral to this story is clear: as we embark on our medical blog journey, what may be current information at the time of publication may turn out to be the wrong advice. The internet can be used to supplement what your provider suggests or fact check the information. But I would suggest avoiding using data found on medical blogs as the ultimate source of truth. Confirm what you read from peer reviewed publications or review your discoveries with your medical provider.

That said, I will do my part to keep the information provided on this blog current. If or when a blog becomes outdated, I will do my best to add an addendum at the top of the article stating that medicine has changed, and it might be better to avoid reading said article and look elsewhere for more current data.

So let the medical blogging begin! We hope to provide you with interesting and informative topics to keep you healthy from a kidney perspective. Enjoy!