Missing all the overwhelming amount of science coming out of #KidneyWk? The #NephJC crew has got you covered Day 2 edition www.nephjc.com/news/kidneyw... via @nephroseeker.medsky.social & moi

Got #KidneyWk FOMO like @nephroseeker.medsky.social ? We got you covered with daily coverage of the simultaneous publications! www.nephjc.com/news/kidneyw...

There is some concern about cancers with glipination - thyroid, pancreas, others - nothing seen so far in trials (but rare outcomes are hard to capture) this study in JAMA Oncology didn't find anything much worrisome jamanetwork.com/journals/jam... but!

A study that I have been thinking about a lot is this pilot study/case series 100-200 mg of spiro in diuretic resistant, acute decompensated heart failure looked safe and effective Any heart failure/diuretic experts know if a larger trial was ever completed? pubmed.ncbi.nlm.nih.gov/31307058/

Always challenged by my occasional (generally intentional) nihilism when it comes to treating frailty & multi morbid patients #eraedta2025

Join us tonite 5/13/25 9pm EST only on #Bluesky #NephSky #NephJC We are discussing 2 studies on the use of desmopressin/ddAVP prophylactically to prevent post kidney biopsy bleeding. Biopsy Blood🩸, ddAVP Sweat💦 and Nephrologist Tears😢 www.nephjc.com/news/ddavp

Efficacy and safety of finerenone in IgA nephropathy: an observational multicentre study doi.org/10.1093/ckj/...

Physiologically it never made sense to fluid restrict HF patients without hyponatremia. No difference in outcomes in 👇study, which was predictable. At the same time - from a study perspective - the actual difference in fluid intake between groups was <300cc/day. pubmed.ncbi.nlm.nih.gov/40159556/

Tomorrow night 3/25/25 at 9 pm EST, only on Bluesky #MedSky #NephSky We will discuss the latest guidance from @kdigo.org on #ADPKD. Topics including screening, cerebral aneurysms, med therapy, KRT, ADPLD and lifestyle recommendations You have to be there, I in-cyst 🫣 www.nephjc.com/news/adpkd-k...

Fantastic opportunity 👇

Two things, this is finally a small RCT for GLP1 meds and alcohol use disorder. Reductions were noticeable and highlights the need for a big RCT for this. Secondarily a very small cohort(n=13) who smoked cigarettes also had a reduction in smoking in this study. Lets get more studies on both!

I learned a lot about subclinical primary aldosteronism reading this piece from the unsinkable @brianrifkin.bsky.social 👇 www.nephjc.com/news/primary...

Prof IgA Jon Barratt presented some phase 1/2 open label data on another APRIL inhibitor (after sibeprenlimab and atacicept) #ISNWCN

At the second high impact trial session At #ISNWCN Vlado Perkovic on ziltivekimab in CKD Covered data on colchicine and Canakinumab (not on market despite CANTOS) Phase 2 data from RESCUE shows huge effect on hs-CRP

Patient self-directed sliding scale furosemide is an underutilized tool in CHF management Can a simple weight-based dosing strategy empower patients to manage CHF, prevent exacerbations, and reduce ED visits? Let's dive in! 👇 #medsky #pharmsky #cardiosky #EMsky #GPsky #MedEd 1/

need some bland, meaningless conclusions for your review article? use these! these conclusions are so nonspecific that they're perfectly applicable to any ICU topic 👌 you're welcome

more external validation of the anti-nephrin story academic.oup.com/ckj/advance-... in @ckj-era.bsky.social In around 20% MCD - but also some FSGS (suggesting again these arbitrary pathologic descriptors are not useful) #NephSky

I like this from Rob Quinn and Pietro Ravani pubmed.ncbi.nlm.nih.gov/24327565/ in @ndt-era.bsky.social to show the various selection biases in most studies of vascular access #FistulaLast

BREAKING NEWS: The FDA has approved Ozempic for patients with chronic kidney disease. This means the popular injection can be used to reduce the risk of kidney disease worsening, kidney failure and death from cardiovascular disease in patients with chronic kidney disease and diabetes.

Finally! Antibiotics are not non-inferior to appendectomy despite a generous 20% non-inferiority margin They are actually inferior: www.thelancet.com/journals/lan... in the @thelancet.bsky.social #MedSky

The efficacy and safety of half-dose glucocorticoids combined with #rituximab versus high-dose glucocorticoids for initial treatment of minimal change disease: a single-center experience #nephsky www.frontiersin.org/journals/pha...

Proposed age-adjusted eGFR thresholds for CKD 👇 #Nephpearls #NephSky eGFR 75 for ages <40 years eGFR 60 for 40-65 years eGFR 45 for >65 years 👉 link.springer.com/book/10.1007... 👉 pubmed.ncbi.nlm.nih.gov/31506289/

Nice write-up of practise changing study by @osduvar.bsky.social for #nephjc Meta-analysis of big name RCTs (AASK, IDNT, RENAAL etc) shows initiating RASi slows CKD progression even when already at stage 4 by more than I’d have guessed - just can’t believe no one had done this analysis before!

The UKKA AKI report is out, h/t @beckybonfield.bsky.social @ukkidney.org www.ukkidney.org/sites/defaul... (PDF) Incl. - Don’t call RAASi nephrotoxic - Don’t delay contrast imaging - Sick day rules are mostly 🐴 💩

European Medicines Agency clears the way for Ozempic's label to list a kidney disease indication. https://buff.ly/4fjah4b #ozempic #kidneydisease #nephsky

Another example of how Decreasing incidence + Decreasing mortality = Increasing prevalence HIV edition from the GBD folks www.thelancet.com/journals/lan... #MedSky #EpiSky

Great as ever from Amy.

I don’t think so Have a listen to www.nephjc.com/freelyfilter... Nav breaks down the data well. The UBI trial results are unbelievable. The same group did the Sevelamer keeps people alive forever RCTs.

Nice to see our blogpost on how to manage DKA in anuric patients on dialysis up to >20,000 views👇 www.renalfellow.org/2021/10/30/d...

"Drink more water!" It's the easiest health advice around. Tired? Headache? Trying to be like Tom Brady? Just drink more water. But as a nephrologist, I get asked all the time: How much is the right amount? And the truth is... we don't really know. 🧵

My Old thread from this. Not sure if the #tweetorial format transfers over as well bsky.app/profile/capt...

When diuretics fail, the albumin-furosemide combo is often considered—but is it science or just tradition? Evidence for its routine use is shaky at best. Are we truly helping our patients or just inflating costs and risks?

New today - @thelancet.bsky.social DM/Endo GLP1RAs and kidney/CV outcomes - SR from @sunilbadve.bsky.social Tuttle, Perkovic et al www.thelancet.com/journals/lan... ($🔒) - with/out DM - kidney outcomes (not albuminuria)

None of the trials initiated at GFR below 20 which ties the gl writers hand (Though flozins not stopped below 20) Now DAPA-advanced CKD presented at #KidneyWk which started at GFRs 10-30 suggest slowing GFR >> GFR dip (paper not published yet) RENAL LIFECYCLES awaited!

Hyponatremia physiology in a minute, forty seconds. #IsHomeostasisAJokeToYou youtu.be/Q93D_SjaOEY

It's probably the later. Effects of SGLT2i on CV, kidney and mortality outcomes are consistent irrespective of metformin use Some useful context on UKPDS and comparative effectiveness across eras in the discussion here: dom-pubs.pericles-prod.literatumonline.com/doi/10.1111/...

Great blog post from Brian highlighting that progress in diabetic nephropathy is far from equal.

Follow the blue: represents CKD-4 and metformin 500 mg QD. Found on SearchNephX.com and courtesy of x.com/BasuNephro

The pendulum regarding SGLT2 inhibitors increasing UOP via natriuresis or an osmotic diuresis has gone back and forth with conflicting studies. 👇 Trial shows improvement in natriuresis with dapagliflozin added to furosemide in pts with ADHF pubmed.ncbi.nlm.nih.gov/38569758/ #nephsky #cardiosky

this is an older look (but it’s their journal - so likely influential) www.canadianjournalofdiabetes.com/article/S149... this was a recent Taiwanese TTE (i don’t see dose mentioned) www.thelancet.com/journals/ecl...

When many of these interventions are tested in larger multicentre trials, the estimate of effect is not commonly replicated. ccforum.biomedcentral.com/articles/10.... #emimcc

The other interesting observation from Canadas diabetes guidelines - I’ve never seen metformin 500mg once daily used in eGFR 15-30. I assume must be thought to be safe & effective if made the guidelines - anyone know the best data to support? #askrenal

Great thread from Dylan on Canada’s new diabetes guidelines. Their guidelines say you can’t initiate SGLT2i at eGFR<20 - but I’ve just taught all our local north east England renal registrars the opposite. Quick thread to justify why I think I’m right👇 #NephSky

Going to try and live skeet the Diabetes Canada Clinical Practice Guidelines Update from #DCCSEM24 in Halifax, updated this year was the type 2 diabetes pharmacology, CKD, and type 1 diabetes chapter, and a new MASLD chapter was written too but that is tomorrow

Key tests here

“Patients who are diagnosed with ACE inhibitor-induced angioedema should be tested for hereditary angioedema types 1/2“ So far, not something that I have been doing … #whatilearnedtoday #nephsky #skyneph onlinelibrary.wiley.com/doi/10.1111/...

This is a great study. Surprised, it wasn't looked at before. Have seen many docs, even neph, DCing or not initiating RAAS-I in CKD 4. www.acpjournals.org/doi/10.7326/... @kidneyboy.bsky.social @hswapnil.bsky.social #nephsky #medsky

Stunning #NephJC

📌SGLT2i in KTR with diabetes 📓Nature Communications 📝Analysis of TriNetX database Propensity score matched n=1970 per group ~70%⬇️ mortality ~50%⬇️ MACE ~50%⬇️ MAKE ✅benefit seen +/-ACEI ❌ increase in UTI (Fungal or otherwise) www.nature.com/articles/s41...

In 2019, we wrote a paper showing that patients with left ventricular thrombus have a long-term risk of embolism, extending to at least 8 years. We were puzzled by the finding… #CardioSky www.ahajournals.org/doi/10.1161/...