📢 New in CJASN: pooled analysis of all completed phase 2/3 RCTs in #IgAN 🔹 4 drug classes (steroids, B-cell, complement, non-immunological) 🔹 All ↓ proteinuria ≥30% 🔹 All improved GFR slope 🔹 Biggest benefit: B-cell therapies journals.lww.com/cjasn/abstra...

If you want to support #NephJC and get some cool merch, check out www.nephjc.com/merch...#NephJC

Attending Kidney Week 2025? Check out details about the plenaries. We'll be there, at Booth 2234! #kidneywk #nephrology #nephsky @asnkidney.bsky.social www.docwirenews.com/post/asn-rev...

Your abstract could be next to inspire change in kidney care. When you share your research at #ISNWCN, the benefits go far beyond the presentation. • Global visibility • Peer recognition • Publication opportunity Submit your abstract today ➡️ http://lite.spr.ly/6...#ISNWCN,

😎Check out the VA for HiLO by @sejalplakhani.bsky.social 🆒 This should be quite the discussion, don't miss it! #NephJC #NephSky www.nephjc.com/news/2025/8/4/the-hilo-trial-visual-abstract

🌏 Join us at WCN'26 in Yokohama! 🧠 Learn from global experts 📈 Share your research 👥 Connect with peers 📅 Abstracts due Oct 22 🎬 #ISNFilmEvent submissions by Nov 5 ✈️ Travel grants & registration open Sept 16 🔗 http://lite.spr.ly/6...#ISNFilmEvent#ISNWCN

SGLT2i in CKD: impact beyond kidneys 🔻 15% all-cause hospitalizations ✅ Consistent regardless of eGFR, UACR & diabetes 🏥 ~36 fewer hospitalizations per 1000 pt-years Large absolute gains for patients & health systems Meta-analysis in @asnpublications.bsky.social journals.lww.com/cjasn/pages/...

Only reason to sequence the RASi first is that they are good antihypertensives (but note the BP effect in the combo arm of #confidence) #nephjc But no matter the sequence, the goal should be to have someone on the four pillars in less than 6 months

@nephjc.bsky.social joining late, hi everyone 👋 nephrologist in Sydney, exec committee member of FIND-CKD, consult to both BI and Bayer and a number of other similar companies

Check out the Kidney Compass 🎙️ from @brendonneuen.bsky.social and Shikha Wadhwani with Rajiv Agarwal on CONFIDENCE podcasts.apple.com/ca/podcast/k... Prep for #NephJC tonight

Randomized, Double-Blind, Placebo-Controlled Phase 2a Study Assessing the Efficacy and Safety of Felzartamab for IgA Nephropathy doi.org/10.1016/j.kint.2025.05.028 #OpenAccess #IgAN #felzartamab #IgANephropathy

Following on CONFIDENCE (on #NephJC tomorrow) The design and baseline data from MIRO-CKD trial academic.oup.com/ndt/advance-... N = 614, balcinerone, dapagliflozin Urine ACR outcome #NephSky

We don’t get to discuss every important study that comes out on #NephJC Hence #NephJCShorts www.nephjc.com/news/nephjc-...

The #NephJC editorial team knows that plenty of papers deserve attention between our bi-monthly, full-length discussions ✨Enter #NephJCShorts - quick hits with a critical eye 🦅 on high-impact reads www.nephjc.com/news/nephjc-... #MedSky #NephSky

From Rivka Galchen’s article in @newyorker.com: “The kidney, a tremendously under-celebrated organ, basically does four-dimensional sudoku with ions.” And that’s how I’m going to explain it from now on.

In the CONFIDENCE trial in persons with chronic kidney disease and type 2 diabetes, combination therapy with finerenone and empagliflozin led to a greater reduction in the urinary albumin-to-creatinine ratio than either drug alone. Full trial results: nej.md/4jEVbbk #ERA25 #MedSky #Nephrology

Huge Danish trial of nudges Patient level (N 22,000) + practice level (1500 practice cluster with N 28,000 pts) To increase RASination & Flozination www.ahajournals.org/doi/abs/10.1... in @ahajournals.bsky.social at #ERA25 Absolutely null effect - is the baseline too high to improve upon?

Baseline use of #SGLT2i in recent trials enrolling patients with #IgAN: Listen to the full podcast discussion between me, Shikha Wadwhani and Vlado Perkovic: hcplive.com/view/kidney-... #ERA25 #kidneycompass #sibeprenlimab #VISIONARY

Optimizing the timing and sequencing of guideline-directed medical therapy for T2D and CKD ca. 2024 from @brendonneuen.bsky.social #ERA25 🇦🇹 #Nephpearls #Cardiorenal #NephSky 👉 pubmed.ncbi.nlm.nih.gov/40179265/

How will the #CONFIDENCE trial shape practice in #CKD + #T2D? I spoke with PI, Rajiv Agarwal, after his #ERA25 late-breaker on why a sequential approach may be doing our patients a disservice Full episode: hcplive.com/view/kidney-... #KidneyCompass #SGLT2i #finerenone

Inside story from PI Rajiv Agarwal: #CONFIDENCE done in 2 parts because of early safety concerns re simultaneous SGLT2i & nsMRA 🔹 Part A: higher GFR with ABPM after first dose 🔹 Part B: Main study without ABPM after 👍 from DSMB Full episode: www.hcplive.com/view/kidney-... #KidneyCompass #ERA25

The problem with starting one drug at a time is that the second drug never gets started Similar to the ‘time is now’ GDMT in HF, we need to overcome the therapeutic inertia and friction in the system @brendonneuen.bsky.social #NephSky #ERA25

Awesome late breaking clinical trials session II session #ERA25 @brendonneuen.bsky.social

It's been a long journey but today we can share the methods and rationale for the #ACHIEVEtrial (Spiro vs placebo for patients with kidney failure receiving maintenance dialysis) and tomorrow we share the results at #era25 journals.sagepub.com/doi/10.1177/...

By the way the #ERA25 hashtag is heating up Go check it out to get the science from Vienna and also find more fresh voices to follow! #NephSky

Sibeprenlimab inches closer to approval www.hcplive.com/view/fda-acc... feat @brendonneuen.bsky.social Phase 3 RCT next week at #ERA25 (& some journal?)

📅 Get ready for the next #NephJC on May 29 🧠💊 We’ll dive into: Lorundrostat for Uncontrolled Hypertension — efficacy, safety, and what it means for the future of BP management. ⏰ #NephSky #MedSKy @nejm.org www.nejm.org/doi/ful...

If someone is close to being on dialysis, I prefer to start dialysis before biopsy FWiW #NephJC

The ASIs have arrived www.nejm.org/doi/full/10.... Aldosterone synthase inhibitors - first one to finish the phase 3 line #Lorundrostat #Hypertension

New in CJASN: Our meta-analysis of 66 CKD trials shows both acute & chronic GFR slope independently predict clinical outcomes Findings support 3-year total slope as the optimal surrogate endpoint for CKD trials @asnpublications.bsky.social: doi.org/10.2215/CJN....

Completely agree Patients with true resistant HT will likely be in sodium excess state and Spiro would make way more sense anyways Or Flozins Or a GLP1RA Depending on the clinical scenario But I 😍 the crisp PRECISION design #NephMadness

After sparsentan, another ERA gets accelerated approval on the basis of albuminuria while GFR slope data is being collected www.novartis.com/us-en/news/m... @nejm.org paper here www.nejm.org/doi/full/10.... #NephSky

Interplay of Chronic Kidney Disease and the Effects of Tirzepatide in Patients With Heart Failure, Preserved Ejection Fraction, and Obesity: The SUMMIT Trial Interesting data on discordance between cystatin and creatinine eGFR - In JACC: www.sciencedirect.com/science/arti...

Rationale and Design of NUDGE-CKD: A Nationwide Randomized Factorial Trial of Electronic Nudges for Increasing Guideline-Directed Medical Therapy in Chronic Kidney Disease From Tor Biering Sorensen and team in Copenhagen: www.sciencedirect.com/science/arti...

ACE Inhibition to Distinguish Low-Renin Hypertension From Primary Aldosteronism #nephsky www.ahajournals.org/doi/10.1161/...

In SOUL, 2596/9650 (26.9%) participants were receiving SGLT2i at baseline (largest CVOT of combined GLP-1/SGLT2 to date) The effect of oral semaglutide on cardiovascular outcomes was consistent, regardless of SGLT2i use #ACC25 www.ahajournals.org/doi/abs/10.1...

Cardiovascular, Kidney & Mortality Outcomes With Long-Acting Injectable & Oral GLP1-RA in T2 Diabetes An updated meta-analysis of >70,000 patients after the SOUL trial ⬇️ 14% MACE ⬇️ 14% heart failure ⬇️ 17% CKD progression ⬇️ 12% all-cause mortality diabetesjournals.org/care/article...

Contribution of the GFR slope to the kidney hierarchical composite endpoint @kidneyint.bsky.social www.sciencedirect.com/science/arti...

Our new analysis of the TESTING trial in @kireports.bsky.social Steroids improve kidney outcomes in #IgAN at high risk of progression, irrespective of proteinuria or eGFR. But the balance of benefits/harms may be less favourable in those with advanced CKD www.kireports.org/article/S246...

Props to @brendonneuen.bsky.social and Shikha Wadhwani for this fantastic discussion of hierarchical composite endpoints in kidney disease trials. So how do we design trials around these? And can trials already underway switch to an HCA without being accused of moving the goalposts? #nephsky

Great topics!

📢 New CREDENCE data in NDT: SGLT2i in CKD and T2D: ✅ ↓ Insulin initiation/dose intensification by 19% ✅ ↑ Reductions in insulin dose by up to 49% ✅ Consistent ↓ in insulin use down to GFR of 30ml/min in whom glycosuric effect is minimal academic.oup.com/ndt/advance-...

Important WHO guideline on K-enriched, lower sodium salt overshadowed by the deluge of news (I.e. US pulling out of the WHO). Attaching some slides recently made for medicine resident lecture. Follow @pawellingmd.bsky.social to learn about the “potassium switch” www.wellinglab.com/potassiumhyp...

Effects of IL-6 inhibition with clazakizumab on anemia and iron metabolism in patients with kidney failure by Drs. @brendonneuen.bsky.social , Chertow et al. journals.lww.com/jasn/abstrac... Clazakizumab may improve iron utilization and reduce ESA usage in patients receiving hemodialysis.

New in @natrevneph.bsky.social With Drs Blum & Grams, we explore how risk-based CKD management aligns care with risk, prioritizes absolute benefits, & improves cost-effectiveness—guiding the use of key therapies for those most likely to benefit 🔗 Read more: www.nature.com/articles/s41...

This is a must read for all #NephSky RCT readers (and RCT wannabe doers) from the Oxford trials folks in @ndt-era.bsky.social #OpenAccess academic.oup.com/ndt/article/... Table with core problems in RCTs and how to solve them 1/

This is from a Bayer funded (but not Bayer influenced) @ndt-era.bsky.social supplement on trials and combination therapies in CKD With really good reviews from experts incl @brendonneuen.bsky.social and many more academic.oup.com/ndt/issue/40... #NephSky

Systematic Review of the Effects of #Iron on #Cardiovascular, #Kidney and Safety Outcomes in Patients With Chronic Kidney Disease #CKD #VisualAbstract by @Husamjz www.kireports.org/ar...#Iron#Cardiovascular,#Kidney#CKD#VisualAbstractrnardchan33 @brendonneuen

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