New out today: Antiproteinuric Effect of Sparsentan in Patients with Genetic-Associated FSGS Enrolled in the DUPLEX Trial Genetic FSGS CAN be treated. journals.lww.com/cjasn/abstra...

I’ll do a pitch for the ASN AKI-D guidance document here #nephjc @nephroninja.bsky.social pubmed.ncbi.nlm.nih.gov/40014384/

#NephJC the editorialist wondered if our control arm represented ‘unnecessary dialysis’ and was not ‘standard of care’—sounds like many at #NephJC do not feel the same way?

#NephJC The traditional approach is increase in native renal function and then dialysis cessation. We proposes a different paradigm: dialysis cessation to promote increase in native renal function.

#NephJC it is important to point out that ‘1st day of recovery’ was defined retrospective. On that day, GFR may be very low (so not ‘recovered’ in the way many people use the word). See 2 figures below for illustration. Both these patients contributed to those Kaplan-Meier curves separating early.

T2f Dialysis-Free Days by Day 28: Conservative: 21 days Conventional: 5 days Most pronounced divergence within the first 10-12 days Clinically, this means these patients spent most of their hospital course not needing dialysis, something no earlier AKI-D trial has demonstrated so clearly. #NephJC

T1c #NephJC 1️⃣Conservative RRT group RRT was done only if one of the following occurred: ✅BUN >112 mg/dL ✅Potassium >6.0 mmol/L, >5.5 after meds ✅pH <7.15 or HCO3 < 12 meq/L ✅Hypoxemia or pulmonary edema ✅Symptomatic overload ✅Clinician judgment 2️⃣ Conventional RRT was 3x/wk

T1a Population: stable AKI-D patients with realistic renal recovery potential Exactly the “gray zone” group we debate daily whether dialysis continuation is necessary. 👀Check out the inclusion/exclusion criteria #NephJC

Hi! I'm a nephrologist and clinical researcher at UCSF. COI: I was one of the LIBERATE-D investigators at the UCSF site. I made a BlueSky account today to join this discussion. #NephJC

Graham Abra Clinical nephrologist and educator COI Fan of the UCSF neph team! #NephJC

#NephJC This is Chi Hsu, senior author and one of the two PI’s for LIBERATE-D. Thanks for choosing our paper. I am borrowing UCSF Nephrology Division’s BlueSky account.

Excited about this @theisn.org initiative, especially under the leadership of @hswapnil.medsky.social as EIC. Nephrology needed this www.theisn.org/blog/2025/12...

The Stanford African Scholars in #GlobalHealth (SASH) program is fostering innovation at a time of growing global health challenges. Through partnerships & knowledge exchange, physician-leaders from African countries gain skills & insights to improve care at home. https://stanford.io/4pt5IKq

It was really interesting researching this topic. Hope it’s useful.

#NephSky as I ask every match day, what is the deal? Endocrinology and Rheumatology (what I would consider the closest comps to nephro) are following almost of their spots while we continue to...not. Do we simply have too many spots?

Yup Figure 1.1 in incidence rate of ESRD in the US Seems to have slipped most people’s awareness 🤷🏽‍♂️

EPA and DHA has an effect on arrhythmias and SCD, especially formation of reentry arrhythmias. e.g. EPA and DHA modulates sodium, calcium and potassium ion channels affecting the cardiac action potential. #NephJC

Indeed! We did not know what to expect, but hopeful. Having worked on this for over a decade, I was initially "stunned" by the result but then not really surprised given the multitude of potential effects of EPA and DHA on the cardiovasculature, and our HD patients deficiencies in it #NephJC

Stop complaining about pill burden in ESRD! There is no pill you are giving your dialysis patient that has data half as impressive as this study. If they are taking too many pills have them stop any of the dozen pills they are taking with ZEERO data in ESRD. #NephJC

Actually, we actually found the opposite - many patients were wanting a "natural" treatment and didnt mind! Some actually left the study to buy commercial fish oil as they didnt know if they had placebo. But to be fair, some also left the study due to pill burden #NephJC

Up next 12/16/25 (our last #NephJC of the year) LIBERATE, A Conservative Dialysis Strategy and Kidney Function Recovery in Dialysis-Requiring Acute Kidney Injury. jamanetwork.com/jour...

We need a daily dose of 1600 mg EPA 800 mg DHA in an ethylester mix of fish oil Did I get that right @kidneyboy.bsky.social @pisces01.bsky.social ? The same company that made it for FISH and PISCES may come out with their formulation soon #NephJC

Since we don’t know the mechanism (secret sauce) hard to say. Is it the EPA/DHA quantities or the ratio or the “quality”, or something else that hasn’t been considered. This is also likely the basis of conflicting data #NephJC

Maybe not as easy as it sounds #NephJC

My first month of trying to prescribe fish oil at the dialysis unit has been a total failure Pharmacies arn’t filling scripts and patients can’t find OTC matches to dose prescribed in PISCES Anyone having success on the high seas?

👇Here are the proposals for the #TopNephrology stories in 2025 🔥 Remember, you can only vote for your favorites if you have subscribed to #NephJC newsletter 📬 Soon we'll send you the voting link. Check your email. www.nephjc.com/news/2025/11...

Maybe the most shocking study from #KidneyWk. 🐚From the depths of the oceans to #BlueSky, we're discussing PISCES 🐟 12/2/25 9pm EST. #NephJC Are you hooked🪝on fish oil for CV disease in ESRD, or are you throwing it back 🌊? www.nephjc.com/news/pisces-fishoil

Holy Mackerel! 🐟 🦜Ahoy matey! Could fish oil unlock the mysteries of increased CV mortality in ESRD? 🏴‍☠️ #NephJC Join us for a lively trawling trip 12/2/25 🛥️at 9pm EST Check out the PISCES VA by @brianrifkin.bsky.social www.nephjc.com/news/piscesva

An aldosterone synthase (CYP11B2 enzyme)–specific 18F-labeled radioligand to help lateralize in PA www.nejm.org/doi/full/10.... very cool science and technology Any comments from the Aldo experts? @anandvaidya17.bsky.social #NephSky #EndoSky

Cool paper Genetics of AMKD getting deeper…

An announcement www.nephjc.com/news/2025/11... #NephJC @kidneyboy.bsky.social and moi hand over the @nephjc.bsky.social reigns to @nephroseeker.medsky.social & @brianrifkin.bsky.social

That was quick! The US FDA approves Sibeprenlimab aka Voyxact for reducing proteinuria in IgA www.fda.gov/drugs/novel-... #NephSky #TopNephrology

I did not know it was this bad Look at the mortality in younger females (versus males) in CKD 5 jamanetwork.com/journals/jam... in @jamainternalmed.com from Alberta #NephSky #GenderDisparities

1/n Recently attended an international congress about Urinalysis in Santiago, Chile 🇨🇱. I was expecting a small meeting. I was wrong. Pleasantly surprised with the size of the meeting and the energy and interest from the participants. Let me share the highlights of my experience:

6/ 📖 Intro ⚡ SGLT2 inhibitors, first made for glucose control, surprised us with strong renal + CV protection 💥 Their small, reversible eGFR dip (like RASi) hinted at the mechanism: more Na⁺ to the macula densa → restored tubuloglomerular feedback → ⬇️ glomerular pressure → nephroprotection. 🧬

Up next: It might seem a little fishy, but was a great catch 🎣 #NephJC PISCES, the use of fish oil to decrease mortality in dialysis patients. www.pubmed.ncbi.nlm....#NephJC

The latest #FreelyFiltered episode has dropped www.nephjc.com/freelyfilter... With pinch hitters Brian Rifkin and Anna Gaddy

The #NephJC summary and VA are live www.nephjc.com/news/atacice... Excellent fast work from @notjustdialysis.bsky.social and @salinesolut.bsky.social Atacicept in IgAN

New Freely Filtered, live from ASN #NephSky podcasts.apple.com/us/podcast/f...

ATTN Fellows!!! Apply to be in the 3rd annual NephMadness NIT Fellows debate at NKF SCM in New Orleans Application here form.jotform.com/252084341700...

Interesting molecule - Troxerutin as an osmotic agent for PD academic.oup.com/ndt/advance-... in @ndt-era.bsky.social It seems it’s a flavonol from the Japanese pagoda tree en.wikipedia.org/wiki/Troxeru... #PDSky #NephSky

A novel system to continuously estimate intradialytic blood pressure in real time More info: academic.oup.com/ndt/article/... @ndt-era.bsky.social, @hjanders.bsky.social

Should obesity remain a contraindication for a kidney transplant? www.ajkd.org/article/S027... In @ajkd.bsky.social Sure it’s a risk factor for graft failure - but so is DM, CAD - which are worse and those are not contraindications! #NephSky #Transplant

I realize folks have probably heard this elsewhere, but it looks like the shutdown will likely end very soon, if not tonight then tomorrow. The good health policy news is that the telehealth flexibilities will be extended until January 30 and made retroactive back to October 1. (1)

Community house HD continues to be a great example of patient centered care and creative thinking

In the PISCES trial involving participants receiving hemodialysis, fish oil (n−3 fatty acids) was compared with corn-oil placebo. The rate of serious cardiovascular events was lower with daily fish-oil supplementation. Full trial results: nej.md/49zWuqo @asnkidney.bsky.social | #KidneyWk

a conservative dialysis strategy in possibly recovering AKI helps people recover faster! jamanetwork.com/journals/jam... in @jama.com from #KidneyWk Like STARRT-AKi et al, at the other end? Small trial - needs replication or this is common sense?