Marc Soco

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amazing job @salinesolut.bsky.social !

Sometimes more lessons are learned from failures than successes. I've learned quite a bit from working through the challenges of this trial. #NephJC

Up next! ☀️📚 We're taking a short break from trials, but don’t go far— #NephJC Summer Book Club is back!
We’ll be diving into “Everything is Tuberculosis”—a powerful, thought-provoking read. Join the conversation soon! 📖

Until now, phosphate has been a villain by reputation, not by trial evidence. The unsettling part is that so much of our practice has been built on consensus rather than solid data #NephJC

I would also add that the separation of 0.8 mg/dl is inflated by the baseline difference in phosphate (i.e., not all the result of the intervention). Also, the outcomes of all-cause mortality & hospitalization have substantial "noise." #NephJC

#NephJC

HiLo2 brought to you by Coca Cola
-free Coke for hi
-free Sprite for lo
#nephjc #newnewnephrology

Correct. Electronic consent with educational materials and videos was mostly successful. The lack of dedicated coordinators- especially on-site coordinators- really left us vulnerable to events such as the pandemic and workforce turnover. #NephJC

Important to highlight the timing here. Enrollment was held for much of 2020 when the pandemic hit. The equally large (and lingering) challenge was the burden placed on the dialysis staff in the wake of the pandemic. This affects all aspects of trial without research staff. #NephJC

T2d
Primary outcome 🎯
After 1.4 years median follow-up:
☠️ Deaths: 16% (Hi) vs 21% (Lo)
🏥 Hospitalizations: 720 (Hi) vs 685 (Lo)
📊 Win ratio: 0.97
Surprised by this ❓#NephJC

Really insightful! definitely something for future pragmatic trials to consider early in the design phase #NephJC

Why wouldn’t folks want to sign up for more diet liberalization/less phos binder requirement? Is it bc that’s a patient centered outcome v a doctor controlled metric? #nephjc

Not a fun for cluster trials for this question either. Massive loss of power due to noise (=large between facility variation) especially for mortality and admission outcomes. Expect me to say this more than once tonight #nephjc

This looks like a good read #NephJC

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#NephJC I’ve got Hi hopes (and Lo expectations)

T0i
Here’s the twist 🌪️

What if patients prescribed strict phosphate control are actually exposed to risks we haven’t fully recognized… because they’ve never been tested in a robust RCT? 😬#NephJC

Take a look at this visual: www.ajkd.org/article...

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Great to see the author join us! Looking forward to an engaging discussion #NephJC

Hey everyone! I'm Marc, a nephrologist based in Cebu, Philippines. Looking forward to join the discussion. No COI. #NephJC

Up at 3 AM—if that’s not dedication, I’m not sure what is! #NephJC

The HiLo Trial - Visual Abstract — NephJC Is a lower versus higher phosphate target beneficial to patients undergoing hemodialysis? Check out this crisp VA by Dr Sejal Lakhani

😎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

🎙️Hosting this chat was a step outside my comfort zone—but we grow as we go, and it’s been a joy
Grateful you joined us, whatever timezone 🌏 #NephJC found you
Always a privilege to learn from and with this amazing community ❗️
That’s a wrap from me– this has been Marc (@msocomd.bsky.social)

👋 Hey everyone! I’m Marc Soco (@msocomd.bsky.social‬), a nephrologist based in Cebu, Philippines — where the coconuts are fresh, the mangoes are sweeter than placebo, and the warmth goes beyond just the weather. No COI #NephJC

📸 Image credit: JAK73

A dose of CONFIDENCE: Building evidence for finerenone-empagliflozin synergy in diabetic kidney disease — NephJC This week, we will discuss how the CONFIDENCE trial gets nephrology closer to the magic CKD polypill of CKD.

⏰ Just 30 minutes left before #NephJC chat

What happens when you combine two proven kidney-protective agents? 💬
Can 1 + 1 > 2?

We’re putting it to the test… with CONFIDENCE 💥
Catch the full summary here👇
www.nephjc.com/news/...

Re”FINE”ing the role of non steroidal MRAs in Cardio Kidney Metabolic syndrome — NephJC This week, we will discuss non-steroidal mineralocorticoid antagonist in the multiverse of cardiovascular-kidney-metabolic. What FINEHEART pooled analysis would add to what we already learned from FIDELIO-DKD trial?

⏰ 60 min to #NephJC

Lights, camera, nephro-action! FIDELIO brings the drama, FIGARO steals the show, and FIDELITY proves it’s no one-hit wonder. Finerenone isn’t just the FINEHEART of kidney protection, it might be the full-blown blockbuster.
👇See FINE❤️recap
www.nephjc.com/news/...

EMPA-Kidney: ‘Empa’sizing the role of Flozins in Chronic Kidney Disease — NephJC This week, we will discussing the EMPA-Kidney Study! Expanding flozin kidney protection to a lower level of GFR and albuminuria.

⏰ 2 hours until #NephJC chat

At #NephJC, we went ALL IN on SGLT2is — true CKD game-changers!
The term #flozinate? Born from a tweet by @hswapnil.medsky.social & @christosargyrop.bsky.social ⚡ A #nephtwitter classic.

Refresh on EMPA-KIDNEY before tonight’s chat 👇
www.nephjc.com/news/...

Join us tomorrow 👇

Our supplement bottle of Ashwagandha (don’t use)

Spotted recently

Don’t horse around with this! pubmed.ncbi.nlm.nih.gov/33305135/ - our case report of acute rejection in @kireports.bsky.social

Introducing NephJC Shorts — NephJC In just over a decade of critical appraisal on NephJC, we have done several experiments. Some of them have worked out phenomenally well, such as the Freely Filtered podcast. Others were not ready for ...

We don’t get to discuss every important study that comes out on #NephJC

Hence #NephJCShorts

www.nephjc.com/news/nephjc-...

When your team works this hard, coaching feels easy. Mighty proud of my residents for winning this year’s Nephrology Quiz Bowl 🏆🫘

Interestingly, nudging strategies are non-existent here (at least from what I know) since patients can directly “walk-in” to specialist clinics even without seeing primary care first. #nephJC