Skeleton Key Group Case #40: Cosmetic Calcium Author: Nikitha (Niki) Cherayil, MD A. The Stem A middle-aged woman with chronic kidney disease stage 3 in the setting of hypertension and recurrent kidney st

Interesting case from the Skeleton Key Group which just keeps pumping out the #FOAMed

www.renalfellow.org/2025/09/28/s...

somewhat related

www.sciencedirect.com/science/arti... in @kireports.bsky.social

see how less often do we think of TKD (4%) but how often it turns out to be (19%)

#NephSky

📖 This weekend don't miss our @kireports.bsky.social #ISNFridaySelection: Early determination of tacrolimus concentration-dose ratio identifies risk of allograft loss in kidney transplantation www.kireports.org/ar...

Should GLP-1 receptor agonist therapy be used to treat obesity in Bardet-Biedl syndrome? buff.ly/3KaQiPj

Jeremy W Tomlinson provides a Commentary on Singh et al. (buff.ly/4F0fcqZ)

Postoperative 20% Albumin Infusion and Acute Kidney Injury in High-Risk Cardiac Surgery Patients - The ALBICS AKI Randomized Clinical Trial by Drs. Shehabi, Pakavakis et al.

jamanetwork.com/journals/jam...

Infusion of 20% albumin increased the risk of AKI.

Chronic Kidney Disease of unexplained cause (CKDx): a consensus statement by the Genes & Kidney Working Group of the ERA Abstract. Chronic kidney disease of unexplained cause (CKDx) is a diagnosis of exclusion. With an estimated global prevalence of at least 16–20% among CKD

academic.oup.com/ndt/advance-...

7/
📣 To the #nephrology community:

We invite all clinicians, geneticists, pathologists & data scientists to:
✅ Use CKDx in your practice & research
✅ Share cases where h/g flags made a difference
✅ Tell us what metadata would help refine diagnostics further

Antibody-mediated Rejection - Treatment Standard Abstract. Antibody-mediated rejection (AMR) remains a major cause of graft failure, with significant health and economic burden. Despite being recognized &

Antibody-mediated Rejection - Treatment Standard by Drs. Böhmig, Budde et al.

academic.oup.com/ndt/article/...

An expert opinion paper about Treatment Standard by ABMR.

Age- and sex-specific reference values of estimated glomerular filtration rate for European adults Kidney function, often assessed by estimated glomerular filtration rate (eGFR), declines naturally with age. However, there is a lack of eGFR reference values to describe normal and abnormal values fo...

This is such a great resource:
www.kidney-international.org/article/S008...
#nephrology #eGFR

Interesting case of dual occurrence of fibrillary GN and lupus nephritis. Full house staining and mixture of many typical IC deposits with fibrils. #renalpath #pathskyr #nephsky www.sciencedirect.com/science/arti...

ADPKD Risk calculator.
This looks well done: halbritter-lab.github.io/adpkd-risk/

Immunosuppressive Regimen and Post-Transplantation Clinical Course.

Also published today
The Boston first in human kidney xenotransplantation case report

@nejm.org #ISNWCN

www.nejm.org/doi/full/10....

Efficacy and Safety of Obinutuzumab in Active Lupus Nephritis | NEJM Obinutuzumab, a humanized type II anti-CD20 monoclonal antibody, provided significantly better renal responses than placebo in a phase 2 trial involving patients with lupus nephritis receiving stan...

In the REGENCY trial, obinutuzumab, a humanized type II anti-CD20 monoclonal antibody, plus standard therapy provided significantly better renal responses than standard therapy alone in patients with lupus nephritis. Full trial results: nej.md/3Eq6gxV

#ISNWCN | @theisn.org

17/
I'm very curious how others (e.g., @kidney_boy @Nephro_Sparks) think through this. It's hard to find articles directly addressing this exact question...

Fast Tac Metabolizers at Risk—It is Time for a C/D Ratio Calculation Tacrolimus (Tac) is a part of the standard immunosuppressive regimen after renal transplantation (RTx). However, its metabolism rate is highly variable. A fast Tac metabolism rate, defined by the Tac ...

There is also quite good data on whether someone metabolizes quickly or slowly after NTx.

pmc.ncbi.nlm.nih.gov/articles/PMC...

Here comes gene therapy for hemophilia

Hypokalemia: Diagnostic algorithm
#Nephpearls #NephSky

☑️ Urine K
☑️ Serum Mg
☑️ Serum CO2
☑️ Blood Pressure
☑️ Urine Chloride
☑️ Renin, Aldosterone

👉 pubmed.ncbi.nlm.nih.gov/18813287/

🚨 ADPKD 2025 guidelines are finally out! Huge congrats to Amy Early and the @kdigo.org team, to our chairs Olivier Devuyst & Vicente Torres, to Reem Mustafa, to the evidence review team, and to all the coauthors. Special thoughts go out to Tess Harris. kdigo.org/guidelines/a...

The assumptions made in the calculation of TTKG are "NOT valid" because there is a large amount of urea reabsorbed in the inner medullary collecting duct.

👉 pubmed.ncbi.nlm.nih.gov/21788894/

Happy to share our paper in @asnpublications.bsky.social examining COL4A5 X-linked Alport Syndrome in an unselected health system-based population. Phenotypic spectrum of X-linked Alport syndrome is wider than previously known. Risk lower for Gly624Asp variant. 1/ journals.lww.com/jasn/fulltex...

Bonus effect. When a drug for diabetes significantly reduces kidney stones, results of a randomized trial of empagliflozin (Jardiance), a SGLT-2 inhibitor, in people without diabetes
www.nature.com/articles/s41...

a man stands in front of a blackboard with the words it 's paradoxical and yet it works ALT: a man stands in front of a blackboard with the words it 's paradoxical and yet it works

The Aldosterone Paradox: A Skeetutorial:

Metabolic Consequences after Urinary Diversion Metabolic disturbances are well-known, but sometimes neglected immediate consequences or late sequelae following urinary diversion (UD) using bowel segments. Whereas subclinical disturbances appear to...

4) Ileal conduit. Not that common, but I had 2 consults for them so

👉When urine ⬆️ in NH4Cl empties into a section of the ileum, NH4 is reabsorbed through the Na-H antiporter of the ileum. Bile acid malabsorption may also cause diarrhea.

👉In sigmoid diversion, Cl is absorbed in exchange for HCO3.

YouTube video by KDIGO Hiding in Plain Sight: The Utility of Genetic Testing in Common Forms of CKD

youtu.be/d_ap7EPap_Q?... @andrewmallett8.bsky.social @ksusztak.bsky.social @kdigo.bsky.social

Pathophysiology of Hepatorenal Syndrome https://www.sciencedirect.com/science/article/pii/S2949813924000028?dgcid=author @NephRodby @Nhepatic @akdhjournal @HrsHarmony #HRS @serenellaavelez

Trial to Assess the Efficacy of EMPAgliflozin and Personalized Dietary Counseling for Kidney STONE Prevention The aim of this randomized trial with a 2-by-2 factorial design is to test the efficacy of the SGLT2 inhibitor empagliflozin and personalized dietary counseling based on 24-hr urine collection results...

5/5 They plan on doing a multi-centre trial, #EMPASTONE

ctv.veeva.com/study/trial-...

SUrvey of renal biopsy registry database and anticancer dRUg therapy in japan (SUBARU-J study) AbstractBackground. Kidney complications associated with anticancer-drug therapy have greatly increased recently. We aimed to investigate the real-world cl

SUrvey of renal biopsy registry database and anticancer dRUg therapy in japan (SUBARU-J study) academic.oup.com/ckj/advance-... @kdjhaveri.bsky.social

So in summary
🔎when considering Hz-glomerulonephritis look for multiple autoantibodies, high ANCA titers, vasculitis and lupus overlap
📆timing occurs after 3-5 years of Hz use, higher doses = higher risk
🧬genetics may increase risk
🏥IS may help, but about 1/3 stay on dialysis

Like brain cells, kidney cells can form memories Scientists found memory’s molecular machinery at work in cells outside the nervous system.

Read my lips: kidney cells can remember stuff, so be very careful when you do bad things to your kidneys.

"Like brain cells, kidney cells can form memories"

YouTube video by Ottawa Nephrology Dialysate Bicarbonate Concentration: A Tricky Balancing Act, with Dr Amber Molnar

On that topic you may enjoy this: youtu.be/GqRk5g93eLc?...

#NephGR - we are participating in a trial to start soon!