Robert Brown

How do older patients with advanced kidney disease, and their family members, understand kidney function and failure? A qualitative study - BMC Nephrology Background Patients approaching kidney failure are increasingly older, and living with multiple long-term conditions. The benefits of kidney replacement therapy (KRT) are uncertain for many in this gr...

doi.org/10.1186/s128...

Excellent paper led by Dr Charlotte Snead - we need to find ways of consulting with people about kidney disease that support them to make person-centred decisions.
@lucyselman.bsky.social @rachaelmorton.bsky.social @flissmurtagh.bsky.social @peolcsw.bsky.social

Visual abstract of the study from Corina

We need a good biomarker for IgAN given the impoartance of immunosuppression (vs non-specific therapies: RASi, Flozins, ERA)

But the Gd-IgA doesn’t seem so impressive to me?

journals.lww.com/cjasn/pages/...

#NephSky @asnpublications.bsky.social #CJASN

VA by @corinateodosiu.bsky.social

Visual abstract

How common is kidney failure with MCD and FSGS?

More than we think … @brianrifkin.bsky.social breaks down the recent @asnpublications.bsky.social JASN paper from the RaDaR study www.nephjc.com/news/nephjc-...

🚨 Exciting Fellowships! 🚨
Join UHB NHS FT as a Clinical Research Fellow in Renal Medicine (12m fixed term, £65k, Birmingham).

Apply now:
🧠 Dialysis & Cognition: jobs.nhs.uk/candidate/joba…
💉 Hypertension & Dialysis: jobs.nhs.uk/candidate/joba���

#Renal #Research

Figure 1 | Patients have diverse preferences that reflect individual variation in what they consider important. Those planning for life with kidney failure want control over their futures and tend to desire autonomy in treatment decision-making. They will trade off the potential benefits of treatments against an over-riding desire to minimize disruption of daily and family life, responsibilities, and interests. The treatments that patients plan for and receive reflect complex processes involving many actors. Familial, community, societal, cultural, spiritual, clinical, and informational factors shape preferences, restrict or provide treatment options, and guide decisions. Skill, investment, and intentional practice are needed to ensure that patient preferences carry weight in decision-making.

Proud of this Kidney International paper: doi.org/10.1016/j.ki.... Nephrology involves optimal delivery of treatments that prolong life, preserve & replace organ function. The art lies in shaping this care to the person.
@rachaelmorton.bsky.social
@lucyselman.bsky.social
@flissmurtagh.bsky.social

UK Kidney Association Clinical Practice Guideline on vascular access for haemodialysis - BMC Nephrology Abstract This guideline is written primarily for doctors and nurses working in dialysis centres and related areas of medicine in the UK, and is an update of a previous version written in 2015. It aims...

No more fistula first, even in the @ukkidney.org vascular access guidelines

Long, helpful document: bmcnephrol.biomedcentral.com/articles/10....

#NephSky

Figure 2 (a) Kidney response to treatment. Scatter plots of individual change in eGFR at 12 months versus baseline eGFR, stratified by duration of glucocorticoid therapy, and (b) individual change in uPCR at 12 months versus baseline uPCR for the whole cohort. r values are Pearson coefficients. Alluvial plots demonstrating change in AAV classification from initial biopsy to interval biopsy (n = 19) for (c) Berden classification, and (d) ANCA Kidney Risk Score. AAV, antineutrophil cytoplasm antibody-associated vasculitis; ANCA, antineutrophil cytoplasm antibody; eGFR, estimated glomerular filtration rate; uPCR, urinary protein-to-creatinine ratio.

Vitamin R + Cyclophosohamide in ANCA vasculitis

A case series from Edinburgh suggesting this allows faster steroid withdrawal?

@kireports.bsky.social www.kireports.org/article/S246...

#NephSky #Vasculitis

🙌 @barnyhole.bsky.social @lucyselman.bsky.social

Few drugs would be licensed with a > 5 % risk of liver enzyme level elevation - why are law makers so lenient with cannabidiol?
jamanetwork.com/journals/jam...

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

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/...

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.

9/10 I want more info:

✅Check out #NephJC summary by @sejalplakhani.bsky.social & @jeyakumarmeyyappan.bsky.social
www.nephjc.com/news/confide...

✅Visual abstract by @shelliefravel.bsky.social
www.nephjc.com/news/2025/7/...

1/10
Last #NephJC we discussed the combination therapy of empagliflozin and finerenone 💊 #TenPostNephJC

🌵From a therapeutic dessert to a flood of options in diabetic kidney disease (DKD) - what is the best timing to keep the kidneys afloat

‘That’s why I wanted him to go on dialysis’ – a qualitative inductive thematic analysis of older patients’ and their family members’ perspectives on kidney failure treatment decision-making - BMC Neph... Background Chronic kidney disease (CKD) is increasingly common amongst frail older patients with multiple health problems. These patients typically decide between kidney replacement therapy (KRT) with...

📢 In BMJo: That’s why I wanted him to go on dialysis-a qualitative analysis of older patients’ & family members’ perspectives on kidney failure treatment rdcu.be/ewi4l
@lucyselman.bsky.social
@leilarooshenas.bsky.social
@peolcsw.bsky.social
@wolfsonpallcare.bsky.social
@flissmurtagh.bsky.social

CONFIDENCE Visual Abstract — NephJC Check out the beautiful visual abstract made by NephJC intern Michelle Fravel .

🎨 Beautiful visual abstract by @shelliefravel.bsky.social #NephJC

www.nephjc.com/news/...

T0b: #NephJC

In DKD, the residual risk with flozins added to RASi, still remains high. We need every option in the arsenal, if we hope for better outcomes. So, here are the 4 pillars of modern cardio-renal therapy:

medicinetoday.com.au...

A letter with visible logos of Kidney Care UK, Kidney Research UK, PKD Charity, UK Kidney Association and The National Kidney Federation at the bottom, addressing important health policy commitments.

🖊️ Do you feel #KidneyDisease is overlooked? It’s time to act. Sign our open letter to the Prime Minister calling for a national #CKDstrategy & a better future for kidney patients 👉 www.ukkidney.org/prime-minist...

@Kidney_Research @kidneycareuk @NKF_UK @PKDCharity @UKKidney

www.kireports.org/article/S246... If all roads to lead to dialysis, the kidney failure population will experience unmet needs unseen for decades. @lucyselman.bsky.social @flissmurtagh.bsky.social @kidneycoalition.bsky.social @rcpdmeetings.bsky.social @kidneyint.bsky.social

🧠 New publication
latent TB screening in CKD
📈 TB incidence in UK dialysis patients > some high-burden countries, yet national screening guidance unclear.
We call for equitable access
👉 : doi.org/10.1093/ckj/...

#Nephrology #TB #CKD #LTBI #PublicHealth #Dialysis #HealthEquity #MigrationHealth

Figure 2

Figure 5

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?

Do you think there is ever a place for tolvaptan in 'diuretic resistant' right sided heart failure plus with sodium in the low 110s? Something I've been asked today.

Core Curriculum by @nephcrit.bsky.social , @hswapnil.medsky.social , Abdulghani Omar Kabli, Oleksa G. Rewa, and Edward G. Clark:

Continuous Kidney Replacement Therapies: Core Curriculum 2025

bit.ly/TeixeiraCC25 (FREE)

YouTube video by Ottawa Nephrology Foundation therapies for heart failure in end stage kidney disease with Dr Matt Graham-Brown

Foundational therapies in ESRD for heart failure

Dr Matt Graham-Brown from Leicester presents at #NephGR

www.youtube.com/watch?v=Ar11...

(Rounds from Feb, late share!)

Figure of survival curve showing no difference

There you have it: BEDMED published in @jama.com

jamanetwork.com/journals/jam...

h/t @drjmluther.bsky.social

No difference in bedtime versus morning BP meds - as expected

#NephSky #Hypertension
1/

@kidneyresearchuk.org are enabling pharmacist-led research. I applied last year www.kidneyresearchuk.org/2025/04/22/p... Supported by @kindaibrahim @rosalynnaustin @jigneshpatel @davidwheeler @ukkidney.org @arcwessex.bsky.social

Genetic mutations in the terminal complement system may lead to increased susceptibility to preeclampsia. Targeting the terminal complement pathway could be a potential therapeutic strategy.
bit.ly/KN1705-19
@silvishah.bsky.social
#ASNKidneyNews

📢 New @RenalRadar paper!

The study explores how nephrotic syndrome progresses & the link between proteinuria & kidney failure risk.

🔍 Insights will help clinicians identify higher risk patients earlier & improve clinical trial design.

Read more 👉 ow.ly/xVyz50VTPQP

Sodium-Glucose Cotransporter-2 Inhibitor Therapy and... : Clinical Journal of the American Society of Nephrology study within the Veterans Health Administration included adults with an ADPKD diagnosis code who initiated SGLT2i between January 2017 and May 2023. Repeated measures models were used to evaluate eGFR...

Promising!

flozination in ADPKD (mostly older adults with DM or CVD) - presumably those with another valid indication - associated with slower GFR slope

journals.lww.com/cjasn/pages/... in @asnpublications.bsky.social #CJASN

With no obvious harm signal

FF 80 KDIGO ADPKD Guidelines — NephJC Yet another KDIGO Guideline draft, this one for ADPKD

The ADPKD @kdigo.org guideline episode of @freelyfiltered.bsky.social

www.nephjc.com/freelyfilter...

Joel, Nayan, AC, with Sophia Ambruso coining a new word for posting here (bleat!)

And Charles Edelstein dropping lot of wisdom + @rheaultm.bsky.social with a cameo

#NephSky

💡New SPOTLIGHT ✨

As part of our 75th celebrations, we're featuring the AKI SIG — a powerhouse of collaboration.

From mapping UK AKI services to developing the world’s first AKI Master Patient Index, the group is transforming #AKICare👏

Explore more about the SIG's work: www.ukkidney.org/75-...