Josh Leisring

NephJC Shorts: Hypertension and The Extreme Elderly — NephJC The NephJC shorts version of the Hypertension medication step-down in a nursing home population from NEJM

🆕 #NephJCshort by @brianrifkin.bsky.social

RETREAT-FRAIL- pragmatic RCT: is less BP medication worse in octogenarians?

www.nephjc.com/news/hyperte...

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?

To Treat or Not to Treat? Watchful Waiting or Oral Antihypertensives for Asymptomatic Inpatient Hypertension | NEJM This feature about a man hospitalized for uncomplicated diverticulitis who is found to have high blood pressure offers a case vignette accompanied by two essays, one supporting ...

To Treat or Not to Treat? Watchful Waiting or Oral Antihypertensives for Asymptomatic Inpatient Hypertension
#nephsky #nephrology
www.nejm.org/doi/full/10....

Ahead of #KidneyWk25, we are recruiting a hypertension fellow to the Stanford Hypertension Center for July 2026. Please come find me at ASN.

med.stanford.edu/nephrology/e...

Samir Parikh gives an update on lupus nephritis. #KidneyWk Looking for rapid reduction of proteinuria? Voclosporin is faster, but belimumab showed similar separation from placebo, it just takes longer due to mechanism of action.

A visual representation of the BaxHTN phase 3 trial, which evaluated baxdrostat, a highly selective, potent aldosterone synthase inhibitor, in patients with hard-to-control hypertension.

BaxHTN phase 3 trial: Aldosterone dysregulation is considered a key driver of hard-to-control hypertension. Research findings on baxdrostat, a highly selective, potent aldosterone synthase inhibitor, in hard-to-control hypertension are summarized in a new Quick Take video. nej.md/3KCsQGJ

Donate and represent!
#NephJC

Our @ukkidney.org guidelines here in BMC Nephrology. 💯% agree that in-unit BP should ONLY be used for determining safety of individual HD sessions and NOT long-term CV risk modification. But changing practice will be a long haul.

link.springer.com/epdf/10.1186...

Subclinical primary aldosteronism is an under-recognized driver of cardiovascular risk. Could it be a new target for CV prevention? Read our Circulation editorial —>

#NephJC is a labor of a passionate volunteer team that believes education should be accessible, no matter where you are from in the world.

Even if editorial team donates unlimited hours of sleep, there are still costs to cover 💸 (👇 blog)

😊 Be kind, help us to #NephItForward

#Medsky #Nephsky

We are thrilled to announce that we have generously received funding for a one-year hypertension fellowship, and we are recruiting now for a candidate to start fellowship July 1, 2026 .
med.stanford.edu/hypertension/e…

-Jehan Zahid Bahrainwala
HTN Fellowship Program Director

NephJC 2025 Fall Pledge Drive — NephJC Help keep NephJC a vital, original, and unbiased source of medical education.

It's that time of year again 🍂🍂🍂
The #NephJC Fall pledge drive.
Plese give if you are able to support our decades long mission of #FOAMed for all. #NephSky #MedSky
www.nephjc.com/news/2025/9/22/nephjc-fall-pledge-drive

🚨 Survey Alert!
Standardized office BP measurements are recommended everywhere, but still underused.
We want to hear from you: what are the barriers to using them as a routine in clinical practice?

Click here to read the consent form and take the survey:
redcap.link/barriers.to....

My guess is at least 500 #doctors at my #hospital are on H1B visas including at least a few dozen #hospitalists, and if we lose even a handful to other countries our house of cards #healthcare system will fall apart, let alone all 500+

Blood Pressure Measurement in Dialysis: There’s No Place Like Home (Part 1) This is a 2-part blog post by #NephJC cofounder, hypertension guru, and longtime AJKD contributor Swapnil Hiremath. In Part 1, he outlines the quandaries of blood pressure management in hemodialysi…

Some of my opinions here on @ajkd.bsky.social Blog; ajkdblog.org/2022/01/19/b...

The @ahascience.bsky.social also has a scientific statement here from 2023 www.ahajournals.org/doi/full/10....

#NephJC Catch up

At our center we do the initial screen without altering the existing meds. Don’t wanna miss the opportunity. Patients with the most overt PA have suppressed renin even on RAASi+thiazide. If results aren’t conclusive and suspicion still there can then washout or try empiric MRA. #NephJC

Reposting this again - very relevant for #NephJC discussion on the new AHA/ACC guidelines.

Agree, screening seems like the most effective avenue to improve treatment rates on a broad scale.

Also, screening and making the diagnosis of PA in an individual patient allows tailored treatment including follow-up on plasma renin to help guide dose titration to get full benefit of MRA

#NephJC

The AHA/ACC 2025 Hypertension Guidelines visual abstract — NephJC New updated guidance on hypertension including screening for secondary causes, use of renal denervation, hypertension and pregnancy, risk assessment, monitoring and treatment. Check out this wonderfu...

❤️Check out the VA for the discussion on the AHA/ACC Hypertension Guidelines 9/16/25 at 9pm EST by @sejalplakhani.bsky.social #NephJC #NephSky #MedSky
www.nephjc.com/news/2025/9/ahaacc-htnguide

To accompany the new ACC/AHA BP guidelines, a practical guide on how to test for Primary Aldosteronism: now recommended for most people with hypertension.

www.jacc.org/doi/10.1016/...

Discordance and shortcomings of aldosterone suppression tests in primary aldosteronism AbstractBackground. The saline suppression test (SST) and the captopril challenge test (CCT) have traditionally been used to confirm or exclude primary ald

Confirmatory testing (aldosterone suppression testing) for primary aldosteronism: not reliable, or reproducible, for diagnosis or predicting lateralization. Sensitivity at the expense of specificity, and vice-versa. Time to simplify the process

academic.oup.com/ejendo/artic...

In ESRD is spironolactone an overACHIEVEr? — NephJC This week, we will discuss the ACHIEVE trial. Will spironolactone achieve CV benefits in ESRD?

Excellent summary of the ACHIEVE trial from @drsaivani.bsky.social & @thekidneywhisperer.bsky.social

#NephJC chat tomorrow

www.nephjc.com/news/achieve

Morphologically Normal-Appearing Adrenal Glands as a Prevalent Source of Aldosterone Production in Primary Aldosteronism AbstractBackground. Normal-appearing adrenal glands on cross-sectional imaging may still be the source of aldosterone production in primary aldosteronism (

#WeekendReads from #EditorsChoice

Can you have normal looking adrenal glands with primary aldosteronism?

🔗 academic.oup.com/ajh/article/... 🔓

Efficacy and Safety of Baxdrostat in Uncontrolled and Resistant Hypertension | NEJM Aldosterone dysregulation plays an important pathogenic role in hard-to-control hypertension. In several studies, baxdrostat, an aldosterone synthase inhibitor, reduced the seated systolic blood pr...

The era of ASIs is slowly dawning

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

(Yeah spironolactone is just as good and cheaper)

Disclosure: we recruited patients for this one

❓What’s new in BP care?
🎥 Watch the #TargetBP webinar on the 2025 @AHAScience / @ACCinTouch Hypertension Guidelines w/ @drwanpen.bsky.social , @jordybc.bsky.social , Keith Ferdinand, & Dan Jones 👉 targetbp.org

This is excellent! Multiple nice learning points all in one well-written case report.

The CPC from last @ahascience.bsky.social #HypertensionSessions now published in @ahajournals.bsky.social

www.ahajournals.org/doi/10.1161/...

thanks to @drjmluther.bsky.social and all the education editors for the invite

We hope it makes for an educational read!

Hydralazine-induced antineutrophil cytoplasmic antibody-associated glomerulonephritis Antineutrophil cytoplasmic antibody-associated glomerulonephritis (ANCA-GN) can lead to multi-organ failure and death [1, 2]. As an antihypertensive medica

More on Hydra-ANCA-zine

Four cases, and review of previous (~ 169) cases reported in the literature

academic.oup.com/ckj/article-... in @ckj-era.bsky.social

#NephSky #Hydralazine

Implementing will be a challenge but that shouldn't discourage broader screening.

From the recent Endo Society guideline - the majority of these newly detected cases can be managed with MRA.

Commentary on expanded screening for primary aldosteronism in the new HTN guideline.

www.ahajournals.org/doi/10.1161/... 🔓