Jamie Willows

Kidney Week in Houston: Day 2 — NephJC in this edition: Fish Oil, GBD, Flozination meta-analysis, CHW intervention in Hispanic/Latino patients, and much more

Missing all the overwhelming amount of science coming out of #KidneyWk?

The #NephJC crew has got you covered

Day 2 edition www.nephjc.com/news/kidneyw... via @nephroseeker.medsky.social & moi

Kidney Week in Houston: Day 1 — NephJC in this edition: Atacicept in IgAN; Albuminuria as a surrogate outcome, Renal Remission and additional CONFIDENCE analysis

Got #KidneyWk FOMO like @nephroseeker.medsky.social ?

We got you covered with daily coverage of the simultaneous publications!

www.nephjc.com/news/kidneyw...

There is some concern about cancers with glipination - thyroid, pancreas, others - nothing seen so far in trials (but rare outcomes are hard to capture)

this study in JAMA Oncology didn't find anything much worrisome jamanetwork.com/journals/jam...

but!

bsky.app/profile/jami...

A study that I have been thinking about a lot is this pilot study/case series

100-200 mg of spiro in diuretic resistant, acute decompensated heart failure looked safe and effective

Any heart failure/diuretic experts know if a larger trial was ever completed?

pubmed.ncbi.nlm.nih.gov/31307058/

Always challenged by my occasional (generally intentional) nihilism when it comes to treating frailty & multi morbid patients
#eraedta2025

Double Trouble: ddAVP and the Bleeding Biopsy — NephJC This week, we will discuss a double header: two single centre ddAVP trials in kidney biopsy from India.

Join us tonite 5/13/25 9pm EST only on #Bluesky #NephSky #NephJC
We are discussing 2 studies on the use of desmopressin/ddAVP prophylactically to prevent post kidney biopsy bleeding.
Biopsy Blood🩸, ddAVP Sweat💦 and Nephrologist Tears😢
www.nephjc.com/news/ddavp

Efficacy and safety of finerenone in IgA nephropathy: an observational multicentre study

doi.org/10.1093/ckj/...

Liberal fluid intake versus fluid restriction in chronic heart failure: a randomized clinical trial - PubMed Fluid restriction is frequently recommended to patients with chronic heart failure, but randomized clinical trials assessing the effects of fluid restriction remain scarce. In this multicenter open-la...

Physiologically it never made sense to fluid restrict HF patients without hyponatremia. No difference in outcomes in 👇study, which was predictable. At the same time - from a study perspective - the actual difference in fluid intake between groups was <300cc/day.

pubmed.ncbi.nlm.nih.gov/40159556/

KDIGO 2025 ADPKD Guidelines Review — NephJC This week, we will discuss the first iteration of KDIGO’s 2025 guidelines on ADPKD. &nbsp;These guidelines are a result of a decade of global collaboration between physicians, researchers, advocates, ...

Tomorrow night 3/25/25 at 9 pm EST, only on Bluesky #MedSky #NephSky
We will discuss the latest guidance from @kdigo.org on #ADPKD. Topics including screening, cerebral aneurysms, med therapy, KRT, ADPLD and lifestyle recommendations
You have to be there, I in-cyst 🫣
www.nephjc.com/news/adpkd-k...

Fantastic opportunity 👇

Two things, this is finally a small RCT for GLP1 meds and alcohol use disorder. Reductions were noticeable and highlights the need for a big RCT for this.
Secondarily a very small cohort(n=13) who smoked cigarettes also had a reduction in smoking in this study. Lets get more studies on both!

IT IS A COMPLIMENT BRIAN.

Undercover Aldosterone — NephJC This week, we will discuss the origins of primary hyperaldosteronism in normotensive patients. Could this undetected anomaly be the cause of idiopathic hypertension and CKD?

I learned a lot about subclinical primary aldosteronism reading this piece from the unsinkable @brianrifkin.bsky.social 👇

www.nephjc.com/news/primary...

Intro slide

Zigakibart MoA

Prof IgA Jon Barratt presented some phase 1/2 open label data on another APRIL inhibitor (after sibeprenlimab and atacicept)

#ISNWCN

Intro slide

Phase 2 data

At the second high impact trial session At #ISNWCN

Vlado Perkovic on ziltivekimab in CKD

Covered data on colchicine and Canakinumab (not on market despite CANTOS)

Phase 2 data from RESCUE shows huge effect on hs-CRP

a person is measuring their weight on a scale that goes up to 40 ALT: a person is measuring their weight on a scale that goes up to 40

Patient self-directed sliding scale furosemide is an underutilized tool in CHF management

Can a simple weight-based dosing strategy empower patients to manage CHF, prevent exacerbations, and reduce ED visits? Let's dive in! 👇 #medsky #pharmsky #cardiosky #EMsky #GPsky #MedEd 1/

need some bland, meaningless conclusions for your review article?

use these!

these conclusions are so nonspecific that they're perfectly applicable to any ICU topic 👌

you're welcome

Anti-nephrin antibody: a potential biomarker of minimal change disease AbstractBackground. Minimal change disease (MCD) is a common pathological type of nephrotic syndrome in children and adults, and the mechanisms remain obsc

more external validation of the anti-nephrin story
academic.oup.com/ckj/advance-... in @ckj-era.bsky.social

In around 20% MCD - but also some FSGS (suggesting again these arbitrary pathologic descriptors are not useful)

#NephSky

FIGURE 1:Sources of bias in prior studies comparing outcomes of patients using catheters to those using fistulas.

I like this from Rob Quinn and Pietro Ravani pubmed.ncbi.nlm.nih.gov/24327565/ in @ndt-era.bsky.social to show the various selection biases in most studies of vascular access

#FistulaLast

FDA approves Novo Nordisk's Ozempic to treat chronic kidney disease in those with diabetes, expanding its use Expanded Ozempic approval in the U.S. could transform how doctors treat patients with chronic kidney disease, which involves a gradual loss of kidney function.

BREAKING NEWS: The FDA has approved Ozempic for patients with chronic kidney disease. This means the popular injection can be used to reduce the risk of kidney disease worsening, kidney failure and death from cardiovascular disease in patients with chronic kidney disease and diabetes.

At 12-month follow-up, primary outcome data were available for 846 (90%) patients. Treatment failure occurred in 153 (34%) of 452 patients in the antibiotic group, compared with 28 (7%) of 394 in the appendicectomy group (difference 26·7%, 90% CI 22·4–30·9).

Finally!

Antibiotics are not non-inferior to appendectomy despite a generous 20% non-inferiority margin

They are actually inferior: www.thelancet.com/journals/lan... in the @thelancet.bsky.social

#MedSky

The efficacy and safety of half-dose glucocorticoids combined with #rituximab versus high-dose glucocorticoids for initial treatment of minimal change disease: a single-center experience
#nephsky
www.frontiersin.org/journals/pha...

Proposed age-adjusted eGFR thresholds for CKD 👇
#Nephpearls #NephSky

eGFR 75 for ages <40 years
eGFR 60 for 40-65 years
eGFR 45 for >65 years

👉 link.springer.com/book/10.1007...
👉 pubmed.ncbi.nlm.nih.gov/31506289/

Nice write-up of practise changing study by @osduvar.bsky.social for #nephjc

Meta-analysis of big name RCTs (AASK, IDNT, RENAAL etc) shows initiating RASi slows CKD progression even when already at stage 4 by more than I’d have guessed - just can’t believe no one had done this analysis before!

RAASi are not nephrotoxic text

The UKKA AKI report is out, h/t @beckybonfield.bsky.social
@ukkidney.org

www.ukkidney.org/sites/defaul... (PDF)

Incl.
- Don’t call RAASi nephrotoxic
- Don’t delay contrast imaging
- Sick day rules are mostly 🐴 💩

European Ozempic Label Will Include Kidney Disease Indication | Docwire News The European label for Ozempic will be updated to include an indication for risk reduction for events related to kidney disease.

European Medicines Agency clears the way for Ozempic's label to list a kidney disease indication.
https://buff.ly/4fjah4b #ozempic #kidneydisease #nephsky

Figure 1 Temporal trends of HIV incidence, mortality, and prevalence counts for 1990–2050 Time trends presented for all-age males, females, and both sexes combined. The shaded areas represent 95% uncertainty intervals.

Another example of how

Decreasing incidence
+
Decreasing mortality
=
Increasing prevalence

HIV edition from the GBD folks www.thelancet.com/journals/lan...

#MedSky #EpiSky

Great as ever from Amy.

Freely Filtered 061: Bicarb in Transplant — NephJC Freely Filtered 061: Bicarbonate did not slow the loss of GFR in this well done Swiss, single-blind study of transplant patients.

I don’t think so

Have a listen to www.nephjc.com/freelyfilter...

Nav breaks down the data well. The UBI trial results are unbelievable. The same group did the Sevelamer keeps people alive forever RCTs.