Josh Waitzman

Immune tolerance in kidney transplantation: from first principles to clinical engineering — NephJC A commentary putting the chimerism and immune tolerance in perspective

Perhaps we can help! Great commentary by @nephroseeker.bsky.social

www.nephjc.com/news/2025/30...

The regulation and differentiation of regulatory T cells and their dysfunction in autoimmune diseases Nature Reviews Immunology - In this Review, the authors discuss the origins of regulatory T (Treg) cells in the periphery and the mechanisms by which Treg cells are induced, as well as the...

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rdcu.be/eJHU8

www.sciencedirect.com/science/arti...

www.annualreviews.org/content/jour...

I guess this means it’s time for me to try to understand what Tregs do…

(Thanks @enirenberg.bsky.social for the great explainer!)

PARASOL Project Expands Focus to APOL1, Membranous Nephropathy PARASOL Project expands to focus on APOL1 kidney disease and primary membranous nephropathy, aiming to improve clinical trial endpoints for these conditions.

PARASOL Project is expanding focus to include biomarkers & endpoints in APOL1 kidney disease and primary MN as well as FSGS. Learn more: eu1.hubs.ly/H0nr8Lv0
@tobias-b-huber.bsky.social @miktmc.bsky.social @jarcyzphd.bsky.social @ohiostatemed.bsky.social @utoronto.ca @nu-nephrology.bsky.social

Dark Teal background with white circle in middle with yellow border. In the circle it says C3G Awareness Day. Under the circle there is a hashtag #C3GAwarenessDay, and the text Every rare kidney disease deserves to be seen.

Today is #C3GAwarenessDay! At ISGD, we stand with people living with this rare kidney disease. As a medical society for #GlomerularDisease experts, we're committed to raising awareness and moving the science forward to bring more hope and solutions to the C3G community. #C3G #ISGD

Excellent thread below

I will also plug this talk by Paola Romagnani on podocytopathies

youtu.be/bRMeqaGgA9I?...

#GlomCon #NephGR

Agree 100% that maintenance dialysis pts and post transplant pts deserve better quality of evidence than we have.
#nephjc

People’s practice habits are so hard-wired in training.
Lisinopril and losartan are still the most prescribed ACEi and ARB.
#nephjc

Thanks for a great discussion! #nephjc

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#nephjc

Right: more aldo, more combo meds, advocating for GLP1 as part of lifestyle change
Wrong: 130=/=120, even stronger aldo rec, even stronger GLP1 rec so that insurance will cover it
#nephjc

If someone figures out how to change nephrology practice, please let me know #nephjc

Cognitive impairment data

Yes! Slide care of Paul Whelton at this year’s #Hypertension25

#nephjc

If someone feels bad on multiple different agents tried serially to get them below 140 that’s a special case.

I do wonder if there’s an argument to look for carotid stenosis or similar in patients like this.

#nephjc

Yes. I worry we’ve told folks “old people can ride higher” for a long time, and it’s fighting a lot of therapeutic inertia to target a lower BPs goal to prevent dementia.

#nephjc

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MORE!

And by MORE! I mean LESS (systolic BP)

#nephjc

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But each has benefits like a fine wine:

-The uric acid lowering of losartan

-The longest half life of telmisartan

-The bonus migraine prophylaxis of candesartan

#nephjc

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Love the spotlight that combo agents get here.

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Olmesartan’s more effective and comes in a combo w amlodipine.

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

#nephjc

I still wonder—does it need to be this complicated for BP?

Why not double down on the 120 systolic goal for everyone and leave the slide rule for statins?

#nephjc

Reposting a q I had re the lower treatment threshold/goal for #nephjc

Or, per endo society guideline, ALL individuals w HTN

academic.oup.com/jcem/article...

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Renin/Aldo? Per the new endo guidelines, every hypertensive pt should get one.
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#nephjc

All the randomized trial data is to a target of 120 systolic.

I still like the KDIGO guideline attitude—just because we are all terrible at measuring BP, it doesn’t mean we should add a fudge factor for bad measurement. It means we should measure better.

#nephjc

AUTHOR IN THE HOUSE!! #nephjc

Josh Waitzman—I work for Vertex and BIDMC.
I like lower BPs and I cannot lie
#nephjc

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Yeah, but shouldn’t target take the center stage? #nephjc