Rolando Claure

#JustDoItSunday 🏃🏻‍♂️ #Run4Kidneys 🫘 #850Challenge 🎗️

New in Nature Reviews Nephrology (Mar 2026) 🌍🩺🫘 I contributed to: “Climate change and AKI: heat, hazards and health-system readiness” (World Kidney Day collection). Extreme heat + environmental hazards raise AKI risk systems need readiness now. doi:10.1038/s41581-026-01048-2
#AKI #ClimateChange

#Run4Kidneys 🫘 🏃🏻 #850Challenge 🎗️

Heat isn’t just uncomfortable—it’s nephrotoxic at scale. 🌡️🩺 CJASN 📄 (US counties, 2005–2019): per +1°C annual avg temp, CKD prevalence +0.23 pp & kidney failure +1.37/100k. Heat-wave days also linked—strongest in high-poverty & nonmetro counties.
🔗 journals.lww.com/cjasn/fullte...

Después del trabajo 👨‍💻 🏥 una corta carrera de recuperación ❤️‍🩹 🏃🏻 #Run4Kidneys 🫘 #850Challenge

100 years ago (1926), Poul Brandt Rehberg introduced creatinine clearance to eGFR shaping how we assess 🫘 function today. A JASN perspective also honors his later life in the 🇩🇰 resistance, arrested by the Gestapo & his postwar science leadership.
🔗 journals.lww.com/jasn/citatio...

Effect of preoperative SGLT2 inhibitor use on postoperative acute kidney injury in patients with type 2 diabetes undergoing surgery: A causal inference study using routinely collected data Aims To assess whether preoperative sodium-glucose co-transporter 2 inhibitor (SGLT2i) use reduces the odds of postoperative acute kidney injury (AKI) in patients with type 2 diabetes undergoing…

Pre-op SGLT2i use may protect kidneys 🫘 after surgery in T2D. In an Australian 🇦🇺 target-trial emulation (738 SGLT2i vs 1,761 no SGLT2i), AKI ≤7d: 18.6% vs 25.8% (29% lower odds). Consistent across subgroups. RCTs needed. #AKI #Diabetes #Surgery
🔗 doi.org/10.1111/dom....

Guidelines recommend finerenone for T2D+CKD to cut CV events & slow CKD👉🏻mechanistic analyses suggest ~90% of benefit is via proteinuria reduction, cheaper steroidal MRAs (e.g., spironolactone) also ⬇️proteinuria. Could they be a lower💲alternative? Head-to-head trial needed.

Editors’ Choice 2025: Impact of Simultaneous Initiation of Finerenone and Empagliflozin on Urinary Albumin-to-Creatinine Ratio in Asia: a Pre-Specified Analysis of CONFIDENCE

Check out the paper here #ASNCJASN: kidney.pub/CJASN0865

The latest ASN Kidney Translation Podcast episode covers advances in kidney transplantation: an SGLT2i trial in kidney transplant recipients (CJASN), delivery outcomes after kidney transplantation (JASN), and strategies and policies for living donation (Kidney360). Tune in: kidney.pub/KTPOD022026

New 📑 activating transcription factor 4 (ATF4) (integrated stress response) links drug-induced AKI to pyroptosis. Tubular ATF4 ↑ with dysfunction; deleting ATF4 improves 🫘 function & inflammation. Pathway: ATF4 → STAT1/GBP2 → NLRP3 → pyroptosis.
🔗 journals.lww.com/jasn/abstrac...

ISN Insight bi-weekly newsletter - Subscribe to ISN newsletter Sept 16, 2024: Congratulations to 23 new ISN Interventional Nephrology Scholars. Subscribe to ISN newsletter.

𝗜𝗡𝗦𝗜𝗚𝗛𝗧, our newsletter is out! Read about:
• Professor Donal O’Donoghue Global Kidney Policy Forum during #ISNWCN
• New report from ISN i3C in @kidneyint.bsky.social
• 10 new ISN INTCs
• New ISN Academy curriculum
• and more
➡️ www.theisn.org/news/insight...

Adjuvant thiazide outperformed simply increasing loop dose for boosting diuretic response in acute HF with diuretic resistance and response didn’t depend on the presumed mechanism of diuretic resistance. #HeartFailure #CardioRenal #Nephrology
🔗 journals.lww.com/jasn/fulltex...

Cardiac surgery-associated acute kidney injury requiring haemofiltration: The immediate postoperative phase is critical to achieve equivalent long-term survival To evaluate the clinical impact of cardiac surgery-associated acute kidney injury requiring continuous venovenous haemofiltration by assessing its imp…

CSA-AKI: immediate postop phase is critical.
J Crit Care (UK, 2015–2024; n=1,530; matched 1:2): pts needing postop hemofiltration had higher in-🏥 mortality (23.1% vs 6.2%) & worse survival to 5y—but among 🏥 survivors, long-term survival was similar.
🔗 doi.org/10.1016/j.jc...

Novel immunotherapies can cause AKI. ICIs: severe acute interstitial nephritis is the key renal adverse event. CAR-T: cytokine release syndrome + IEC-associated HLH can injure kidneys via multiple mechanisms. Need better prevention & earlier diagnosis. 🔗 journals.lww.com/kidney360/fu...

A multicenter retrospective HRS-HARMONY study (11 🇺🇸 🏥 systems; n=374 cirrhosis + AKI requiring dialysis): HRS-AKI was not associated with higher 90-day mortality vs other AKI etiologies. Overall mortality 59.6%—similar to other AKI-dialysis cohorts. 🔗 journals.lww.com/kidney360/fu...

Proud to have been part of this newly published phase 2 RCT in AKI + iron deficiency (n=120). A single 1,200 mg IV iron dextran infusion was safe but did not reduce MAKE at 90 days vs usual care (82% vs 75%; p=0.37). #AKI #Nephrology #ClinicalTrials
🔗 journals.lww.com/kidney360/ab...

#JustDoItSunday 🏃🏻‍♂️ #Run4Kidneys 🫘 #850Challenge 🎗️ 2026

Supplementing with fish oil reduces the risk of serious cardiovascular events in patients receiving maintenance dialysis per a new randomized clinical trial. Read more in #ASNKidneyNews: kidney.pub/KN1801-26

AI is becoming the backbone of kidney care. The #ASN 🤖 Workgroup urges responsible use: patient benefit first, clinician oversight, & innovation where burden is highest. AI should augment, not replace judgment. Transparency, validation + education. www.kidneynews.org/view/journal...

Toward an understanding of the intrinsic kidney response to acute injury - Nature Reviews Nephrology Kidneys are highly susceptible to acute injury. Several studies in 2025 revealed insights into mechanisms of protection and susceptibility — including sex-specific mechanisms of protection against…

#AKI insights: response to ⚡️
• 17β-estradiol blocks ferroptosis (non-genomic+genomic) → sex diffs
• AKI mtDNA mutations impair resilience; adenosine restores ATP & function
• Hypoxia ↑ tRNA-Asp-GTC-3′tDR traps PUS7 → RNA autophagy → protection
🔗 doi.org/10.1038/s415...

Climate change is a kidney issue: heat stress, floods/water insecurity, dengue/lepto, pollution & nephrotoxins → more community-acquired #AKI—hitting outdoor workers & underserved communities hardest. “Heat-season” readiness can save lives. Read: rdcu.be/eY1G0

Acute kidney injury and chronic kidney disease in individuals with Down syndrome: A nationwide cohort study AbstractBackground. It is unclear whether individuals with Down syndrome (DS) are at increased risk of kidney disease. This study aims to examine the risk

Large Danish matched study (2,815 Down syndrome; 1:10 controls) found consistently higher risks of AKI & CKD across adulthood—even among those without congenital heart disease. Kidney monitoring deserves more attention in this population. #DownSyndrome
doi.org/10.1093/ckj/...

ABG is the gold standard, but arterial sticks hurt & carry risks. A Kidney360 study (5,419 paired samples) derived formulas to estimate arterial pH, pCO₂ & HCO₃⁻ from VBG—meeting acceptable clinical expectations. #Nephrology #CriticalCare #AcidBase
journals.lww.com/kidney360/ab...

After preeclampsia, kidney risk persists. 171,693 pregnancies 🤰(FU 7y): preeclampsia → 2.53× severe albuminuria (>300 mg/g) & 2.18× eGFR<60. But in the 1st postpartum year: only 20% Cr and 10% albumin testing. #Preeclampsia #CKD journals.lww.com/jasn/abstrac...

Extracorporeal Blood Purification Therapies in Latin America – Bridging Gaps in Availability and Training Abstract. Introduction: Socioeconomic and developmental diversity across Latin America (LA) significantly affects the availability of extracorporeal blood purification (EBP) therapies to treat acute k...

SLANH 🌎 survey (Mar–Dec 2024; n=505; 20 LA countries): EBP for AKI 👉🏻IHD 98%, PD 65%, CRRT 59% (unavailable in 🇭🇹, 🇳🇮, 🇵🇾 & 🇻🇪). Advanced EBP scarce: ECMO 16.7%, ECCO₂R 7%. Top training needs: ECMO, ECCO₂R, CRRT, TPE. @SLANH_ #AKI #EBP
🔗 doi.org/10.1159/0005...

Hi, I’m Cello Tonelli, President of the ISN.

Join us for the #ISNWCN in March. Register today ➡️ lite.spr.ly/6007Ol8D

PPIs have been linked to AKI/CKD risk. A 📑 in 🇰🇷 found P-CAB users had fewer kidney events than PPI users: creatinine doubling and eGFR ≥50% decline were lower; adjusted risk reductions 48% and 37%. Observational—needs confirmation.
🔗 doi.org/10.1093/ckj/...

Read more: 🔗 doi.org/10.1038/s415... #AKI #KidneyHealth

AKI is rising 🗺️ hit hardest in LMICs. The 5R framework (Risk, Recognition, Response, Renal Support, Rehab) guides action: advocacy + access, better detection, patient-centered care, closing gaps, equity & climate action, & tools like POC tests, EMRs, digital health & AI. #AKI