The Topsy-Turvy approach to CVD in Kidney Transplant with Prof Adnan Sharif YouTube video by Ottawa Nephrology

No

Here’s @adnan-sharif.bsky.social making an eloquent case youtu.be/4l_1j24CdOg?...

The best treatment for CAD in a dialysis patient is a kidney transplant

www.ajkd.org/content/core...

Let me know if the link that I sent worked. If not I can walk you through how I found it.

www.ajkd.org/content/core...

What is your diagnosis for this finding in a young patient with renal artery stenosis?

#DiagnoseThis #nephsky #pathsky #renal #kidneypath

OK thread of all simulpubs at this year's #KidneyWk

ORIGIN-3: Atacicept pubmed.ncbi.nlm.nih.gov/41196369/

CKD as a curable dz? www.kidney-international.org/article/S008...

Albuminuria as a surrogate endpoint www.nature.com/articles/s41...

Shocking first high impact trial of the day. Fish oil reduces CV events in dialysis patients! #Pisces #kidneywk

Simultaneous pub in NEJM

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

The BICAR-ICU-2 trial just dropped!

RCT involving IV bicarb in metabolic acidosis among patients with mod-severe AKI

Bicarb didn't affect mortality but it reduced the need for dialysis & risk of bacteremia

VERY similar conclusions to BICAR-ICU-1

🧵 #1/

jamanetwork.com/journals/jam... #EMIMCC

I think this was the expected finding based on the original BICAR-ICU trial. In that one, 52% of the control group received RRT (and therefore bicarb) with a mean of 7 hours from enrollment. With poor separation of treatment arms, it’s hard to attribute the mortality benefit to the intervention.

Gain-of-function mutation of H+ATPase (gene ATP6V0A4) linked to renal tubular ALKALOSIS. dm5migu4zj3pb.cloudfront.net/manuscripts/...

Renalism: The failure to perform appropriate diagnostic/ therapeutic interventions in patients with CKD due to concern about risk of AKI #Nephpearls #NephSky

👉🏼 pubmed.ncbi.nlm.nih.gov/15339996/

I don’t think it matters if they are a DO or MD. They have the same training now. There are bad MDs (look at Casey Means) and DOs and there are great MDs and DOs.

🚨NEW paper alert🚨 co-led by Fan Fan, Jane (Qian) Liu (from the zeelab.org), and an interdisciplinary, multi-institutional team using computational image analysis and machine learning methods to identify novel tubular features associated with clinical outcomes above and beyond known risk factors👇

What is the name of the finding at the end of the arrow and what condition is it classically associated with?

#DiagnoseThis #pathology #renal #kidneypath #pathsky #nephsky

On September 18, @kdigo.org will release The 2025 Clinical Practice Guideline for the Management of IgA Nephropathy (IgAN) and IgA Vasculitis (IgAV)
#Nephpearls #NephSky

Glycemia Assessed by Continuous Glucose Monitoring among... : Journal of the American Society of Nephrology ilure and its treatments disrupt glucose homeostasis in ways that may promote both hyperglycemia and hypoglycemia. Continuous glucose monitoring (CGM) delineates detailed glycemic profiles, but publis...

Have hyperglycemia (and other DM badness) been hiding in plain sight in ESKD?

Probably.

Great study using CGMs in ESKD.

Pts with treated DM, mean TIR only 43% while mean HbA1c was 7.0%

journals.lww.com/jasn/abstrac...

Real-world use of terlipressin in cirrhosis and acute kidney injury: frequent use beyond hepatorenal syndrome Terlipressin is indicated to treat hepatorenal syndrome (HRS)-acute kidney injury (AKI), but is likely used outside this primary indication in clinica…

Real-world use of terlipressin in cirrhosis and acute kidney injury: frequent use beyond hepatorenal syndrome
#nephsky
www.sciencedirect.com/science/arti...

Not just for albuminuria - flozination and co sequent glycosuria can result in interference for other biomarkers too

Albuminuria data: pubmed.ncbi.nlm.nih.gov/36736537/

Visual abstract of trial

Interesting pilot/feasibility trial in @kireports.bsky.social

Decremental dialysis in elderly patients with small inter dialytic weight gains - going from 3 to 2x week HD. Easy to recruit, good adherence.

www.kireports.org/article/S246...

What do clinical trials teach us about the pathophysiology of human IgA nephropathy? Abstract. Immunoglobulin A nephropathy (IgAN) is a primary glomerulonephritis characterized by IgA-dominant or co-dominant mesangial immune deposits seen o

Unlike most pathogenesis reviews which have multidirectional arrows or hypothesis based on 🐁 data

This @ndt-era.bsky.social review uses data from completed and ongoing trials to explain what we know about IgAN

academic.oup.com/ndt/advance-...

#NephSky #OpenAccess

Spironolactone in patients on chronic haemodialysis at high risk of adverse cardiovascular outcomes (ALCHEMIST): a multicentre, double-blind, randomised, placebo-controlled trial and updated meta-anal... In patients with kidney failure on haemodialysis and with high risk of adverse cardiovascular outcomes, spironolactone did not reduce the incidence of major cardiovascular events. The updated meta-ana...

Paired nicely with the French ALCHEMIST trial (also negative)

www.thelancet.com/journals/lan...

#NephJC #NephSky

Spironolactone versus placebo in patients undergoing maintenance dialysis (ACHIEVE): an international, parallel-group, randomised controlled trial Among patients receiving maintenance dialysis, spironolactone 25 mg daily orally did not reduce the composite outcome of cardiovascular mortality and hospitalisation due to heart failure compared with...

Spironolactone does not work for dialysis

ACHIEVE published in @thelancet.com

@lastwalsh.bsky.social and colleagues

www.thelancet.com/journals/lan...

Coming soon to a #NephJC near you

Diagnosis and Management of Osteoporosis in Advanced Kidney Disease: A Review ca. 2022 from @ajkd.bsky.social
#Nephpearls #NephSky

👉🏼 pubmed.ncbi.nlm.nih.gov/34419519/

A bold guideline from the beginning!

“We suggest that all individuals with hypertension be screened for primary aldosteronism”

Re”FINE”ing the role of non steroidal MRAs in Cardio Kidney Metabolic syndrome — NephJC This week, we will discuss non-steroidal mineralocorticoid antagonist in the multiverse of cardiovascular-kidney-metabolic. What FINEHEART pooled analysis would add to what we already learned from FID...

Finerenone gets the HFpEF nod from FDA - as expected

NephJC coverage of FINEHEARTS www.nephjc.com/news/fineheart

Our editorial on kidney outcomes from FINEARTS: pubmed.ncbi.nlm.nih.gov/39814475/

PRECISION: In patients w/ resistant hypertension, aprocitentan was well tolerated & superior to placebo in lowering BP at week 4 w/ a sustained effect at week 40 ca. 2022 from @thelancet.com
#Nephpearls #NephSky

👉🏼 www.thelancet.com/journals/lan...

splash slide

This week at the Ottawa #NephGR

we have @vijayanmd.bsky.social from Intermountain Health on outpatient dialysis after AKI

#NephSky

Adrenal Insufficiency in Adults Adrenal insufficiency is a syndrome of cortisol deficiency. A recent JAMA Review summarizes the pathophysiology, diagnosis, and treatment of adrenal insufficiency and adrenal crisis. JAMA Associate Editor David Simel, MD, MHS, discusses this and more with author Anand Vaidya, MD, MMSc.

Adrenal insufficiency is a syndrome of cortisol deficiency.

🎙️ In this podcast episode, listen to author Anand Vaidya discuss the pathophysiology, diagnosis, and treatment of adrenal insufficiency and adrenal crisis with JAMA Associate Editor David Simel.

🎧 Listen now:

Low risk of tac balanced out by real risk of infection and thrombosis in uncontrolled nephrotic syndrome. People forget that 80-90% of these kids died pre-steroid. #NephJC

George Medicines announces FDA approval of WIDAPLIK™ (telmisartan, amlodipine and indapamide), a new single pill combination treatment for hypertension in adults, including initial treatment Novel, single pill, triple combination with a standard dose and two lower doses that can deliver the efficacy benefits of combination therapy, with an established safety profile and good tolerability ...

Triple drug combo now available in US - approved by FDA

Telmisartan 10
Amlodipine 1.25
Indapamide 0.625

george-medicines.com/george-medic...

#Hypertension
#Widaplik

Also in higher doses:
20/2.5/1.25 and
40/5/2.5