A short Bluetorial on plots of NIH application success rates as a function of percentile.
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09.03.2026 14:56
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A short Bluetorial on plots of NIH application success rates as a function of percentile.
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Maybe they’ll start pushing electric cars…
Clinical course of proteinuria due to cubilin variants: a large multicenter pediatric cohort
@ped-neph.bsky.social
link.springer.com/article/10.1...
Use of auto BP devices is rec'd by guidelines but many still measure BP manually. In this preprint, we categorize BP device based on terminal digit (manual BP results in even # terminal digits). Manual BP ~6mmHg lower and associated with 1.16x stroke risk vs automated www.medrxiv.org/content/10.6...
Underestimation of Blood Pressure and Stroke Risk by Manual Blood Pressure Measurement https://www.medrxiv.org/content/10.64898/2026.02.24.26346929v1
![Figure 1:The four established pillars supporting the diagnosis and management of CKD in glomerulonephritis: kidney histology, optimal blood pressure control, RAS blockade, and SGLT2 inhibition. These form the foundation of current best practice, highlighting the challenge for emerging therapies to integrate into this already optimized framework while still demonstrating additional benefit. The new treatment options for IgA nephropathy include targeting APRIL, BAFF, complement, and CD38, as well as combined AT1 and endothelin receptor inhibitors, and extended-release intestinal budesonide. Illustration created with BioRender and adapted from Li et al., 2025 [49].](https://cdn.bsky.app/img/feed_thumbnail/plain/did:plc:33h4q6nw674jdcwfxaq2m2nl/bafkreibe6r5nknp6zjzmgwf3t2dgrazhkfvoycuzobvwtczkkz5jubl5uy)
Figure 1:The four established pillars supporting the diagnosis and management of CKD in glomerulonephritis: kidney histology, optimal blood pressure control, RAS blockade, and SGLT2 inhibition. These form the foundation of current best practice, highlighting the challenge for emerging therapies to integrate into this already optimized framework while still demonstrating additional benefit. The new treatment options for IgA nephropathy include targeting APRIL, BAFF, complement, and CD38, as well as combined AT1 and endothelin receptor inhibitors, and extended-release intestinal budesonide. Illustration created with BioRender and adapted from Li et al., 2025 [49].
![annual treatment costs of new therapies vary by region, with sparsentan ranging from €56 640 in Germany to $118 800 in the USA [43, 44], slow-release budesonide from €126 655 to $174,00 0 [45], and Iptacopan from €460 510 to $550 377 [45]. Anti-APRIL and anti-BAFF therapies are expected to be in the range of €100 000–150 000 or $100 000–150 000 per patient per year [46]. It is estimated that ~400 000 patients with IgA nephropathy live in the EU and the USA combined, and up to 50% of them may be eligible to receive these new therapies [47, 48].
Given these expenses, the revenue generated by the new specific therapies should be sufficient to support outcome studies conducted on a background of up-to-date therapies, particularly SGLT2 inhibition, as outlined before. At the same time, this is also a call to action for all nephrologists managing patients with glomerular diseases: novel and expensive therapies should not be prescribed uncritically before ensuring that the four fundamental pillars of supportive care are fully in place for at least several months, as demonstrated in the STOP-IgA trial [39].](https://cdn.bsky.app/img/feed_thumbnail/plain/did:plc:33h4q6nw674jdcwfxaq2m2nl/bafkreiba5o4li72zhbaaipuqlkikslqikj6xmr5pe3dpdxvejfrmcwmzc4)
annual treatment costs of new therapies vary by region, with sparsentan ranging from €56 640 in Germany to $118 800 in the USA [43, 44], slow-release budesonide from €126 655 to $174,00 0 [45], and Iptacopan from €460 510 to $550 377 [45]. Anti-APRIL and anti-BAFF therapies are expected to be in the range of €100 000–150 000 or $100 000–150 000 per patient per year [46]. It is estimated that ~400 000 patients with IgA nephropathy live in the EU and the USA combined, and up to 50% of them may be eligible to receive these new therapies [47, 48]. Given these expenses, the revenue generated by the new specific therapies should be sufficient to support outcome studies conducted on a background of up-to-date therapies, particularly SGLT2 inhibition, as outlined before. At the same time, this is also a call to action for all nephrologists managing patients with glomerular diseases: novel and expensive therapies should not be prescribed uncritically before ensuring that the four fundamental pillars of supportive care are fully in place for at least several months, as demonstrated in the STOP-IgA trial [39].
Interesting POV on new therapies in glomerular diseases in NDT #Free
academic.oup.com/ndt/article/...
What Jon Barratt calls palliative, others call supportive, these call ‘foundational’. RASi and Flozins ✅evidence for BP is opinion I think?
But cost issues are huge, as shown here.
If no nonimmunosuppressive therapies for IgA are “palliative” then we all have patients who have been on “hospice” for many years and likely discharged from hospice…
Glomerular basement membrane (GBM) structural integrity dictates trans-tissu... www.sciencedirect.com/science/arti... Really proud of this Cell Reports paper showing that the potentially pathogenic laminin alpha2 in the Alport GBM comes not from glomerular cells, but from the bloodstream.
Thanks Gates, totally agree very important for us to discuss hygiene and not easy for many to talk about!
SGLTi question - is it important to consider circumcision status for males? pt mentioned difficulties retracting foreskin due (sugary urine must have some impact) resulting in discontinuation…and happened to notice another pt had a similar problem @askrenal.bsky.social
Excited to share our research letter published today in JAMA on the new Apple Watch Hypertension Notification Feature! jamanetwork.com/journals/jam...
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#WeekendReads from the Advance articles section
Trends in Initial Combination Antihypertensive Therapy in a US Health System
🔗 academic.oup.com/ajh/advance-... 🔒
Impact of Smartphone-Enabled Home Urinary Albumin-to-Creatinine Ratio Testing on Albuminuria Screening and Management
bit.ly/4pMQekv (OPEN ACCESS)
@alexchangmd.bsky.social
Wow so confusing, gotta use cutoffs 25% lower for lc-ms/ms measured aldosterone
I think there could be more clarity in how many labs report results. i.e what threshold should be considered a suppressed renin, positive screen, etc. The variety of different assays/units remains a major source of confusion. Most clinicians won't be aware of Table 5 from the Endo society guideline
For example, my institution's lab historically reported renin/aldo with these reference ranges. Cases of overt PA could be interpreted as normal. But results are now reported with guidance on interpretation with the relevant cutoffs from our lab's assays.
You’re awesome! Harder for those already on 3-5 BP meds by the time they get to us. Trying to figure out how to push this more for the less attentive/knowledgeable providers
This is nice thank you for sharing!
https://www.endocrine.org/clinical-practice-guidelines/primary-aldosteronism-2
As guidelines rec more Aldo/renin testing in htn, wondering whats labs role to ensure/capture details on relevant factors (timing, Na restriction, meds, KP)? Should labs rec pts test in more standardized conditions, log key details or just do it-clinicians duty to sort out? @askrenal.bsky.social
Excited to share our thoughts on the Apple Watch Hypertension alert!
@jordybc.bsky.social @deanpicone.bsky.social @alta-schutte.bsky.social
Apple Watch for Hypertension Screening | Hypertension www.ahajournals.org/doi/10.1161/...
Pilot phase PREvention of CardIovascular and DiabEtic kidNey disease in Type 2 Diabetes (PRECIDENTD) trial. Monotherapy vs. dual therapy fill rates were 87% vs. 68% overall (P=0.004) at 10months. Of those filling meds, 22% in monotherapy, 49% in dual therapy d/c'ed
pubmed.ncbi.nlm.nih.gov/41456635/
Wow congratulations Michelle!
I do wonder how much of the effect may be due to initiation of MRA vs higher potassium in itself. #cardiosky #emimcc
Random Mention of beef tallow in this short “guideline” is about all you need to know about its seriousness
I agree. My license elapsed for it due to my low use of it. I find it distasteful to instead spend time fixing the AIs note after the fact
Impact of Cost-Sharing on Self-Measured Blood Pressure: Cost and Prescription Abandonment for Home BP Monitors in a Large FQHC
academic.oup.com/ajh/article-...
Nephrotic syndrome genomic discovery in the Mass General Brigham Biobank identifies monoallelic MEFV variants as a risk factor for focal segmental glomerulosclerosis
#nephsky #nephrology
www.kidney-international.org/article/S008...
New out today:
Antiproteinuric Effect of Sparsentan in Patients with Genetic-Associated FSGS Enrolled in the DUPLEX Trial
Genetic FSGS CAN be treated. journals.lww.com/cjasn/abstra...
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