Fresh from the press in
@NatRevImmunol
The 5 types of glomerulonephritis that connect pathogenesis with immunotherapy thanks to
@PRomagnani
@KitchingLab
and Nelson Leung from Mayo
Now online in
@NDTsocial
Hyponatremia - Treatment standard 2024
🥸 A gradual correction and clinical evaluation is preferable over the rapid normalization of serum sodium towards the laboratory reference ranges.
▶️
Our latest review just went online in
@NatRevRheumatol
#Lupus
nephritis-related chronic CKD
Check out all things to do beyond prescribing immunosuppressants to improve kidney outcomes
(together with your nephrologist)
Here is a free view only link
Now open access in
@NDTsocial
Antibody-mediated podocytopathies: a disease entity that implies immunotherapy
🧐A novel disease concept beyond MCD/FSGS lesion patterns discussed by the Immunonephrology Working Group of
@ERAkidney
▶️
Now open access in
@NDTsocial
Management of adult patients with podocytopathies - an update from the ERA Immunonephrology Working Group
@smirioglu
@AKronbichler
▶️
Our primer on "Lupus nephritis" is now free online during the Springer Nature collection “Rheumatic Disease Awareness Month” until Oct 20.
@kidneydoc101
@BradRovin
Now online at
@NDTsocial
@HerrmannMd
Immune checkpoint inhibitor-associated nephritis - treatment standard
🧐A subset of patients will require additional steroid-sparing therapies for corticosteroid-dependent or refractory ICI-AKI.
▶️
IgAN, MN, SLE, ANCA-GN,... all seem different GNs but all develop from same immune system. Only AGs differ ⏩location of 🔥. But we don`t target AG! We target always the same immune system. Tx differs only by level of autoimmune activity ⏩ basket RCTs
Now open access in Nat Rev Dis Primers "Podocytopathies"
An updated view on nephrotic syndromes (MCD, FSGS, SSNS, SRNS, ...). Role of APOL1, global epidemiology, pathomechanisms, diagnostics, QoL, and management.
@nephcure
During his 25 years as a nephrologist, HJA has travelled to many conferences on kidney disease. On his return, his patients often ask him if he has learnt anything relevant to them. For more than two decades, “I had to tell them no”…
🙏 that changed
1. episode of
#lupus
nephritis = irreversible nephron loss, which 🔽kidney functional reserve, e.g., needed for a pregnancy.
Result: HTN, proteinuria, preeclampsia rates as kidneys do not stand the ⬆️workload. Same with obesity/DM later in life
@NDTsocial
Latest GN supplement all free online
▶️New GN classification
▶️Factor Bb predicts IgAN outcomes
▶️All immunomodulatory drugs for kidney disease
▶️Novel complement inhibitors for GN
▶️How to prevent infections in GN
▶️CKD therapy in GN
Now open access in
@NDTsocial
A Stain Reclaimed: The Legacy of Drs. Prescott & Brodie
by
@jrseltzer
@VelezNephHepato
@rmothy
🧐This stain reduces confusion for both the novice and experienced clinician doing urinary microscopy.
⏩
The adverse effect of SGLT2 inh not reported in RCTs/metanalysis: Worrisome increases in Hgb levels - now free online in NDT
Sodium-glucose co-transporter-2 inhibitor use and erythrocytosis: assessment of risk and need for referral to hematology
Now open access in
@NDTsocial
SELECT: a 10% reduction in body weight with GLP-1 receptor agonists improves kidney outcomes in overweight and obese patients without diabetes
Happy to see this finally out. The first study able to define the sensitivity and specificity of commercial anti-nephrin Ab by using kidney biopsies as gold standard. Standard Elisas do the job well.
If something in nephrology is too complicated to be explained to medical students, e.g.,
#glomerulonephritis
, it`s likely not yet well understood
Read how everyone can understand the GNs:
▶️
@KitchingLab
@PRomagnani
Now open access in
@NDTsocial
IV methylprednisolone for nephrotic syndrome with minimal change lesions in adults: a RCT
🧐 Short-term IV MP followed by oral pred may be a better choice for NS patients with MC lesions
▶️
Now online in
@NDTsocial
Clinical and histological comparison of IgAN and renal IgAV
🧐 IgAN and IgAV follow distinct courses/require different tx strategies. Oxford classif.&LN-CI can categorize and predicting long-term prognosis in both
▶️
Association between serum iron markers, iron supplementation, and cardiovascular morbidity in pre-dialysis chronic kidney disease | Nephrology Dialysis Transplantation | Oxford Academic
Do you know our short author videos of accepted
@NDTsocial
papers? Here is our latest on SGLT2i in GN
Here is the full collection of NDT author videos (free access)
Now online in
@NDTsocial
Anti-C1Q monitoring predicts relapses of
#lupus
nephritis
🧐High titres of anti-C1qAb at start of therapy and their persistent positivity at 1 year is strongly associated with renal flares.
▶️
Important concepts because low nephron no is a 🔝RF for HTN, proteinuria of any cause, pre-eclampsia, DKD, progression of CKD, AKI/CKD transition etc etc.
Nephrons develop by log2 , so most come from the last rounds of branching = last wks of pregnancy
@valerie_luyckx
Does this compromize the ongoing IgAN trials that do not include SGLT2 inhibition as SOC? Will there really be still a need for immune modulators for IgAN, if dual RAS/SGLT2 inhibition is so potent?
#asn2020
Now free online in
@NDTsocial
Genetic kidney stones disease in adults
Editorial by Bernd Hoppe, et al
🧐New treatment options in rare metabolic diseases are now available
▶️
Now open access in
@NDTsocial
Extrarenal manifestations in inherited kidney diseases
🧐The interplay between genetic variants and molecular pathways underscores the importance of exploring the extrarenal aspects of inherited kidney diseases.
▶️
HTN and CKD are frequently associated and causality HTN->CKD is a popular misconcept.
The fact that monogenic forms of HTN do not cause CKD disproves HTN->CKD theory.
CKD->HTN !
"Essential" HTN:
1. Urine exam, nephron no?, birth weight?, previous AKI?, etc...
2. Aldo/Renin
Now open access in
@NDTsocial
Placement of tunneled hemodialysis catheters - interventional standard
🧐Novel developments include catheter placement with ultrasound-guidance or ECG-guidance.
▶️
Now open access in
@NDTsocial
Albuminuria predicts
#kidney
events in IgAN
📢 Lower levels of UACR significantly associated with MAKE (major adverse kidney events)
👉 IgAN is glomerular and a form of CKD. UACR seems to be top for assessment
⏩
Congrats to
@StefanieSteige6
for her mechanistic explanation on the controversy on the role of uric acid in the progression of
#CKD
. Maybe crystalluria can help to identify pts. that potentially benefit from urate-lowering therapy? No role w/o crystals!
Everyone speaks about AKI, few speak about AKD, but many pts develop AKD w/o AKI. AKD +/- AKI has important consequences on mortality and subsequent CKD.
Incidence and prognosis of AKI versus AKD among 71,041 inpatients
Now online in
@NDTsocial
Metabolic Alkalosis Treatment Standard
🧐While metabolic alkalosis is frequently not dangerous, in certain settings, metabolic alkalosis may contribute to mortality and should be aggressively managed
▶️
Had a rhabdomyolysis case today with eGFR(Cr): 15 ml/min and eGFR(Cys): 60 ml/min !??
Good read and now open access in
@NDTsocial
▶️"Diagnostic standard: Assessing GFR"
by
@PStoneOftheYear
, et al.
Proud to be named a Highly Cited Researcher 2022 by
@ClarivateAG
. See the full list
#HighlyCited2022
Thanks to everyone reading and citing our research!!
Now open access in
@NDTsocial
Magnesium Biology
🧐Recently, prebiotic dietary fibers and SGLT2 inhibitors have been proposed as promising new therapeutic pathways to treat hypomagnesemia.
▶️
Now OA in
@NDTsocial
Primary immunodeficiency (PID) as a cause of immune-mediated kidney diseases
👉PIDs can cause autoimmunity
👉largely neglected in nephrology
👉many possibilities for research
👉PID as cause for infectious complications
▶️
Every patient with
#lupusnephritis
is a CKD pt. With every LN episode she/he looses nephrons (just as in an AKI episode), Nephron loss = shortening of
#kidney
life span!
Thus, let a pt. with LN NEVER have a 2. LN episode, AKI, drug tox, etc. Check out at
Now online in
@NDTsocial
Prophylactic treatment of FSGS recurrence in pts who relapsed in a previous kidney graft
🧐Better no prophylactic treatment in pts receiving a 2nd graft after recurrent FSGS in a previous graft
⏩
Now open access in
@NDTsocial
Cardio-renoprotective effects of SGLT2 inhibitors—the role of anaemia correction
😇 more erythropoiesis and hemoconcentration
⏩
1. Most drugs for GN act outside the kidney (spleen, lymph nodes, bone marrow)
2. Long pipeline of drugs for 3 of the 5 groups of GN that connect immunopathogenesis + immunotherapy
Now in
@NatRevImmunol
@KitchingLab
@PRomagnani
, Nelson Leung
Free online:
Pregnancy-related hyperfiltration is a kidney stress test and those with insufficient reserve to adapt to the increased workload develop HTN and proteinuria like everyone else that exceeds reserve (DM, obesity, low nephron no).
Now online in
@NDTsocial
A novel approach to induce early remission in high-risk primary membranous nephropathy
👉A combination of RTX, IVCYC, and steroids is effective and safe in high-risk pts
▶️
Now online in
@NDTsocial
Biology of the proximal tubule in body homeostasis and kidney disease
🧐The PT is critical for understanding disease phenotypes, their systemic complications and for developing new therapeutic strategies
▶️
End of
#2021
token. Just received a copy of this book to which we had the honour to contribute a chapter on renal hemodynamics and the RAS together with
@PepaSolerR
@MotrapuManga
. Thanks
@edgarvlermamd
and crew. Note that the book title avoids DN/DKD!!
Now open access in
@NDTsocial
😬Weight loss with GLP1- and dual-receptor agonists affect both SCr and Cys-based eGFR formulas suggesting fake kidney function improvements
📢One possible solution: remove body surface correction
⏩
Important milestone in nephrology. Finally, we can treat hemodynamic and metabolic overload of the remaining nephrons, the major drivers of CKD progression 👍
Now online in
@NDTsocial
Chimeric HLA antibody receptor T cell therapy for humoral transplant rejection
🧐 From CAR-T cells to CHAR-T cells in order to target alloreactive ab-producing immune cells in the recipient
▶️
Novartis investigational iptacopan Phase III study demonstrates clinically meaningful and highly statistically significant proteinuria reduction in patients with IgA nephropathy (IgAN) | Novartis
Baricitinib for systemic lupus erythematosus: a double-blind, randomised, placebo-controlled, phase 3 trial (SLE-BRAVE-I) - The Lancet. Also check this:
Now free online in
@FrontImmunol
Macrophages and fibrosis: how resident and infiltrating mononuclear phagocytes account for organ injury, regeneration or atrophy
@buschraml
@PRomagnani
Delighted to share our state-of-the-art review on treatment of IgAN in
@NDTsocial
. Honoured to work on this with
@IgAN_JBarratt
and
@MichelleOShaug3
. Exciting times for IgAN therapeutics!
These results have important implications! Once SCr is elevated (CKD3 or more) it's tooo late (>65% of nephrons lost). Treating CKD must start from the stage of urinary abnormalities (or before). Thus, the window-of-opportunity is mostly in the hands of GPs, not nephrologists.
Now online in
@NDTsocial
The effect of preeclampsia on long-term kidney function among pregnant women with CKD
🧐Preeclampsia = greater risk of long-term CKD progression or ESKD , especially in patients with early-onset preeclampsia.
▶️
How hyperuricemia with or without UA crystalluria affects the kidney. Mechanisms explaining
#PERL
#CKDFIX
For next CKD allopurinol trial include only pts with UA crystalluria!
@StefanieSteige6
@JASN_News
Now online in JASN