Rolando Claure

🫘 Empagliflozin in ADPKD: A pilot RCT (JASN; n=50) showed good tolerability and an early eGFR dip followed by stabilization, but greater kidney volume increase vs placebo. 🔬 Larger trials needed. 🔗 www.ovid.com/jnls/jasn/fu...

💊 Drug dosing in post-dilution HDF: Are standard HD doses appropriate? A review highlights the impact of drug properties, convection volume, & post-dialysis rebound on drug clearance. Individualized dosing & therapeutic drug monitoring are essential. 🔗 journals.lww.com/cjasn/fullte...

Promising advances in kidney transplant desensitization! A phase 1 study reports that dual CD19/BCMA CAR-T therapy induced profound but transient B-cell depletion, ⬇️HLA sensitization, & enabled kidney transplantation in 2 highly sensitized patients 🔗DOI: 10.1056/NEJMoa2513428

#KidneyWk 👉🏻Rethinking post-AKI care! 🏥 COPE-AKI trial: Can multidisciplinary care improve recovery after severe AKI? 👩‍⚕️ Nurse navigator + pharmacist + nephrologist + remote monitoring 🎯: hospital-free days at 90 days. Kidney recovery needs team-based care beyond discharge!

#KidneyWk 2026 | Post-AKI care: One size does NOT fit all! KAMPS provides a framework: 🩺 Kidney function 📢 Advocacy 💊 Medications 🩸 Pressure ⚠️ Sick-day rules 💡 Recovery care must be individualized by AKI etiology, comorbidities & medication needs.

#KidneyWk 2026 | Closing the post-AKI care gap 📊 AKI documentation at discharge improved from 22% to 92% with bundled intervention. ⚠️ Yet fewer than 25% receive🫘 function testing within 90 days. AKI recovery requires structured follow-up, better ℹ️ & multidisciplinary care!

#KidneyWk 2026 | Moving from AKI recognition to prevention! 📊 Tackling AKI: Better care, shorter hospital stays, but no mortality benefit. 💊 NINJA: 23.8% reduction in nephrotoxic AKI across centers. 💡 The future of AKI prevention lies in system-level interventions!

🔬 #KidneyWk 2026 | Biomarkers in AKI Urinary CCL14 outperformed NGAL, CHI3L1, cystatin C & proenkephalin in predicting persistent severe AKI. 📊 Higher CCL14 levels were linked to greater RRT requirements. CCL14 may improve risk stratification and guide kidney care decisions.

🔬 #KidneyWk 2026 Beyond urine output & CrCl, proenkephalin (penKid) may help predict kidney recovery. 📊 ELAIN analysis: Lower pre-RRT penKid predicted earlier successful dialysis liberation. 💡 Biomarkers + functional assessment may guide personalized RRT discontinuation.

🔬 #KidneyWk 2026 | Urine microscopy is valuable for AKI diagnosis, but its role in guiding RRT discontinuation remains unvalidated. ⚠️ Operator dependence & unreliable urine chemistry limit its use. Diagnostic utility ≠ predictive value for 🫘recovery.

Pre-admission proteinuria is a key predictor of renal non-recovery! In patients with baseline eGFR 15–29, 90-day kidney recovery declined from 45.5% to 25.3% with ≥2+ proteinuria. AKI recovery depends not only on injury severity, but also on pre-existing 🫘health. #KidneyWk

Can the furosemide stress test predict 🫘 recovery after CRRT? In 25 patients, urine output after IV furosemide was significantly ⬆️in those who recovered 🫘function (654 vs 48 mL; AUC 0.84). A promising functional tool to guide RRT liberation, beyond serum sCr alone. #KidneyWk

A paradigm shift in AKI-D management #KidneyWk The LIBERATE-D study challenges the idea that 🫘 function must recover before stopping dialysis. Even with CrCl of 5–<10 mL/min, 44% remained dialysis-free for 7 days. Could stopping dialysis be part of the path to kidney recovery?

🧬 From the RNA world to complex life! At #KidneyWk 2026, Craig Mello explores how biological information evolved—from RNA & DNA to intricate networks of molecular interactions. Life’s information is not just encoded in genes; it emerges from dynamic, self-organizing networks.

🧬 Identical transgenes at the same chromosomal site can remain ON or OFF through stable gene silencing. A striking example of RNA-mediated epigenetic regulation—and its potential to inspire precision therapies! 🔬#KidneyWk

🧬 At #KidneyWk 2026, Craig Mello highlights RNAi’s therapeutic power: synthetic siRNAs guide Argonaute (RISC) to complementary mRNAs, triggering their degradation and reducing disease-causing protein production. Precision medicine at the RNA level! 🔬

🧬 From C. elegans to precision medicine At #KidneyWk 2026, Craig Mello highlights how RNAi transformed basic science into targeted therapeutics. The breakthrough: silencing disease-causing genes at the mRNA level, opening new avenues for treating previously undruggable targets

Inspiring start to Day 3 of #KidneyWk 2026! Listening to Nobel Laureate Craig C. Mello on RNA interference, from discoveries in C. elegans to a revolution in molecular biology and medicine. A powerful reminder of how basic science transforms human health! 🔬🧬

🚨 Double the runs. Double the fun #NephJC is bringing TWO NephRuns to #KidneyWk! 🏃 Friday NephRun 🏃 Saturday NephRun 5K Start your day with fresh air, great company, and the best community in nephrology. See you at the starting line! 👇More details www.nephjc.com/news/...

Proud to see my mentor, Prof. Ravindra L. Mehta, receive the prestigious @asnkidney.bsky.social 2026 Robert G. Narins Award at #KidneyWk! As a former mentee, I am deeply grateful for his guidance, inspiration, and lasting impact on my professional journey. Well-deserved recognition, Ravi!

🏃‍♂️ Another early morning run in Denver before Day 3 of #KidneyWk 2026! 🏔️ This time led by @kidneyboy.bsky.social! Nothing beats starting the day with exercise, friendship, and our wonderful nephrology community! @nephjc.bsky.social @asnkidney.bsky.social #NephRun #NephRun

🩺 #KidneyWk 2026 | Hemodynamic assessment beyond POCUS! CRT is a simple 🛌 marker of peripheral perfusion. ✅ Hand at heart level ✅ Apply pressure for 10 seconds ✅ CRT >3 seconds is abnormal Integrate CRT with POCUS & clinical findings to assess tissue perfusion.

🫀 #KidneyWk 2026 | ❤️ POCUS LVOT VTI provides a practical estimate of stroke volume and cardiac output. 🔹 Stroke volume = LVOT area × VTI 🔹 Cardiac output = SV × heart rate 💡 IVC and VExUS assess venous congestion, while LVOT VTI helps evaluate forward cardiac flow.

🫁 #KidneyWk 2026 | Lung POCUS B-lines indicate increased lung density—not necessarily fluid overload. They may occur in pulmonary edema, ARDS, pneumonia, interstitial lung disease, or alveolar hemorrhage. 💡 B-lines detect an interstitial-alveolar syndrome, not its cause

🩺 #KidneyWk 2026 | Beyond the IVC: VExUS! A dilated IVC suggests elevated right atrial pressure, but does not establish systemic venous congestion. VExUS integrates hepatic, portal & intrarenal venous Doppler to grade congestion severity. Don’t rely on IVC diameter alone

🩺 #KidneyWk | LUST trial pearl: Lung US–guided fluid management in HD improved decongestion (78% vs 56%)& reduced intradialytic hypotension. ⚠️ No significant reduction in the primary composite of death, MI, or HF. Takeaway: Better volume assessment ≠ proven survival benefit

POCUS pearls at #KidneyWk 2026! IVC - Know your anatomy, assess diameter and respiratory variation, & recognize limitations of estimating right atrial pressure. ⚠️ Mechanical ventilation changes IVC dynamics. Never interpret IVC findings in isolation—clinical context matters!

Renal POCUS: Always scan the bladder, assess in two planes, use Doppler, and recognize mimics of hydronephrosis. Look beyond stones and pay special attention to kidney transplants. Practical pearls for better clinical decisions! #KidneyWk #POCUS

Social determinants matter after AKI! Among 30,498 ICU-AKI survivors, Black race was associated with a 43% higher risk of kidney failure, while health insurance was linked to a 40% lower risk. Neighborhood deprivation also increased risk. #KidneyWk

results from the IMAgINATION trial at #KidneyWk! Sefaxersen, an RNA-targeted therapy for IgA nephropathy, achieved a 43.1% reduction in proteinuria vs placebo at week 37. ✅ Consistent efficacy across subgroups ✅ Greater hematuria resolution ✅ Favorable safety profile

Promising PAES trial results at #KidneyWk: Imlifidase enabled transplantation in highly sensitized kidney recipients (cPRA ≥95%). At 1 year (n=50): • 90% graft failure-free survival • 98% patient survival • 92% graft survival A potential path to transplant for this patients

Phase IIa results HLX79/E-602 + rituximab (30 mg/kg) vs rituximab alone: ✅ Faster response: 3 vs 11 weeks ✅ Week 24 remission: 86% vs 67% ✅ Week 36 remission: 100% vs 50% ✅ No new safety signals ⚠️ Small study (n=26); confirmation needed. #KidneyWk

🫘 Beyond B-cell depletion in membranous nephropathy! HLX79/E-602, a novel sialidase, may enhance rituximab-mediated B-cell clearance and overcome delayed clinical remission. 🔬 Phase IIa trial: rituximab ± HLX79 (10–30 mg/kg). #KidneyWk

☀️ SIMPLIFIED Trial: safety findings in dialysis (n=3,866). 🔹 Hospitalizations: 69% vs 70% 🔹 No major differences in serious adverse events ⚠️ Hypercalcemia and calciphylaxis reported High-dose vitamin D did not improve survival; monitor calcium and safety. #KidneyWk

☀️ SIMPLIFIED Trial at #KidneyWk (n=3,866): High-dose cholecalciferol in dialysis: ❌ No significant survival benefit (HR 0.95; P=.26) ✅ Lower MACE (HR 0.88; P=.034) ❌ No clear benefit for infections, fractures or cancer 💡 Correcting vitamin D ≠ improving survival.

☀️ Does correcting vitamin D deficiency improve survival in dialysis? The SIMPLIFIED RCT (n=3,866) tested cholecalciferol 60,000 IU every 2 weeks vs standard care. ✅ 25(OH)D increased from 36.5 to 141 nmol/L. #KidneyWk

🌍 Air pollution & CKD: it’s not just PM2.5! Atmospheric reactions generate secondary pollutants potentially more harmful than direct emissions. 🔬 VOC reaction products, brake/tire particles & wildfire smoke deserve greater attention. #KidneyWk

🌍 Air pollution & CKD: beyond PM2.5! Primary pollutants react in sunlight, forming secondary organic aerosols (SOA) rich in reactive peroxides. 🔬 These may drive oxidative stress, inflammation & kidney injury. Are we measuring the true nephrotoxic agents? #KidneyWk

🫀 HFpEF and CKD share a common metabolic phenotype! Hypertension treatment should target more than BP—prioritize therapies with cardiac and kidney benefits, tailored to metabolic risk, comorbidities and patient phenotype. Treat the patient, not just the numbers! #KidneyWk

🫀 Hypertension in HFpEF: treat the phenotype, not just the BP! 🔹 Spironolactone may benefit selected metabolic/inflammatory phenotypes. 🔹 Amlodipine vs metoprolol: ↓ BP, ↓ NT-proBNP, ↑ exercise tolerance. 💡 Clinical pearl: Individualize BP therapy. #KidneyWk

🚨 Closing the screening gap in primary aldosteronism! At #KidneyWk: A targeted clinic intervention increased screening orders from 1.8% to 16.4% (~9-fold)! Yet fewer than half of ordered tests were completed in the intervention clinic. Implementation matters! #Hypertension

🚨 Expanding screening for primary aldosteronism! 2025 hypertension guidelines recommend screening in resistant HTN, hypoK, OSA, adrenal incidentaloma & relevant family history. 🔹 Screening may also be considered in stage 2 HTN. Detect early, treat specifically! #KidneyWk

🫘 Primary aldosteronism in CKD: does surgery offer advantages? In a cohort of 239 patients, adrenalectomy (n=158) vs medical therapy (n=81) was associated with: ✅ Lower SBP ✅ Fewer antihypertensive medications ✅ Similar kidney & CV event rates #KidneyWk

🚨 Primary aldosteronism: a major missed opportunity in resistant HTN! 🔹 Only 1.6% underwent screening 🔹 Only 14% received MRA therapy Early detection matters! Screening can identify treatable causes of hypertension and potentially prevent kidney & CV damage. #KidneyWk

🏃‍♂️ Day 2 at #KidneyWk 2026! Another early morning run through beautiful Denver! 🌄🏔️ Great views, fresh air, and even better company. The perfect way to start another exciting day of science, learning, and reconnecting with friends and colleagues! @nephjc.bsky.social 🏃🏻‍♀️ 🏃🏻‍♂️

🩸Hemoadsorption +HD: toward precision medicine! Rome 2025 consensus proposes phenotype-guided selection based on: ✅ Refractory pruritus, restless legs & fatigue ✅ Frailty, cognitive decline & poor recovery ✅ β2-MG, uremic toxins & inflammation Treat 🧍‍♂️not just Kt/V! #KidneyWk

🩸 Hemoperfusion in maintenance HD! Beijing multicenter RCT (n=440): Adding HA130 hemoperfusion to low- or high-flux HD was associated with: ✅ Lower β2-microglobulin & PTH ✅ Reduced systemic inflammation ✅ Improved uremic pruritus Promising symptomatic benefits! #KidneyWk

🩸 Hemoadsorption in maintenance HD: promising results! Shanghai multicenter RCT (n=1,407): ⬇️ All-cause mortality: 22% (HR 0.78) ⬇️ CV mortality: 34% (HR 0.66) ⬇️ Major CV events: 23% (HR 0.77) Benefits vs mostly low-flux HD. Important context! #KidneyWk #Dialysis

🫀 Can EBP prevent cardiac surgery–associated AKI? SIRAKI02 RCT (n=343): ✅ CSA-AKI: 28.4% vs 39.7% (P=.01) ✅ Fewer transient AKI episodes ✅ Lower TNF-α and IL-8 levels Promising evidence for AKI prevention during cardiac surgery! #KidneyWk #AKI #EBP