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grahamabra.bsky.social @grahamabra.bsky.social · 5h

Much needed trial!

We need to study all the DKD pillars to DMI

I have a couple proactive DMI patients on SGLT2i (and Finerenone!) with urine ketone monitoring

diabetesjournals.org/care/article...

International Consensus on Risk Management of Diabetic Ketoacidosis in Patients With Type 1 Diabetes Treated With Sodium–Glucose Cotransporter (SGLT) Inhibitors

Sodium–glucose cotransporter (SGLT) inhibitors are new oral antidiabetes medications shown to effectively reduce glycated hemoglobin (A1C) and glycemic var

diabetesjournals.org

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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 13h

I like this trial!

Lead by David Cherney in Canada

Sotagliflozin in T1DM and DKD kidney.ca/Research/Sup...

Deliberately using a Flozin in T1DM
Everyone gets CGM
Everyone gets ketone monitoring

#CSNHomecoming

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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 13h

With an interesting DKA mitigation protocol

#CSNHomecoming

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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 6d

The 2025 #NephJC at #KidneyWk details

www.nephjc.com/news/2025/10...

Thanks to @jadav.bsky.social!

The 2025 NephJC Night, in Houston — NephJC

SAVE THE DATE! On FRIDAY night, NOVEMBER 7th, NephJC will be hosting another of its legendary NephJC Nights during ASN Kidney Week

www.nephjc.com

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Jonathan Zuckerman MD PhD @jzrenalpath.bsky.social · 7d

A startling biopsy. Severe acute TMA in a pt with suspected scleroderma renal crisis. Massive vascular thrombosis, mucoid intimal edema, and early onion skin change associated with severe cortical necrosis. #renalpath #nephsky #pathsky

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grahamabra.bsky.social @grahamabra.bsky.social · 9d

Nailed it.

grahamabra.bsky.social @grahamabra.bsky.social · 9d

The list is short and contains none :)

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Jonathan Pollack @jonathanpollack.bsky.social · 13d

Fascinating that CLYM116 is compared to sibe in a preclinical study. Hope we see more head-to-head comparisons with other leading or emerging agents!

Climb Bio Announces CLYM116 Preclinical Data Highlighting Potential for Best-In-Class Therapeutic for IgAN | Climb Bio

New preclinical data demonstrate deeper IgA reduction and a longer half-life compared to first-generation anti-APRIL monoclonal antibody CLYM116 Phase 1 trial initiation expected in Q4 2025, with init...

ir.climbbio.com

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grahamabra.bsky.social @grahamabra.bsky.social · 9d

These issues are really important

Lots of KOLs pushing multi target therapy in IgA Nephropathy with basically no data in trails to date

It’s mechanistically appealing but who knows what the right answer is unless we do the studies

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grahamabra.bsky.social @grahamabra.bsky.social · 14d

And there is the longer term followup study AURORA 2 that did not show signs of nephrotoxicity (concern of course with CNI)

pubmed.ncbi.nlm.nih.gov/37466424/

Safety and Efficacy of Long-Term Voclosporin Treatment for Lupus Nephritis in the Phase 3 AURORA 2 Clinical Trial - PubMed

Data demonstrate the safety and efficacy of long-term voclosporin treatment over three years of follow-up in patients with LN.

pubmed.ncbi.nlm.nih.gov

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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 16d

Very strange post singling out Voclosporin and lupus nephritis from the FDA CDER chap

www.linkedin.com/posts/george... since deleted already

h/t @ericweinhandl.bsky.social and @grahamabra.bsky.social

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grahamabra.bsky.social @grahamabra.bsky.social · 18d

Agreed.

I’m all for proteinuria reduction to bring in more smart people to kidney disease work but we need to make sure we avoid the never ending phosphate binder style blackhole of believing and writing surrogate outcome altering meds into guidelines

Show me the 📈 GFR!

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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 20d

And it’s live

Iptacopan in C3GN makes it to @thelancet.com

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

#NephSky

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NEJM.org @nejm.org · 19d

A 52-year-old woman with hypertension presented to the hospital with a 1-month history of fatigue, as well as 6 days of vomiting and 1 day of confusion. Over the past 20 years, she had not received regular treatment for hypertension. 1/2

#MedSky

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grahamabra.bsky.social @grahamabra.bsky.social · 21d

Small group Peritoneal Dialysis case discussion leaders at the Home Dialysis Academy of Excellence!

Drs Ananthakrishnan and Young from UC Davis Division of Nephrology Dr @grahamabra.bsky.social from Stanford Division of Nephrology and Dr Harini Sarathy from UCSF Division of Nephrology

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Nephrology Journal Club @nephjc.bsky.social · 24d

It's that time of year again 🍂🍂🍂
The #NephJC Fall pledge drive.
Plese give if you are able to support our decades long mission of #FOAMed for all. #NephSky #MedSky
www.nephjc.com/news/2025/9/22/nephjc-fall-pledge-drive

NephJC 2025 Fall Pledge Drive — NephJC

Help keep NephJC a vital, original, and unbiased source of medical education.

www.nephjc.com

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Joel Topf @kidneyboy.bsky.social · 26d

I teach it. I have not seen this studied in a systematic way, but Edelman equation is not just a good idea, it’s the law.

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grahamabra.bsky.social @grahamabra.bsky.social · 26d

Has anyone studied the use of K supplementation to increase daily solute load and subsequently free water excretion in SIADH?

#AskRenal

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grahamabra.bsky.social @grahamabra.bsky.social · 26d

Certainly warrants more investigation, understudied area, we need good prospective RCTs targeting CGM metrics and/or HbA1c in ESKD showing improvement in important clinical outcomes (DM complications, hospitalizations ect) to know

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grahamabra.bsky.social @grahamabra.bsky.social · 26d

🤦‍♂️

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grahamabra.bsky.social @grahamabra.bsky.social · 27d

It’s an exciting time to be taking care of patients with Lupus Nephritis!

www.healio.com/news/nephrol...

A new era of lupus nephritis therapy is here

Lupus nephritis occurs in approximately half of patients diagnosed with systemic lupus erythematosus. One in 10 patients with lupus nephritis will progress to end-stage kidney disease, and risk is hig...

www.healio.com

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grahamabra.bsky.social @grahamabra.bsky.social · 27d

Calling @hswapnil.medsky.social

🚨 vitamin D alert 🚨

ASN Publications @asnpublications.bsky.social · 27d

In patients post-kidney transplantation, vitamin D insufficiency is associated with higher risk of death-censored graft failure and infection-related mortality. Read more in #ASNKidney360: kidney.pub/KID0942

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grahamabra.bsky.social @grahamabra.bsky.social · Sep 14

Here’s the link to the paper - original post has the poster

journals.lww.com/jasn/fulltex...

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...

journals.lww.com

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grahamabra.bsky.social @grahamabra.bsky.social · Sep 14

Great question.

Don’t know myself but always been fascinated by the question of why PD and HD mortality outcomes are the same despite being totally different modalities

Do the metabolic complications outweigh the other benefits of PD (eg better kidney function preservation)?

grahamabra.bsky.social @grahamabra.bsky.social · Sep 14

#AskRenal

Iain Bressendorff, MD PhD @ibressendorff.bsky.social · Sep 14

that’s pretty wild. Do we know if there are more non-renal microvascular complications in PD vs HD? Neuropathy or retinopathy?

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