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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 5h

PRO/CON debate: nonsteroidal (finerenone) vs. steroidal (spironolactone/ eplerenone) mineralocorticoid receptor antagonists in CKD: progress, pragmatism, and remaining uncertainties ca. 2026 from @ckj-era.bsky.social #Nephpearls #Cardiorenal #NephSky 👉 pubmed.ncbi.nlm.nih.gov/42682722/

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 07/10/2026

C3G Glomerulopathy: Mechanistic Targets 🎯 of Potential Novel Therapies from @kdigo.org #Nephpearls #NephSky 👉 kdigo.org/infographics/

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 07/10/2026

IgA Nephropathy #IgAN: Pathophysiology and Mechanistic Targets 🎯 of Potential Novel Therapies from @kdigo.org #Nephpearls #NephSky 👉 kdigo.org/infographics/

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 04/10/2026

Select RCTs, informing current management strategies for patients with SA-AKI #Nephpearls #AKIinICU #NephJC #NephSky 👉 shop.lww.com/Handbook-of-...

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 04/10/2026

Sepsis-associated AKI (SA-AKI): Pathophysiology #Nephpearls #AKIinICU 📌 Organ dysfunction during sepsis develops even in the absence of decreased O2 delivery (Hypotension and ischemic injury are not the sole cause) 👉 pubmed.ncbi.nlm.nih.gov/36823168/

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 04/10/2026

Sepsis is a syndrome defined by organ dysfunction because of a dysregulated host response to infection #Nephpearls #AKIinICU #NephSky 📌 Septic shock is a subset of sepsis defined by hypotension requiring vasopressors to maintain an MAP >/= 65 mm Hg and serum lactate >2 mmol/L after resuscitation

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 03/10/2026

Treatment with maximally tolerated RAASi alone does not sufficiently slow the rate of eGFR decline in high-risk patients with IgA nephropathy #IgAN, leaving patients at risk of ESKD ca. 2026 from @asnpublications.bsky.social #Nephpearls #NephSky 👉 pubmed.ncbi.nlm.nih.gov/42584957/

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 01/10/2026

Clinical conditions related to LVADs that may arise during hemodialysis #Nephpearls #NephSky 👉 link.springer.com/book/10.1007...

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 30/09/2026

Call 📢 for papers: "The Jerry Yee: Clinical Challenges in Diagnosis and Treatment in Nephrology" #Nephpearls #NephSky 🗓️ Deadline for submissions: 15 October 2026 👉 www.sciencedirect.com/special-issu...

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 30/09/2026

Impact of proteinuria levels on long-term kidney outcomes in IgA nephropathy: a meta-analysis ca. 2026 from @glomcon.org Rare Kidney Disease journal #Nephpearls #NephSky 👉🏼 link.springer.com/article/10.1...

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 30/09/2026

Ten tips for the diagnosis and management of nephrotic syndrome ca. 2026 #Nephpearls #NephSky 👉🏼 pubmed.ncbi.nlm.nih.gov/42707999/

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 26/09/2026

Classic course of whole-kidney GFR and UAE according to the natural (proteinuric) pathway of #Diabetic #Kidney Disease (DKD) ca. 2017 #Nephpearls #NephSky 👉🏼 pubmed.ncbi.nlm.nih.gov/28143897/

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 26/09/2026

Adults with #IgAN are at greater risk of adverse kidney outcomes versus nonglomerular CKD and substantially higher risks of heart failure and death compared with no CKD ca. 2026 from @KIReports #Nephpearls #RKDSummit #NephSky 👉🏼 pubmed.ncbi.nlm.nih.gov/42027552/

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 26/09/2026

Not all #IgAN therapies are created equal #Nephpearls #RKDSummit #NephSky 👉🏼 pubmed.ncbi.nlm.nih.gov/40928891/

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 26/09/2026

Dipstick hemoglobinuria is associated with histologic markers of active disease in #IgAN and may provide clinically relevant information to complement current assessment of disease activity in #IgAN ca. 2026 #Nephpearls #RKDSummit #NephSky 👉🏼 pubmed.ncbi.nlm.nih.gov/42628835/

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 26/09/2026

Microscopic hematuria as a risk factor for #IgAN progression: considering this biomarker in selecting and monitoring patients ca. 2023 #Nephpearls #RKDSummit #NephSky 👉🏼 pubmed.ncbi.nlm.nih.gov/38053974/

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 26/09/2026

Targeting B cells in immune-mediated kidney diseases: conclusions from @kdigo.org Controversies Conference ca. 2026 #Nephpearls #RKDSummit #NephSky 👉🏼 pubmed.ncbi.nlm.nih.gov/42034308/

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 25/09/2026

Colloids vs Crystalloids #Nephpearls #AKIinICU #NephSky 👉 shop.lww.com/Handbook-of-...

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 09/09/2026

Thank you for the kind words and the wonderful hospitality! It was an absolute honor to present at the Renal Research Forum and engage with such a fantastic group of colleagues at Mayo Clinic 🙏 #NephSky

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 05/09/2026

Kidney Health Guidance on Cardiovascular-Kidney-Metabolic (CKM) Syndrome ca. 2026 from @asnpublications.bsky.social #Nephpearls #NephSky #Cardiorenal 👉 pubmed.ncbi.nlm.nih.gov/42684397/

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 31/08/2026

Hypomagnesemia: Outpatient management #Nephpearls #NephSky 👉 shop.lww.com/Manual-of-Ne...

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 27/08/2026

Syndrome of Inappropriate Antidiuresis (SIAD): From Pathophysiology to Management ca. 2023 #Nephpearls #NephSky 👉🏼 pubmed.ncbi.nlm.nih.gov/36974717/

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 25/08/2026

Lower Time Averaged-Proteinuria (TA-P) was associated with progressively reduced risk of kidney failure in adults with IgA Nephropathy #IgAN in the US ca. 2026 from @glomcon.org Rare Kidney Disease Journal #Nephpearls #NephSky 👉 link.springer.com/article/10.1...

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 11/08/2026

In ADPKD, probenecid reduced tolvaptan-induced polyuria and nocturia while preserving its disease-modifying effects 🔑 A potential strategy to make tolvaptan more tolerable - and a new window into renal water homeostasis #Nephpearls #NephSky 👉 pubmed.ncbi.nlm.nih.gov/42298327/

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 07/08/2026

Phase 3 proteinuria and eGFR data for available and emerging IgA Nephropathy #IgAN therapeutics (as of August 3, 2026) #Nephpearls #GlomConHawaii 🌊 #NephSky 👉 pubmed.ncbi.nlm.nih.gov/41895685/

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 04/08/2026

VISIONARY: Sibeprenlimab in IgA nephropathy #IgAN ✅ Proteinuria reduction ✅ Preservation of kidney function #Nephpearls #GlomConHawaii 🌊 #NephSky #VisualAbstract by @alexgr23.bsky.social

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 30/07/2026

nsMRAs in CKM Syndrome: Disease-Specific Deep Dives www.medscape.org/viewarticle/... via @MedscapeCME #Nephpearls #NephSky

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 19/07/2026

Urea vs. tolvaptan for hospitalized patients with SIADH ca. 2026 #Nephpearls #NephSky 👉🏼 pubmed.ncbi.nlm.nih.gov/42455009/

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 18/07/2026

Kick, Sweat, Protect: Kidney Health Through the Lens of Soccer (Football) ca. 2026 #Nephpearls #WorldCup #WorldCup2026 #NephSky 👉🏼 www.kidneymedicinejournal.org/article/S259...

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 16/07/2026

Enthusiasm for EGDT has waned as 3 large, multicenter trials failed to reproduce the results of the Rivers trial #Nephpearls #AKIinICU #NephSky 🔑 Current Surviving Sepsis guidelines recommend an initial bolus of 30 mL/kg to be followed by additional fluid to maintain and improve perfusion

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 15/07/2026

The kidney in the middle: @kdigo.org guidelines address multiple key components of cardiovascular-kidney-metabolic syndrome ca. 2026 from @Kidney_Int #Nephpearls #Cardiorenal #NephSky 👉🏼 pubmed.ncbi.nlm.nih.gov/42191113/

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 15/07/2026

When shock is refractory to initial fluid resuscitation, it is appropriate to consider vasopressor support #Nephpearls #AKIinICU #NephSky 📌 Distributive shock requires alpha-adrenergic stimulation to promote vasoconstriction and raise SVR

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 14/07/2026

Screening algorithms in septic shock #Nephpearls #AKIinICU #NephSky ⚠️ SIRS may be highly sensitive but lacks specificity ⚠️ qSOFA may lack sensitivity for early sepsis or septic shock 🔑 These limitations highlight the importance of high clinical suspicion for shock 👉 shop.lww.com/Handbook-of-...

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 13/07/2026

The fundamental problem in shock is "inadequate end-organ perfusion" #Nephpearls #AKIinICU #NephSky 📌 Low cardiac output (CO) ✔️ Hypovolemic ✔️ Cardiogenic ✔️ Obstructive 📌 Low systemic vascular resistance (SVR) aka Distributive: Sepsis

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 28/06/2026

B cell maturation, treatment targets, and therapies ca. 2026 from @kidneyint.bsky.social @kdigo.org #Nephpearls #NephSky 👉 pubmed.ncbi.nlm.nih.gov/42034308/

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 23/06/2026

Fabry Disease: Current Perspectives on Diagnosis and Management Strategies ca. 2026 from @akdhjournal.bsky.social @saynanorouzi.bsky.social #Nephpearls #NephSky 👉🏼 pubmed.ncbi.nlm.nih.gov/42331443/

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 13/06/2026

ARISE FLUIDS: Vasopressors or Fluids in Early Septic Shock ca. 2026 from @nejm.org #Nephpearls #AKIinICU #NephSky 📌 No significant difference in days alive and out of hospital at day 90 ⚠️ Pulmonary edema: Lower in restricted fluids group (0.6% vs. 5.0%) 👉 pubmed.ncbi.nlm.nih.gov/42274006/

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 12/06/2026

Guideline for Prevention, Detection, Evaluation, & Management of Cardiovascular-Kidney-Metabolic (CKM) Syndrome ca. 2026 from @americanheart.bsky.social @accintouch.bsky.social @amdiabetesassn.bsky.social @asnkidney.bsky.social #Nephpearls #Cardiorenal #NephSky 👉 pubmed.ncbi.nlm.nih.gov/42265997/

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 12/06/2026

C3 glomerulopathy in transplant “like yet unlike native”: Pathophysiology, recent advances in therapeutics and evolving paradigms ca. 2026 @saynanorouzi.bsky.social #Nephpearls #NephSky 👉 pubmed.ncbi.nlm.nih.gov/42281853/

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 09/06/2026

Mechanisms by which novel antihypertensive drug classes reduce blood pressure ca. 2025 from @natrevcardiol.nature.com #Nephpearls #NephSky 👉 pubmed.ncbi.nlm.nih.gov/39920248/

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 09/06/2026

Aprocitentan in Patients With CKD and Resistant Hypertension ca. 2026 #Nephpearls #NephSky ✅ Well tolerated ✅ Lowered BP (nighttime ambulatory BP) ✅ Markedly reduced urine albumin-to-creatinine ratio (UACR) in participants w/ CKD and resistant hypertension 👉 pubmed.ncbi.nlm.nih.gov/41363010/

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 07/06/2026

Hemodynamic monitoring in in ICU: Capillary refill time (CRT), is quick, easily performed, and a long-standing component of the physical exam #Nephpearls #AKIinICU #NephSky 👉 pubmed.ncbi.nlm.nih.gov/30772908/ 👉 www.wolterskluwer.com/en/solutions...

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 05/06/2026

FIND-CKD: Among adults with CKD who did not have diabetes, finerenone led to a slower decrease in the eGFR than placebo over 32 months ca. 2026 from @nejm.org #Nephpearls #ERA26 #NephSky 👉 www.nejm.org/doi/full/10....

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 05/06/2026

Hyperkalemia and Its Treatment: Real-World Evidence and Managed Care Considerations Supporting Use of Potassium Binders ca. 2026 from @beaverspharmd.bsky.social #Nephpearls #NephSky 👉 pubmed.ncbi.nlm.nih.gov/42213908/

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 05/06/2026

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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 05/06/2026

Consensus Recommendation: Real World Insights on Attitudes and Treatment of Hyperkalemia ca. 2026 from @garysinger.bsky.social @renalphysicians.bsky.social #Nephpearls #NephSky 👉 pubmed.ncbi.nlm.nih.gov/42069178/

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