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ASN Publications @asnpublications.bsky.social · 14/01/2026

This study in #ASNKidney360 examined depletion of the antioxidant ergothioneine in patients undergoing dialysis. They compared levels in blood from patients on peritoneal dialysis hemodialysis, and healthy controls. Read more about what they found: kidney.pub/KID1105 @grahamabra.bsky.social

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Michelle Rheault, MD @rheaultm.bsky.social · 23/12/2025

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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grahamabra.bsky.social @grahamabra.bsky.social · 17/12/2025

Makes sense for all the reasons outlined as possible dialysis harms In big busy centers my guess is the schedule overrides the more nuanced approach we’d all take if we had a small list with limited chaos #NephJC

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UCSF Nephrology @ucsfnephrology.bsky.social · 17/12/2025

#NephJC the editorialist wondered if our control arm represented ‘unnecessary dialysis’ and was not ‘standard of care’—sounds like many at #NephJC do not feel the same way?

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grahamabra.bsky.social @grahamabra.bsky.social · 17/12/2025

You swim against the tide when you pull an AKI-D patient off schedule, I don’t think the control arm was unrepresentative of practice #NephJC

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grahamabra.bsky.social @grahamabra.bsky.social · 17/12/2025

Makes sense there is some ceiling of how much small solute you can allow to build up #NephJC

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grahamabra.bsky.social @grahamabra.bsky.social · 17/12/2025

Is 90 day mortality the right outcome? A good fraction of patients will have left the hospital and can’t really expect the acute in hospital AKI-D strategy to impact events outside. #NephJC

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UCSF Nephrology @ucsfnephrology.bsky.social · 17/12/2025

#NephJC The traditional approach is increase in native renal function and then dialysis cessation. We proposes a different paradigm: dialysis cessation to promote increase in native renal function.

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grahamabra.bsky.social @grahamabra.bsky.social · 17/12/2025

It’s always the high protein tube feeds… and the high tacrolimus troughs… and the high dose diuretics… #NephJC

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UCSF Nephrology @ucsfnephrology.bsky.social · 17/12/2025

#NephJC it is important to point out that ‘1st day of recovery’ was defined retrospective. On that day, GFR may be very low (so not ‘recovered’ in the way many people use the word). See 2 figures below for illustration. Both these patients contributed to those Kaplan-Meier curves separating early.

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Nephrology Journal Club @nephjc.bsky.social · 17/12/2025

T2f Dialysis-Free Days by Day 28: Conservative: 21 days Conventional: 5 days Most pronounced divergence within the first 10-12 days Clinically, this means these patients spent most of their hospital course not needing dialysis, something no earlier AKI-D trial has demonstrated so clearly. #NephJC

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grahamabra.bsky.social @grahamabra.bsky.social · 17/12/2025

There’s no difference in the in hospital death so the day 28 mortality must be driven by outside the hospital events - can’t really expect conservative acute dialysis to have an impact on this #NephJC

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grahamabra.bsky.social @grahamabra.bsky.social · 17/12/2025

Totally get this but also get that the pt is in a controlled environment and with AKI-D your balancing keeping the pt safe from complications of AKI and complications from the dialysis itself I like that the triggers were set up this way, demonstrates how much breathing room we really have #NephJC

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grahamabra.bsky.social @grahamabra.bsky.social · 17/12/2025

In our practice and others I’ve worked in there is often a lot of non-neph clinician discomfort around the red lab values and any symptom that might be uremic (AMS being a common one) and the dialysis machine is so available that withholding it often requires a lot of discussion #NephJC

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Nephrology Journal Club @nephjc.bsky.social · 17/12/2025

T1c #NephJC 1️⃣Conservative RRT group RRT was done only if one of the following occurred: ✅BUN >112 mg/dL ✅Potassium >6.0 mmol/L, >5.5 after meds ✅pH <7.15 or HCO3 < 12 meq/L ✅Hypoxemia or pulmonary edema ✅Symptomatic overload ✅Clinician judgment 2️⃣ Conventional RRT was 3x/wk

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Nephrology Journal Club @nephjc.bsky.social · 17/12/2025

T1a Population: stable AKI-D patients with realistic renal recovery potential Exactly the “gray zone” group we debate daily whether dialysis continuation is necessary. 👀Check out the inclusion/exclusion criteria #NephJC

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grahamabra.bsky.social @grahamabra.bsky.social · 17/12/2025

Did you guys add any resources (eg APPs) to help manage this or did it just become part the standard workflow? #NephJC

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nephroninja.bsky.social @nephroninja.bsky.social · 17/12/2025

Hi! I'm a nephrologist and clinical researcher at UCSF. COI: I was one of the LIBERATE-D investigators at the UCSF site. I made a BlueSky account today to join this discussion. #NephJC

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grahamabra.bsky.social @grahamabra.bsky.social · 17/12/2025

Graham Abra Clinical nephrologist and educator COI Fan of the UCSF neph team! #NephJC

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UCSF Nephrology @ucsfnephrology.bsky.social · 17/12/2025

#NephJC This is Chi Hsu, senior author and one of the two PI’s for LIBERATE-D. Thanks for choosing our paper. I am borrowing UCSF Nephrology Division’s BlueSky account.

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Juan Carlos Q Vélez, MD @juancarlosqvelez.bsky.social · 09/12/2025

Excited about this @theisn.org initiative, especially under the leadership of @hswapnil.medsky.social as EIC. Nephrology needed this www.theisn.org/blog/2025/12...

theisn.org

Turning clinical experience into shared knowledge: ISN launches Kidney International Case ReportsTM - International Society of Nephrology

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Stanford Department of Medicine @stanforddeptmed.bsky.social · 08/12/2025

The Stanford African Scholars in #GlobalHealth (SASH) program is fostering innovation at a time of growing global health challenges. Through partnerships & knowledge exchange, physician-leaders from African countries gain skills & insights to improve care at home. stanford.io/4pt5IKq

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Sarah Sanghavi @sarahsanghavi.bsky.social · 05/12/2025

It was really interesting researching this topic. Hope it’s useful.

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Evan Zeitler @littlebiggloms.bsky.social · 03/12/2025

#NephSky as I ask every match day, what is the deal? Endocrinology and Rheumatology (what I would consider the closest comps to nephro) are following almost of their spots while we continue to...not. Do we simply have too many spots?

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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 03/12/2025

Yup Figure 1.1 in incidence rate of ESRD in the US Seems to have slipped most people’s awareness 🤷🏽‍♂️

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grahamabra.bsky.social @grahamabra.bsky.social · 04/12/2025

Totally unknown which is frustrating!

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pisces01.bsky.social @pisces01.bsky.social · 03/12/2025

EPA and DHA has an effect on arrhythmias and SCD, especially formation of reentry arrhythmias. e.g. EPA and DHA modulates sodium, calcium and potassium ion channels affecting the cardiac action potential. #NephJC

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pisces01.bsky.social @pisces01.bsky.social · 03/12/2025

Indeed! We did not know what to expect, but hopeful. Having worked on this for over a decade, I was initially "stunned" by the result but then not really surprised given the multitude of potential effects of EPA and DHA on the cardiovasculature, and our HD patients deficiencies in it #NephJC

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Joel Topf @kidneyboy.bsky.social · 03/12/2025

Stop complaining about pill burden in ESRD! There is no pill you are giving your dialysis patient that has data half as impressive as this study. If they are taking too many pills have them stop any of the dozen pills they are taking with ZEERO data in ESRD. #NephJC

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pisces01.bsky.social @pisces01.bsky.social · 03/12/2025

Actually, we actually found the opposite - many patients were wanting a "natural" treatment and didnt mind! Some actually left the study to buy commercial fish oil as they didnt know if they had placebo. But to be fair, some also left the study due to pill burden #NephJC

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Nephrology Journal Club @nephjc.bsky.social · 03/12/2025

Up next 12/16/25 (our last #NephJC of the year) LIBERATE, A Conservative Dialysis Strategy and Kidney Function Recovery in Dialysis-Requiring Acute Kidney Injury. jamanetwork.com/jour...

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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 03/12/2025

We need a daily dose of 1600 mg EPA 800 mg DHA in an ethylester mix of fish oil Did I get that right @kidneyboy.bsky.social @pisces01.bsky.social ? The same company that made it for FISH and PISCES may come out with their formulation soon #NephJC

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grahamabra.bsky.social @grahamabra.bsky.social · 03/12/2025

I’m sure they will. Why use a dose that is basically unfindable anywhere else? 😏 #NephJC

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grahamabra.bsky.social @grahamabra.bsky.social · 03/12/2025

This is also why I’m going crazy trying to find a preparation that matches what was used in the trial! #NephJC

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Brian Rifkin @brianrifkin.bsky.social · 03/12/2025

Since we don’t know the mechanism (secret sauce) hard to say. Is it the EPA/DHA quantities or the ratio or the “quality”, or something else that hasn’t been considered. This is also likely the basis of conflicting data #NephJC

media.tenor.com

a baby is making a funny face with the words this is confusing me written above it .

ALT: a baby is making a funny face with the words this is confusing me written above it .

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grahamabra.bsky.social @grahamabra.bsky.social · 03/12/2025

I have not. Agreed it’s close but not quite what was used in PISCES (1000mg tab with 200mg DHA and 400mg EPA - total dose 4 tabs qday)

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grahamabra.bsky.social @grahamabra.bsky.social · 03/12/2025

I couldn’t even find the right order for it in EPIC! Nearly went insane scrolling through dozens of different omega3 preparations #NephJC

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Brian Rifkin @brianrifkin.bsky.social · 03/12/2025

Maybe not as easy as it sounds #NephJC

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grahamabra.bsky.social @grahamabra.bsky.social · 02/12/2025

My first month of trying to prescribe fish oil at the dialysis unit has been a total failure Pharmacies arn’t filling scripts and patients can’t find OTC matches to dose prescribed in PISCES Anyone having success on the high seas?

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Nephrology Journal Club @nephjc.bsky.social · 26/11/2025

👇Here are the proposals for the #TopNephrology stories in 2025 🔥 Remember, you can only vote for your favorites if you have subscribed to #NephJC newsletter 📬 Soon we'll send you the voting link. Check your email. www.nephjc.com/news/2025/11...

nephjc.com

Which were the Top Nephrology Stories of 2024? — NephJC

Time to vote for the Top Stories of 2025

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Nephrology Journal Club @nephjc.bsky.social · 01/12/2025

Maybe the most shocking study from #KidneyWk. 🐚From the depths of the oceans to #BlueSky, we're discussing PISCES 🐟 12/2/25 9pm EST. #NephJC Are you hooked🪝on fish oil for CV disease in ESRD, or are you throwing it back 🌊? www.nephjc.com/news/pisces-fishoil

nephjc.com

Fish Oil in Dialysis: A Big Catch or an Empty Net — NephJC

Holy Mackerel! This week we will discuss fish oil use in maintenance hemodialysis patients. Could this be the one thing that bends the curve on CV mortality, or is it just a red herring?

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Nephrology Journal Club @nephjc.bsky.social · 01/12/2025

Holy Mackerel! 🐟 🦜Ahoy matey! Could fish oil unlock the mysteries of increased CV mortality in ESRD? 🏴‍☠️ #NephJC Join us for a lively trawling trip 12/2/25 🛥️at 9pm EST Check out the PISCES VA by @brianrifkin.bsky.social www.nephjc.com/news/piscesva

nephjc.com

PISCES: The Visual Abstract — NephJC

Curious how n-3 PUFAs may cut serious cardiovascular events in dialysis? 🐟 A big signal, a big dose, and a big discussion ahead — don’t miss this #NephJC! Check out the VA made by our master Brian...

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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 28/11/2025

An aldosterone synthase (CYP11B2 enzyme)–specific 18F-labeled radioligand to help lateralize in PA www.nejm.org/doi/full/10.... very cool science and technology Any comments from the Aldo experts? @anandvaidya17.bsky.social #NephSky #EndoSky

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grahamabra.bsky.social @grahamabra.bsky.social · 26/11/2025

Cool paper Genetics of AMKD getting deeper…

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