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Jamie Willows

@jamiekwillows.bsky.social
618 followers 494 following 37 posts

Renal / GIM consultant STSFT, UK. Dad x3. Runner. Poker. PoCUS. #NephJC

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Reposted by Jamie Willows
David W (aka Flex NP) @rnflex.bsky.social · 07/06/2026
What about kidney function? Well Lilly snuck this in the appendix but I still continue to have questions! Both the 9mg and 12mg dose increased Cys-C eGFR by about 4ml/min. Modest decrease in UACR but baseline was low. Show us the full renal data from Transcend CKD Lilly. PLEASE. #NephJC
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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 22/06/2026
Took us more than 10 years to get this to this stage AVF versus catheters - doing an RCT was difficult and we learnt a lot. Hope our community also does?
journals.lww.com
Comparing Catheters to Fistulas in Older Patients Starting... : Journal of the American Society of Nephrology
recommendations were based is observational with potential for bias. Methods A pilot randomized controlled trial was conducted in 12 hemodialysis centers in Canada and Australia. Individuals aged 55…
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Nephrology Journal Club @nephjc.bsky.social · 22/06/2026
Is it time for a new leader in membranous nephropathy, or is it just a game of thrones 👑? This week we're discussing OBI vs TAC in the MAJESTRY trial from #ERA26 🏰🐑 #NephSky We welcome back from retirement @jamiekwillows.bsky.social with the summary ✍️ www.nephjc.com/news/2026/06/22-majestyobi
nephjc.com
Heir to the Throne? Obinutuzumab in the membranous nephropathy MAJESTY trial — NephJC
This week, NephJC will discuss whether obinutuzumab is ready to outperform tacrolimus in primary membranous nephropathy
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Jamie Willows @jamiekwillows.bsky.social · 04/06/2026
Agree - while the proteinuria drop seems great it’s harder to know what that means for long term outcome when it is neither related to haemodynamic mechanism or immunomodulation, and short-ish term eGFR data pretty marginal.
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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 08/11/2025
Missing all the overwhelming amount of science coming out of #KidneyWk? The #NephJC crew has got you covered Day 2 edition www.nephjc.com/news/kidneyw... via @nephroseeker.medsky.social & moi
nephjc.com
Kidney Week in Houston: Day 2 — NephJC
in this edition: Fish Oil, GBD, Flozination meta-analysis, CHW intervention in Hispanic/Latino patients, and much more
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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 07/11/2025
Got #KidneyWk FOMO like @nephroseeker.medsky.social ? We got you covered with daily coverage of the simultaneous publications! www.nephjc.com/news/kidneyw...
nephjc.com
Kidney Week in Houston: Day 1 — NephJC
in this edition: Atacicept in IgAN; Albuminuria as a surrogate outcome, Renal Remission and additional CONFIDENCE analysis
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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 12/09/2025
There is some concern about cancers with glipination - thyroid, pancreas, others - nothing seen so far in trials (but rare outcomes are hard to capture) this study in JAMA Oncology didn't find anything much worrisome jamanetwork.com/journals/jam... but!
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Jamie Willows @jamiekwillows.bsky.social · 08/06/2025
bsky.app/profile/jami...
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Joel Topf @kidneyboy.bsky.social · 31/05/2025
A study that I have been thinking about a lot is this pilot study/case series 100-200 mg of spiro in diuretic resistant, acute decompensated heart failure looked safe and effective Any heart failure/diuretic experts know if a larger trial was ever completed? pubmed.ncbi.nlm.nih.gov/31307058/
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Jayana Devathasan @jyndvthsn.bsky.social · 04/06/2025
Always challenged by my occasional (generally intentional) nihilism when it comes to treating frailty & multi morbid patients #eraedta2025
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Nephrology Journal Club @nephjc.bsky.social · 13/05/2025
Join us tonite 5/13/25 9pm EST only on #Bluesky #NephSky #NephJC We are discussing 2 studies on the use of desmopressin/ddAVP prophylactically to prevent post kidney biopsy bleeding. Biopsy Blood🩸, ddAVP Sweat💦 and Nephrologist Tears😢 www.nephjc.com/news/ddavp
nephjc.com
Double Trouble: ddAVP and the Bleeding Biopsy — NephJC
This week, we will discuss a double header: two single centre ddAVP trials in kidney biopsy from India.
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Clinical Kidney Journal @ckj-era.bsky.social · 30/04/2025
Efficacy and safety of finerenone in IgA nephropathy: an observational multicentre study doi.org/10.1093/ckj/...
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Nayan Arora @captainchloride.bsky.social · 01/04/2025
Physiologically it never made sense to fluid restrict HF patients without hyponatremia. No difference in outcomes in 👇study, which was predictable. At the same time - from a study perspective - the actual difference in fluid intake between groups was <300cc/day. pubmed.ncbi.nlm.nih.gov/40159556/
pubmed.ncbi.nlm.nih.gov
Liberal fluid intake versus fluid restriction in chronic heart failure: a randomized clinical trial - PubMed
Fluid restriction is frequently recommended to patients with chronic heart failure, but randomized clinical trials assessing the effects of fluid restriction remain scarce. In this multicenter open-la...
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Nephrology Journal Club @nephjc.bsky.social · 24/03/2025
Tomorrow night 3/25/25 at 9 pm EST, only on Bluesky #MedSky #NephSky We will discuss the latest guidance from @kdigo.org on #ADPKD. Topics including screening, cerebral aneurysms, med therapy, KRT, ADPLD and lifestyle recommendations You have to be there, I in-cyst 🫣 www.nephjc.com/news/adpkd-k...
nephjc.com
KDIGO 2025 ADPKD Guidelines Review — NephJC
This week, we will discuss the first iteration of KDIGO’s 2025 guidelines on ADPKD. &nbsp;These guidelines are a result of a decade of global collaboration between physicians, researchers, advocates, ...
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Jamie Willows @jamiekwillows.bsky.social · 07/03/2025
Fantastic opportunity 👇
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Jamie Willows @jamiekwillows.bsky.social · 11/02/2025
IT IS A COMPLIMENT BRIAN.
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Jamie Willows @jamiekwillows.bsky.social · 10/02/2025
I learned a lot about subclinical primary aldosteronism reading this piece from the unsinkable @brianrifkin.bsky.social 👇 www.nephjc.com/news/primary...
nephjc.com
Undercover Aldosterone — NephJC
This week, we will discuss the origins of primary hyperaldosteronism in normotensive patients. Could this undetected anomaly be the cause of idiopathic hypertension and CKD?
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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 09/02/2025
Prof IgA Jon Barratt presented some phase 1/2 open label data on another APRIL inhibitor (after sibeprenlimab and atacicept) #ISNWCN
Intro slideZigakibart MoA
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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 09/02/2025
At the second high impact trial session At #ISNWCN Vlado Perkovic on ziltivekimab in CKD Covered data on colchicine and Canakinumab (not on market despite CANTOS) Phase 2 data from RESCUE shows huge effect on hs-CRP
Intro slide Phase 2 data
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Anthony Lau, PharmD BCPS @alaurx.bsky.social · 31/01/2025
Patient self-directed sliding scale furosemide is an underutilized tool in CHF management Can a simple weight-based dosing strategy empower patients to manage CHF, prevent exacerbations, and reduce ED visits? Let's dive in! 👇 #medsky #pharmsky #cardiosky #EMsky #GPsky #MedEd 1/
media.tenor.com
a person is measuring their weight on a scale that goes up to 40
ALT: a person is measuring their weight on a scale that goes up to 40
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josh farkas 💊 @pulmcrit.bsky.social · 28/01/2025
need some bland, meaningless conclusions for your review article? use these! these conclusions are so nonspecific that they're perfectly applicable to any ICU topic 👌 you're welcome
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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 30/01/2025
more external validation of the anti-nephrin story academic.oup.com/ckj/advance-... in @ckj-era.bsky.social In around 20% MCD - but also some FSGS (suggesting again these arbitrary pathologic descriptors are not useful) #NephSky
academic.oup.com
Anti-nephrin antibody: a potential biomarker of minimal change disease
AbstractBackground. Minimal change disease (MCD) is a common pathological type of nephrotic syndrome in children and adults, and the mechanisms remain obsc
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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 30/01/2025
I like this from Rob Quinn and Pietro Ravani pubmed.ncbi.nlm.nih.gov/24327565/ in @ndt-era.bsky.social to show the various selection biases in most studies of vascular access #FistulaLast
FIGURE 1:Sources of bias in prior studies comparing outcomes of patients using catheters to those using fistulas.
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National Kidney Foundation @kidney.org · 28/01/2025
BREAKING NEWS: The FDA has approved Ozempic for patients with chronic kidney disease. This means the popular injection can be used to reduce the risk of kidney disease worsening, kidney failure and death from cardiovascular disease in patients with chronic kidney disease and diabetes.
cnbc.com
FDA approves Novo Nordisk's Ozempic to treat chronic kidney disease in those with diabetes, expanding its use
Expanded Ozempic approval in the U.S. could transform how doctors treat patients with chronic kidney disease, which involves a gradual loss of kidney function.
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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 17/01/2025
Finally! Antibiotics are not non-inferior to appendectomy despite a generous 20% non-inferiority margin They are actually inferior: www.thelancet.com/journals/lan... in the @thelancet.bsky.social #MedSky
At 12-month follow-up, primary outcome data were available for 846 (90%) patients. Treatment failure occurred in 153 (34%) of 452 patients in the antibiotic group, compared with 28 (7%) of 394 in the appendicectomy group (difference 26·7%, 90% CI 22·4–30·9).
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haysamrady @sodatroubles.bsky.social · 11/01/2025
The efficacy and safety of half-dose glucocorticoids combined with #rituximab versus high-dose glucocorticoids for initial treatment of minimal change disease: a single-center experience #nephsky www.frontiersin.org/journals/pha...
frontiersin.org
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Edgar V. Lerma 🇵🇭 @edgarvlermamd.medsky.network · 10/01/2025
Proposed age-adjusted eGFR thresholds for CKD 👇 #Nephpearls #NephSky eGFR 75 for ages <40 years eGFR 60 for 40-65 years eGFR 45 for >65 years 👉 link.springer.com/book/10.1007... 👉 pubmed.ncbi.nlm.nih.gov/31506289/
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Jamie Willows @jamiekwillows.bsky.social · 17/12/2024
Nice write-up of practise changing study by @osduvar.bsky.social for #nephjc Meta-analysis of big name RCTs (AASK, IDNT, RENAAL etc) shows initiating RASi slows CKD progression even when already at stage 4 by more than I’d have guessed - just can’t believe no one had done this analysis before!
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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 13/12/2024
The UKKA AKI report is out, h/t @beckybonfield.bsky.social @ukkidney.org www.ukkidney.org/sites/defaul... (PDF) Incl. - Don’t call RAASi nephrotoxic - Don’t delay contrast imaging - Sick day rules are mostly 🐴 💩
RAASi are not nephrotoxic text
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Nephrology Times @nephtimes.bsky.social · 13/12/2024
European Medicines Agency clears the way for Ozempic's label to list a kidney disease indication. buff.ly/4fjah4b #ozempic #kidneydisease #nephsky
buff.ly
European Ozempic Label Will Include Kidney Disease Indication | Docwire News
The European label for Ozempic will be updated to include an indication for risk reduction for events related to kidney disease.
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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 01/12/2024
Another example of how Decreasing incidence + Decreasing mortality = Increasing prevalence HIV edition from the GBD folks www.thelancet.com/journals/lan... #MedSky #EpiSky
Figure 1 Temporal trends of HIV incidence, mortality, and prevalence counts for 1990–2050

Time trends presented for all-age males, females, and both sexes combined. The shaded areas represent 95% uncertainty intervals.
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Jamie Willows @jamiekwillows.bsky.social · 02/12/2024
Great as ever from Amy.
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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 29/11/2024
I don’t think so Have a listen to www.nephjc.com/freelyfilter... Nav breaks down the data well. The UBI trial results are unbelievable. The same group did the Sevelamer keeps people alive forever RCTs.
nephjc.com
Freely Filtered 061: Bicarb in Transplant — NephJC
Freely Filtered 061: Bicarbonate did not slow the loss of GFR in this well done Swiss, single-blind study of transplant patients.
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Jamie Willows @jamiekwillows.bsky.social · 27/11/2024
Nice to see our blogpost on how to manage DKA in anuric patients on dialysis up to >20,000 views👇 www.renalfellow.org/2021/10/30/d...
renalfellow.org
DKA in Patients on Dialysis and Anuria: Pathophysiology, Pearls, and Pitfalls
Simon Smith, MDInternQueen Elizabeth Hospital, Gateshead, UK Jamie Willows, MDRenal fellowFreeman Hospital, Newcastle Upon Tyne, UK Diabetic ketoacidosis
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Jamie Willows @jamiekwillows.bsky.social · 27/11/2024
guidelines.ukkidney.org/quick-refere...
guidelines.ukkidney.org
Quick Reference Guide – UK Kidney Association
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F. Perry Wilson, MD @fperrywilson.bsky.social · 26/11/2024
"Drink more water!" It's the easiest health advice around. Tired? Headache? Trying to be like Tom Brady? Just drink more water. But as a nephrologist, I get asked all the time: How much is the right amount? And the truth is... we don't really know. 🧵
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Nayan Arora @captainchloride.bsky.social · 25/11/2024
My Old thread from this. Not sure if the #tweetorial format transfers over as well bsky.app/profile/capt...
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Humberto Luna @renalguy.bsky.social · 24/11/2024
When diuretics fail, the albumin-furosemide combo is often considered—but is it science or just tradition? Evidence for its routine use is shaky at best. Are we truly helping our patients or just inflating costs and risks?
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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 25/11/2024
New today - @thelancet.bsky.social DM/Endo GLP1RAs and kidney/CV outcomes - SR from @sunilbadve.bsky.social Tuttle, Perkovic et al www.thelancet.com/journals/lan... ($🔒) - with/out DM - kidney outcomes (not albuminuria)
Forest plot of kidney outcomes with GLP1RAs
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Jamie Willows @jamiekwillows.bsky.social · 26/11/2024
Apologies. Yes that will be fascinating piece of dapa LIFE-CYCLES. I’ve kept a handful of patients on HD with HFrEF on flozins, not seen side-effects but who knows if help. My rule of thumb is those without T2DM generally get any benefits but with less side-effects so wouldn’t distinguish by this.
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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 25/11/2024
None of the trials initiated at GFR below 20 which ties the gl writers hand (Though flozins not stopped below 20) Now DAPA-advanced CKD presented at #KidneyWk which started at GFRs 10-30 suggest slowing GFR >> GFR dip (paper not published yet) RENAL LIFECYCLES awaited!
Design of DAPA advanced CKDGFR slope showing slower slope in DAPA group Overall outcomes
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Jamie Willows @jamiekwillows.bsky.social · 25/11/2024
Indeed exciting to see slowing more than dip here but mean eGFR 19 and takes a year to get slope benefit - so probably vast majority of patients with eGFR <20 benefit but some nuance as some won’t have enough time (though would hopefully benefit in other ways even if not CKD progression!)
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Joel Topf @kidneyboy.bsky.social · 25/11/2024
Hyponatremia physiology in a minute, forty seconds. #IsHomeostasisAJokeToYou youtu.be/Q93D_SjaOEY
youtu.be
physiology and pathophysiology of hyponatremia
YouTube video by Joel Topf
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Jamie Willows @jamiekwillows.bsky.social · 25/11/2024
Yes the flozin heart failure trials certainly had large populations without diabetes and found them efficacious (and much, much lower euDKA risk than in patients with diabetes)
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Jamie Willows @jamiekwillows.bsky.social · 25/11/2024
The evidence of CV benefit is less robust, and for some patients needing renal replacement therapy soon there may not be time to ‘get over’ the initial eGFR drop to benefit from slowing of CKD, but otherwise I’m not aware of any safety concern and do use them.
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Brendon Neuen @brendonneuen.bsky.social · 24/11/2024
It's probably the later. Effects of SGLT2i on CV, kidney and mortality outcomes are consistent irrespective of metformin use Some useful context on UKPDS and comparative effectiveness across eras in the discussion here: dom-pubs.pericles-prod.literatumonline.com/doi/10.1111/...
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Jamie Willows @jamiekwillows.bsky.social · 23/11/2024
Great read as always Brian. Really hope this one is positive 🤞 pubmed.ncbi.nlm.nih.gov/37805000/ I would use MRA now but I find so often by time patient comes to renal here their potassium is already causing challenges with just single RASi unfortunately.
pubmed.ncbi.nlm.nih.gov
Rationale and design of a randomised phase III registration trial investigating finerenone in participants with type 1 diabetes and chronic kidney disease: The FINE-ONE trial - PubMed
ClinicalTrials.gov NCT05901831.
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Jamie Willows @jamiekwillows.bsky.social · 23/11/2024
Great blog post from Brian highlighting that progress in diabetic nephropathy is far from equal.
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Jamie Willows @jamiekwillows.bsky.social · 23/11/2024
90% patients in EMPA-KIDNEY not on metformin (metformin use <25% even in those with diabetes). Messaging that says must be on metformin first (or indeed, max RASi first) would introduce delay in starting the flozins which have best evidence base (assuming can afford etc).
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