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Alex Meraz

@nephroguy.bsky.social
676 followers 291 following 66 posts

Academic Nephrologist in Winnipeg 🇨🇦. Onconeph and Critical care neph FTW!

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Alex Meraz @nephroguy.bsky.social · 17/08/2026
Did you know that iconic Canadian shoe band John Fluevog has a kidney inspired line? A percentage of the earnings is donated to the Kidney Foundation of Canada and to the American Society of Transplantation. They also have a pin! @hswapnil.medsky.social @csnscn.bsky.social @asnkidney.bsky.social
The Patty and the Alan.
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NEJM.org @nejm.org · 17/06/2026
In the SNAP trial, cefazolin was noninferior to flucloxacillin or cloxacillin with respect to 90-day mortality in patients with methicillin-susceptible Staphylococcus aureus bacteremia and had fewer nephrotoxic effects. Read the full trial results: nej.md/4vL0M6m
The image is a graph showing the posterior probability distribution of the treatment effect for cefazolin versus (flu)cloxacillin regarding 90-day all-cause mortality in the Treatment Policy Strategy population. The x-axis is labeled "Odds ratio (estimand 1)" ranging from 0.4 to 1.5, and the y-axis is labeled "Cefazolin (adults)." The distribution is depicted as a light blue curve, with credible intervals marked at 0.95, 0.99, and 1, indicated by darker shades of blue. A vertical dashed line is at the odds ratio of 1.2.
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NEJM.org @nejm.org · 04/06/2026
In adults without diabetes who had chronic kidney disease, the nonsteroidal mineralocorticoid receptor antagonist finerenone led to a slower decrease in the estimate glomerular filtration rate than placebo over 32 months. Full phase 3 FIND-CKD trial results: nej.md/4wWOFV4 #ERA26
Graph comparing mean eGFR slopes between finerenone and placebo groups. The chart has three sections: Total, Baseline to Month 3, and Month 3 to End of Treatment. Numerical values are provided above the bars, showing treatment differences with confidence intervals.
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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 04/06/2026
Unlike COMPASS, TRACK demonstrates rivaroxaban doesn’t have the same CV benefit in CKD jamanetwork.com/journals/jam... Simultaneous pubs from #ERA26
jamanetwork.com
Low-Dose Rivaroxaban and Cardiovascular Events in Advanced Kidney Disease
This randomized clinical trial examines the safety and efficacy of low-dose rivaroxaban in the treatment of patients with advanced chronic kidney disease at high risk for cardiovascular events.
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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 04/06/2026
Final GFR results from Atrasentan (ALIGN) in the Lancet Underwhelming to me - the Flozin + Atrasentan looks pretty good OTOH www.thelancet.com/journals/lan... Simulpubs from #ERA26
thelancet.com
Atrasentan in patients with IgA nephropathy (ALIGN): final 2·5-year results from a randomised, double-blind, placebo-controlled, phase 3 trial
Atrasentan reduced proteinuria and preserved kidney function after 2·5 years. This effect was present with or without concomitant SGLT2 inhibitor use. Atrasentan was well tolerated.
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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 05/06/2026
And FIND CKD is live already on NEJM www.nejm.org/doi/full/10.... #ERA26
nejm.org
Finerenone in Persons with Chronic Kidney Disease without Diabetes | NEJM
In randomized trials, finerenone, a nonsteroidal mineralocorticoid receptor antagonist, improved kidney and cardiovascular outcomes in patients with type 2 diabetes and chronic kidney disease (CKD)...
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Alex Meraz @nephroguy.bsky.social · 05/06/2026
Perhaps the most important slide of #ERA26
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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 05/06/2026
Another #ERA26 simulpub Effect of empa/finerenone on BP, yet another splice from CONFIDENCE www.ahajournals.org/doi/10.1161/... (If you want a BP effect, use Spiro)
ahajournals.org
Safety and Synergy of Finerenone and Empagliflozin in Lowering Blood Pressure | Hypertension
BACKGROUND: This secondary analysis of the CONFIDENCE (combination effect of fInerenone and empagliflozin in participants with chronic kidney disease and type 2 diabetes using a UACR endpoint) trial…
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Alex Meraz @nephroguy.bsky.social · 03/06/2026
New to catch up with podcasts; audiobooks are taking all my bandwidth
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Alex Meraz @nephroguy.bsky.social · 03/06/2026
You’d be surprised at how many centres practice like the control group. I was excited about this trial, a little underwhelmed by the results, but when presented in JC, the sentiment was: “it is not worth the effort to change practice based on it”.
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American Journal of Kidney Diseases @ajkd.bsky.social · 09/05/2026
Cancer Incidence in People With Glomerular Disease: A Population-Level Study bit.ly/4smBPMv (OPEN ACCESS)
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American Journal of Kidney Diseases @ajkd.bsky.social · 08/05/2026
Hemodiafiltration: A Mini Review bit.ly/4awrvuf
Dilution Modes in Hemodiafiltration. Released under a CC BY 3.0 license from Imamovic et al
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Canadian Society of Nephrology @csnscn.bsky.social · 07/05/2026
✨ CSN and CKD-N are happy to welcome Dorry Segev from the USA as keynote speaker for this morning’s joint session on Artificial Intelligence 👨🏻‍🏫 #csnagm #csnscn #ai
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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 07/05/2026
The big experiment failed Giving bonuses and penalizing for performance to increase home dialysis and transplant did nothing. An RCT jamanetwork.com/journals/jam... in JAMA health forum
Figure 1.  Line Graphs of Trends in Home Dialysis, Kidney Transplant, and Waitlist in End-Stage Renal Disease Treatment Choices (ETC) Model and Control Regions, January 2017-September 2024
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Alex Meraz @nephroguy.bsky.social · 08/05/2026
The man, the myth, the legend!
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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 08/05/2026
The healthcare costs of the forest fires Making the point we *cannot* afford not to plan #CSNAGM
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Alex Meraz @nephroguy.bsky.social · 08/05/2026
The boss!!!!
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Alex Meraz @nephroguy.bsky.social · 08/05/2026
Wanna reduce burnout? Less mandatory courses and more AI! #csnagm #csnscn
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Alex Meraz @nephroguy.bsky.social · 07/05/2026
Don’t let previous abnormal surgeries to be a barrier for PD catheter insertion. But, the presence of adhesions has been associated with worse outcomes #csnagm #csnscn
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Alex Meraz @nephroguy.bsky.social · 06/05/2026
Player to has entered: CRB2 the second podocyte autoantigen. #csnagm #csnscn
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Canadian Society of Nephrology @csnscn.bsky.social · 06/05/2026
📢✨Join us today for the opening session of the 2026 CSN-AGM! Welcome to all attendees in Quebec City & to those following us online from afar! 👋 #csnagm #csnscn
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Alex Meraz @nephroguy.bsky.social · 18/12/2025
I see a pattern here…
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American Journal of Kidney Diseases @ajkd.bsky.social · 30/11/2025
#RenalPath: Diffuse granular capillary wall staining for phospholipase A2 receptor (PLA2R). PLA2R staining is positive in approximately 70% of patients with clinically idiopathic membranous nephropathy (immunofluorescence microscopy, PLA2R). bit.ly/2xVkJzs (FREE)
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Alex Meraz @nephroguy.bsky.social · 30/11/2025
Tell me you are shooting yourself on the foot without telling me you are shooting yourself on the foot.
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Alex Meraz @nephroguy.bsky.social · 28/11/2025
Heard that Twitter is imploding. Good riddance
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Alex Meraz @nephroguy.bsky.social · 14/11/2025
Thanks. I wish it was more accessible. @maximalchange.bsky.social any chance you can share?
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Alex Meraz @nephroguy.bsky.social · 14/11/2025
@hswapnil.medsky.social @kidneyboy.bsky.social What’s the name of the nephrology song you play at the end of the podcast?
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Alex Meraz @nephroguy.bsky.social · 10/11/2025
Outstanding
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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 08/11/2025
The second sibeprenlimab paper in @nejm.org (At least we gave it an oral at #KidneyWk unlike the poster for the phase 2 data in 2023!) www.nejm.org/doi/full/10....
nejm.org
Sibeprenlimab in IgA Nephropathy — Interim Analysis of a Phase 3 Trial | NEJM
The cytokine A proliferation-inducing ligand (APRIL) is considered a key driver of the pathogenesis of IgA nephropathy. Sibeprenlimab, a humanized IgG2 monoclonal antibody, selectively binds to and...
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Alex Meraz @nephroguy.bsky.social · 25/10/2025
Maybe because not all attendees are expert nephrologists? Lots of students, residentes, nurses attending as well.
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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 26/09/2025
And it’s live Iptacopan in C3GN makes it to @thelancet.com www.thelancet.com/journals/lan... #NephSky
thelancet.com
Oral iptacopan therapy in patients with C3 glomerulopathy: a randomised, double-blind, parallel group, multicentre, placebo-controlled, phase 3 study
Iptacopan showed a statistically significant, clinically meaningful proteinuria reduction in addition to RAAS inhibitors and immunosuppression at 6 months. Iptacopan was well tolerated with an accepta...
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Alex Meraz @nephroguy.bsky.social · 05/08/2025
Awesome congrats!!! Is this limited to losartan or it would be more a class effect of ARBs?
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Joel Topf @kidneyboy.bsky.social · 14/07/2025
Amazing to me that a seemingly acute event is either A) has long-term sequellae despite being apparently resolving or B) a dramatic and early presentation of profound endothelial disease
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Alex Meraz @nephroguy.bsky.social · 25/06/2025
Amazing reference
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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 14/06/2025
Way scarier story. Stories. www.nytimes.com/2025/06/13/t... (Gift link)
nytimes.com
They Asked an A.I. Chatbot Questions. The Answers Sent Them Spiraling.
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Hugo Diniz, MD 🇵🇹🇪🇺 @hugodiniz.medsky.social · 06/06/2025
Sibeprenlimab in IgA Nephropathy #ERA25 * Data presented is the 9-month reduction in proteinuria
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Alex Meraz @nephroguy.bsky.social · 05/06/2025
Dr Meghan Sise presenting on serum cr/cystatin outcomes in patients treated with cisplatin or carboplatin #Onconeph #ERA25
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Alex Meraz @nephroguy.bsky.social · 05/06/2025
Shite!
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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 05/06/2025
Hyperkalemia rates not lower with adding a flozin to the MRA 🤔 www.nejm.org/doi/full/10.... #ERA25
Adverse effects
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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 05/06/2025
The first #ERA25 simultaneous pub CONFIDENCE trial of empagliflozin + finerenone in N = 579 Greater reduction in ACR and BP Note the impressive GFR dip www.nejm.org/doi/full/10....
Urinary Albumin-to-Creatinine Ratio, Serum Potassium Level, Estimated Glomerular Filtration Rate, and Systolic Blood Pressure over Time.
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NEJM.org @nejm.org · 05/06/2025
In the CONFIDENCE trial in persons with chronic kidney disease and type 2 diabetes, combination therapy with finerenone and empagliflozin led to a greater reduction in the urinary albumin-to-creatinine ratio than either drug alone. Full trial results: nej.md/4jEVbbk #ERA25 #MedSky #Nephrology
A graph of the least-squares mean ratio of the change from baseline in the urinary albumin-to-creatinine ratio in the full analysis population.
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Alex Meraz @nephroguy.bsky.social · 05/06/2025
Missed it. Give us the highlights! #ERA25
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Alex Meraz @nephroguy.bsky.social · 05/06/2025
@kevinyau.bsky.social GLP1 agonist master Jedi presenting at #ERA25. 💉GLP1 agonist reduce ED visits and hospitalizations!!! 📉Awesome methods. Best of the session: 💊DDP4 for comparison, IPTW, ICES data. Ticking all the right boxes (EPI nerd). 💊Only 40% on SGLT2i!!! We should flozinate more!!!
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Alex Meraz @nephroguy.bsky.social · 05/06/2025
@kevinyau.bsky.social @armelleid.bsky.social
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Alex Meraz @nephroguy.bsky.social · 05/06/2025
I wish we had any of the new treatments in Canada. Any.
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Alex Meraz @nephroguy.bsky.social · 05/06/2025
#ERA25 baby!!!
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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 03/06/2025
Experiential Evidence of Systemic Racism for Indigenous Peoples Navigating Transplantation in Canada - in @kireports.bsky.social www.kireports.org/article/S246... #NephSky
Visual abstract
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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 03/06/2025
The US spends billions of dollars on binders every year We are doing the RCT to get you the answer - more than 3000 enrolled ajkdblog.org/2021/06/16/c... and www.nephjc.com/news/2021/2/...
ajkdblog.org
Could High Be Better Than Low? Targeting Phosphate in Trials
Phosphate is bad, right? As kidney function declines, phosphate excretion goes down. Serum phosphate levels rise, causing parathyroid hormone (PTH) to increase and bring phosphate down. Phosphate h…
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Alex Meraz @nephroguy.bsky.social · 12/05/2025
I am not going. But see you in Vienna!!!!
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Alex Meraz @nephroguy.bsky.social · 04/04/2025
I feel you pain bro.
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