Thank you Swiss National Science Foundation !! We just received 3.42 Mio CHF funding for our EMPASTONE trial. Looking forward to working with colleagues in Switzerland, Germany, France, Italy and the UK.
clinicaltrials.gov/study/NCT066...
Our new webinar in german language:
SGLT-2 Inhibitoren & Nierensteine: SWEETSTONE - Prof. D. Fuster, Prof. S. Trelle (Bern, Schweiz)
WATCH NOW:
youtu.be/i_YTcIQ4YQk?...
@danfuster.bsky.social
@gunnarheine.bsky.social
@marcussaemann.bsky.social
Thank you Pedro. Unfortunately not many groups working on these important transporters anymore.
Just out in Nature Communications…..a mystery solved. It’s all about lipids in the regulation of intracellular NHEs. Thank you David for this great collaboration.
rdcu.be/efxE2
visual abstract of NOSTONE and bone density from Hector
So @danfuster.bsky.social and colleagues seem to find HCTZ doesn’t work for anything!
In a post hoc analysis of NOSTONE (where CT scans were done in all & repurposed for calculating bone density) HCTZ doesn’t increase it vs placebo
journals.lww.com/cjasn/pages/... in @asnpublications.bsky.social
Hydrochlorothiazide and Bone Mineral Density in Patients with Kidney Stones: A Post Hoc Analysis of the NOSTONE Trial by Drs. Christe, @danfuster.bsky.social et al.
journals.lww.com/cjasn/abstra...
HCTZ up to 50 mg daily did not preserve BMD compared to placebo over 3 years!
Happy to share that our research letter has been accepted in @ndt-era.bsky.social. Here we showed that impaired renal acid excretion is strongly associated with CaOx stone presence in the Swiss Kidney Stone Cohort: bit.ly/41rKodu. Many thanks to all co-authors in Switzerland for their support.
HCTZ not better than placebo for the prevention of BMD loss among individuals with calcium kidney stones
journals.lww.com/cjasn/abstra...
Excited to share the results of our SWEESTONE trial 🔥🔥🔥@NatureMedicine
Wonderful collaboration with colleagues @unibern @inselgruppe and DCR Bern.
www.nature.com/articles/s41...
Empagliflozin substantially reduced urinary supersaturations in non-diabetic patients with kidney stones.
Agree. This study shows nicely that it is dose equivalence and not type of thiazide that matters. CTD is ~2x more potent than HCT (and Indapamide ~20x more potent than HCT).
Chlorthalidone is not better than hydrochlorothiazide in kidney outcome prevention in a secondary analysis of the large DCP study. Very important results.
jamanetwork.com/journals/jam...
Not that I know of - and yes this should be done. Likely indirect effect in PT (as is the case for SGLT2i-mediated inhibition of NHE3), yet direct inhibition cannot be ruled out at this stage. NaDC1 has been a prime target for stone prevention for long-it seems SGLT2is are what we were looking for !
No - we were told first two weeks in January 25
Many putative mechanisms how RSR CaP can affect CaOx stone formation (Randall, heterogeneous nucleation etc), but also threats ( increase in urine calcium). This is why we need outcome data
Went up slightly from 30 to 35 mmol/d.
SGLT2is likely inhibit citrate reabsorption in the PT. No need for alkalosis. Urine citrate and pH drove reduction in RSR CaP.
Urine calcium went up in patients with calcium stones, no change in oxalate.
… and you might even dream (or fool yourself?) about achieving lower sodium intake in your patients, but the most likely explanation for the negative result of #NOSTONE, is just that: Thiazides do not work very well in preventing recurrent kidney stones. 2/2
I’m biased (local PI, steering committee), but the quality of #NOSTONE far exceeds most (if not all) data that the critics base their many assumptions and beliefs on.
You can speculate about the additional effects of citrate or a different type or dose of diuretic, … 1/2
Acidosis and CKD journals.lww.com/cjasn/citati...
"Whether there will be a definitive, adequately powered trial of this inexpensive, fairly safe intervention in CKD is up to funding
agencies to decide"
Cardiology is doing large outcome trials with colchicine - why can we not do this with alkali ?