Just made someone very overtly diabetic within 6 weeks of starting… Definitely not a “benign” steroid!

How has BK beat CMV??? Scandalous! 😂

Definitely because it’s a pain in someone who is proteinuric but also has HF - you can never get to the max possible dose of valsartan with the combination which is what I really want in those folks.

True…

Though could be done if funded from government agencies/charities etc.

As for voclosporin - used it once and never again! Product info mandates monthly bloods for entire time they’re on it. Cheap as chips generic Tac all the way for me 😀

A head to head comparison between Obi and Ritux would be v helpful. Theoretically Obi should give better B cell clearance and more durable response- might be like in lupus, why bother with Ritux when Obi works better?

The Roles of A Proliferation-Inducing Ligand (APRIL) and B-Cell Activating Factor (BAFF) in IgA Nephropathy

bit.ly/4rs0u1r

@askrenal.bsky.social anyone in England/Scotland/Wales - do you have to dispense Kinpeygo and Sparsentan direct from hospital pharmacy or is it available via community pharmacy? In NI we have to dispense direct from hospital due to an issue about cost parity in primary care.

Looking forward to our March teaching session for neph trainees in NI! It’s all about the #NephMadness!

Illustration of IgA Nephropathy pathophysiology from JAMA. Four-hit hypothesis shows: 1) Aberrant IgA1 production; 2) Gd-IgA1 entering circulation; 3) Immune complex formation; 4) Complex deposition in glomerulus. Published online January 26, 2026.

IgA nephropathy is the most common cause of immune-mediated glomerular disease worldwide.

📄 This Review summarizes the pathophysiology, epidemiology, clinical presentation, diagnosis, treatment, and prognosis of primary IgA nephropathy in adults.

ja.ma/47bIhht

No uptake of HIF-PHIs in our unit either. Pricey when compared to ESA and no obvious benefits.

2026 KDIGO Anemia Management Guidelines — NephJC This week, we will discuss 2026 KDIGO anemia management in patients with kidney disease

This week we discuss the 2026 KDIGO anemia guidelines on #NephJC

Read our deep dive into the data here www.nephjc.com/news/kdigo-a...

Our unit has been routinely doing HDF for a number of years now. Great to see accumulating evidence of benefit. One practical point we learned though… Our unit was designed in 1990s for HD. The drains didn’t cope well with the turbid effluent from HDF so the place stank until we got them fixed!

Real-World Hospitalization Outcomes with On-Line Hemodiafiltration Versus High-Flux Hemodialysis ca. 2025 from @asnpublications.bsky.social
#Nephpearls #NephSky

#VisualAbstract by @husamjz.bsky.social

👉 pubmed.ncbi.nlm.nih.gov/41433104/

I’m not on ASN communities but will try to sign up. Still think it would be a big shame to lose discussion on Bluesky - I really like it as a platform and think nephJC still works well on it.

Maybe folks just became disillusioned with social media and afraid to post in case they get piled on? If so, that won’t change no matter what the platform.

Thanks - has bone marrow/splenic involvement too so low WCC chronically making Aza a no-go. Saw @kidneyboy.bsky.social’s post about lack of discussion. Wonder if it’s nothing to do with platform but that attitudes to social media have changed after twitter became a s**tshow?

#askrenal @nephjc.bsky.social have a young male with multisystem sarcoid. Eyes, liver, hilar LNs and interstitial nephritis. Granulomas so big you could pick them out without magnification on histo slide! Any experience of anti TNF as steroid sparing for renal involvement?

A secondary analysis of the TESTING trial predicted individual patient response to corticosteroid treatment in IgA nephropathy Corticosteroids are effective for treating IgA nephropathy but have important adverse effects. In this secondary analysis of the TESTING cohort, we generated a model to predicts, for an individual…

A secondary analysis of the TESTING trial predicted individual patient response to corticosteroid treatment in IgA nephropathy
#nephsky

Exercise and Kidney Health: Core Curriculum 2026

bit.ly/3YK6uXv (OPEN ACCESS)

Systematic Review of Efficacy and Safety of #Avacopan in #RealWorld Clinical Practice

#VisualAbstract by @Cteodosiu

www.kireports.org/article/S2468-0249(25)00...

NICE have recommended that a new treatment, obinutuzumab, can be used in combination with mycophenolate mofetil (MMF) to treat some patients with lupus nephritis in the NHS in England and Wales. 

👉 Learn more at https://lupusuk.org.uk/latest-news/

#Lupus #LupusNephritis #Obinutuzumab

A visual representation of the PISCES trial, which assessed whether fish oil could prevent cardiovascular events in patients on hemodialysis.

PISCES trial: More than two thirds of patients receiving hemodialysis for end-stage kidney disease are affected by cardiovascular disease. Research findings on fish-oil supplementation in patients treated with hemodialysis are summarized in a new Quick Take video. nej.md/3YsyWx2

#MedSky

View from the office this morning. Sunrise over #Belfast

@leannestratton.bsky.social one for you

Breakdown of solved cases by gene category. Breakdown of the solved uKF cases by gene and phenotypic category. All percentages represent a proportion of the total solved cases (n=38). ADTKD, autosomal dominant tubulointerstitial kidney disease; CAKUT, congenital anomalies of the kidneys and urinary tract.

Quantifying APOL1, Human Leukocyte Antigen, and Other Genetic Contributions to Unexplained Kidney Failure #OpenAccess

bit.ly/4nfGoXe

#Delphi Consensus on Surrogate Endpoints in #C3G and Primary #ICMPGN

#VisualAbstract by Jade Teakell, MD

www.kireports.org/article/S2468-0249(25)00...

Wonder what it would be like in a head to head with obinutuzumab? Used it successfully for first time recently in young male with min change who didn’t respond to ritux

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...

Simultaneous publication in the NEJM
#KidneyWk

www.nejm.org/doi/full/10....

Balcinrenone in combination with dapagliflozin compared with dapagliflozin alone in patients with chronic kidney disease and albuminuria: a randomised, active-controlled double-blind, phase 2b clinica... In participants with chronic kidney disease at increased risk of disease progression, a fixed dose combination of balcinrenone and dapagliflozin was superior to dapagliflozin alone in reducing albumin...

And another ns-MRA

Balcinrenone added to Dapa in proteinuric CKD

#KidneyWK

@thelancet.com

www.thelancet.com/journals/lan...

After all the fancy new medications we’ve tried in HD to improve prognosis… We should just have given them cod liver oil! #KidneyWk #nephjc