Alex Chang, MD
@alexchangmd.bsky.social
Associate professor, clinician-scientist/dad/husband interested in early prevention/treatment of kidney disease
tweets=personal views #nephsky
tweets=personal views #nephsky
Pinned
Happy to share our paper in @asnpublications.bsky.social examining COL4A5 X-linked Alport Syndrome in an unselected health system-based population. Phenotypic spectrum of X-linked Alport syndrome is wider than previously known. Risk lower for Gly624Asp variant. 1/ journals.lww.com/jasn/fulltex...
Reposted by Alex Chang, MD
#WeekendReads from the Advance articles section
Trends in Initial Combination Antihypertensive Therapy in a US Health System
🔗 academic.oup.com/ajh/advance-... 🔒
Trends in Initial Combination Antihypertensive Therapy in a US Health System
🔗 academic.oup.com/ajh/advance-... 🔒
Trends in Initial Combination Antihypertensive Therapy in a US Health System
AbstractBackground. Initial combination therapy has been recommended for patients with high blood pressure (BP). We evaluated annual trends in initial comb
academic.oup.com
February 1, 2026 at 4:00 PM
#WeekendReads from the Advance articles section
Trends in Initial Combination Antihypertensive Therapy in a US Health System
🔗 academic.oup.com/ajh/advance-... 🔒
Trends in Initial Combination Antihypertensive Therapy in a US Health System
🔗 academic.oup.com/ajh/advance-... 🔒
Reposted by Alex Chang, MD
Impact of Smartphone-Enabled Home Urinary Albumin-to-Creatinine Ratio Testing on Albuminuria Screening and Management
bit.ly/4pMQekv (OPEN ACCESS)
@alexchangmd.bsky.social
bit.ly/4pMQekv (OPEN ACCESS)
@alexchangmd.bsky.social
January 28, 2026 at 11:06 AM
Impact of Smartphone-Enabled Home Urinary Albumin-to-Creatinine Ratio Testing on Albuminuria Screening and Management
bit.ly/4pMQekv (OPEN ACCESS)
@alexchangmd.bsky.social
bit.ly/4pMQekv (OPEN ACCESS)
@alexchangmd.bsky.social
Reposted by Alex Chang, MD
I think there could be more clarity in how many labs report results. i.e what threshold should be considered a suppressed renin, positive screen, etc. The variety of different assays/units remains a major source of confusion. Most clinicians won't be aware of Table 5 from the Endo society guideline
January 23, 2026 at 1:22 PM
I think there could be more clarity in how many labs report results. i.e what threshold should be considered a suppressed renin, positive screen, etc. The variety of different assays/units remains a major source of confusion. Most clinicians won't be aware of Table 5 from the Endo society guideline
Reposted by Alex Chang, MD
For example, my institution's lab historically reported renin/aldo with these reference ranges. Cases of overt PA could be interpreted as normal. But results are now reported with guidance on interpretation with the relevant cutoffs from our lab's assays.
January 23, 2026 at 1:30 PM
For example, my institution's lab historically reported renin/aldo with these reference ranges. Cases of overt PA could be interpreted as normal. But results are now reported with guidance on interpretation with the relevant cutoffs from our lab's assays.
As guidelines rec more Aldo/renin testing in htn, wondering whats labs role to ensure/capture details on relevant factors (timing, Na restriction, meds, KP)? Should labs rec pts test in more standardized conditions, log key details or just do it-clinicians duty to sort out? @askrenal.bsky.social
January 22, 2026 at 1:37 PM
As guidelines rec more Aldo/renin testing in htn, wondering whats labs role to ensure/capture details on relevant factors (timing, Na restriction, meds, KP)? Should labs rec pts test in more standardized conditions, log key details or just do it-clinicians duty to sort out? @askrenal.bsky.social
Reposted by Alex Chang, MD
Excited to share our thoughts on the Apple Watch Hypertension alert!
@jordybc.bsky.social @deanpicone.bsky.social @alta-schutte.bsky.social
Apple Watch for Hypertension Screening | Hypertension www.ahajournals.org/doi/10.1161/...
@jordybc.bsky.social @deanpicone.bsky.social @alta-schutte.bsky.social
Apple Watch for Hypertension Screening | Hypertension www.ahajournals.org/doi/10.1161/...
Apple Watch for Hypertension Screening | Hypertension
www.ahajournals.org
January 21, 2026 at 9:24 PM
Excited to share our thoughts on the Apple Watch Hypertension alert!
@jordybc.bsky.social @deanpicone.bsky.social @alta-schutte.bsky.social
Apple Watch for Hypertension Screening | Hypertension www.ahajournals.org/doi/10.1161/...
@jordybc.bsky.social @deanpicone.bsky.social @alta-schutte.bsky.social
Apple Watch for Hypertension Screening | Hypertension www.ahajournals.org/doi/10.1161/...
Pilot phase PREvention of CardIovascular and DiabEtic kidNey disease in Type 2 Diabetes (PRECIDENTD) trial. Monotherapy vs. dual therapy fill rates were 87% vs. 68% overall (P=0.004) at 10months. Of those filling meds, 22% in monotherapy, 49% in dual therapy d/c'ed
pubmed.ncbi.nlm.nih.gov/41456635/
pubmed.ncbi.nlm.nih.gov/41456635/
Dual versus monotherapy with SGLT2 inhibitor and GLP-1 receptor agonist:PRECIDENTD pragmatic randomized trial - PubMed
ClinicalTrials.gov, NCT05390892, https://clinicaltrials.gov/study/NCT05390892.
pubmed.ncbi.nlm.nih.gov
January 20, 2026 at 6:39 PM
Pilot phase PREvention of CardIovascular and DiabEtic kidNey disease in Type 2 Diabetes (PRECIDENTD) trial. Monotherapy vs. dual therapy fill rates were 87% vs. 68% overall (P=0.004) at 10months. Of those filling meds, 22% in monotherapy, 49% in dual therapy d/c'ed
pubmed.ncbi.nlm.nih.gov/41456635/
pubmed.ncbi.nlm.nih.gov/41456635/
Reposted by Alex Chang, MD
I do wonder how much of the effect may be due to initiation of MRA vs higher potassium in itself. #cardiosky #emimcc
In patients with cardiovascular disease and an implantable cardioverter–defibrillator, increasing potassium levels to the high-normal range reduced the risk of arrhythmia events, hospitalizations, and death. Full POTCAST trial results and Research Summary: nej.md/4oQtHTN
#MedSky
#MedSky
January 8, 2026 at 11:14 AM
I do wonder how much of the effect may be due to initiation of MRA vs higher potassium in itself. #cardiosky #emimcc
Reposted by Alex Chang, MD
Impact of Cost-Sharing on Self-Measured Blood Pressure: Cost and Prescription Abandonment for Home BP Monitors in a Large FQHC
academic.oup.com/ajh/article-...
academic.oup.com/ajh/article-...
Impact of Cost-Sharing on Self-Measured Blood Pressure: Cost and Prescription Abandonment for Home BP Monitors in a Large FQHC
AbstractBACKGROUND. Self-measured blood pressure is an important tool for diagnosing and controlling hypertension. Current insurance coverage for home bloo
academic.oup.com
January 2, 2026 at 11:00 AM
Impact of Cost-Sharing on Self-Measured Blood Pressure: Cost and Prescription Abandonment for Home BP Monitors in a Large FQHC
academic.oup.com/ajh/article-...
academic.oup.com/ajh/article-...
Reposted by Alex Chang, MD
Nephrotic syndrome genomic discovery in the Mass General Brigham Biobank identifies monoallelic MEFV variants as a risk factor for focal segmental glomerulosclerosis
#nephsky #nephrology
www.kidney-international.org/article/S008...
#nephsky #nephrology
www.kidney-international.org/article/S008...
Nephrotic syndrome genomic discovery in the Mass General Brigham Biobank identifies monoallelic MEFV variants as a risk factor for focal segmental glomerulosclerosis
Health system-based biobanks with genetic data provide a unique opportunity for nephrotic
syndrome (NS) genomic discovery. This is predicated on finding cases in the electronic-health-record.
www.kidney-international.org
December 24, 2025 at 3:15 PM
Nephrotic syndrome genomic discovery in the Mass General Brigham Biobank identifies monoallelic MEFV variants as a risk factor for focal segmental glomerulosclerosis
#nephsky #nephrology
www.kidney-international.org/article/S008...
#nephsky #nephrology
www.kidney-international.org/article/S008...
Reposted by Alex Chang, MD
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...
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...
December 23, 2025 at 8:16 PM
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...
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...
Sign up for our NKF SCM26 Lunch Workshop - Nephrogenetic Essentials for Nephrology Providers!
Take your SCM learning up a level 📚
SCM26 Lunch Workshops deliver interactive, hands-on discussions focused on practical challenges in nephrology care.
Browse workshops: bit.ly/4qfRVHd
Additional registration required.
#NKFClinicals #Nephrology #MedEd #NephSky
SCM26 Lunch Workshops deliver interactive, hands-on discussions focused on practical challenges in nephrology care.
Browse workshops: bit.ly/4qfRVHd
Additional registration required.
#NKFClinicals #Nephrology #MedEd #NephSky
December 23, 2025 at 10:03 PM
Sign up for our NKF SCM26 Lunch Workshop - Nephrogenetic Essentials for Nephrology Providers!
Reposted by Alex Chang, MD
1/n young adult gets transferred to our hospital for higher level of care. Had presented to a rural institution with weakness; found to have Hgb 7.5, serum Cr 2.6 mg/dL, hematuria. Prompted a positive p-ANCA. Nephrology is consulted on arrival
a man wearing a shirt that says sticker giant on it
ALT: a man wearing a shirt that says sticker giant on it
media.tenor.com
December 22, 2025 at 7:23 PM
1/n young adult gets transferred to our hospital for higher level of care. Had presented to a rural institution with weakness; found to have Hgb 7.5, serum Cr 2.6 mg/dL, hematuria. Prompted a positive p-ANCA. Nephrology is consulted on arrival
Reposted by Alex Chang, MD
Thanks to @jefftiedrich.bsky.social and @rubinallergy.bsky.social for keeping urine ingestion topical. This is NOT what the kidney community considers the cutting edge of nephrology, but that's where Oz, RFK Jr, Makary, Prasad, et al are leading us. @hswapnil.medsky.social
December 19, 2025 at 9:15 PM
Thanks to @jefftiedrich.bsky.social and @rubinallergy.bsky.social for keeping urine ingestion topical. This is NOT what the kidney community considers the cutting edge of nephrology, but that's where Oz, RFK Jr, Makary, Prasad, et al are leading us. @hswapnil.medsky.social
Reposted by Alex Chang, MD
Happy to contribute to this important statement
@ahascience.bsky.social on cuffless devices led by @jordybc.bsky.social !
Cuffless Devices for the Measurement of Blood Pressure: A Scientific Statement From the American Heart Association | Hypertension ahajournals.org/doi/10.1161/...
@ahascience.bsky.social on cuffless devices led by @jordybc.bsky.social !
Cuffless Devices for the Measurement of Blood Pressure: A Scientific Statement From the American Heart Association | Hypertension ahajournals.org/doi/10.1161/...
December 11, 2025 at 1:36 PM
Happy to contribute to this important statement
@ahascience.bsky.social on cuffless devices led by @jordybc.bsky.social !
Cuffless Devices for the Measurement of Blood Pressure: A Scientific Statement From the American Heart Association | Hypertension ahajournals.org/doi/10.1161/...
@ahascience.bsky.social on cuffless devices led by @jordybc.bsky.social !
Cuffless Devices for the Measurement of Blood Pressure: A Scientific Statement From the American Heart Association | Hypertension ahajournals.org/doi/10.1161/...
Calibri’s woke www.nytimes.com/2025/12/09/u...
At State Dept., a Typeface Falls Victim in the War Against Woke
www.nytimes.com
December 10, 2025 at 11:37 AM
Calibri’s woke www.nytimes.com/2025/12/09/u...
Excellent Rare Kidney Disease Conference hosted by Loma Linda at the historic Mission Inn led by @saynanorouzi.bsky.social great case discussions on IgA nephropathy, c3G, PKd, genetic testing and galore! Enjoyed the AI discussant as an additional panelist, and Dr Glassock taking down AI bots
December 7, 2025 at 10:11 PM
Excellent Rare Kidney Disease Conference hosted by Loma Linda at the historic Mission Inn led by @saynanorouzi.bsky.social great case discussions on IgA nephropathy, c3G, PKd, genetic testing and galore! Enjoyed the AI discussant as an additional panelist, and Dr Glassock taking down AI bots
Reposted by Alex Chang, MD
🆕 #NephJCshort by @brianrifkin.bsky.social
RETREAT-FRAIL- pragmatic RCT: is less BP medication worse in octogenarians?
www.nephjc.com/news/hyperte...
RETREAT-FRAIL- pragmatic RCT: is less BP medication worse in octogenarians?
www.nephjc.com/news/hyperte...
NephJC Shorts: Hypertension and The Extreme Elderly — NephJC
The NephJC shorts version of the Hypertension medication step-down in a nursing home population from NEJM
www.nephjc.com
December 4, 2025 at 9:12 AM
🆕 #NephJCshort by @brianrifkin.bsky.social
RETREAT-FRAIL- pragmatic RCT: is less BP medication worse in octogenarians?
www.nephjc.com/news/hyperte...
RETREAT-FRAIL- pragmatic RCT: is less BP medication worse in octogenarians?
www.nephjc.com/news/hyperte...
Reposted by Alex Chang, MD
Yes. This is a game changer. Beyond being able to replace AVS, it allows one to “see” the underlying pathological contributors to a large proportion of “idiopathic” hypertension. This is another piece of evidence that should make clinicians rethink the pathogenesis and treatment of hypertension
November 28, 2025 at 6:05 PM
Yes. This is a game changer. Beyond being able to replace AVS, it allows one to “see” the underlying pathological contributors to a large proportion of “idiopathic” hypertension. This is another piece of evidence that should make clinicians rethink the pathogenesis and treatment of hypertension
Reposted by Alex Chang, MD
I did not know it was this bad
Look at the mortality in younger females (versus males) in CKD 5
jamanetwork.com/journals/jam... in @jamainternalmed.com from Alberta
#NephSky #GenderDisparities
Look at the mortality in younger females (versus males) in CKD 5
jamanetwork.com/journals/jam... in @jamainternalmed.com from Alberta
#NephSky #GenderDisparities
November 25, 2025 at 7:14 PM
I did not know it was this bad
Look at the mortality in younger females (versus males) in CKD 5
jamanetwork.com/journals/jam... in @jamainternalmed.com from Alberta
#NephSky #GenderDisparities
Look at the mortality in younger females (versus males) in CKD 5
jamanetwork.com/journals/jam... in @jamainternalmed.com from Alberta
#NephSky #GenderDisparities
Reposted by Alex Chang, MD
I am encountering yet more men on testosterone having huge heart attacks. Bear in mind I’m only on call 1/12th of the time (ie my rota has 12 consultants) and yet I’ve now seen 5 men in the last couple of months who’ve had STEMIs in their 40s and 50s. All very fit and *externally* in great shape
November 23, 2025 at 9:34 AM
I am encountering yet more men on testosterone having huge heart attacks. Bear in mind I’m only on call 1/12th of the time (ie my rota has 12 consultants) and yet I’ve now seen 5 men in the last couple of months who’ve had STEMIs in their 40s and 50s. All very fit and *externally* in great shape
Reposted by Alex Chang, MD
We’re excited to bring SCM to New Orleans for the very first time. Don’t miss this opportunity to connect with colleagues and learn from experts across the kidney care spectrum.
👉 Secure your registration now: www.kidney.org/spring-clini...
#NKFClinicals #Nephrology #MedEd
👉 Secure your registration now: www.kidney.org/spring-clini...
#NKFClinicals #Nephrology #MedEd
November 22, 2025 at 5:03 PM
We’re excited to bring SCM to New Orleans for the very first time. Don’t miss this opportunity to connect with colleagues and learn from experts across the kidney care spectrum.
👉 Secure your registration now: www.kidney.org/spring-clini...
#NKFClinicals #Nephrology #MedEd
👉 Secure your registration now: www.kidney.org/spring-clini...
#NKFClinicals #Nephrology #MedEd
Saw 2 pts in clinic who had anaplasmosis and AKI this summer, scary ticks…yikes!
November 20, 2025 at 6:50 PM
Saw 2 pts in clinic who had anaplasmosis and AKI this summer, scary ticks…yikes!
Reposted by Alex Chang, MD
I think Aliza Thompson is an unsung hero in this story for spearheading the albuminuria acceptance at FDA
journals.lww.com/cjasn/pages/...
#NephJC
journals.lww.com/cjasn/pages/...
#NephJC
journals.lww.com
November 19, 2025 at 3:00 AM
I think Aliza Thompson is an unsung hero in this story for spearheading the albuminuria acceptance at FDA
journals.lww.com/cjasn/pages/...
#NephJC
journals.lww.com/cjasn/pages/...
#NephJC
Reposted by Alex Chang, MD
From RAAS blockade to regenerative medicine: evolving treatment strategies in #Alport syndrome pubmed.ncbi.nlm.nih.gov/41243004/
November 17, 2025 at 3:54 PM
From RAAS blockade to regenerative medicine: evolving treatment strategies in #Alport syndrome pubmed.ncbi.nlm.nih.gov/41243004/