Current NT-proBNP thresholds miss high-BMI patients at risk. In pooled #HFpEF trials, those w/ severe obesity faced over twice the event rate despite “normal” values. It’s time to personalize BNP cutoffs. ⚖️

Explore more in the new issue of #JACC: https://bit.ly/3Lp3JaX

#CardioSky

After empa-kidney, it still wasn’t clear what to do for patients with CKD without diabetes or albuminuria. This meta-analysis suggests you use flozins. #kidneywk

jamanetwork.com/journals/jam...

HRS-AKI dx 📑
2015: req 48h albumin + no structural injury.
2024 ADQI/ICA: cirrhosis+ascites, KDIGO AKI, no alt cause, no SCr/UO improv after ~24h resus → dx; avoid 48h albumin; use HRS-AKI/AKD/CKD. Albumin challenge still helps (Ma’24: ~34% response). #KidneyWk

We’ve just initiated the final center change in our stepped-wedge Sweet-Water trial! Aiming to include approximately 4,500 patients by the end of the year — we’re extremely curious to see what we’ll find out. Should Glucose 5% be the universal drug solvent? #nephsky #nephrology #IntensiveCare

The sodium burden in ICU patients is off the charts! In an effort to bring about change, we’ve designed the Sweet-Water Trial — so excited that it’s up and running! #Nephrology #IntensiveCare #MedSky

DOI: 10.1136/bmjopen-2024-097361

Great to see this finally published. The VIPAR study!
@kidneyint.bsky.social

In kidney transplant recipients with chronic active AMR, IVIG stabilized histology & eGFR, reduced intragraft gene; B-, T-, NK-cell & fibrosis associated transcripts.
www.kidney-international.org/article/S008...

Amiloride was noninferior to spironolactone in lowering home systolic blood pressure at 12 weeks.

https://ja.ma/42XMGD9

Our #NephJC summary double header is live

www.nephjc.com/news/ddavp

Is DDAVP any use before a kidney biopsy?

Excellent writing from @sayalibthakare.bsky.social @dramiliflores.bsky.social & @nephroseeker.medsky.social

New in CJASN:

Our meta-analysis of 66 CKD trials shows both acute & chronic GFR slope independently predict clinical outcomes

Findings support 3-year total slope as the optimal surrogate endpoint for CKD trials

@asnpublications.bsky.social: doi.org/10.2215/CJN....

Intravenous albumin is generally safe for most patients. However, its potential harms may be unknown. Given safety and cost concerns, authors of a recent #Perspective recommend that for most patients, use of intravenous albumin should adhere to ICTMG recommendations. https://bit.ly/JASN0750
#ASNJASN

Can we have Real Talk about "Target Trial Emulation"?

These are just re-branded retrospective, observational analyses.

Change My Mind

#medsky
www.nejm.org/doi/10.1056/...