Josh Leisring
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joshleisring.bsky.social
Josh Leisring
@joshleisring.bsky.social
230 followers 120 following 93 posts
Nephrologist / Hypertension Specialist in Columbus, Ohio
#Nephsky
He / him
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joshleisring.bsky.social
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
joshleisring.bsky.social
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
joshleisring.bsky.social
I'm in favor of doing the initial screen in non-optimal setting. Remove barriers to testing. The most overt cases will still be identified. In borderline cases if clinical suspicion is still high, can repeat under more standardized conditions (including considering medication effects).
January 23, 2026 at 1:13 PM
Reposted by Josh Leisring
alexchangmd.bsky.social
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
https://www.endocrine.org/clinical-practice-guidelines/primary-aldosteronism-2
January 22, 2026 at 1:37 PM
Reposted by Josh Leisring
spjuraschek.bsky.social
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/...
Apple Watch for Hypertension Screening | Hypertension
www.ahajournals.org
January 21, 2026 at 9:24 PM
Reposted by Josh Leisring
hswapnil.medsky.social
Cuffless BP review with @farahwehbe92.bsky.social - incoming HT fellow in Ottawa, with tables, and details of technology, devices and ongoing trials

pubmed.ncbi.nlm.nih.gov/41460057/

thanks to @profdg.bsky.social for the invite!
Cuffless blood pressure in 2025: from promise to practice: a narrative review - PubMed
Cuffless wearables may be used as adjuncts to surface patterns and support engagement; diagnosis and treatment decisions must be confirmed with validated upper-arm measurements. A pragmatic "good-enough" checklist includes stable calibration over weeks, accuracy across dynamic states and subgroups, …
pubmed.ncbi.nlm.nih.gov
January 7, 2026 at 11:13 PM
Reposted by Josh Leisring
jbrianbyrd.bsky.social
Dan Batlle & I wrote about testing for primary aldosteronism, bringing a critical lens to the usual approach

www.ahajournals.org/doi/full/10....
American Heart Association Journals
www.ahajournals.org
December 22, 2025 at 6:14 PM
joshleisring.bsky.social
We have so much evidence demonstrating the real clinical impact of renin (predicting response to MRAs in PATHWAY-2, increased CV risk when renin remains suppressed, etc). I would hope AngII testing could be incorporated into trials to build a dataset for comparison.
December 23, 2025 at 2:16 AM
joshleisring.bsky.social
Thought-provoking read! I wonder if this should be a more common measurement in clinical trials (nsMRAs, ASIs, etc) since the studies so far have involved small numbers of patients. Without more concrete data showing the clinical utility it is hard to justify muddying the waters more.
December 23, 2025 at 2:10 AM
Reposted by Josh Leisring
thecurbsiders.bsky.social
🚨 Fresh Hypertension Guidelines Alert 🚨

Don’t get caught treating high blood pressure like it’s 2024 👀

In Episode #509, West Philly doc Dr. Jordy Cohen @jordybc.bsky.social
keeps our hypertension management fresh with a clear walk-through of the new HTN guidelines & more!

www.thecurbsiders.com
December 22, 2025 at 7:10 PM
joshleisring.bsky.social
AHA Scientific Statement on Single-Pill Combination Therapy
www.ahajournals.org/doi/10.1161/... #Nephsky
December 16, 2025 at 2:18 PM
Reposted by Josh Leisring
spjuraschek.bsky.social
If you are interested in hypertension training and research, check out our hypertension fellowship.

research.bidmc.org/medicine-gme...
Clinical Hypertension Fellowship
research.bidmc.org
December 12, 2025 at 9:19 PM
Reposted by Josh Leisring
spjuraschek.bsky.social
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/...
December 11, 2025 at 1:36 PM
joshleisring.bsky.social
"Older and Black participants had higher aldo-to-renin ratio...and women had higher aldo levels than men across the lifespan. With newly expanded indications for PA testing, a greater appreciation of the influence of demographic characteristics will be required." #nephsky
tinyurl.com/yc8ryxmu
Impact of Age, Sex, and Race on Primary Aldosteronism Test Interpretations | Hypertension
BACKGROUND: New guidelines recommend testing for primary aldosteronism (PA) in all people with hypertension. Interpreting population-based results for PA will require understanding the influence of de...
tinyurl.com
December 11, 2025 at 1:17 PM
Reposted by Josh Leisring
hswapnil.medsky.social
Our take on the baxdrostat PA trial in @asnpublications.bsky.social #KidneyNews

www.kidneynews.org/view/journal... with @nephroseeker.medsky.social and @dramiliflores.bsky.social !

Thanks to Sam Kant and @kdjhaveri.bsky.social for the invite!!
VA of SPARK trial
December 9, 2025 at 2:33 AM
Reposted by Josh Leisring
nephjc.bsky.social
🆕 #NephJCshort by @brianrifkin.bsky.social

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
Reposted by Josh Leisring
grahamabra.bsky.social
My first month of trying to prescribe fish oil at the dialysis unit has been a total failure

Pharmacies arn’t filling scripts and patients can’t find OTC matches to dose prescribed in PISCES

Anyone having success on the high seas?
December 2, 2025 at 7:21 PM
Reposted by Josh Leisring
sodatroubles.bsky.social
To Treat or Not to Treat? Watchful Waiting or Oral Antihypertensives for Asymptomatic Inpatient Hypertension
#nephsky #nephrology
www.nejm.org/doi/full/10....
To Treat or Not to Treat? Watchful Waiting or Oral Antihypertensives for Asymptomatic Inpatient Hypertension | NEJM
This feature about a man hospitalized for uncomplicated diverticulitis who is found to have high blood pressure offers a case vignette accompanied by two essays, one supporting ...
www.nejm.org
November 20, 2025 at 11:02 AM
Reposted by Josh Leisring
bhallaresearch.bsky.social
Ahead of #KidneyWk25, we are recruiting a hypertension fellow to the Stanford Hypertension Center for July 2026. Please come find me at ASN.

med.stanford.edu/nephrology/e...
Hypertension Fellowship
med.stanford.edu
November 5, 2025 at 7:57 AM
Reposted by Josh Leisring
rheaultm.bsky.social
Samir Parikh gives an update on lupus nephritis. #KidneyWk Looking for rapid reduction of proteinuria? Voclosporin is faster, but belimumab showed similar separation from placebo, it just takes longer due to mechanism of action.
November 5, 2025 at 3:38 PM
Reposted by Josh Leisring
nejm.org
BaxHTN phase 3 trial: Aldosterone dysregulation is considered a key driver of hard-to-control hypertension. Research findings on baxdrostat, a highly selective, potent aldosterone synthase inhibitor, in hard-to-control hypertension are summarized in a new Quick Take video. nej.md/3KCsQGJ
A visual representation of the BaxHTN phase 3 trial, which evaluated baxdrostat, a highly selective, potent aldosterone synthase inhibitor, in patients with hard-to-control hypertension.
October 15, 2025 at 7:02 PM
joshleisring.bsky.social
Donate and represent!
#NephJC
October 2, 2025 at 12:36 PM
Reposted by Josh Leisring
kentkidneydoc.bsky.social
Our @ukkidney.org guidelines here in BMC Nephrology. 💯% agree that in-unit BP should ONLY be used for determining safety of individual HD sessions and NOT long-term CV risk modification. But changing practice will be a long haul.

link.springer.com/epdf/10.1186...
Management of blood pressure in adults, children and young people on dialysis: UK kidney association clinical practice guideline
link.springer.com
September 30, 2025 at 12:03 PM
Reposted by Josh Leisring
giaconajohn.bsky.social
Subclinical primary aldosteronism is an under-recognized driver of cardiovascular risk. Could it be a new target for CV prevention? Read our Circulation editorial —>
September 29, 2025 at 7:03 PM
Reposted by Josh Leisring
nephroseeker.medsky.social
#NephJC is a labor of a passionate volunteer team that believes education should be accessible, no matter where you are from in the world.

Even if editorial team donates unlimited hours of sleep, there are still costs to cover 💸 (👇 blog)

😊 Be kind, help us to #NephItForward

#Medsky #Nephsky
September 28, 2025 at 4:47 PM