Brendon Neuen
@brendonneuen.bsky.social
Nephrologist; Associate Professor; Program Lead, Renal & Metabolic, George Institute; Director, Kidney Trials, Royal North Shore Hospital; Secretariat, #SMART-C; Podcast host, #KidneyCompass
www.SMART-C.net
www.SMART-C.net
From the Lancet 2022 paper:
But I agree it is worth drilling down a bit more (it is on the to-do list)
But I agree it is worth drilling down a bit more (it is on the to-do list)
October 21, 2025 at 9:32 AM
From the Lancet 2022 paper:
But I agree it is worth drilling down a bit more (it is on the to-do list)
But I agree it is worth drilling down a bit more (it is on the to-do list)
📢 New in CJASN: pooled analysis of all completed phase 2/3 RCTs in #IgAN
🔹 4 drug classes (steroids, B-cell, complement, non-immunological)
🔹 All ↓ proteinuria ≥30%
🔹 All improved GFR slope
🔹 Biggest benefit: B-cell therapies
journals.lww.com/cjasn/abstra...
🔹 4 drug classes (steroids, B-cell, complement, non-immunological)
🔹 All ↓ proteinuria ≥30%
🔹 All improved GFR slope
🔹 Biggest benefit: B-cell therapies
journals.lww.com/cjasn/abstra...
September 12, 2025 at 2:24 AM
📢 New in CJASN: pooled analysis of all completed phase 2/3 RCTs in #IgAN
🔹 4 drug classes (steroids, B-cell, complement, non-immunological)
🔹 All ↓ proteinuria ≥30%
🔹 All improved GFR slope
🔹 Biggest benefit: B-cell therapies
journals.lww.com/cjasn/abstra...
🔹 4 drug classes (steroids, B-cell, complement, non-immunological)
🔹 All ↓ proteinuria ≥30%
🔹 All improved GFR slope
🔹 Biggest benefit: B-cell therapies
journals.lww.com/cjasn/abstra...
Reduction in all-cause hospitalisation driven by fewer admissions for:
- Cardiac
- Renal
- Metabolic disorders, and
- Infections
Interestingly reduction in infections also observed with semaglutide in the FLOW trial - could GDMT improve physical resilience & susceptibility to infections?
- Cardiac
- Renal
- Metabolic disorders, and
- Infections
Interestingly reduction in infections also observed with semaglutide in the FLOW trial - could GDMT improve physical resilience & susceptibility to infections?
July 15, 2025 at 9:16 PM
Reduction in all-cause hospitalisation driven by fewer admissions for:
- Cardiac
- Renal
- Metabolic disorders, and
- Infections
Interestingly reduction in infections also observed with semaglutide in the FLOW trial - could GDMT improve physical resilience & susceptibility to infections?
- Cardiac
- Renal
- Metabolic disorders, and
- Infections
Interestingly reduction in infections also observed with semaglutide in the FLOW trial - could GDMT improve physical resilience & susceptibility to infections?
SGLT2i in CKD: impact beyond kidneys
🔻 15% all-cause hospitalizations
✅ Consistent regardless of eGFR, UACR & diabetes
🏥 ~36 fewer hospitalizations per 1000 pt-years
Large absolute gains for patients & health systems
Meta-analysis in @asnpublications.bsky.social
journals.lww.com/cjasn/pages/...
🔻 15% all-cause hospitalizations
✅ Consistent regardless of eGFR, UACR & diabetes
🏥 ~36 fewer hospitalizations per 1000 pt-years
Large absolute gains for patients & health systems
Meta-analysis in @asnpublications.bsky.social
journals.lww.com/cjasn/pages/...
July 15, 2025 at 3:40 AM
SGLT2i in CKD: impact beyond kidneys
🔻 15% all-cause hospitalizations
✅ Consistent regardless of eGFR, UACR & diabetes
🏥 ~36 fewer hospitalizations per 1000 pt-years
Large absolute gains for patients & health systems
Meta-analysis in @asnpublications.bsky.social
journals.lww.com/cjasn/pages/...
🔻 15% all-cause hospitalizations
✅ Consistent regardless of eGFR, UACR & diabetes
🏥 ~36 fewer hospitalizations per 1000 pt-years
Large absolute gains for patients & health systems
Meta-analysis in @asnpublications.bsky.social
journals.lww.com/cjasn/pages/...
Or alternative endpoints such as hierarchical composite endpoints that may increase statistical power to detect treatment effects, incorporating both clinical outcomes (dialysis, 2xSCr etc) and intermediate endpoints (GFR slope)
July 9, 2025 at 1:41 AM
Or alternative endpoints such as hierarchical composite endpoints that may increase statistical power to detect treatment effects, incorporating both clinical outcomes (dialysis, 2xSCr etc) and intermediate endpoints (GFR slope)
Baseline use of #SGLT2i in recent trials enrolling patients with #IgAN:
Listen to the full podcast discussion between me, Shikha Wadwhani and Vlado Perkovic: hcplive.com/view/kidney-...
#ERA25 #kidneycompass #sibeprenlimab #VISIONARY
Listen to the full podcast discussion between me, Shikha Wadwhani and Vlado Perkovic: hcplive.com/view/kidney-...
#ERA25 #kidneycompass #sibeprenlimab #VISIONARY
June 8, 2025 at 10:13 PM
Baseline use of #SGLT2i in recent trials enrolling patients with #IgAN:
Listen to the full podcast discussion between me, Shikha Wadwhani and Vlado Perkovic: hcplive.com/view/kidney-...
#ERA25 #kidneycompass #sibeprenlimab #VISIONARY
Listen to the full podcast discussion between me, Shikha Wadwhani and Vlado Perkovic: hcplive.com/view/kidney-...
#ERA25 #kidneycompass #sibeprenlimab #VISIONARY
How will the #CONFIDENCE trial shape practice in #CKD + #T2D?
I spoke with PI, Rajiv Agarwal, after his #ERA25 late-breaker on why a sequential approach may be doing our patients a disservice
Full episode: hcplive.com/view/kidney-...
#KidneyCompass #SGLT2i #finerenone
I spoke with PI, Rajiv Agarwal, after his #ERA25 late-breaker on why a sequential approach may be doing our patients a disservice
Full episode: hcplive.com/view/kidney-...
#KidneyCompass #SGLT2i #finerenone
June 6, 2025 at 11:55 PM
How will the #CONFIDENCE trial shape practice in #CKD + #T2D?
I spoke with PI, Rajiv Agarwal, after his #ERA25 late-breaker on why a sequential approach may be doing our patients a disservice
Full episode: hcplive.com/view/kidney-...
#KidneyCompass #SGLT2i #finerenone
I spoke with PI, Rajiv Agarwal, after his #ERA25 late-breaker on why a sequential approach may be doing our patients a disservice
Full episode: hcplive.com/view/kidney-...
#KidneyCompass #SGLT2i #finerenone
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....
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....
April 21, 2025 at 11:26 AM
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....
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....
Rationale and Design of NUDGE-CKD: A Nationwide Randomized Factorial Trial of Electronic Nudges for Increasing Guideline-Directed Medical Therapy in Chronic Kidney Disease
From Tor Biering Sorensen and team in Copenhagen:
www.sciencedirect.com/science/arti...
From Tor Biering Sorensen and team in Copenhagen:
www.sciencedirect.com/science/arti...
April 3, 2025 at 11:40 PM
Rationale and Design of NUDGE-CKD: A Nationwide Randomized Factorial Trial of Electronic Nudges for Increasing Guideline-Directed Medical Therapy in Chronic Kidney Disease
From Tor Biering Sorensen and team in Copenhagen:
www.sciencedirect.com/science/arti...
From Tor Biering Sorensen and team in Copenhagen:
www.sciencedirect.com/science/arti...
In SOUL, 2596/9650 (26.9%) participants were receiving SGLT2i at baseline (largest CVOT of combined GLP-1/SGLT2 to date)
The effect of oral semaglutide on cardiovascular outcomes was consistent, regardless of SGLT2i use
#ACC25
www.ahajournals.org/doi/abs/10.1...
The effect of oral semaglutide on cardiovascular outcomes was consistent, regardless of SGLT2i use
#ACC25
www.ahajournals.org/doi/abs/10.1...
March 29, 2025 at 10:25 PM
In SOUL, 2596/9650 (26.9%) participants were receiving SGLT2i at baseline (largest CVOT of combined GLP-1/SGLT2 to date)
The effect of oral semaglutide on cardiovascular outcomes was consistent, regardless of SGLT2i use
#ACC25
www.ahajournals.org/doi/abs/10.1...
The effect of oral semaglutide on cardiovascular outcomes was consistent, regardless of SGLT2i use
#ACC25
www.ahajournals.org/doi/abs/10.1...
Cardiovascular, Kidney & Mortality Outcomes With Long-Acting Injectable & Oral GLP1-RA in T2 Diabetes
An updated meta-analysis of >70,000 patients after the SOUL trial
⬇️ 14% MACE
⬇️ 14% heart failure
⬇️ 17% CKD progression
⬇️ 12% all-cause mortality
diabetesjournals.org/care/article...
An updated meta-analysis of >70,000 patients after the SOUL trial
⬇️ 14% MACE
⬇️ 14% heart failure
⬇️ 17% CKD progression
⬇️ 12% all-cause mortality
diabetesjournals.org/care/article...
March 29, 2025 at 10:00 PM
Cardiovascular, Kidney & Mortality Outcomes With Long-Acting Injectable & Oral GLP1-RA in T2 Diabetes
An updated meta-analysis of >70,000 patients after the SOUL trial
⬇️ 14% MACE
⬇️ 14% heart failure
⬇️ 17% CKD progression
⬇️ 12% all-cause mortality
diabetesjournals.org/care/article...
An updated meta-analysis of >70,000 patients after the SOUL trial
⬇️ 14% MACE
⬇️ 14% heart failure
⬇️ 17% CKD progression
⬇️ 12% all-cause mortality
diabetesjournals.org/care/article...
Contribution of the GFR slope to the kidney hierarchical composite endpoint
@kidneyint.bsky.social
www.sciencedirect.com/science/arti...
@kidneyint.bsky.social
www.sciencedirect.com/science/arti...
March 28, 2025 at 3:57 AM
Contribution of the GFR slope to the kidney hierarchical composite endpoint
@kidneyint.bsky.social
www.sciencedirect.com/science/arti...
@kidneyint.bsky.social
www.sciencedirect.com/science/arti...
Our new analysis of the TESTING trial in @kireports.bsky.social
Steroids improve kidney outcomes in #IgAN at high risk of progression, irrespective of proteinuria or eGFR. But the balance of benefits/harms may be less favourable in those with advanced CKD
www.kireports.org/article/S246...
Steroids improve kidney outcomes in #IgAN at high risk of progression, irrespective of proteinuria or eGFR. But the balance of benefits/harms may be less favourable in those with advanced CKD
www.kireports.org/article/S246...
March 17, 2025 at 5:56 AM
Our new analysis of the TESTING trial in @kireports.bsky.social
Steroids improve kidney outcomes in #IgAN at high risk of progression, irrespective of proteinuria or eGFR. But the balance of benefits/harms may be less favourable in those with advanced CKD
www.kireports.org/article/S246...
Steroids improve kidney outcomes in #IgAN at high risk of progression, irrespective of proteinuria or eGFR. But the balance of benefits/harms may be less favourable in those with advanced CKD
www.kireports.org/article/S246...
📢 New CREDENCE data in NDT:
SGLT2i in CKD and T2D:
✅ ↓ Insulin initiation/dose intensification by 19%
✅ ↑ Reductions in insulin dose by up to 49%
✅ Consistent ↓ in insulin use down to GFR of 30ml/min in whom glycosuric effect is minimal
academic.oup.com/ndt/advance-...
SGLT2i in CKD and T2D:
✅ ↓ Insulin initiation/dose intensification by 19%
✅ ↑ Reductions in insulin dose by up to 49%
✅ Consistent ↓ in insulin use down to GFR of 30ml/min in whom glycosuric effect is minimal
academic.oup.com/ndt/advance-...
March 2, 2025 at 10:18 AM
📢 New CREDENCE data in NDT:
SGLT2i in CKD and T2D:
✅ ↓ Insulin initiation/dose intensification by 19%
✅ ↑ Reductions in insulin dose by up to 49%
✅ Consistent ↓ in insulin use down to GFR of 30ml/min in whom glycosuric effect is minimal
academic.oup.com/ndt/advance-...
SGLT2i in CKD and T2D:
✅ ↓ Insulin initiation/dose intensification by 19%
✅ ↑ Reductions in insulin dose by up to 49%
✅ Consistent ↓ in insulin use down to GFR of 30ml/min in whom glycosuric effect is minimal
academic.oup.com/ndt/advance-...
Clazakizumab, an IL-6 inhibitor, improves iron metabolism & may reduce ESA use in dialysis
✅ ↓ Hepcidin (~44%)
✅ ↑ TSAT (up to 19%)
✅ ↓ ESA dose uptitration
P3 trial (n=2,200) ongoing for CV outcomes.
Our findings now in JASN @asnpublications.bsky.social : journals.lww.com/jasn/citatio...
✅ ↓ Hepcidin (~44%)
✅ ↑ TSAT (up to 19%)
✅ ↓ ESA dose uptitration
P3 trial (n=2,200) ongoing for CV outcomes.
Our findings now in JASN @asnpublications.bsky.social : journals.lww.com/jasn/citatio...
February 9, 2025 at 11:10 AM
Clazakizumab, an IL-6 inhibitor, improves iron metabolism & may reduce ESA use in dialysis
✅ ↓ Hepcidin (~44%)
✅ ↑ TSAT (up to 19%)
✅ ↓ ESA dose uptitration
P3 trial (n=2,200) ongoing for CV outcomes.
Our findings now in JASN @asnpublications.bsky.social : journals.lww.com/jasn/citatio...
✅ ↓ Hepcidin (~44%)
✅ ↑ TSAT (up to 19%)
✅ ↓ ESA dose uptitration
P3 trial (n=2,200) ongoing for CV outcomes.
Our findings now in JASN @asnpublications.bsky.social : journals.lww.com/jasn/citatio...
Rationale and design of the FAIR-HF2
trial: Ferric carboxymaltose assessment of
morbidity and mortality in patients with iron deficiency & heart failure
onlinelibrary.wiley.com/doi/pdf/10.1...
trial: Ferric carboxymaltose assessment of
morbidity and mortality in patients with iron deficiency & heart failure
onlinelibrary.wiley.com/doi/pdf/10.1...
February 2, 2025 at 9:10 PM
Rationale and design of the FAIR-HF2
trial: Ferric carboxymaltose assessment of
morbidity and mortality in patients with iron deficiency & heart failure
onlinelibrary.wiley.com/doi/pdf/10.1...
trial: Ferric carboxymaltose assessment of
morbidity and mortality in patients with iron deficiency & heart failure
onlinelibrary.wiley.com/doi/pdf/10.1...
New in @natrevneph.bsky.social
With Drs Blum & Grams, we explore how risk-based CKD management aligns care with risk, prioritizes absolute benefits, & improves cost-effectiveness—guiding the use of key therapies for those most likely to benefit
🔗 Read more: www.nature.com/articles/s41...
With Drs Blum & Grams, we explore how risk-based CKD management aligns care with risk, prioritizes absolute benefits, & improves cost-effectiveness—guiding the use of key therapies for those most likely to benefit
🔗 Read more: www.nature.com/articles/s41...
January 30, 2025 at 11:48 PM
New in @natrevneph.bsky.social
With Drs Blum & Grams, we explore how risk-based CKD management aligns care with risk, prioritizes absolute benefits, & improves cost-effectiveness—guiding the use of key therapies for those most likely to benefit
🔗 Read more: www.nature.com/articles/s41...
With Drs Blum & Grams, we explore how risk-based CKD management aligns care with risk, prioritizes absolute benefits, & improves cost-effectiveness—guiding the use of key therapies for those most likely to benefit
🔗 Read more: www.nature.com/articles/s41...
📢 New Systematic Review & Meta-Analysis in
@kireports.bsky.social 📢
We evaluated the effects of iron therapy on clinical outcomes in chronic kidney disease (CKD), analyzing 45 randomized trials. A summary of our findings: 🧵
www.kireports.org/article/S246...
@kireports.bsky.social 📢
We evaluated the effects of iron therapy on clinical outcomes in chronic kidney disease (CKD), analyzing 45 randomized trials. A summary of our findings: 🧵
www.kireports.org/article/S246...
January 30, 2025 at 12:48 AM
📢 New Systematic Review & Meta-Analysis in
@kireports.bsky.social 📢
We evaluated the effects of iron therapy on clinical outcomes in chronic kidney disease (CKD), analyzing 45 randomized trials. A summary of our findings: 🧵
www.kireports.org/article/S246...
@kireports.bsky.social 📢
We evaluated the effects of iron therapy on clinical outcomes in chronic kidney disease (CKD), analyzing 45 randomized trials. A summary of our findings: 🧵
www.kireports.org/article/S246...
Case study: FLOW trial
FLOW (semaglutide in type 2 diabetes and CKD) included oral diuretic augmentation in its worsening HF endpoint definition. This adaptation aligns with growing evidence that such events are valuable for evaluating treatment effects on HF
www.jacc.org/doi/10.1016/...
FLOW (semaglutide in type 2 diabetes and CKD) included oral diuretic augmentation in its worsening HF endpoint definition. This adaptation aligns with growing evidence that such events are valuable for evaluating treatment effects on HF
www.jacc.org/doi/10.1016/...
January 23, 2025 at 10:28 PM
Case study: FLOW trial
FLOW (semaglutide in type 2 diabetes and CKD) included oral diuretic augmentation in its worsening HF endpoint definition. This adaptation aligns with growing evidence that such events are valuable for evaluating treatment effects on HF
www.jacc.org/doi/10.1016/...
FLOW (semaglutide in type 2 diabetes and CKD) included oral diuretic augmentation in its worsening HF endpoint definition. This adaptation aligns with growing evidence that such events are valuable for evaluating treatment effects on HF
www.jacc.org/doi/10.1016/...
Important new data from CREDENCE:
Oral loop diuretic intensification (ODI) in diabetes & CKD:
- Is frequent (1 in 7 patients)
- Associated with 30x increased risk of subsequent HF
- Is reduced with SGLT2i by 40%
Led by Safia Chatur, open access in #EJHF
onlinelibrary.wiley.com/doi/10.1002/...
Oral loop diuretic intensification (ODI) in diabetes & CKD:
- Is frequent (1 in 7 patients)
- Associated with 30x increased risk of subsequent HF
- Is reduced with SGLT2i by 40%
Led by Safia Chatur, open access in #EJHF
onlinelibrary.wiley.com/doi/10.1002/...
January 23, 2025 at 10:25 AM
Important new data from CREDENCE:
Oral loop diuretic intensification (ODI) in diabetes & CKD:
- Is frequent (1 in 7 patients)
- Associated with 30x increased risk of subsequent HF
- Is reduced with SGLT2i by 40%
Led by Safia Chatur, open access in #EJHF
onlinelibrary.wiley.com/doi/10.1002/...
Oral loop diuretic intensification (ODI) in diabetes & CKD:
- Is frequent (1 in 7 patients)
- Associated with 30x increased risk of subsequent HF
- Is reduced with SGLT2i by 40%
Led by Safia Chatur, open access in #EJHF
onlinelibrary.wiley.com/doi/10.1002/...
Prevent kidney failure to reduce carbon emissions ♻️ 🍃 🏭
Our new analysis of CREDENCE assessing environmental impacts from ⬇️ hospitalisations & dialysis 🏥 with SGLT2i
SGLT2i ⬇️ greenhouse gas emissions from inpatient bed days & dialysis by 20% (39 kg CO2e per yr)
www.thelancet.com/journals/lan...
Our new analysis of CREDENCE assessing environmental impacts from ⬇️ hospitalisations & dialysis 🏥 with SGLT2i
SGLT2i ⬇️ greenhouse gas emissions from inpatient bed days & dialysis by 20% (39 kg CO2e per yr)
www.thelancet.com/journals/lan...
December 12, 2024 at 12:45 AM
Prevent kidney failure to reduce carbon emissions ♻️ 🍃 🏭
Our new analysis of CREDENCE assessing environmental impacts from ⬇️ hospitalisations & dialysis 🏥 with SGLT2i
SGLT2i ⬇️ greenhouse gas emissions from inpatient bed days & dialysis by 20% (39 kg CO2e per yr)
www.thelancet.com/journals/lan...
Our new analysis of CREDENCE assessing environmental impacts from ⬇️ hospitalisations & dialysis 🏥 with SGLT2i
SGLT2i ⬇️ greenhouse gas emissions from inpatient bed days & dialysis by 20% (39 kg CO2e per yr)
www.thelancet.com/journals/lan...
What an enlightening conversation on #KidneyCompass today with Shikha Wadhwan & special guests @dannygale.bsky.social & Laura Mariani
A deep dive into the PARASOL initiative and how it is helping to accelerate therapeutic development for FSGS
Don’t miss this podcast episode - out next week!
A deep dive into the PARASOL initiative and how it is helping to accelerate therapeutic development for FSGS
Don’t miss this podcast episode - out next week!
December 3, 2024 at 11:07 PM
What an enlightening conversation on #KidneyCompass today with Shikha Wadhwan & special guests @dannygale.bsky.social & Laura Mariani
A deep dive into the PARASOL initiative and how it is helping to accelerate therapeutic development for FSGS
Don’t miss this podcast episode - out next week!
A deep dive into the PARASOL initiative and how it is helping to accelerate therapeutic development for FSGS
Don’t miss this podcast episode - out next week!
🎙️Really looking forward to recording our next episode of #KidneyCompass tomorrow!
We’ll be joined by Laura Mariani & @dannygale.bsky.social to discuss the important PARASOL initiative from @ISGDtweets to accelerating therapeutic innovation for FSGS
We’ll be joined by Laura Mariani & @dannygale.bsky.social to discuss the important PARASOL initiative from @ISGDtweets to accelerating therapeutic innovation for FSGS
December 2, 2024 at 11:13 PM
🎙️Really looking forward to recording our next episode of #KidneyCompass tomorrow!
We’ll be joined by Laura Mariani & @dannygale.bsky.social to discuss the important PARASOL initiative from @ISGDtweets to accelerating therapeutic innovation for FSGS
We’ll be joined by Laura Mariani & @dannygale.bsky.social to discuss the important PARASOL initiative from @ISGDtweets to accelerating therapeutic innovation for FSGS
In people with T2D, effects of GLP1-RA on CV, kidney & mortality outcomes are consistent irrespective of SGLT2i
Our meta-analysis of the 3 GLP1RA diabetes clinical outcome trials with the largest prevalent use of SGLT2i in @ahajournals.bsky.social Circulation
www.ahajournals.org/doi/10.1161/...
Our meta-analysis of the 3 GLP1RA diabetes clinical outcome trials with the largest prevalent use of SGLT2i in @ahajournals.bsky.social Circulation
www.ahajournals.org/doi/10.1161/...
November 27, 2024 at 8:54 PM
In people with T2D, effects of GLP1-RA on CV, kidney & mortality outcomes are consistent irrespective of SGLT2i
Our meta-analysis of the 3 GLP1RA diabetes clinical outcome trials with the largest prevalent use of SGLT2i in @ahajournals.bsky.social Circulation
www.ahajournals.org/doi/10.1161/...
Our meta-analysis of the 3 GLP1RA diabetes clinical outcome trials with the largest prevalent use of SGLT2i in @ahajournals.bsky.social Circulation
www.ahajournals.org/doi/10.1161/...