Nephrology Journal Club
@nephjc.bsky.social
A twice monthly nephrology journal club that used to meet on Twitter. Hashtag #NephJC
www.nephjc.com
www.nephjc.com
This is Akshaya 👩⚕️@nephromommy-akshu.bsky.social signing off!
Do checkout our department's page - x.com/CMCNephrology
Have a wonderful day, and an amazing scientific feast at #kidneyweek!
Nandri - Vanakkam 💙✨🙏
#NephJC
Do checkout our department's page - x.com/CMCNephrology
Have a wonderful day, and an amazing scientific feast at #kidneyweek!
Nandri - Vanakkam 💙✨🙏
#NephJC
October 29, 2025 at 1:59 AM
This is Akshaya 👩⚕️@nephromommy-akshu.bsky.social signing off!
Do checkout our department's page - x.com/CMCNephrology
Have a wonderful day, and an amazing scientific feast at #kidneyweek!
Nandri - Vanakkam 💙✨🙏
#NephJC
Do checkout our department's page - x.com/CMCNephrology
Have a wonderful day, and an amazing scientific feast at #kidneyweek!
Nandri - Vanakkam 💙✨🙏
#NephJC
Heartfelt gratitude to our mentors 🌟 @kidneyboy.bsky.social,@nephroseeker.medsky.social,@dramiliflores.bsky.social,@brianrifkin.bsky.social and @drpallaviprasad.bsky.social for being so kind, patient, and supportive — thank you for fine-tuning everything to perfection. You’re the best! 💙 #NephJC
October 29, 2025 at 1:58 AM
Heartfelt gratitude to our mentors 🌟 @kidneyboy.bsky.social,@nephroseeker.medsky.social,@dramiliflores.bsky.social,@brianrifkin.bsky.social and @drpallaviprasad.bsky.social for being so kind, patient, and supportive — thank you for fine-tuning everything to perfection. You’re the best! 💙 #NephJC
Hope you all had an enriching discussion and got some new perspectives. 📈 📊
I would love to thank my team Dr Sai Vani @drsaivani.bsky.social, Natalia @roxnonna23.bsky.social, Bogdan @thekidneywhisperer.bsky.social and Janany @glomerican.bsky.social for all the hard work!
Cheers to us ! 🎉🥳
I would love to thank my team Dr Sai Vani @drsaivani.bsky.social, Natalia @roxnonna23.bsky.social, Bogdan @thekidneywhisperer.bsky.social and Janany @glomerican.bsky.social for all the hard work!
Cheers to us ! 🎉🥳
October 29, 2025 at 1:57 AM
Hope you all had an enriching discussion and got some new perspectives. 📈 📊
I would love to thank my team Dr Sai Vani @drsaivani.bsky.social, Natalia @roxnonna23.bsky.social, Bogdan @thekidneywhisperer.bsky.social and Janany @glomerican.bsky.social for all the hard work!
Cheers to us ! 🎉🥳
I would love to thank my team Dr Sai Vani @drsaivani.bsky.social, Natalia @roxnonna23.bsky.social, Bogdan @thekidneywhisperer.bsky.social and Janany @glomerican.bsky.social for all the hard work!
Cheers to us ! 🎉🥳
October 29, 2025 at 1:56 AM
If you want to stay on top of #NephJC happenings, sign up for our once a week newsletter 📰 📢
www.nephjc.com/newsl...
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October 29, 2025 at 1:55 AM
If you want to stay on top of #NephJC happenings, sign up for our once a week newsletter 📰 📢
www.nephjc.com/newsl...
www.nephjc.com/newsl...
Up next! ☀️📚 We're going to #KidneyWeek in Houston! Many late breaking simultaneous papers to be sure (plenty to pick from, we’d love to hear your choices). Hope to see many of you at the #NephJC party 🎈
October 29, 2025 at 1:54 AM
Up next! ☀️📚 We're going to #KidneyWeek in Houston! Many late breaking simultaneous papers to be sure (plenty to pick from, we’d love to hear your choices). Hope to see many of you at the #NephJC party 🎈
Don’t forget to support #FOAMed and #NephJC with our annual fundraiser. Every donation helps keep us going (even as unpaid volunteers). 🫶🫶🫶
www.nephjc.com
www.nephjc.com
October 29, 2025 at 1:53 AM
Don’t forget to support #FOAMed and #NephJC with our annual fundraiser. Every donation helps keep us going (even as unpaid volunteers). 🫶🫶🫶
www.nephjc.com
www.nephjc.com
🤔 What did we miss?
🧐 What else caught your attention and should be discussed?
✅❌ What did KDIGO get right/wrong?
⏰ Do you want more frequent disease-specific guidance?
#NephJC
🧐 What else caught your attention and should be discussed?
✅❌ What did KDIGO get right/wrong?
⏰ Do you want more frequent disease-specific guidance?
#NephJC
October 29, 2025 at 1:52 AM
🤔 What did we miss?
🧐 What else caught your attention and should be discussed?
✅❌ What did KDIGO get right/wrong?
⏰ Do you want more frequent disease-specific guidance?
#NephJC
🧐 What else caught your attention and should be discussed?
✅❌ What did KDIGO get right/wrong?
⏰ Do you want more frequent disease-specific guidance?
#NephJC
🟢First-ever guidelines fully dedicated to IgAN
🟢Aim to deliver a practical, risk-aligned, & updated treatment guidance.
🟢Advances precision risk stratification by histology, proteinuria trajectories, and validated prediction tools.
🔴Yet, we are already anticipating an update. #NephJC
🟢Aim to deliver a practical, risk-aligned, & updated treatment guidance.
🟢Advances precision risk stratification by histology, proteinuria trajectories, and validated prediction tools.
🔴Yet, we are already anticipating an update. #NephJC
October 29, 2025 at 1:51 AM
🟢First-ever guidelines fully dedicated to IgAN
🟢Aim to deliver a practical, risk-aligned, & updated treatment guidance.
🟢Advances precision risk stratification by histology, proteinuria trajectories, and validated prediction tools.
🔴Yet, we are already anticipating an update. #NephJC
🟢Aim to deliver a practical, risk-aligned, & updated treatment guidance.
🟢Advances precision risk stratification by histology, proteinuria trajectories, and validated prediction tools.
🔴Yet, we are already anticipating an update. #NephJC
APRIL/BAFF inhibition: 🎯💊🩺
Trials are under way on this pathway, which promise to get to the root cause of IgAN. However, with great innovation comes…greater confusion. Sequence of treatment, cost, and side effects will need to be considered when increasing immunosuppression.
#NephJC
Trials are under way on this pathway, which promise to get to the root cause of IgAN. However, with great innovation comes…greater confusion. Sequence of treatment, cost, and side effects will need to be considered when increasing immunosuppression.
#NephJC
October 29, 2025 at 1:50 AM
APRIL/BAFF inhibition: 🎯💊🩺
Trials are under way on this pathway, which promise to get to the root cause of IgAN. However, with great innovation comes…greater confusion. Sequence of treatment, cost, and side effects will need to be considered when increasing immunosuppression.
#NephJC
Trials are under way on this pathway, which promise to get to the root cause of IgAN. However, with great innovation comes…greater confusion. Sequence of treatment, cost, and side effects will need to be considered when increasing immunosuppression.
#NephJC
Additional studies of endothelin antagonists, complement inhibition (iptacopan, avacopan, ravulizumab, IONIS-FB-LRx), and APRIL/BAFF inhibition (atacicept, telitacicept, povetacicept, sibeprenlimab) are currently underway.
The next IgAN update will have much to discuss!
#NephJC
The next IgAN update will have much to discuss!
#NephJC
October 29, 2025 at 1:49 AM
Additional studies of endothelin antagonists, complement inhibition (iptacopan, avacopan, ravulizumab, IONIS-FB-LRx), and APRIL/BAFF inhibition (atacicept, telitacicept, povetacicept, sibeprenlimab) are currently underway.
The next IgAN update will have much to discuss!
#NephJC
The next IgAN update will have much to discuss!
#NephJC
Areas of future research: 💉🩺
Though we have learnt a lot on IgA Nephropathy today, still incomplete knowledge of many grey areas to be answered. What do you want to know more about IgAN in the next update (2 years)?
#NephJC
Though we have learnt a lot on IgA Nephropathy today, still incomplete knowledge of many grey areas to be answered. What do you want to know more about IgAN in the next update (2 years)?
#NephJC
October 29, 2025 at 1:48 AM
Areas of future research: 💉🩺
Though we have learnt a lot on IgA Nephropathy today, still incomplete knowledge of many grey areas to be answered. What do you want to know more about IgAN in the next update (2 years)?
#NephJC
Though we have learnt a lot on IgA Nephropathy today, still incomplete knowledge of many grey areas to be answered. What do you want to know more about IgAN in the next update (2 years)?
#NephJC
IgAV with RPGN: 🚨
Treatment should follow the KDIGO 2024 recommendations for ANCA-associated vasculitis, consisting of systemic glucocorticoids in combination with cyclophosphamide/rituximab. #NephJC
Treatment should follow the KDIGO 2024 recommendations for ANCA-associated vasculitis, consisting of systemic glucocorticoids in combination with cyclophosphamide/rituximab. #NephJC
October 29, 2025 at 1:47 AM
IgAV with RPGN: 🚨
Treatment should follow the KDIGO 2024 recommendations for ANCA-associated vasculitis, consisting of systemic glucocorticoids in combination with cyclophosphamide/rituximab. #NephJC
Treatment should follow the KDIGO 2024 recommendations for ANCA-associated vasculitis, consisting of systemic glucocorticoids in combination with cyclophosphamide/rituximab. #NephJC
Treatment: 💊🩺
Systemic glucocorticoids are not recommended for preventing renal involvement in patients with IgAV without nephritis. Management follows similar principles to those used in IgAN: BP control, RASi, possible addition of SGLT2i, and lifestyle modification.
#NephJC
Systemic glucocorticoids are not recommended for preventing renal involvement in patients with IgAV without nephritis. Management follows similar principles to those used in IgAN: BP control, RASi, possible addition of SGLT2i, and lifestyle modification.
#NephJC
October 29, 2025 at 1:45 AM
Treatment: 💊🩺
Systemic glucocorticoids are not recommended for preventing renal involvement in patients with IgAV without nephritis. Management follows similar principles to those used in IgAN: BP control, RASi, possible addition of SGLT2i, and lifestyle modification.
#NephJC
Systemic glucocorticoids are not recommended for preventing renal involvement in patients with IgAV without nephritis. Management follows similar principles to those used in IgAN: BP control, RASi, possible addition of SGLT2i, and lifestyle modification.
#NephJC
IgA Vasculitis- Prognosis 📈
Bad prognostic factors uncontrolled HTN and ⬆️proteinuria at presentation and during follow-up.
Oxford MEST-C score helps histologic assessment, especially E1(endocapillary hypercellularity) ➡️ Faster disease progression. #NephJC
Bad prognostic factors uncontrolled HTN and ⬆️proteinuria at presentation and during follow-up.
Oxford MEST-C score helps histologic assessment, especially E1(endocapillary hypercellularity) ➡️ Faster disease progression. #NephJC
October 29, 2025 at 1:44 AM
IgA Vasculitis- Prognosis 📈
Bad prognostic factors uncontrolled HTN and ⬆️proteinuria at presentation and during follow-up.
Oxford MEST-C score helps histologic assessment, especially E1(endocapillary hypercellularity) ➡️ Faster disease progression. #NephJC
Bad prognostic factors uncontrolled HTN and ⬆️proteinuria at presentation and during follow-up.
Oxford MEST-C score helps histologic assessment, especially E1(endocapillary hypercellularity) ➡️ Faster disease progression. #NephJC
IgA Vasculitis
A kidney biopsy is mandatory in patients with persistent proteinuria ≥0.5 g/day for more than 4 weeks, impaired kidney function, or suspicion of rapidly progressive glomerulonephritis (RPGN).
#NephJC
A kidney biopsy is mandatory in patients with persistent proteinuria ≥0.5 g/day for more than 4 weeks, impaired kidney function, or suspicion of rapidly progressive glomerulonephritis (RPGN).
#NephJC
October 29, 2025 at 1:43 AM
IgA Vasculitis
A kidney biopsy is mandatory in patients with persistent proteinuria ≥0.5 g/day for more than 4 weeks, impaired kidney function, or suspicion of rapidly progressive glomerulonephritis (RPGN).
#NephJC
A kidney biopsy is mandatory in patients with persistent proteinuria ≥0.5 g/day for more than 4 weeks, impaired kidney function, or suspicion of rapidly progressive glomerulonephritis (RPGN).
#NephJC
IgA Vasculitis or HSP: 🥵
Formerly known as Henoch–Schönlein purpura (HSP), is a small-vessel vasculitis characterized by IgA deposition, typically affecting the skin, joints, gastrointestinal tract, and kidneys. #NephJC
Formerly known as Henoch–Schönlein purpura (HSP), is a small-vessel vasculitis characterized by IgA deposition, typically affecting the skin, joints, gastrointestinal tract, and kidneys. #NephJC
October 29, 2025 at 1:42 AM
IgA Vasculitis or HSP: 🥵
Formerly known as Henoch–Schönlein purpura (HSP), is a small-vessel vasculitis characterized by IgA deposition, typically affecting the skin, joints, gastrointestinal tract, and kidneys. #NephJC
Formerly known as Henoch–Schönlein purpura (HSP), is a small-vessel vasculitis characterized by IgA deposition, typically affecting the skin, joints, gastrointestinal tract, and kidneys. #NephJC
Follow up of pediatric patients: 👶🩺
Target UPCR <200 mg/gm and SBP in the <90th percentile of age sex and height.
At least annual follow-up of BP, GFR and proteinuria should be done. #NephJC
Target UPCR <200 mg/gm and SBP in the <90th percentile of age sex and height.
At least annual follow-up of BP, GFR and proteinuria should be done. #NephJC
October 29, 2025 at 1:41 AM
Follow up of pediatric patients: 👶🩺
Target UPCR <200 mg/gm and SBP in the <90th percentile of age sex and height.
At least annual follow-up of BP, GFR and proteinuria should be done. #NephJC
Target UPCR <200 mg/gm and SBP in the <90th percentile of age sex and height.
At least annual follow-up of BP, GFR and proteinuria should be done. #NephJC
Treatment in children: 👶💉
Management is based on RAS blockade, salt restriction, and blood pressure control. Glucocorticoids are used in those with persistent proteinuria or high-risk features, sometimes combined with cyclophosphamide in severe cases.
#NephJC
Management is based on RAS blockade, salt restriction, and blood pressure control. Glucocorticoids are used in those with persistent proteinuria or high-risk features, sometimes combined with cyclophosphamide in severe cases.
#NephJC
October 29, 2025 at 1:39 AM
Treatment in children: 👶💉
Management is based on RAS blockade, salt restriction, and blood pressure control. Glucocorticoids are used in those with persistent proteinuria or high-risk features, sometimes combined with cyclophosphamide in severe cases.
#NephJC
Management is based on RAS blockade, salt restriction, and blood pressure control. Glucocorticoids are used in those with persistent proteinuria or high-risk features, sometimes combined with cyclophosphamide in severe cases.
#NephJC
Kidney biopsy in children (cont): 👶💉
Kidney biopsy specimens of children with IgAN show more inflammation, mesangial and endocapillary proliferation compared to adults.
This might be because associated with doing an early biopsy, due to visible hematuria. #NephJC
Kidney biopsy specimens of children with IgAN show more inflammation, mesangial and endocapillary proliferation compared to adults.
This might be because associated with doing an early biopsy, due to visible hematuria. #NephJC
October 29, 2025 at 1:38 AM
Kidney biopsy in children (cont): 👶💉
Kidney biopsy specimens of children with IgAN show more inflammation, mesangial and endocapillary proliferation compared to adults.
This might be because associated with doing an early biopsy, due to visible hematuria. #NephJC
Kidney biopsy specimens of children with IgAN show more inflammation, mesangial and endocapillary proliferation compared to adults.
This might be because associated with doing an early biopsy, due to visible hematuria. #NephJC
Indications for kidney biopsy in children: 👶💉
Presents as hematuria, proteinuria and ⬇️ GFR, with normal C3.
Biopsy should be performed:
👶At presentation
👶Persistent, recurrent hematuria, Nephrotic proteinuria or ⬇️eGFR
👶Hematuria + 200-500mg/g in 3 measurements 1-2w apart
#NephJC
Presents as hematuria, proteinuria and ⬇️ GFR, with normal C3.
Biopsy should be performed:
👶At presentation
👶Persistent, recurrent hematuria, Nephrotic proteinuria or ⬇️eGFR
👶Hematuria + 200-500mg/g in 3 measurements 1-2w apart
#NephJC
October 29, 2025 at 1:37 AM
Indications for kidney biopsy in children: 👶💉
Presents as hematuria, proteinuria and ⬇️ GFR, with normal C3.
Biopsy should be performed:
👶At presentation
👶Persistent, recurrent hematuria, Nephrotic proteinuria or ⬇️eGFR
👶Hematuria + 200-500mg/g in 3 measurements 1-2w apart
#NephJC
Presents as hematuria, proteinuria and ⬇️ GFR, with normal C3.
Biopsy should be performed:
👶At presentation
👶Persistent, recurrent hematuria, Nephrotic proteinuria or ⬇️eGFR
👶Hematuria + 200-500mg/g in 3 measurements 1-2w apart
#NephJC
IgAN in children: 👶🩺
Children tend to have more episodes of visible (gross) hematuria.
These episodes often coincide with URIs. 🩸
Hence children tend to present early, with preserved GFR and less proteinuria compared to adults.
#NephJC
Children tend to have more episodes of visible (gross) hematuria.
These episodes often coincide with URIs. 🩸
Hence children tend to present early, with preserved GFR and less proteinuria compared to adults.
#NephJC
October 29, 2025 at 1:36 AM
IgAN in children: 👶🩺
Children tend to have more episodes of visible (gross) hematuria.
These episodes often coincide with URIs. 🩸
Hence children tend to present early, with preserved GFR and less proteinuria compared to adults.
#NephJC
Children tend to have more episodes of visible (gross) hematuria.
These episodes often coincide with URIs. 🩸
Hence children tend to present early, with preserved GFR and less proteinuria compared to adults.
#NephJC
IgAN and lactation: 🤱💊
Sparsentan and nefecon are contraindicated.
The only ACEi that is approved for use, if clinically indicated, is enalapril (monitor baby for low BP as trace amounts can be found in breast milk). #NephJC
Sparsentan and nefecon are contraindicated.
The only ACEi that is approved for use, if clinically indicated, is enalapril (monitor baby for low BP as trace amounts can be found in breast milk). #NephJC
October 29, 2025 at 1:35 AM
IgAN and lactation: 🤱💊
Sparsentan and nefecon are contraindicated.
The only ACEi that is approved for use, if clinically indicated, is enalapril (monitor baby for low BP as trace amounts can be found in breast milk). #NephJC
Sparsentan and nefecon are contraindicated.
The only ACEi that is approved for use, if clinically indicated, is enalapril (monitor baby for low BP as trace amounts can be found in breast milk). #NephJC
