All we have here in Canada is low dose Testing prednisone then MMF 😔 once the proteinuria rebounds

Putting these patients in ASI trials locally too

Do you use steroidal MRAs if you don’t have access to a finerenone or aldosterone synthase inhibitor trial?

The percentage in the placebo arm reflects that potassium fluctuations in HD are common related to missed dialysis, diet and other factors. Other takeaway is that hyperkalemia is manageable and typically harm patients.

I think we are all excited to see how to anti-inflammatory hypothesis pans out over the next couple of years as well

And stayed tuned for some secondary papers in addition to the ones already published on run-in adherence assessment (study within a trial) and heart failure event definitions in dialysis RCTs (meta-epidemiological)

Late to the party but important takeaways: large publically funded international trials are feasible in dialysis, run-ins are great, low dose spironolactone is safe and consider it’s use in HFrEF in dialysis or PD for low K+ or for volume, we don’t believe the sex subgroup analysis #NephJC

Some really interesting stories in this one!

We need a Canadian registry!

Local approach in the couple of places I’ve practiced in Canada is to intensify with daily HD because of the morbidity and mortality of calciphylaxis. Does this mean you would keep on PD if adequate MBD parameters? Could this be a domain in BEAT-Calci? I doubt given lack of equipoise.

When I order eGFR cys it’s because I think eGFR Cr is falsely high or low and I have a clinical reason for this which I already know affects prognosis (e.g. cirrhosis, malignancy, neuromuscular disease, athlete). How was this accounted for?

Would you accept 0.3mg po every other day over prednisone for “idiopathic” pericarditis?

Great paper! Would like to see this work also done in Alberta where I suspect MRP, remuneration model, work up and evaluation process, access to weight loss programs and navigators all play a role.

So weird

I used this to find my current position. Definitely worth checking out, we have some fantastic institutions in Canada.

I think the only place that does bone biopsy in Canada is in Quebec! Wish we had it availability locally.

What’s the eGFR? 31 is probably different than 59 for the risk of adverse events. I don’t think I would have any concerns re: bisphosphonate but would monitor PTH more closely than usual and if it drops or there is an AE consider an alternative.

Agree with getting what you can on board ASAP

Congrats @kidneydoc101.bsky.social