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Trailer 路 Why NephSpace
Why I built NephSpace, in my own voice, plus three short moments from the show. Two minutes.
About this trailer
Knowledge, transformed: easy to reach, hard to stop.
New kidney research, picked by a nephrologist: short stories to read, episodes to listen to.
Listen Latest episodes
All episodesWeekly 路 Oct 26: IgA Nephropathy's Turning Point, Access in the Very Old, SGLT2 in ADPKD and the Federal Kidney Plan
Your weekly digest: IgA nephropathy's two-year test, catheters by design in the very old, and the federal kidney plan that names nephrologists.
Episode notes, chapters and sourcesWeekly 路 Oct 20: Intermittent or Continuous Dialysis in the ICU, Fluid Creep, Deprescribing and the Dialysis Bike
Your weekly digest: the ICU dialysis trial that stopped early, where ICU fluid really comes from, and a bike in the dialysis chair.
Episode notes, chapters and sourcesWeekly 路 Oct 12: Fluids or Pressors, ICU Bicarbonate and What's Holding Back PD
Your weekly digest: fluids or pressors for septic shock, bicarbonate at 2 a.m., and what's really holding back PD.
Episode notes, chapters and sourcesRead Latest stories
All stories
Policy and news
The HHS Kidney Care National Plan: prevention, transplant and the dialysis market
The federal plan, released October 20, sets out what HHS should consider in kidney care, and devotes a section to how dialysis chains build financial ties with nephrologists. DaVita, Fresenius Medical Care and Kidney Care Partners responded.
Dialysis
As low as possible, as high as necessary: a patient's view of incremental PD
In CJASN's Patient Voice series, Jan van Cruchten describes starting peritoneal dialysis to protect his remaining kidney function, still making good urine more than five years in, and why the dose and the decision should be shared.
Dialysis
Residual kidney function: everyone values it, but few hemodialysis guidelines say how to measure it or use it
A global scoping review of 12 hemodialysis guideline documents found that only four gave guidance a clinician could act on, and only one, from 2007, covered measurement, dose and monitoring in full.
Other
Did water fail, or did the coaching? A commentary on the PUSH kidney stone trial
The PUSH trial paid, coached and texted people with kidney stones to drink more, and stone events didn't fall. A Kidney International commentary argues the trial tested a behavioral strategy, not water: urine volume barely separated between the groups.
CKD and cardiometabolic
Empagliflozin in ADPKD: well tolerated in a 50-patient pilot, but kidneys grew faster on the drug
In a 50-patient randomized, placebo-controlled pilot in polycystic kidney disease, empagliflozin was well tolerated, but total kidney volume grew about 10% a year on the drug, against about 5% on placebo. A secondary outcome in a small trial, but the investigators say it should give us pause.
Dialysis
Vascular access at Kidney Week: catheters needed the fewest procedures in the very old, and a bioengineered vessel shortened catheter time for women
In OASIS, a randomized trial in people 70 and older with limited life expectancy, catheters needed fewer access procedures than fistulas. In a trial in women, a bioengineered vessel was usable in under two months, against more than five for a fistula. Both are conference abstracts so far.
Glomerular disease
IgA nephropathy's two-year test: on sibeprenlimab and atacicept, kidney function barely declined, and ravulizumab won accelerated approval
Two drugs approved on proteinuria reported their two-year kidney function results in NEJM. On sibeprenlimab, the eGFR on average didn't fall; atacicept was about five points a year better than placebo. The same week, the FDA gave ravulizumab an accelerated approval on proteinuria.
Dialysis
A new fistula asks the heart to do more; a very high NT-proBNP may mark the hearts that can't keep up
In a small Sydney study, cardiac output rose as new fistulas matured, and patients whose output didn't rise by at least 15% had more than four times higher NT-proBNP. Exploratory and hypothesis-generating.
Dialysis
Pedaling during dialysis: about 90 minutes a week or more was linked to fewer deaths
In a Portuguese cohort of 741 hemodialysis patients followed for about three years, those who cycled at least about 90 minutes a week during dialysis had about a third of the adjusted risk of death of those who declined. Lighter exercisers did no better than decliners.
Dialysis
Deprescribing on hemodialysis is possible, but hard: now we need to work out who does it, when, where and how
The IMPROVED feasibility study offered deprescribing of gabapentin and other potentially inappropriate medications to older adults in 10 dialysis clinics. Seventeen of 41 patients approached agreed to try; symptoms returned in some, without serious events.