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Weekly · Oct 2: The Middle-Molecule Race, a Dipstick Adherence Check, and AI for Fellows

Two ways to clear more middle molecules arrive in US dialysis units at once. A urine dipstick can show whether patients are taking their SGLT2 inhibitor. Two papers disagree about who should let AI write the notes. Nine picks from the week of September 21, 2026, each with the story, the numbers…

Dr Wael Hussein

— 3 min read
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Two ways to clear more middle molecules arrive in US dialysis units at once. A urine dipstick can show whether patients are taking their SGLT2 inhibitor. Two papers disagree about who should let AI write the notes. Nine picks from the week of September 21, 2026, each with the story, the numbers and a take.

Disclosure: Dr. Hussein serves on the Fresenius Medical Care US Home Medical Advisory Board. Fresenius sells hemodiafiltration machines, which are discussed in this episode.

Chapters

  • 00:00 Cold open and running order.
  • 01:10 Hemodiafiltration: a JASN review makes the case for high-volume HDF as the global default, and how to prescribe it. Read the story
  • 05:06 Medium cutoff dialyzers: Nipro's ELISIO-HX is cleared in the US and DaVita is scaling it up. What the interview shows, and what it doesn't. Read the story
  • 08:13 Obinutuzumab: FDA approval for preventing relapse in frequently relapsing or steroid-dependent childhood-onset nephrotic syndrome, from age 2 into adulthood. Read the story
  • 11:08 Nephrology and CKM syndrome: an AJKD perspective on shifting the specialty from organ failure to prevention. Read the story
  • 13:59 Atherosclerosis in CKD: a CJASN review of mechanisms, risk prediction and the treatment menu. Read the story
  • 17:54 GLP-1 receptor agonists in CKD: a case-based CJASN "How I Treat" piece. Read the story
  • 21:03 The dipstick adherence check: glucosuria on routine urinalysis as a marker that patients are taking their SGLT2 inhibitor. Read the story
  • 24:31 AI in practice: where AI can take paperwork off the nephrologist's desk. Read the story
  • 27:44 Fellows and AI: training for the AI era without "never-skilling". Read the story
  • 30:24 Close.

Papers and news in this episode

  • Blankestijn PJ, et al. Hemodiafiltration: Clinical Practice of Today and a Look into the Future. JASN 2026 (ahead of print). Link
  • Healio | Nephrology, September 24, 2026. Q&A with DaVita's chief medical officer: recent FDA approval prompts expansion of medium cutoff dialyzers. Link
  • Healio | Nephrology, September 25, 2026. FDA approves obinutuzumab (Gazyva) for idiopathic nephrotic syndrome. Background in this segment also came from FDA-approval coverage in Contemporary Pediatrics and HCPLive and from Genentech's trial release, not only from the Healio report. Link
  • Sridhar VS, Levin A. AJKD perspective on the nephrologist's role in cardiovascular-kidney-metabolic syndrome. AJKD 2026 (ahead of print). Link
  • Correa S, Cuningham JW, Mc Causland FR. Atherosclerotic Cardiovascular Disease in CKD: Contemporary Insights into Pathogenesis, Diagnosis, and Management. CJASN 2026 (ahead of print). Link
  • Cheung DS. GLP-1 Receptor Agonists in CKD: A Case-Based Discussion of Translating Evidence into Practice. CJASN 2026 (ahead of print). Link
  • Li Z, et al. Glucosuria as a Marker of Adherence to Sodium-Glucose Cotransporter 2 Inhibitors and Clinical Outcomes in Real-World Practice. JASN 2026 (ahead of print). Link
  • Aiumtrakul N, Thongprayoon C, Cheungpasitporn W. Artificial Intelligence in Nephrology Practice: Practical Pathways to Improve Efficiency. Kidney360 2026 (ahead of print, open access). Link
  • Fong JMN, Wang AYM. Equipping Nephrology Fellows with the Knowledge, Skills, and Attitudes for the Artificial Intelligence Era. CJASN 2026 (ahead of print). Link

Listen anywhere: Apple Podcasts · Spotify · other apps. Discuss: NephSpace on LinkedIn.

Physician-led, AI-assisted. Dr. Wael Hussein chooses the papers, reviews and edits every script, and approves every episode. AI (Claude, by Anthropic) writes the first draft from the full text of each paper, and a separate AI check compares every number with the papers; Dr. Hussein then reviews and edits the draft before the AI hosts (ElevenLabs) voice it. Everything is summarized in our own words. For education and information only, not medical advice. Please talk to your own physician or care team about your health. Clinicians: read the original before changing practice. See our disclaimer. Views are the creator's own and not those of his employer. No sponsors.

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