Freely Filtered, a NephJC Podcast

NephJC
NephJC
  • 4.9 (176)
  • Medicine
  • Updated Monthly

Twice monthly (aspirational) recap of the NephJC journal club. NephJC reviews the most important manuscripts which are driving nephrology forward and improving our understanding of the kidney.

  1. Sep 27

    FF97 MERCURI-2, Can a Flozin prevent AKI?

    Bypass surgery continues to be the laboratory where we test the most innovative ideas on the prevention of AKI The Filtrate Joel Topf @kidney_boy Swapnil Hiremath @hswapnil.medsky.social Vipin Varghese Sophia Ambruso Special Guests Rahul Ganatra Deputy Editor NEJM Clinician. https://clinician.nejm.org/editors/AU3406 Jay Koyner Professor of Medicine, University of Chicago. https://www.uchicagomedicine.org/find-a-physician/physician/jay-koyner Editing Vipin Varghese The Kidney Connection written and performed by Timothy Yau Show Notes Back to the Future: https://youtu.be/BDuZqYeNiOA?is=r-RE2DgIDBazRAlW Amino Acids for AKI: The PROTECTION Study NephJC: Trial by Combat: Do Amino Acids provide PROTECTION to the Kidneys? In 2016 the FDA posted a warning that SGLT2i could induce AKI. This Nature Reviews Nephrology explores possible mechanisms for the AKI: Acute kidney injury from SGLT2 inhibitors: potential mechanisms https://www.nature.com/articles/nrneph.2016.159 But by 2019 the SMART-C Collaboration was looking at the risk of AKI in the large RCTs and found Flozins to be protective: SGLT2 inhibitors for the prevention of kidney failure in patients with type 2 diabetes: a systematic review and meta-analysis. https://www.thelancet.com/journals/landia/article/PIIS2213-8587(19)30256-6/abstract If you are actually looking for the best data you should look at the updated meta-analysis from 2025 which extends the findings to patients with and without diabetes and to patients with and without CKD: SGLT2 Inhibitors and Kidney Outcomes by Glomerular Filtration Rate and Albuminuria https://pmc.ncbi.nlm.nih.gov/articles/PMC12595549/ 2012 KDIGO AKI Guidelines: https://kdigo.org/wp-content/uploads/2016/10/KDIGO-2012-AKI-Guideline-English.pdf The 2025/2026 AKI Draft guidelines: https://kdigo.org/wp-content/uploads/2026/03/KDIGO-2026-AKI-AKD-Guideline-Public-Review-Draft-March-2026.pdf Meta-analysis of frusemide to prevent or treat acute renal failure https://www.bmj.com/content/early/2005/12/31/bmj.38902.605347.7C Euglycemic Diabetic Ketoacidosis: A Potential Complication of Treatment With Sodium–Glucose Cotransporter 2 Inhibition https://diabetesjournals.org/care/article-abstract/38/9/1687/37246/Euglycemic-Diabetic-Ketoacidosis-A-Potential Topic of this podcast, the MERCURI-2 trial: Dapagliflozin and Acute Kidney Injury Following Cardiac Surgery https://jamanetwork.com/journals/jama/article-abstract/2852324 | NephJC: Too sweet to be true? Prophylactic SGLT2 inhibitors before cardiac surgery https://www.nephjc.com/news/2026/8/18/mercuri2 MERCURI-1 Pilot trial is described here. Looks like it was only published as a pre-print. The first link provides a glimpse at MERCURI-3 https://abrahamhulst.com/research/mercuri-1/ https://www.medrxiv.org/content/10.1101/2024.03.27.24304998v1.full.pdf Vipin Varghese used to believe in the urinalysis: Diagnostic Utility of Serial Microscopic Examination of the Urinary Sediment in Acute Kidney Injury https://pubmed.ncbi.nlm.nih.gov/35373012/ MERCURI-2 in ClinicalsTrials.gov: proMoting Effective Renoprotection in Cardiac sURgery Patients by Inhibition of SGLT-2 (MERCURI-2)   https://clinicaltrials.gov/study/NCT05590143 Roger Rodby’s 4 favortite equations in Nephrology from Channel Your Enthusioasm: https://pca.st/episode/abff985f-6a87-41f9-bcc9-80b8a85c2441?t=3257.0 IDEAL ICU Timing of Renal-Replacement Therapy in Patients with Acute Kidney Injury and Sepsis https://www.nejm.org/doi/full/10.1056/NEJMoa1803213?referrer=https%3A%2F%2Fwww.google.com%2F Rethinking the definition of oliguria: Identification of an optimal threshold to define oliguria in critically ill patients: an observational study https://pubmed.ncbi.nlm.nih.gov/37254158/ Editorial on MERCURI-2 in JAMA by Wolfgang Winkelmayer and  Glenn Chertow https://jamanetwork.com/journals/jama/fullarticle/2852331          Tubular Secretion Swapnil Spider Noire Amazon Prime Sophia Bernadoodle via Starlight Bernadoodle https://starlightbernedoodles.com Rahul Derry Girls on Netflix Vipin Tennis Cincinnati Open and the US Open. The death of the one handed backhand. Jay Slow Horses on Apple TV and Adults on Hulu Joel Silo season three. Mountain biking.

  2. Aug 30

    FF96 Majesty: Obi in membranous

    The Filtrate Joel Topf @kidney_boy Swapnil Hiremath @hswapnil.medsky.social Natalie Freidin Program director at Medical University of South Carolina AC @medpeedskidneys.bsky.social Special Guests Fernando Fervenza Professor of Medicine, The Mayo Clinic Editing Vip Vergues The Kidney Connection written and performed by Timothy Yau Show Notes MENTOR NephJC | NEJM | Freely Filtered episode 7 PLA2r in 2009 M-Type Phospholipase A2 Receptor as Target Antigen in Idiopathic Membranous Nephropathy NEJM MAJESTY NephJC | NEJM Obinutuzumab or Tacrolimus in Primary Membranous Nephropathy Giuseppe Remuzzi discovers rituximab works in primary membranous. Rituximab for idiopathic membranous nephropathy The Lancet 2002 Fervenza’s 15-person study of Rituximab treatment of idiopathic membranous nephropathy Kidney International 2008. Larry Beck’s NEJM PLA2r study M-Type Phospholipase A2 Receptor as Target Antigen in Idiopathic Membranous Nephropathy NEJM 2009 2011 (not 2010) JASN paper where using banked serum from two prior rituximab studies in membranous nephropathy, Beck and Fervenza showed that declines in anti-PLA2R antibodies preceded reductions in proteinuria and predicted subsequent clinical remission, establishing the concept that immunologic remission precedes clinical remission. Rituximab-Induced Depletion of Anti-PLA2R Autoantibodies Predicts Response in Membranous Nephropathy PubMed The National Institute of Animal Health…a Fervenza fiction Robert A. Star, M.D. NIH Daniel C. Cattran, M.D. NephCure Tubular Secretions Swap do not go to see Mandalorian and Grogu or Supergirl AC doing nothing Natalie The Wealth Ladder by Nick Maggiulli (amazon) Fernando South Portugal and GlomCon Hawaii Joel The Boundary Waters Canoe Area

  3. Aug 23

    FF95 The PUSH Trial

    The Filtrate Joel Topf@kidney_boy Vipin Verghese@vipvargh.bsky.social Nayan Arora @captainchloride Special Guests David Goldfarb Professor of Medicine, NYU (COI) Megan Prochaska Assistant professor of medicine at University of Chicago John Asplin Medical Director Consultant LithoLink (Twitter) Editing Anna Gaddy The Kidney Connection written and performed by Timothy Yau Show Notes Kidney Treks, University of Chicago. For medical students. The Push Trial: Prevention of urinary stones with hydration: a randomised clinical trial of an adherence intervention NephJC Short | The Lancet Charlie Pak trial showing increased urine volume reduced risk of kidney stones. Evidence justifying a high fluid intake in treatment of nephrolithiasis PubMed The Borghi Trial: Urinary volume, water and recurrences in idiopathic calcium nephrolithiasis: a 5-year randomized prospective study PubMed Medical Management of Kidney Stones: AUA Guideline (2026) Weird little trial Asplin mentioned with amlodipine. But it was actually verapami. By Kemal Sarical: The effect of calcium channel blockers on stone regrowth and recurrence after shock wave lithotripsy PubMed Borghi’s other giant study in kidney stones: Comparison of Two Diets for the Prevention of Recurrent Stones in Idiopathic Hypercalciuria NEJM The No Stone Trial: Hydrochlorothiazide and Prevention of Kidney-Stone Recurrence NephJC | NEJM Gary Curhan epidemiologic data from the Nurses Health Study and the Health Professionals Follow-up Study: Twenty-four-hour urine chemistries and the risk of kidney stones among women and men PubMed Gary Curhan epidemiologic data on sugar sweetened beverages and risk of kidney stones. Soda and other beverages and the risk of kidney stones PubMed Eric Topol’s tweet:NephJC in 2014 on the ACP Kidney Stone Guidelines NephJC Goldfarb’s scathing editorial on said guidelines, not on NephJC as I said but, on Fred Coe’s website at the University of Chicago. Link Tubular Secretions Nayan: Shrinking on Apple TV Wikipedia David: The deaths of Sonny Rollins (Wikipedia) and James Blood Ulmer (Wikipedia) Megan: Sri Lanka for travel (National Geographic) Vipin: Memory Eternal: Living with Grief as Orthodox Christians (Amazon) John: A History of Rock Music in 500 Songs (Link) Patty Smith’s memoir, Just Kids (Amazon) Joel: This is How You Lose The War by Amal El-Mohtar and Max Gladstone (Amazon) for the second time, and Acquired PodCast (Link)

  4. Jul 17

    FF94 C3 Glomerulopathy with Carla Nester

    The Filtrate Joel Topf kidneyboy.bsky.social Swapnil Hiremath @hswapnil.medsky.social Natalie Freidin Program director at Medical University of South Carolina Sophia Ambruso @sophia_kidney AC @medpeedskidneys.bsky.social Special Guests Carla Nester, Professor of Medicine, Professor of Pediatrics, University of Iowa. Senior author of Valiant Editing Natalie Freidin The Kidney Connection written and performed by Timothy Yau Show Notes Trial of Pegcetacoplan in C3 Glomerulopathy and Immune-Complex MPGN NEJM | NephJC Tubular Secretions Swapnil: City of Last Chances by Adrian Tchaikovsky (Amazon) Natalie: Heated Rivalry, the books by Rachel Reid Carla: Rowing and gold fiber embroidery AC: Audiobooks, that are appropriate for children: The Giver and Tuck Everlasting Sophia: Greeking Out podcast and the Wheel of Time by Robert Jordan (Wikipedia) Joel: This is How You Lose The War by Amal El-Mohtar and Max Gladstone (Amazon)

  5. Jun 30

    FF93 The Hyponatremia Intervention Trial

    The Filtrate Joel Topf kidneyboy.bsky.social Swapnil Hiremath @hswapnil.medsky.social Pedro Teixeira @nephcrit.bsky.social Special Guests Ewout J. Hoorn, Professor of Medicine Erasmus MC, Netherlands. One of the primary authors. Harish Seethapathy, Assistant physician at Massachusetts General Hospital Editing Vipin Verghese The Kidney Connection written and performed by Timothy Yau Show Notes A Randomized Trial of Targeted Hyponatremia Correction in Hospitalized Patients in NEJM Evidence, in PubMed, in NephJC Seethapathy: Severe Hyponatremia Correction, Mortality, and Central Pontine Myelinolysis in NEJM Evidence MacMillan: Osmotic Demyelination Syndrome in Patients Hospitalized with Hyponatremia in NEJM Evidence SALSA: Risk of Overcorrection in Rapid Intermittent Bolus vs Slow Continuous Infusion Therapies of Hypertonic Saline for Patients With Symptomatic Hyponatremia: The SALSA Randomized Clinical Trial in JAMA Internal Medicine SALT 1 and 2: Tolvaptan, a Selective Oral Vasopressin V2-Receptor Antagonist, for Hyponatremia in NEJM Hyponatremia registry: Current treatment practice and outcomes. Report of the hyponatremia registry in Kidney International The Richard Sterns’ article on the lower mortality with more severe hyponatremia: Mortality and Serum Sodium: Do Patients Die from or with Hyponatremia? in CJASN The European Hyponatremia Guidelines: Clinical practice guideline on diagnosis and treatment of hyponatraemia in The European Journal of Endocrinology The American Hyponatremia Guidelines: Diagnosis, Evaluation, and Treatment of Hyponatremia: Expert Panel Recommendations in American Journal of Medicine Treating hyponatremia: damned if we do and damned if we don't by Tom Berl in Kidney International Prospective (clamp) versus reactive (rescue) DDAVP in hyponatremia: Safety and efficacy of proactive versus reactive administration of desmopressin in severe symptomatic hyponatremia: a randomized controlled trial in Nature Scientific Reports and as covered in PBFluids Helbert Rondon’s RCT of urea Urea for Chronic Hyponatremia on ClinicalTrials.gov Tubular Secretions Swapnil: Catfishing on CatNet: A Novel by Naomi Kritzer (Amazon) Harish: Disney Cruise Edward: Flesh: A Novel (Booker Prize Winner) by David Szalay (Amazon) Pedro: Scrubs reboot (IMDB) Joel: KIDNEYcon

    FF93 The Hyponatremia Intervention Trial

  6. Jun 9

    FF92 Live from Dublin

    The Filtrate Joel Topf kidneyboy.bsky.social Special Guests Dr. Samir Parikh, President of the American Society of Nephrology Prof. Donal Reddan, President, Irish Nephrology Society Prof. Catherine Godson Editing Joel Topf The Kidney Connection written and performed by Timothy Yau Show Notes Tubular Secretions Joel Topf, the Dublin Port Greenway Link Catherine Godson: never heard of the Dublin Port Greenway Samir Parikh: Trinity College Dublin and specifically the Eavan Boland Library, named after the Irish poet. Donal Reddan: Something about rugby

  7. Mar 30

    FF91 Liberate-D

    The Filtrate Joel Topf kidneyboy.bsky.social Pedro Teixeira @nephcrit.bsky.social Nayan Arora @captainchloride.bsky.social Anna Gaddy @annagaddy.bsky.social Swapnil Hiremath @hswapnil.medsky.social and on LinkedIn Special Guests Ian McCoy, MD @NephroNinja study author and UCSF Chi-yuan Hsu Senior author and Chief of the Division of Nephrology at UCSF Samuel Silver Associate Professor at Queens University in Canada Editing Vipin Verghese and Joel Topf Show Notes NephJC Discusion: Dialyze Less, Recover More? AKI’s Chance to Get LIBERATE-D Manuscript: A Conservative Dialysis Strategy and Kidney Function Recovery in Dialysis-Requiring Acute Kidney InjuryThe Liberation From Acute Dialysis (LIBERATE-D) Randomized Clinical Trial JAMA | PubMed Ben’s pilot study: RAD-AKI Pilot study: Recovery After Dialysis-Requiring Acute Kidney Injury (RAD-AKI) (ClinicalTrials.gov) STARRT-AKI NephJC Editorial in JAMA: A-E-I-O-U and Sometimes Why—Dialysis in Acute Kidney Injury (JAMA) What Is Dialytrauma? (Nephrology Times) How Fragile Are the Results of a Trial? The Fragility Index (PubMedCentral) Shiffl Trial: Daily Hemodialysis and the Outcome of Acute Renal Failure (NEJM) AKIKI: Initiation Strategies for Renal-Replacement Therapy in the Intensive Care Unit (NEJM) AKIKI2: How Late it was, How Late! (NephJC) Sam Silver’s study: Promoting Kidney Recovery After Acute Kidney Injury Receiving Dialysis (Recover-AKI) (ClinicalTrial.Gov) Marie Kondo (Wikipedia) Tubular Secretions Swap: The smutty dragon novels of novels of Rebecca Yarros (Wikipedia) Specifically The Empyrean series Anna: Brisket recipes Pedro: The Naked Gun (Wikipedia) with Liam Neeson Ian: ASN Kidney Health Guidance on the Outpatient Management of Patients with Dialysis-Requiring Acute Kidney Injury (PubMed) he really doesn’t get Tubular Secretions. Nayan: Tilt: A Novel by Emma Pattee (Amazon) Chi: The Year of Magical Thinking by Joan Didion (Wikipedia) and Innovations in Nephrology (Springer Nature) Sam: Monopoly Super Electronic Banking Board Game (Amazon) Joel: Song Sung Blue (Wikipedia)

  8. Mar 21

    FF90 NephMadness 2026: Animal House

    The Filtrate Joel Topf (kidneyboy.bsky.social) AC (@medpeedskidneys.bsky.social)NephMadness Anna Gaddy (@AnnaGaddy) Vipin Verghese (@vipvargh.bsky.social) Natalie Freidin Program director at Medical University of South Carolina Special Guests Anna Vinnikova (@kidneywars.bsky.social) Long time game maker for NephMadness and Associate Professor at Virginia Commonwealth University Autumn Harris Associate Professor of Veterinary Medicine at NC State Sarah Street MD PhD Assistant Professor of Medicine at Virginia Commonwealth University Editing Joel Topf Show Notes Animal House scouting report Autumn Harris on Team Cat Cheese!

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Twice monthly (aspirational) recap of the NephJC journal club. NephJC reviews the most important manuscripts which are driving nephrology forward and improving our understanding of the kidney.

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