Freely Filtered, a NephJC Podcast

This is our second time releasing a podcast simultaneous with presentation and publication. Super exciting.This podcast covers a retrospective trial study on pregnancy complications in kidney donors. The FiltrateJoel Topf @kidney_boySwapnil Hiremath @hswapnil.medsky.socialAnna Gaddy @GaddyAnnaRNayan Arora @captainchlorideSophia Ambruso @sophia_kidneySpecial GuestsAmit Garg @AmitXGarg, Nephrologist at Western University, London and PI of the current studyEditingJoel TopfThe Kidney Connection written and performed by Timothy YauShow NotesPrevious appearances by Dr Garg:Episode 56 MyTEMPEpisode 63 Enhance Access to Kidney Transplantation and Living Kidney Donation (EnAKT LKD) (Late breaking and High impact clinical trial session at KidneyWeek 2023 in PhiladelphiaOur last attempt to podcast about preeclampsia did not go so well: Episode 70: Predicting Preeclampsia, the PRAECIS trial and Episode 70b Do Over: Predicting Preeclampsia, the PRAECIS trial (https://www.nephjc.com/freelyfiltered/2024/freely-filtered-70b-do-over-preeclampsia) The use of the words “men” and “women” in scientific papers, an editorialThe Big Ask, The Big GiftGarg’s prior work on male donors and scrotal surgery: Risk for Scrotal Surgery After Laparoscopic Donor Nephrectomy : A Population-Based Cohort Study PubMedGarg’s prior work on donor and pregnancy outcomes: Gestational Hypertension and Preeclampsia in Living Kidney Donors NEJM The Consensus Statement of the Amsterdam Forum on the Care of the Live Kidney Donor 2004 TransplantationKDIGO 2017 Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors KDIGOTubular SecretionSwapnil Babylon 5 on AmazonPrime WikipediaSophia The Gentleman, the series on NetFlix Wikipedia and Gentleman, the film WikipediaAnna and her boat, Freshwater Deficit. Heavy Weather Sailing by Adlard Coles AmazonNayan William Osler: A Life in Medicine AmazonAmit Law and Order ethicsJoel All the NephJC activities at Kidney Week: The Run | The other run | The Party

The FiltrateJoel Topf @kidney_boySwapnil Hiremath @hswapnil.medsky.socialAnna Gaddy @annagaddy.bsky.social Natalie Freidin Program director at Medical University of South CarolinaSpecial GuestsBrendon “Brendo” Neuen The first Five-Time guest on Freely Filtered. Nephrologist and Director, Kidney Trials, Royal North Shore Hospital. Associate Professor of Medicine at the George InstituteEditingNatalie FreidinThe Kidney Connection written and performed by Timothy YauShow NotesDonate to the fall pledge drive: https://www.nephjc.com/news/2026/9/8/nephjc-fall-pledge-drive Come to the ASN NephJC Night in Denver the Kidney Week: https://www.nephjc.com/news/2026/9/13/the-2026-nephjc-night FIND-CKD: Finerenone in Persons with Chronic Kidney Disease without Diabetes NEJM | NephJC2-year GFR data on sibeprelimab‍ ‍Incidence of ESRD in the US due to IgAN (estimate using USRDS data) Heinz 57 wikipediaRandomised placebo-controlled trial of effect of ramipril on decline in glomerular filtration rate and risk of terminal renal failure in proteinuric, non-diabetic nephropathy. The Lancet 1997. The REIN trial for people with nephrotic range proteinuria (>3 grams/day)Renoprotective properties of ACE-inhibition in non-diabetic nephropathies with non-nephrotic proteinuria, The Lancet 1999 REIN Stratum 1 for sub-nephrotic range proteinuria (1-3 grams/day)Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes FIDELIO in NephJC | NEJMBenefits of aldosterone receptor antagonism in chronic kidney disease BARACK-D RCT PubMedWe discussed the run in. Importantly the run in for FIDELIO and FIGRO did not give finerenone. This is sometimes done to assure that participants in a trial will tolerate the study drug but this will over inflate data on tolerability. See NephJC’s discussion on run ins here: https://www.nephjc.com/news/run-in-period Sean Barbour on Freely Filtered talking about the TESTING TrialFINALITY-HF A randomized, double-blind, placebo-controlled pragmatic study to evaluate FINerenone on clinicAL effIcacy and safeTY in patients with Heart Failure and reduced ejection fraction who are intolerant of or not eligible for treatment with steroidal mineralocorticoid receptor antagonists. ClinicalTrials.govBoehringer provides update on EASi-KIDNEY trial 😢 Pooled finerenone data INFINITY Pooled Analysis       Tubular SecretionSwapnil The Will of the Many by James Islington (Amazon)Anna The Art Thief: A True Story of Love, Crime, and a Dangerous Obsession by Michael Finkel (Amazon)Brendo John Mayer Electric Guitar (PRS Guitar)Natalie Great Big Beautiful Life by Emily Henry (Amazon)Joel Come to the NephJC party at Kidney Week!

Bypass surgery continues to be the laboratory where we test the most innovative ideas on the prevention of AKIThe FiltrateJoel Topf @kidney_boySwapnil Hiremath @hswapnil.medsky.socialVipin VargheseSophia AmbrusoSpecial GuestsRahul Ganatra Deputy Editor NEJM Clinician. https://clinician.nejm.org/editors/AU3406Jay Koyner Professor of Medicine, University of Chicago. https://www.uchicagomedicine.org/find-a-physician/physician/jay-koynerEditingVipin VargheseThe Kidney Connection written and performed by Timothy YauShow NotesBack to the Future: https://youtu.be/BDuZqYeNiOA?is=r-RE2DgIDBazRAlWAmino 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.2016.159But 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/abstractIf 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.pdfThe 2025/2026 AKI Draft guidelines: https://kdigo.org/wp-content/uploads/2026/03/KDIGO-2026-AKI-AKD-Guideline-Public-Review-Draft-March-2026.pdfMeta-analysis of frusemide to prevent or treat acute renal failure https://www.bmj.com/content/early/2005/12/31/bmj.38902.605347.7CEuglycemic 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-PotentialTopic 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/mercuri2MERCURI-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.pdfVipin 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/NCT05590143Roger Rodby’s 4 favortite equations in Nephrology from Channel Your Enthusioasm: https://pca.st/episode/abff985f-6a87-41f9-bcc9-80b8a85c2441?t=3257.0IDEAL 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%2FRethinking 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 SecretionSwapnil Spider Noire Amazon PrimeSophia Bernadoodle via Starlight Bernadoodle https://starlightbernedoodles.comRahul Derry Girls on NetflixVipin Tennis Cincinnati Open and the US Open. The death of the one handed backhand. Jay Slow Horses on Apple TV and Adults on HuluJoel Silo season three. Mountain biking.

The FiltrateJoel Topf @kidney_boySwapnil Hiremath @hswapnil.medsky.social Natalie Freidin Program director at Medical University of South CarolinaAC @medpeedskidneys.bsky.socialSpecial GuestsFernando Fervenza Professor of Medicine, The Mayo ClinicEditingVip VerguesThe Kidney Connection written and performed by Timothy YauShow Notes MENTOR NephJC | NEJM | Freely Filtered episode 7PLA2r in 2009 M-Type Phospholipase A2 Receptor as Target Antigen in Idiopathic Membranous Nephropathy NEJM MAJESTY NephJC | NEJM Obinutuzumab or Tacrolimus in Primary Membranous NephropathyGiuseppe Remuzzi discovers rituximab works in primary membranous. Rituximab for idiopathic membranous nephropathy The Lancet 2002Fervenza’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 20092011 (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 fictionRobert A. Star, M.D. NIHDaniel C. Cattran, M.D. NephCureTubular SecretionsSwap do not go to see Mandalorian and Grogu or Supergirl AC doing nothingNatalie The Wealth Ladder by Nick Maggiulli (amazon)Fernando South Portugal and GlomCon HawaiiJoel The Boundary Waters Canoe Area

The FiltrateJoel Topf@kidney_boyVipin [email protected] Arora @captainchlorideSpecial GuestsDavid Goldfarb Professor of Medicine, NYU (COI)Megan Prochaska Assistant professor of medicine at University of ChicagoJohn Asplin Medical Director Consultant LithoLink (Twitter)EditingAnna GaddyThe Kidney Connection written and performed by Timothy YauShow 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 LancetCharlie Pak trial showing increased urine volume reduced risk of kidney stones. Evidence justifying a high fluid intake in treatment of nephrolithiasis PubMedThe Borghi Trial: Urinary volume, water and recurrences in idiopathic calcium nephrolithiasis: a 5-year randomized prospective study PubMedMedical 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 PubMedBorghi’s other giant study in kidney stones: Comparison of Two Diets for the Prevention of Recurrent Stones in Idiopathic Hypercalciuria NEJMThe No Stone Trial: Hydrochlorothiazide and Prevention of Kidney-Stone Recurrence NephJC | NEJMGary 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 PubMedGary Curhan epidemiologic data on sugar sweetened beverages and risk of kidney stones. Soda and other beverages and the risk of kidney stones PubMedEric Topol’s tweet:NephJC in 2014 on the ACP Kidney Stone Guidelines NephJCGoldfarb’s scathing editorial on said guidelines, not on NephJC as I said but, on Fred Coe’s website at the University of Chicago. LinkTubular SecretionsNayan: Shrinking on Apple TV WikipediaDavid: 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)