Nephrology

Approach to Acid-Base Disorders — A Stepwise Guide for Clinicians

Maintaining acid-base balance is vital for cellular function. Our bodies tightly regulate blood pH around 7.4, since even slight deviations can alter enzyme activity and protein structure. Let’s break down how clinicians approach acid-base disorders in a systematic way. Source … Read More

Hyponatremia Management Algorithm

1. Starting Point Hyponatremia 2. Step 1: Rule out non-hypotonic causes 3. Step 2: Assess severity Decision: Acute or severe symptoms? 4. Step 3: Urine Osmolality Decision: Urine osmolality 5. Step 4: Urine Sodium Decision: Urine sodium 6. Step 5: … Read More

BARACK-D Trial: Spironolactone in CKD

BARACK-D Trial: Low-Dose Spironolactone and Cardiovascular Outcomes in Moderate Stage Chronic Kidney Disease The BARACK-D trial is a prospective, randomized, open, blinded endpoint study that investigates the effects of low-dose spironolactone in patients with stage 3b chronic kidney disease (CKD) … Read More

RADIANCE-HTN TRIO Trial: Renal Denervation in HTN

The RADIANCE-HTN TRIO trial, detailed in The Lancet in 2021, is another pivotal study in the domain of hypertension treatment, focusing on a challenging group of patients: those resistant to a standard triple combination pill. This trial delves into the … Read More

DUPLEX Trial: Sparsentan in FSGS

The DUPLEX Trial: Evaluating Kidney Protection in FSGS Patients The DUPLEX trial, a rigorous study published in the New England Journal of Medicine in 2023, has garnered significant attention in the nephrology community. The trial investigated the long-term nephroprotective potential … Read More

CONVINCE Trial: Hemodiafiltration or Hemodialysis in Kidney Failure

CONVINCE Trial Summary The abstract discusses the results of the CONVINCE trial, a randomized, controlled study comparing high-dose hemodiafiltration (HDF) with conventional high-flux hemodialysis (HD) in patients with end-stage kidney disease (ESKD). The trial aimed to determine whether high-dose HDF … Read More

AMPLITUDE-O Trial: CV and Renal Outcomes with Efpeglenatide

2021 AMPLITUDE-O TRIAL M Cardiovascular and renal outcomes with efpeglenatide in type 2 diabetes international, randomized, controlled trial Objective: To evaluate efpeglenatide in participants with type 2 diabetes and either a history of cardiovascular disease or current kidney disease 4076 … Read More

DCP Trial Summary: HCTZ vs Chlorthalidone

2022 DCP TRIAL Chlorthalidone compared with hydrochlorothiazide for the preven- tion of cardiovascular events in patients with hypertension: The Diuretic Comparison Project (DCP) Open-label, pragmatic, randomized controlled trial Objective: To compare the differences between hydrochlorothiazide (HCTZ) compared with chlorthalidone in … Read More

AMACING Trial Summary: IV Hydration for CIN

2017 AMACING TRIAL Prophylactic hydration to protect renal function from intravascular iodinated contrast material in patients at high risk of contrast-induced nephropathy. M Single-center, randomised, parallel-group, open-label, phase 3, non-inferiority trial 660 patients Objective: To evaluate the impact of prophylactic … Read More

AKIKI 2 Trial Summary: RRT for Severe AKI

2021 AKIKI 2 TRIAL Comparison of two delayed strategies for renal replacement therapy initiation for severe AKI Multicentre, open-label, randomised, controlled trial Objective: To test the hypothesis that a more-delayed initiation strategy would result in more RRT-free days, compared with … Read More