Meta
joel topf
NephJC 2026 Fall Pledge Drive

Help keep NephJC a vital, original, and unbiased source of medical education.

NephJC 2026 Fall Pledge Drive
Background
Brian Rifkin
REFINe-ing AI’s Role in Nephrology Diagnosis

This week, we will discuss the use of LLMs for the diagnosis of complex nephrology cases. Can AI help nephrologists nail the correct diagnosis?

REFINe-ing AI’s Role in Nephrology Diagnosis
Background
Akshaya J
Too sweet to be true? Prophylactic SGLT2 ...

MERCURI-2 reports that dapagliflozin cuts postoperative AKI after cardiac surgery, but the headline result is mostly a urine-output story, not a creatinine one. That matters: urine output after surgery is easily swayed by anesthesia, fluid shifts, vasopressors, and a diuretic drug in the mix. Until dapagliflozin shows it protects kidney function, not just urine output.

Too sweet to be true? Prophylactic SGLT2 inhibitors before cardiac surgery
Background
Cristina Adriana Popa
Buffering without benefit? The SODa-BIC study

This week, we will discuss SODaBIC trial: with ICU acidosis driven by multiple overlapping mechanisms, is bicarbonate infusion supported by robust evidence, or does it persist mainly out of habit rather than physiology?

Buffering without benefit? The SODa-BIC study
Background
Pallavi Prasad
Beyond Diabetic Kidney Disease: FIND-ing ...

FIND-CKD extends finerenone beyond diabetic kidney disease, showing slower eGFR decline and sustained albuminuria reduction in non-diabetic CKD. While the benefits are modest and cardiovascular effects remain uncertain, the trial opens the door to broader use of nsMRAs and raises important questions about combination therapy with SGLT2 inhibitors.

Beyond Diabetic Kidney Disease: FIND-ing Finerenone's Next Role

Meta

What's up with the NephJC signal cityscape

In the last few months we have been scheduling our chats out further and further, however this breaks down when a high impact trial is published. This led to the concept of the emergency NephJC chat. We did it first for AKIKI and ELAIN:

And then most recently for this week's chat on EMPA-REG

Some people have asked about the buildings in the cityscape. They are:

Sears Tower in Chicago for Edgar

Leaning Tower of Pisa for Francesco

The Gherkin in London for Tom and Matt

The Statue of Liberty in New York for Kenar and Scherly

The CN Tower of Toronto for Swapnil (closest I could get to Ottawa)

The Renaissance Center in Detroit for Joel

The AT&T building in Nashville for Anna

The Trans America Pyramid in San Francisco for Graham

That's not the whole team but it is a start.

NephJC Summer Book Club Selection

Thanks everyone for voting. The results are in and Eric Topol's The Patient Will See You Now won.

The voting looked like this:

But the reason we asked how likely you are to read the book was so we could weight the votes. The weighting worked like this:

  • 0.2 for I'll read it if I have time
  • 0.4 for I'll read it if it is the book I want
  • 0.6 for 50-50
  • 0.8 for I will buy and start
  • 1.0 for scout's honor

This turned out to not really affect the results

So Topol's book it is. The Patient Will See You Now examines how changes in technology are forcing a democratization of medicine and empowering patients in an unprecedented way. This seems like an important theme for today medical climate. The exact date of the chat has not been fixed but it will likely be mid to late July, so start reading. Watch the blog for summaries of all the chapters, similar to how we covered Being Mortal.

Ted Cruz drops out, the primaries are over!

Thanks everyone for voting for what you want covered in NephJC.

The winner is a prospective RCT to see if this Pip/Tazo+Vanco toxicity is real. The reference is here. Back ground from NephMadness 2015 here and ALiEM discussed it here. We will be discussing this on May 31 and June 1. There is an #AskASN chat on May24 pushing us back a week.

Don't forget Next Tuesday/Wednesday we go all Acid-Base for a discussion of acetazolamide.

 

 

study 

The NephJC Book Club Returns. Vote for your choice.

Last summer we did a book club on Atul Gawande's Being Mortal. The NephJC team blogged its way through every chapter and we did a discussion of the book during one of our Tuesday/Wednesday chats. We think the summer is a great time to slow down from the rapid digestion of medical literature and enjoy a slower paced book. We couldn't decide on a book among ourselves so we are turning to you to pick this Summer's book. Here are the choices:

1. When Breath Becomes Air by Dr. Paul Kalanithi. NYT Review.

2. The Patient will See You Now by Dr. Eric Topol (@erictopol) NYT Review. 

3. How doctors think by Dr. Jerome Groopman. NYT Review

4. On the Move by Dr. Oliver Sacks. NYT Review

5. The Laws of Medicine: Field Notes from an Uncertain Science by Dr. Siddhartha Mukherjee. Los Angeles Times Review

VOTE!

#NephJC is now part of Altmetrics

Altmetrics is a company that tracks realtime references, reads and mentions of research articles across the web and social media. They give authors and institutions a sense of what research is moving the needle faster and more comprehensively than reference tracking could. The work NephJC does will now be part captured as part of this goal.

When I read the following on their website, I knew that NephJC and Altmetrics were natural partners:

“Scientists are increasingly discussing papers online, but on social media sites, rather than on publisher’s sites. There’s huge value in being able to see what your peers - and people in other fields - have said about an article. Up until now, this has been difficult to achieve.”

Our spotlight just got a little brighter.

,

The Neph-Twitterverse discovers Twitter polls

,

A few weeks ago, the folks at twitter announced they were rolling out Twitter polls. Previously, tweeps would use manually counting responses or the RT-if-you-agree Fav-if-you-don't approach. This is how the polls were supposed to work:

So what, you might say? A few users (notably @conradhackett from Pew research) played a lot with them, sample poll:

The ease of setting one up, and the option to just click and be done were some of the major selling points. But it wasn't clear if would be just a passing fad or something more. I used one at the #KidneyWk, but there were few responders

Then Matt decided to poll the #nephjc followers after the suPAR chat

And Thomas Hiemstra decided to design his next #DreamRCT on therapy for Membranous nephropathy with a series of tweets:

Second scenario

And it wasn't long before Graham Abra re-ran an older question on the utility of urine eosinophils in allergic interstitial nephritis

another one on the duration of steroids in SLE, in remission

So we guess polls on twitter are here to say. Nephrology tweeps find it awesome (and I can say so with confidence, backed by facts, or shall we say, a poll?)

Swapnil Hiremath