Freely Filtered, a NephJC Podcast

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.

Please give 🙏🏽 here: https://www.nephjc.com/news/2026/9/8/nephjc-fall-pledge-drive

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

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)

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)