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Jonathan Pollack @jonathanpollack.bsky.social · 7m

How can I get in touch with Detective Nephron? Is there a searchlight? A secret handshake? A code word?

Jonathan Pollack @jonathanpollack.bsky.social · 4h

KDIGO IgAN suggests flozination with eGFR 20-45 even with low UACR. What's the current opinion on -flozins, and what kind of real-world eGFR dips do nephrologists see with them, if any?

Jonathan Pollack @jonathanpollack.bsky.social · 2d

Guess I'll stick with my AAR and you can keep the retatrutide. I wish there were more non-pharmacological trials to see about modifying established fibrosis instead of new injury. There's a lot of evidence pointing different places, but nothing solid.

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Jonathan Pollack @jonathanpollack.bsky.social · 2d

LLM says membranous nephropathy. How'd it do?

Jonathan Pollack @jonathanpollack.bsky.social · 2d

It's still in CKD trials, right? Do we know the effect on normotensive people with normal BMI, no T2D, etc.?

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Jonathan Pollack @jonathanpollack.bsky.social · 2d

Sounds like a great miracle drug to add on as part of an untrialed multi-target therapy that could potentially kill me! Not sure if my UPCR (I don't have UACR tested) can get much lower or even if eGFR can improve, but I am doing all I can to avoid dialysis & transplantation.

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Jonathan Pollack @jonathanpollack.bsky.social · 2d

I'm a patient doing a fully plant-based diet with intermittent amino acid restriction (i.e. low-protein days) to try to modulate mTOR activity and autophagy signaling - aiming to reduce renal fibrosis and support tubular repair. Phew. And I do love my protein days, especially peanut butter days.

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Jonathan Pollack @jonathanpollack.bsky.social · 2d

Great that KDIGO recommends it, then! I mean, it's working for me, so...

Jonathan Pollack @jonathanpollack.bsky.social · 2d

Is there a list of multi-target therapies that have been trialed?

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Jonathan Pollack @jonathanpollack.bsky.social · 2d

So no Comic Sans then?

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Jonathan Pollack @jonathanpollack.bsky.social · 2d

I don't want a tonsilectomy based on a regional skew in trial participants...

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Jonathan Pollack @jonathanpollack.bsky.social · 2d

I am prepared to be a case study.

Jonathan Pollack @jonathanpollack.bsky.social · 2d

Good to hear there are others. They're hard to find. I feel like my eGFR↑ trajectory is somewhat unusual given my biopsy. Also serum creatinine keeps falling. This is on DEARA + TRF-budesonide.

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Jonathan Pollack @jonathanpollack.bsky.social · 3d

Why are you discounting my lived experience?!

Jonathan Pollack @jonathanpollack.bsky.social · 4d

Let's also aim for targeted autophagy, reversal of tubular atrophy and interstitial fibrosis, lab-grown 3-D printed kidneys, xenotransplantation, ...

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Jonathan Pollack @jonathanpollack.bsky.social · 4d

Excellent tip, will try my best to avoid cancer.

I burned through my ridiculously high annual maximum early this year getting a kidney biopsy and everything has been "free" after that point. I will get to start fresh in January when I'll have an even worse Marketplace plan with less coverage.

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Jonathan Pollack @jonathanpollack.bsky.social · 4d

That sounds like a horrible place to be.

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Jonathan Pollack @jonathanpollack.bsky.social · 5d

I think it’s going to get harder to recruit for rare disease trials where patients get either a potential breakthrough therapy or a placebo, while the standard of care keeps getting stronger. I wouldn’t risk my numbers against that reality!

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Jonathan Pollack @jonathanpollack.bsky.social · 5d

I'm still hopeful that more will come to use active control like PROTECT. Maybe I'm too optimistic here.

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Jonathan Pollack @jonathanpollack.bsky.social · 6d

Fascinating that CLYM116 is compared to sibe in a preclinical study. Hope we see more head-to-head comparisons with other leading or emerging agents!

Climb Bio Announces CLYM116 Preclinical Data Highlighting Potential for Best-In-Class Therapeutic for IgAN | Climb Bio

New preclinical data demonstrate deeper IgA reduction and a longer half-life compared to first-generation anti-APRIL monoclonal antibody CLYM116 Phase 1 trial initiation expected in Q4 2025, with init...

ir.climbbio.com

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Reposted by Jonathan Pollack

KDIGO @kdigo.org · 6d

New KDIGO Conversations in Nephrology series on #IgAN! Hosted by Dana Rizk, experts share key takeaways from the new KDIGO IgAN Guideline.

In Ep. 24, Brad Rovin shares key guideline updates. In Ep. 25, Shikha Wadhwani discusses the IgAN treatment revolution.

Listen now: kdigo.co/Conversation...

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Jonathan Pollack @jonathanpollack.bsky.social · 10d

Have nephrologists here seen patients w/similar T2 MEST-C (~50% cortical fibrosis/atrophy and 3/16 glomeruli with segmental sclerosis) achieve complete proteinuria remission (<0.3 g/g) for >=6 mo, reduction of serum creatinine, and a sustained rise in eGFR from ~28 to mid-30s?

Am I an IgAN outlier?

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Jonathan Pollack @jonathanpollack.bsky.social · 11d

Working on my highly-specific standup routine. 1 joke down.

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Jonathan Pollack @jonathanpollack.bsky.social · 11d

Triggered by a Pillsbury ad suggesting that I have crescents with dinner. Happy to stick with my C0, thanks.

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Jonathan Pollack @jonathanpollack.bsky.social · 12d

I had the same thought when it happened to me. No, no feedback.

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