Rolando Claure
@runningkidneys.bsky.social
#KidneyDoctor #Researcher
Member Executive Committee @kdigo.org Member #SLANH #AKI committee
Views do not represent those of my employer
#KidneyRunner 🏃🏻♂️ #StopAKI
Member Executive Committee @kdigo.org Member #SLANH #AKI committee
Views do not represent those of my employer
#KidneyRunner 🏃🏻♂️ #StopAKI
Adjuvant thiazide outperformed simply increasing loop dose for boosting diuretic response in acute HF with diuretic resistance and response didn’t depend on the presumed mechanism of diuretic resistance. #HeartFailure #CardioRenal #Nephrology
🔗 journals.lww.com/jasn/fulltex...
🔗 journals.lww.com/jasn/fulltex...
February 10, 2026 at 4:33 PM
Adjuvant thiazide outperformed simply increasing loop dose for boosting diuretic response in acute HF with diuretic resistance and response didn’t depend on the presumed mechanism of diuretic resistance. #HeartFailure #CardioRenal #Nephrology
🔗 journals.lww.com/jasn/fulltex...
🔗 journals.lww.com/jasn/fulltex...
January 25, 2026 at 10:43 PM
PPIs have been linked to AKI/CKD risk. A 📑 in 🇰🇷 found P-CAB users had fewer kidney events than PPI users: creatinine doubling and eGFR ≥50% decline were lower; adjusted risk reductions 48% and 37%. Observational—needs confirmation.
🔗 doi.org/10.1093/ckj/...
🔗 doi.org/10.1093/ckj/...
January 8, 2026 at 3:26 PM
PPIs have been linked to AKI/CKD risk. A 📑 in 🇰🇷 found P-CAB users had fewer kidney events than PPI users: creatinine doubling and eGFR ≥50% decline were lower; adjusted risk reductions 48% and 37%. Observational—needs confirmation.
🔗 doi.org/10.1093/ckj/...
🔗 doi.org/10.1093/ckj/...
🌍🏃♂️ We’re ending the year running around the world: 3 continents (Americas, Europe, Asia), 7 countries (🇧🇴🇪🇨🇺🇸🇮🇳🇩🇪🇵🇦🇲🇽) & 10 cities—1,450 km total. Proud to complete the #850Challenge again, raising kidney disease awareness worldwide. 💚🩺🌎 #Run4Kidneys 🫘
December 31, 2025 at 9:43 PM
🌍🏃♂️ We’re ending the year running around the world: 3 continents (Americas, Europe, Asia), 7 countries (🇧🇴🇪🇨🇺🇸🇮🇳🇩🇪🇵🇦🇲🇽) & 10 cities—1,450 km total. Proud to complete the #850Challenge again, raising kidney disease awareness worldwide. 💚🩺🌎 #Run4Kidneys 🫘
December 25, 2025 at 1:51 PM
Key updates on IgAN & complement-mediated kidney disease from KI/KIR: felzartamab, vWF–platelet targeting, and advances in C3G & IC-MPGN. Plus endotyping, biomarkers, and trial updates refining risk stratification & therapy.
ISN eDigest team 👏🏻
🔗 www.theisn.org/edigest-isn-...
ISN eDigest team 👏🏻
🔗 www.theisn.org/edigest-isn-...
December 17, 2025 at 4:43 PM
Key updates on IgAN & complement-mediated kidney disease from KI/KIR: felzartamab, vWF–platelet targeting, and advances in C3G & IC-MPGN. Plus endotyping, biomarkers, and trial updates refining risk stratification & therapy.
ISN eDigest team 👏🏻
🔗 www.theisn.org/edigest-isn-...
ISN eDigest team 👏🏻
🔗 www.theisn.org/edigest-isn-...
Inactive lupus nephritis & SGLT2i data: NDT cross-over trial (n=30). Dapagliflozin + standard care vs usual therapy for 6 mo; 9 excluded (flare/LTFU). Proteinuria ↓ –36.1% vs –3.5%. More hypotension symptoms; no sig BP/weight changes. #LupusNephritis
🔗 doi.org/10.1093/ndt/...
🔗 doi.org/10.1093/ndt/...
December 10, 2025 at 4:06 PM
Inactive lupus nephritis & SGLT2i data: NDT cross-over trial (n=30). Dapagliflozin + standard care vs usual therapy for 6 mo; 9 excluded (flare/LTFU). Proteinuria ↓ –36.1% vs –3.5%. More hypotension symptoms; no sig BP/weight changes. #LupusNephritis
🔗 doi.org/10.1093/ndt/...
🔗 doi.org/10.1093/ndt/...
Our 🆕 review out in Nature Reviews Nephrology! We discuss the global epidemiology of #AKI why major gaps and inequities persist 🗺️ , & practical opportunities to improve outcomes through the 5R framework, stronger surveillance, & digital/innovation-enabled care.
www.nature.com/articles/s41...
www.nature.com/articles/s41...
December 6, 2025 at 4:26 PM
Our 🆕 review out in Nature Reviews Nephrology! We discuss the global epidemiology of #AKI why major gaps and inequities persist 🗺️ , & practical opportunities to improve outcomes through the 5R framework, stronger surveillance, & digital/innovation-enabled care.
www.nature.com/articles/s41...
www.nature.com/articles/s41...
🚨 Abstracts close Dec 12 for the International AKI & CRRT Conference.
Showcase your research, boost visibility, and connect with the AKI & CRRT and critical care community.
Submit today!
#AKI #CRRT #MedicalResearch #AKICRRT
🔗 crrtonline.com/crrtconferen...
Showcase your research, boost visibility, and connect with the AKI & CRRT and critical care community.
Submit today!
#AKI #CRRT #MedicalResearch #AKICRRT
🔗 crrtonline.com/crrtconferen...
December 5, 2025 at 12:11 PM
🚨 Abstracts close Dec 12 for the International AKI & CRRT Conference.
Showcase your research, boost visibility, and connect with the AKI & CRRT and critical care community.
Submit today!
#AKI #CRRT #MedicalResearch #AKICRRT
🔗 crrtonline.com/crrtconferen...
Showcase your research, boost visibility, and connect with the AKI & CRRT and critical care community.
Submit today!
#AKI #CRRT #MedicalResearch #AKICRRT
🔗 crrtonline.com/crrtconferen...
New NEJM RCT in 1,228 maintenance HD pts: 4 g/day n-3 PUFA (fish oil) vs corn oil placebo reduced serious CV events (HR 0.57) and non-cardiac death (HR 0.77). Time to revisit fish oil in HD? #NephJC
December 1, 2025 at 9:55 PM
New NEJM RCT in 1,228 maintenance HD pts: 4 g/day n-3 PUFA (fish oil) vs corn oil placebo reduced serious CV events (HR 0.57) and non-cardiac death (HR 0.77). Time to revisit fish oil in HD? #NephJC
Just received my complimentary copy of Tropical Nephrology (2nd Ed.) 📘🌿
Recently discussed my chapter on kidney disease from herbal medicine with our fellows—2 days later we saw an AKI case linked to these products.
We must ask about herbal meds/supplements routinely. #AKI #CKD
Recently discussed my chapter on kidney disease from herbal medicine with our fellows—2 days later we saw an AKI case linked to these products.
We must ask about herbal meds/supplements routinely. #AKI #CKD
November 25, 2025 at 4:57 PM
Subclinical #AKI in the wards: in 103 at-risk adults, a simple urine microscopy score (UMS≥2) within ARA-F4 identified AKI-1S; 90% developed clinical AKI with higher KRT use & ☠️. UMS (AUC 0.84) is a low-cost trigger for earlier intervention in LMICs. journals.lww.com/kidney360/fu...
November 22, 2025 at 4:43 PM
Subclinical #AKI in the wards: in 103 at-risk adults, a simple urine microscopy score (UMS≥2) within ARA-F4 identified AKI-1S; 90% developed clinical AKI with higher KRT use & ☠️. UMS (AUC 0.84) is a low-cost trigger for earlier intervention in LMICs. journals.lww.com/kidney360/fu...
November 9, 2025 at 2:09 PM
Starting HD? Don’t rush to 🛑loop diuretics. Medicare cohort (n=11,297): continuing loops ↓ hospitalizations (IRR 0.93), ↓ intradialytic hypotension (IRR 0.95) &↓ interdialytic weight gain; no mortality difference at 1 yr. If still making urine, consider continuing. #KidneyWk
November 8, 2025 at 11:29 PM
Starting HD? Don’t rush to 🛑loop diuretics. Medicare cohort (n=11,297): continuing loops ↓ hospitalizations (IRR 0.93), ↓ intradialytic hypotension (IRR 0.95) &↓ interdialytic weight gain; no mortality difference at 1 yr. If still making urine, consider continuing. #KidneyWk
AKI-D pearls:
•Gentle UF & individualized Rx-minimize dialytrauma
•⬇️frequency/intensity as recovery starts
•Prevent IDH: 🆒 dialysate + slower UF
•Consider tolerating pre-HD SBP 🆙 to 180 mmHg before starting antihypertensives to avoid recurrent AKI & aid ❤️🩹#KidneyWk
•Gentle UF & individualized Rx-minimize dialytrauma
•⬇️frequency/intensity as recovery starts
•Prevent IDH: 🆒 dialysate + slower UF
•Consider tolerating pre-HD SBP 🆙 to 180 mmHg before starting antihypertensives to avoid recurrent AKI & aid ❤️🩹#KidneyWk
November 8, 2025 at 11:21 PM
AKI-D pearls:
•Gentle UF & individualized Rx-minimize dialytrauma
•⬇️frequency/intensity as recovery starts
•Prevent IDH: 🆒 dialysate + slower UF
•Consider tolerating pre-HD SBP 🆙 to 180 mmHg before starting antihypertensives to avoid recurrent AKI & aid ❤️🩹#KidneyWk
•Gentle UF & individualized Rx-minimize dialytrauma
•⬇️frequency/intensity as recovery starts
•Prevent IDH: 🆒 dialysate + slower UF
•Consider tolerating pre-HD SBP 🆙 to 180 mmHg before starting antihypertensives to avoid recurrent AKI & aid ❤️🩹#KidneyWk
AKI-D isn’t “ESRD lite.” Patients face ↑ disability, ↓HRQoL, CKD after “recovery,” and high CV events (Lee 2018). Outpatient HD still lacks ID flags, order sets, recovery monitoring, and dedicated teams. Time for AKI-D–specific pathways. #KidneyWk
November 8, 2025 at 7:09 PM
AKI-D isn’t “ESRD lite.” Patients face ↑ disability, ↓HRQoL, CKD after “recovery,” and high CV events (Lee 2018). Outpatient HD still lacks ID flags, order sets, recovery monitoring, and dedicated teams. Time for AKI-D–specific pathways. #KidneyWk
AKI-D recovery is shaped by layers beyond the kidney:
• Patient—older age, female, minority status, CKD/proteinuria, HF/CVD
• Meds—nephrotoxins
• Dialysis—↑UF/UFR, longer sessions, IDH
• SDOH—neighborhood poverty, dual-eligibility
(Babroudi et al., JASN 2024) #KidneyWk
• Patient—older age, female, minority status, CKD/proteinuria, HF/CVD
• Meds—nephrotoxins
• Dialysis—↑UF/UFR, longer sessions, IDH
• SDOH—neighborhood poverty, dual-eligibility
(Babroudi et al., JASN 2024) #KidneyWk
November 8, 2025 at 6:08 PM
AKI-D recovery is shaped by layers beyond the kidney:
• Patient—older age, female, minority status, CKD/proteinuria, HF/CVD
• Meds—nephrotoxins
• Dialysis—↑UF/UFR, longer sessions, IDH
• SDOH—neighborhood poverty, dual-eligibility
(Babroudi et al., JASN 2024) #KidneyWk
• Patient—older age, female, minority status, CKD/proteinuria, HF/CVD
• Meds—nephrotoxins
• Dialysis—↑UF/UFR, longer sessions, IDH
• SDOH—neighborhood poverty, dual-eligibility
(Babroudi et al., JASN 2024) #KidneyWk
LIBERATE-D RCT in AKI-D (n=218) — conservative dialysis (only when metabolic/clinical triggers) vs conventional 3x/wk. Kidney recovery at discharge: 64% vs 50% (ARR 13.8%). Adjusted OR NS → needs larger trial. #KidneyWk
November 8, 2025 at 6:01 PM
LIBERATE-D RCT in AKI-D (n=218) — conservative dialysis (only when metabolic/clinical triggers) vs conventional 3x/wk. Kidney recovery at discharge: 64% vs 50% (ARR 13.8%). Adjusted OR NS → needs larger trial. #KidneyWk
Take-home from #KidneyWk💡
💧 Balanced crystalloids: modest survival benefit.
💉 IV bicarbonate: no survival advantage in severe acidosis overall.
⚠️ But in KDIGO stage 2–3 AKI + acidosis, may delay or reduce KRT need.
The story of bicarb continues… #AKI #CriticalCare
💧 Balanced crystalloids: modest survival benefit.
💉 IV bicarbonate: no survival advantage in severe acidosis overall.
⚠️ But in KDIGO stage 2–3 AKI + acidosis, may delay or reduce KRT need.
The story of bicarb continues… #AKI #CriticalCare
November 8, 2025 at 3:42 PM
Take-home from #KidneyWk💡
💧 Balanced crystalloids: modest survival benefit.
💉 IV bicarbonate: no survival advantage in severe acidosis overall.
⚠️ But in KDIGO stage 2–3 AKI + acidosis, may delay or reduce KRT need.
The story of bicarb continues… #AKI #CriticalCare
💧 Balanced crystalloids: modest survival benefit.
💉 IV bicarbonate: no survival advantage in severe acidosis overall.
⚠️ But in KDIGO stage 2–3 AKI + acidosis, may delay or reduce KRT need.
The story of bicarb continues… #AKI #CriticalCare
BICARICU-2 insights 🔍
Event rates lower than expected, 15% crossover (controls got bicarb, 50% KRT).
KRT reduction remains provocative—true renal protection or just buying time?
Still not powered for MAKE-90.
More data coming from MOSAICC & SODa-BIC!
#KidneyWk
Event rates lower than expected, 15% crossover (controls got bicarb, 50% KRT).
KRT reduction remains provocative—true renal protection or just buying time?
Still not powered for MAKE-90.
More data coming from MOSAICC & SODa-BIC!
#KidneyWk
November 8, 2025 at 3:41 PM
BICARICU-2 insights 🔍
Event rates lower than expected, 15% crossover (controls got bicarb, 50% KRT).
KRT reduction remains provocative—true renal protection or just buying time?
Still not powered for MAKE-90.
More data coming from MOSAICC & SODa-BIC!
#KidneyWk
Event rates lower than expected, 15% crossover (controls got bicarb, 50% KRT).
KRT reduction remains provocative—true renal protection or just buying time?
Still not powered for MAKE-90.
More data coming from MOSAICC & SODa-BIC!
#KidneyWk
BICARICU-2: 627 adults with KDIGO stage 2–3 AKI + metabolic acidosis (pH≤7.2, HCO3≤20, SOFA≥4) in 43 French ICUs randomized to 4.2% NaHCO₃ (target pH≥7.30) vs usual care. Primary: 90-day mortality; key secondary: KRT, MAKE-90, organ failure. #KidneyWk
November 8, 2025 at 3:40 PM
BICARICU-2: 627 adults with KDIGO stage 2–3 AKI + metabolic acidosis (pH≤7.2, HCO3≤20, SOFA≥4) in 43 French ICUs randomized to 4.2% NaHCO₃ (target pH≥7.30) vs usual care. Primary: 90-day mortality; key secondary: KRT, MAKE-90, organ failure. #KidneyWk
BICAR-ICU
389 adults with severe acidemia randomized to 4.2% IV bicarb vs usual care. Overall primary outcome neutral, but in AKI stage 2–3 bicarb ↓ composite events, mortality, organ failure & KRT use (52%→35%). More alkalosis, hyperNa, hypoCa. #KidneyWk
389 adults with severe acidemia randomized to 4.2% IV bicarb vs usual care. Overall primary outcome neutral, but in AKI stage 2–3 bicarb ↓ composite events, mortality, organ failure & KRT use (52%→35%). More alkalosis, hyperNa, hypoCa. #KidneyWk
November 8, 2025 at 3:37 PM
BICAR-ICU
389 adults with severe acidemia randomized to 4.2% IV bicarb vs usual care. Overall primary outcome neutral, but in AKI stage 2–3 bicarb ↓ composite events, mortality, organ failure & KRT use (52%→35%). More alkalosis, hyperNa, hypoCa. #KidneyWk
389 adults with severe acidemia randomized to 4.2% IV bicarb vs usual care. Overall primary outcome neutral, but in AKI stage 2–3 bicarb ↓ composite events, mortality, organ failure & KRT use (52%→35%). More alkalosis, hyperNa, hypoCa. #KidneyWk