Freely Filtered, a NephJC Podcast

Latest Episodes:

FF99 Late Breaking and High Impact Clinical Trials Session at KidneyWk: Pregnancy Outcomes after Kidney Donation Oct 22, 2026

Show notes

This is our second time releasing a podcast simultaneous with presentation and publication. Super exciting.

This podcast covers a retrospective trial study on pregnancy complications in kidney donors.

The Filtrate

Joel Topf @kidney_boy

Swapnil Hiremath @hswapnil.medsky.social

Anna Gaddy @GaddyAnnaR

Nayan Arora @captainchloride

Sophia Ambruso @sophia_kidney

Special Guests

Amit Garg @AmitXGarg, Nephrologist at Western University, London and PI of the current study

Editing

Joel Topf

The Kidney Connection written and performed by Timothy Yau

Show Notes

Previous appearances by Dr Garg:

Episode 56 MyTEMP

Episode 63 Enhance Access to Kidney Transplantation and Living Kidney Donation (EnAKT LKD) (Late breaking and High impact clinical trial session at KidneyWeek 2023 in Philadelphia

Our last attempt to podcast about preeclampsia did not go so well: Episode 70: Predicting Preeclampsia, the PRAECIS trial and Episode 70b Do Over: Predicting Preeclampsia, the PRAECIS trial (https://www.nephjc.com/freelyfiltered/2024/freely-filtered-70b-do-over-preeclampsia)

The use of the words “men” and “women” in scientific papers, an editorial

The Big Ask, The Big Gift

Garg’s prior work on male donors and scrotal surgery: Risk for Scrotal Surgery After Laparoscopic Donor Nephrectomy : A Population-Based Cohort Study PubMed

Garg’s prior work on donor and pregnancy outcomes: Gestational Hypertension and Preeclampsia in Living Kidney Donors NEJM

The Consensus Statement of the Amsterdam Forum on the Care of the Live Kidney Donor 2004 Transplantation

KDIGO 2017 Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors KDIGO

Tubular Secretion

Swapnil Babylon 5 on AmazonPrime Wikipedia

Sophia The Gentleman, the series on NetFlix Wikipedia and Gentleman, the film Wikipedia

Anna and her boat, Freshwater Deficit. Heavy Weather Sailing by Adlard Coles Amazon

Nayan William Osler: A Life in Medicine Amazon

Amit Law and Order ethics

Joel All the NephJC activities at Kidney Week: The Run | The other run | The Party

FF98 FIND-CKD Finerenone Tackles non-diabetic CKD Oct 15, 2026

Show notes

The Filtrate

Joel Topf @kidney_boy

Swapnil Hiremath @hswapnil.medsky.social

Anna Gaddy @annagaddy.bsky.social

Natalie Freidin Program director at Medical University of South Carolina

Special Guests

Brendon “Brendo” Neuen The first Five-Time guest on Freely Filtered. Nephrologist and Director, Kidney Trials, Royal North Shore Hospital. Associate Professor of Medicine at the George Institute

Editing

Natalie Freidin

The Kidney Connection written and performed by Timothy Yau

Show Notes

Donate to the fall pledge drive: https://www.nephjc.com/news/2026/9/8/nephjc-fall-pledge-drive

Come to the ASN NephJC Night in Denver the Kidney Week: https://www.nephjc.com/news/2026/9/13/the-2026-nephjc-night

FIND-CKD: Finerenone in Persons with Chronic Kidney Disease without Diabetes NEJM | NephJC

2-year GFR data on sibeprelimab‍ ‍

Incidence of ESRD in the US due to IgAN (estimate using USRDS data)

Heinz 57 wikipedia

Randomised placebo-controlled trial of effect of ramipril on decline in glomerular filtration rate and risk of terminal renal failure in proteinuric, non-diabetic nephropathy. The Lancet 1997. The REIN trial for people with nephrotic range proteinuria (>3 grams/day)

Renoprotective properties of ACE-inhibition in non-diabetic nephropathies with non-nephrotic proteinuria, The Lancet 1999 REIN Stratum 1 for sub-nephrotic range proteinuria (1-3 grams/day)

Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes FIDELIO in NephJC | NEJM

Benefits of aldosterone receptor antagonism in chronic kidney disease BARACK-D RCT PubMed

We discussed the run in. Importantly the run in for FIDELIO and FIGRO did not give finerenone. This is sometimes done to assure that participants in a trial will tolerate the study drug but this will over inflate data on tolerability. See NephJC’s discussion on run ins here: https://www.nephjc.com/news/run-in-period

Sean Barbour on Freely Filtered talking about the TESTING Trial

FINALITY-HF A randomized, double-blind, placebo-controlled pragmatic study to evaluate FINerenone on clinicAL effIcacy and safeTY in patients with Heart Failure and reduced ejection fraction who are intolerant of or not eligible for treatment with steroidal mineralocorticoid receptor antagonists. ClinicalTrials.gov

Boehringer provides update on EASi-KIDNEY trial 😢

Pooled finerenone data INFINITY Pooled Analysis

Tubular Secretion

Swapnil The Will of the Many by James Islington (Amazon)

Anna The Art Thief: A True Story of Love, Crime, and a Dangerous Obsession by Michael Finkel (Amazon)

Brendo John Mayer Electric Guitar (PRS Guitar)

Natalie Great Big Beautiful Life by Emily Henry (Amazon)

Joel Come to the NephJC party at Kidney Week!

FF97 MERCURI-2, Can a Flozin prevent AKI? Sep 27, 2026

Show notes

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.

NephJC Fall Pledge Drive 2026 Sep 23, 2026

Show notes

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

FF96 MAJESTY, or Mentor Two Aug 30, 2026

Show notes

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

FF95 The PUSH trial. Push it real good! Aug 23, 2026

Show notes

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)

FF94 C3 Glomerulopathy with Carla Nester Jul 17, 2026

Show notes

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)

FF93 Hyponatremia Interventional Trial Jun 30, 2026

Show notes

The Filtrate

Joel Topf kidneyboy.bsky.social

Swapnil Hiremath @hswapnil.medsky.social

Pedro Teixeira @nephcrit.bsky.social

Special Guests

Ewout J. Hoorn, Professor of Medicine Erasmus MC, Netherlands. One of the primary authors.

Harish Seethapathy, Assistant physician at Massachusetts General Hospital

Editing

Vipin Verghese

The Kidney Connection written and performed by Timothy Yau

Show Notes

A Randomized Trial of Targeted Hyponatremia Correction in Hospitalized Patients in NEJM Evidence, in PubMed, in NephJC

Seethapathy: Severe Hyponatremia Correction, Mortality, and Central Pontine Myelinolysis in NEJM Evidence

MacMillan: Osmotic Demyelination Syndrome in Patients Hospitalized with Hyponatremia in NEJM Evidence

SALSA: Risk of Overcorrection in Rapid Intermittent Bolus vs Slow Continuous Infusion Therapies of Hypertonic Saline for Patients With Symptomatic Hyponatremia: The SALSA Randomized Clinical Trial in JAMA Internal Medicine

SALT 1 and 2: Tolvaptan, a Selective Oral Vasopressin V2-Receptor Antagonist, for Hyponatremia in NEJM

Hyponatremia registry: Current treatment practice and outcomes. Report of the hyponatremia registry in Kidney International

The Richard Sterns’ article on the lower mortality with more severe hyponatremia: Mortality and Serum Sodium: Do Patients Die from or with Hyponatremia? in CJASN

The European Hyponatremia Guidelines: Clinical practice guideline on diagnosis and treatment of hyponatraemia inThe European Journal of Endocrinology

The American Hyponatremia Guidelines: Diagnosis, Evaluation, and Treatment of Hyponatremia: Expert Panel Recommendations in American Journal of Medicine

Treating hyponatremia: damned if we do and damned if we don't by Tom Berl in Kidney International

Prospective (clamp) versus reactive (rescue) DDAVP in hyponatremia: Safety and efficacy of proactive versus reactive administration of desmopressin in severe symptomatic hyponatremia: a randomized controlled trial in Nature Scientific Reports and as covered in PBFluids

Helbert Rondon’s RCT of urea Urea for Chronic Hyponatremia on ClinicalTrials.gov

Tubular Secretions

Swapnil: Catfishing on CatNet: A Novel by Naomi Kritzer (Amazon)

Harish:Disney Cruise

Edward: Flesh: A Novel (Booker Prize Winner) by David Szalay (Amazon)

Pedro: Scrubs reboot (IMDB)

Joel: KIDNEYcon

FF92 Live from Dublin, The Irish Nephrology Society Jun 09, 2026

Show notes

The Filtrate

Joel Topf kidneyboy.bsky.social

Special Guests

Dr. Samir Parikh, President of the American Society of Nephrology

Prof. Donal Reddan, President, Irish Nephrology Society

Prof. Catherine Godson

Editing

Joel Topf

The Kidney Connection written and performed by Timothy Yau

Show Notes

Tubular Secretions

Joel Topf, the Dublin Port Greenway Link

Catherine Godson: never heard ofthe Dublin Port Greenway

Samir Parikh: Trinity College Dublin and specifically the Eavan Boland Library, named after the Irish poet.

Donal Reddan: Something about rugby

FF91 Liberate-D Mar 30, 2026

Show notes

The Filtrate

Joel Topf kidneyboy.bsky.social

Pedro Teixeira @nephcrit.bsky.social

Nayan Arora @captainchloride.bsky.social

Anna Gaddy @annagaddy.bsky.social

Swapnil Hiremath @hswapnil.medsky.social and on LinkedIn

Special Guests

Ian McCoy, MD @NephroNinja study author and UCSF

Chi-yuan Hsu Senior author and Chief of the Division of Nephrology at UCSF

Samuel Silver Associate Professor at Queens University in Canada

Editing

Vipin Verghese and Joel Topf

Show Notes

NephJC Discusion: Dialyze Less, Recover More? AKI’s Chance to Get LIBERATE-D

Manuscript: A Conservative Dialysis Strategy and Kidney Function Recovery in Dialysis-Requiring Acute Kidney InjuryThe Liberation From Acute Dialysis (LIBERATE-D) Randomized Clinical Trial JAMA | PubMed

Ben’s pilot study: RAD-AKI Pilot study: Recovery After Dialysis-Requiring Acute Kidney Injury (RAD-AKI) (ClinicalTrials.gov)

STARRT-AKI NephJC

Editorial in JAMA: A-E-I-O-U and Sometimes Why—Dialysis in Acute Kidney Injury (JAMA)

What Is Dialytrauma? (Nephrology Times)

How Fragile Are the Results of a Trial? The Fragility Index (PubMedCentral)

Shiffl Trial: Daily Hemodialysis and the Outcome of Acute Renal Failure (NEJM)

AKIKI: Initiation Strategies for Renal-Replacement Therapy in the Intensive Care Unit (NEJM)

AKIKI2: How Late it was, How Late! (NephJC)

Sam Silver’s study: Promoting Kidney Recovery After Acute Kidney Injury Receiving Dialysis (Recover-AKI) (ClinicalTrial.Gov)

Marie Kondo (Wikipedia)

Tubular Secretions

Swap: The smutty dragon novels of novels of Rebecca Yarros (Wikipedia) Specifically The Empyrean series

Anna: Brisket recipes

Pedro: The Naked Gun (Wikipedia) with Liam Neeson

Ian: ASN Kidney Health Guidance on the Outpatient Management of Patients with Dialysis-Requiring Acute Kidney Injury (PubMed) he really doesn’t get Tubular Secretions.

Nayan: Tilt: A Novel by Emma Pattee (Amazon)

Chi: The Year of Magical Thinking by Joan Didion (Wikipedia) and Innovations in Nephrology (Springer Nature)

Sam: Monopoly Super Electronic Banking Board Game (Amazon)

Joel: Song Sung Blue (Wikipedia)