Latest Nephrology research

Top 10 this week

Week of 1 November 2026

1. 1

   Colchicine and Perioperative Acute Kidney Injury: A Substudy of the COP-AF Randomized Clinical Trial

   American journal of kidney diseases : the official journal of the National Kidney Foundation · Q1 journal · RCT · Evidence level 1 (High) · 30 October 2026

   In a randomized substudy of 2,947 patients having major noncardiac thoracic surgery, acute kidney injury occurred in 4.7% of those given colchicine and 4.4% given placebo. The findings were similar across kidney injury definitions and in patients with chronic kidney disease, but the study had limited power to detect small effects, including on kidney injury requiring dialysis.

2. 2

   Consensus statement from the International Society of Glomerular Disease for Certification of Centers of Excellence in Glomerular Disease

   Kidney international · Q1 journal · Guideline · Evidence level 1 (High) · 8 October 2026

   The International Society of Glomerular Disease sets certification criteria across four areas: clinical expertise, research, education and advocacy. The standards are designed to be rigorous but inclusive, and the society has joined with GlomCon to build a unified program, with applications planned for 2026; whether centers can meet the criteria and expand collaboration remains to be seen.

3. 3

   Alterations to the Consent Process in Five Pragmatic Randomized Trials of Routine Hemodialysis Care

   Journal of the American Society of Nephrology : JASN · Q1 journal · RCT · Evidence level 1 (High) · 20 August 2026

   Consent alterations in pragmatic hemodialysis trials

4. 4

   The Veterans Affairs Pentoxifylline in Diabetic Kidney Disease (VA PTXRx) Study: Baseline Characteristics

   Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · Q1 journal · RCT · Evidence level 1 (High) · 22 October 2026

   Large RCT, tests pentoxifylline to delay dialysis

5. 5

   Protein-bound Uremic Toxin Lowering Effects of Sevelamer in Hyperphosphatemic Hemodialysis Patients: A Multicenter Randomized Controlled Trial

   Kidney medicine · Q1 journal · RCT · Evidence level 1 (High) · 11 September 2026

   In this 24-week trial of 124 hemodialysis patients, sevelamer did not significantly lower p-cresyl sulfate compared with calcium carbonate. It was linked to a 0.63-point smaller increase in the cardio-ankle vascular index, a measure of arterial stiffness, but the study did not assess cardiovascular events; larger, longer trials are needed to clarify the clinical importance.

6. 6

   The effect of renal denervation on blood pressure in patients with chronic kidney disease (RDN-CKD Study): Results of a multicentre, prospective, randomized, sham-controlled and blinded investigator-initiated trial

   Journal of hypertension · Q1 journal · RCT · Evidence level 1 (High) · 20 October 2026

   Among 20 people with stage 3 chronic kidney disease and uncontrolled hypertension, ultrasound renal denervation reduced 24-hour diastolic blood pressure by about 6 mmHg more than a sham procedure at six months; systolic pressure did not fall significantly. Kidney function remained stable and no safety signals emerged, but early stopping and the small sample mean a larger trial is needed to confirm the findings.

7. 7

   Short-term effects of an SGLT2 inhibitor on divalent ions in autosomal dominant polycystic kidney disease: a randomized crossover trial

   Clinical kidney journal · Q1 journal · RCT · Evidence level 1 (High) · 2 October 2026

   No change in urinary divalent ion excretion

8. 8

   Patient-Reported Outcomes with High-Volume Hemodiafiltration Versus High-Flux Hemodialysis Across Clinical Subgroups: Results from the CONVINCE Trial

   Clinical journal of the American Society of Nephrology : CJASN · Q1 journal · RCT · Evidence level 1 (High) · 30 October 2026

   Among 1,211 adults receiving dialysis, patient-reported outcomes were broadly similar across clinical subgroups with high-volume hemodiafiltration versus high-flux hemodialysis. A few modest subgroup differences appeared, but they were inconsistent and not adjusted for multiple comparisons, so the analysis found no convincing basis to select or exclude patients based on these outcomes.

9. 9

   Network and pairwise meta-analysis of the effects of novel hypoglycemic agents on cardiorenal outcomes in patients with type 2 diabetes and heart failure

   Frontiers in endocrinology · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 14 October 2026

   In a meta-analysis of 13,886 people with type 2 diabetes and heart failure, sodium-glucose cotransporter 2 inhibitors reduced the risk of heart-failure composite outcomes by 25% versus placebo; they also lowered heart-failure hospitalization and cardiovascular death. GLP-1 receptor agonists showed a similar reduction in the composite outcome, but kidney benefits were not statistically clear, and the analysis did not establish one drug class as superior.

10. 10

    Acetate-free dialysate, protein-energy wasting, and muscle outcomes in maintenance hemodialysis: a randomized-controlled trial

    Clinical kidney journal · Q1 journal · RCT · Evidence level 1 (High) · 22 September 2026

    In a 60-person randomized crossover trial, six months of acetate-free dialysate did not improve prealbumin, body composition, grip strength, walking speed, albumin, or inflammation compared with conventional dialysate. Safety outcomes also did not differ significantly. The single-center trial found no advantage on these measures, leaving larger studies to assess whether specific patient groups benefit.

Paper of the day, last two weeks

• Meta-analysis of the effect of nafamostat mesilate versus no-anticoagulation regimens in adult patients undergoing continuous renal replacement therapy

  Frontiers in medicine · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 21 October 2026

  In eight studies involving 969 adults on continuous renal replacement therapy, nafamostat was linked to longer-lasting filters and fewer filter changes, with bleeding risks similar to regimens without anticoagulation. The analysis also found lower in-hospital mortality, but the mix of randomized and observational studies cannot establish that nafamostat caused better survival; evidence beyond East Asia remains uncertain.

• Preparing for responsive management versus renal dialysis in older people living with kidney failure and frailty or multimorbidity in the UK (Prepare for Kidney Care): a two-arm, superiority, parallel-group, open-label, pragmatic, phase 3, individually randomised controlled trial

  Lancet (London, England) · Q1 journal · RCT · Evidence level 1 (High) · 4 November 2026

  Pragmatic RCT comparing conservative care vs dialysis in frail elders

• Changes in Metabolic and Blood Pressure Outcomes With Semaglutide Across Chronic Kidney Disease Stages: A Post Hoc Analysis of the FLOW Trial

  Diabetes, obesity & metabolism · Q1 journal · RCT · Evidence level 1 (High) · 3 November 2026

  In a post hoc analysis of 3,533 adults with type 2 diabetes and chronic kidney disease, semaglutide reduced HbA1c by 0.7 to 1.0 percentage points and weight by 2.5 to 4.6 kg more than placebo over 104 weeks. Effects on these measures did not differ significantly across kidney function or albuminuria groups; blood pressure also improved in some groups, but the analysis was not designed to establish differences between them.

• Shared decision-making and non-hemodialysis kidney replacement therapy selection in end-stage kidney disease: a quasi-experimental, difference-in-differences study

  Kidney research and clinical practice · Q1 journal · Non-randomized trial · Evidence level 2 (Moderate) · 30 October 2026

  In this 556-patient study, patients treated by physicians participating in a structured shared decision-making program more often chose peritoneal dialysis or a transplant over hemodialysis during the program period: 48.5% versus 21.9%. The adjusted association was driven mainly by transplant choices, not peritoneal dialysis, and unplanned dialysis did not decline; other centers need to confirm the findings.

• Sodium bicarbonate therapy for metabolic acidosis in critically ill patients: a Bayesian systematic review and meta-analysis of randomised controlled trials

  Intensive care medicine · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 2 November 2026

  Across four randomized trials involving 1,544 critically ill adults with metabolic acidosis, sodium bicarbonate was associated with about 26% fewer starts of kidney replacement therapy. It showed no clear short-term survival benefit, and effects on other outcomes were uncertain; further trials must identify which patients, if any, benefit most.

• Dose-Specific Network Meta-Analysis of Mineralocorticoid Receptor Antagonists in CKD

  Kidney international reports · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 17 September 2026

  In a network analysis of 32 trials involving 21,678 people with chronic kidney disease, all mineralocorticoid receptor antagonist doses reduced albuminuria, with overlapping effects; spironolactone 25 mg and finerenone 20 mg had similar reductions. Hyperkalemia was more frequent with treatment, and adverse events increased with longer follow-up and lower kidney function.

• Target Trial of Semaglutide Versus Dulaglutide or Liraglutide in Patients Receiving Hemodialysis

  Diabetes care · Q1 journal · Retrospective cohort · Evidence level 3 (Low) · 27 October 2026

  In a US data study emulating a target trial, patients on hemodialysis taking semaglutide had 11% one-year mortality, versus 13% with dulaglutide or liraglutide; hospitalization was also less common, and weight loss was greater. The mortality and hospitalization differences appeared in comparisons with dulaglutide, but not liraglutide, and observational data cannot establish that semaglutide caused the benefits.

• Efficacy and safety of eculizumab in patients with anti-glomerular basement membrane disease: an investigator-initiated, open-label, phase II clinical trial

  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · Q1 journal · Non-randomized trial · Evidence level 2 (Moderate) · 27 October 2026

  Phase II study of complement inhibition for anti-GBM kidney disease

• Donor-Recipient Size Mismatch is a Critical Determinant of Kidney Transplant Outcome

  Kidney international reports · Q1 journal · Prospective cohort · Evidence level 2 (Moderate) · 23 September 2026

  Large transplant cohort links donor-recipient size mismatch to graft outcomes

• Trends in Mortality of Patients with Central Venous Catheters versus Arteriovenous Accesses for Hemodialysis

  Journal of the American Society of Nephrology : JASN · Q1 journal · Cohort · Evidence level 3 (Low) · 22 October 2026

  Comparative mortality outcomes by hemodialysis vascular access

• Low Daily Protein Intake and Risk of Kidney Failure and Mortality in Chronic Kidney Disease

  JAMA network open · Q1 journal · Prospective cohort · Evidence level 2 (Moderate) · 1 October 2026

  Among 1,861 South Korean adults with nondialysis chronic kidney disease, those consuming less than 0.6 grams of protein per kilogram daily had a 42% higher risk of kidney failure and more than twice the risk of death than those consuming over 1.2 grams, over 9.3 years of follow-up. This observational link does not prove restriction caused harm, but argues for monitoring nutrition rather than imposing rigid limits.

• Long-term efficacy and safety for the complement factor B inhibitor iptacopan in IgA nephropathy

  Kidney international · Q1 journal · Non-randomized trial · Evidence level 2 (Moderate) · 22 October 2026

  In an open-label extension, patients who switched from placebo to iptacopan saw annual kidney function loss slow from 5.29 to 2.11 milliliters per minute per 1.73 square meters over the next two years. Proteinuria reductions persisted for up to four years, with no new safety signals over as long as five years, but the extension lacked a placebo comparison.

Evidence summaries in Nephrology

• Acute Kidney Injury
• Chronic Kidney Disease
• Hyperkalemia
• Hyponatremia
• Nephrotic Syndrome
• Kidney Transplant Rejection
• Renal Tubular Reabsorption