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Edgar V. Lerma 🇵🇭 Profile picture
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23 Jun, 6 tweets, 8 min read
Efficacy and safety of voclosporin versus placebo for #lupus nephritis (AURORA 1): a double-blind, randomised, multicentre, placebo-controlled, phase 3 trial from @TheLancet @BradRovin #NephJC #Nephpearls
#VisualAbstract by @katierizzolo
👉🏼 thelancet.com/journals/lance…
Voclosporin: Hope on the Horizon for #Lupus Nephritis ⁉️ from @KidneyNews February 2021 issue #Nephpearls #NephJC
👉 asn-online.org/publications/k…
AURA-LV: A randomized, controlled double-blind study comparing the efficacy and safety of dose-ranging voclosporin with placebo in achieving remission in patients with active lupus nephritis ca. 2018 from @Kidney_Int @BradRovin #Nephpearls #NephJC
👉🏼 kidney-international.org/article/S0085-…
Pooled AURA-LV and AURORA1 #NephJC #Nephpearls
Voclosporin: Mechanisms in #Lupus nephritis #NephJC #Nephpearls
MT @myadla @isn_india ROVIN: Given the current uncertainties of voclosporin, a CNI, on long-term kidney function, "this may not the the 1st choice for patients with #Lupus nephritis and severely impaired eGFR #NephJC #Nephpearls

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More from @edgarvlermamd

Edgar V. Lerma 🇵🇭 Profile picture
17 Jun
Happening now‼️
@NKFIllinois Controversies in #Nephrology #Nephpearls Image
Balanced crystalloids vs saline in critically ill & non-critically ill adult patients from @NEJM #Nephpearls
#VisualAbstract by @aakashshingada
👉🏼 SALT-ED pubmed.ncbi.nlm.nih.gov/29485926/
👉🏼 SMART pubmed.ncbi.nlm.nih.gov/29485925/ ImageImageImage
Urgent-start PD is defined as initiation of PD in patients w/ newly diagnosed ESKD who are not yet on dialysis and who require dialysis initiation < 2 weeks (as little as 24-48 hours) after PD catheter placement but do not require emergent dialysis #Nephpearls Image
Read 5 tweets
Edgar V. Lerma 🇵🇭 Profile picture
7 Jun
Tweetorial: @goKDIGO Level 2B Recommendation - We suggest that adults w/ high BP & CKD be treated with a target SBP <120, when tolerated, using standardized office BP measurement (1/9) #Nephpearls
👉 kdigo.org/guidelines/blo…
There is evidence that targeting SBP <120 when measured under standardized conditions, reduces CV events & all-cause mortality in CKD

📌 In most people w/ high BP (incl. frail & elderly), these benefits appear to outweigh the risks of harm (hypotension & AKI) (2/9) #Nephpearls
There is however, some uncertainty that the benefits outweigh the harms in certain scenarios (3/9) #Nephpearls
👉 kdigo.org/guidelines/blo…
Read 11 tweets
Edgar V. Lerma 🇵🇭 Profile picture
9 Apr
MOE: Phosphorus or Phosphate
👉 PROXIMAL Tubule: Main site for regulation of phosphate (some is reabsorbed with Na and H20; most is regulated by change in FGF23)
👉 DISTAL Tubule: Main site for regulation of calcium and potassium
#NKFClinicals #Nephpearls #CKDMBD ImageImageImage
Phosphorus bioavailability "varies" by source
#NKFClinicals #Nephpearls Image
Active Intestinal Phosphate Transport and Passive Intestinal Phosphate (Paracellular) Transport
📌 Note that in these tight junctions, there are 5 groups of proteins that regulate this: occludens, claudins, JAMA, E-cadherin, desmosomes
#NKFClinicals #Nephpearls ImageImage
Read 6 tweets
Edgar V. Lerma 🇵🇭 Profile picture
12 Mar
Acute on Chronic Liver Failure ca. 2020 from @NEJM #Hepatorenal #Nephpearls

nejm.org/doi/full/10.10…
#Hepatorenal syndrome ca. 2019 from @CJASN #Nephpearls

👉 cjasn.asnjournals.org/content/14/5/7…
CONFIRM: In this trial involving adults w/ cirrhosis and HRS-1, terlipressin was more effective than placebo in improving renal function but was associated with serious adverse events, including respiratory failure (ca. 2021) #Hepatorenal #Nephpearls
nejm.org/doi/full/10.10…
Read 5 tweets
Edgar V. Lerma 🇵🇭 Profile picture
11 Mar
.@goKDIGO Controversies Conference on Home 🏡 Dialysis
#KDIGOHomeDialysis 🎧

👉🏼 kdigo.org/conferences/hd/ ImageImageImageImage
Unmet need in kidney failure treatment worldwide
#KDIGOHomeDialysis 🎧
#WorldKidneyDay
👉🏼 thelancet.com/journals/lance… ImageImage
Number of people getting KRT worldwide
#KDIGOHomeDialysis 🎧
#WorldKidneyDay
👉🏼 thelancet.com/journals/lance… ImageImage
Read 7 tweets
Edgar V. Lerma 🇵🇭 Profile picture
10 Mar
KALM-1: A Phase 3 Trial of Difelikefalin in Hemodialysis Patients with Pruritus ca. 2020 from @NEJM @sfishbane #Nephpearls
#VisualAbstract by @kidney_boy

nejm.org/doi/full/10.10…
International Comparisons of Prevalence, Awareness, and Treatment of Pruritus in People on Hemodialysis ca. 2017 from @CJASN @DOPPStudy @WMRenalN @DrMattGB @brurobinson1 #Nephpearls
👉 cjasn.asnjournals.org/content/12/12/…
RCT of Difelikefalin for Chronic Pruritus in Hemodialysis Patients ca. 2020 from @KIReports @sfishbane #Nephpearls
👉 kireports.org/article/S2468-…
Read 4 tweets

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