Kidney Compass: Navigating Clinical Trials

Welcome back to Kidney Compass!Recording from ASN Kidney Week 2026 in Denver, Colorado, cohosts Shikha Wadhwani, MD, MS, and Brendon Neuen, MBBS, PhD, welcomed Stephen Seliger, MD, of the University of Maryland School of Medicine, and Michel Chonchol, MD, of the University of Colorado Anschutz Medical Campus. The investigators discussed their pilot randomized trial of empagliflozin in autosomal dominant polycystic kidney disease (ADPKD), published simultaneously in the Journal of the American Society of Nephrology.¹Results showed the drug was safe and well tolerated, but an unexpected increase in kidney volume raised new questions for SGLT2 inhibitor research in this population.For more: https://www.hcplive.com/view/kidney-compass-testing-sglt2-inhibition-in-rapidly-progressing-adpkd

Welcome back to Kidney Compass!Recording from ASN Kidney Week 2026 in Denver, Colorado, cohosts Brendon Neuen, MBBS, PhD, and Shikha Wadhwani, MD, MS, welcomed back Katherine Tuttle, MD, of Providence Inland Northwest Health and the University of Washington School of Medicine.The group broke down new analyses from the FIND-CKD trial of finerenone in non-diabetic chronic kidney disease (CKD), presented during a dedicated finerenone session. Topics included combination therapy with SGLT2 inhibitors, hyperkalemia, IgA nephropathy, and outcomes across CKD severity.Key Episode Timestamps00:05 - Welcome and episode overview01:54 - Finerenone with and without SGLT2 inhibitors in FIND-CKD03:38 - Hyperkalemia risk and management07:01 - Finerenone in IgA nephropathy13:31 - Cardiovascular risk and holistic care in IgAN15:34 - Sequencing therapies for residual albuminuria17:58 - Kidney injury biomarkers and innate immunity22:07 - Finerenone effects across CKD severityFor more: https://www.hcplive.com/view/kidney-compass-new-find-ckd-finerenone-data-from-asn-kidney-week-2026

Welcome back to Kidney Compass!Recording from ASN Kidney Week 2026 in Denver, Colorado, cohosts Brendon Neuen, MBBS, PhD, and Shikha Wadhwani, MD, MS, welcomed back Jicheng Lv, MD, of Peking University First Hospital, after he presented final 2-year results from the phase 3 TELIGAN trial during the late-breaking plenary.For more: https://www.hcplive.com/view/kidney-compass-final-2-year-teligan-data-for-telitacicept-in-iga-nephropathy 

Welcome back to Kidney Compass!Recording from ASN Kidney Week 2026 in Denver, Colorado, cohosts Brendon Neuen, MBBS, PhD, and Shikha Wadhwani, MD, MS, sat down with Jonathan Barratt, PhD, FRCP, of the University of Leicester, shortly after he presented the final efficacy analysis of the phase 3 ORIGIN 3 trial at the opening plenary.The results, published simultaneously in the New England Journal of Medicine, show atacicept, a dual B-cell activating factor (BAFF) and A proliferation-inducing ligand (APRIL) inhibitor, stabilized eGFR over 1 year.¹,² The conversation moved from the data to trial design, treatment sequencing, and global access.Key Episode Timestamps00:00 - IgA nephropathy takes over the ASN plenary01:33 - ORIGIN 3 final analysis: eGFR, proteinuria, and kidney outcomes05:18 - Why the eGFR end point moved to week 5206:44 - Consistency across prespecified subgroups08:38 - Placebo-group discontinuations and future trial design10:32 - Should B-cell therapy come first in IgA nephropathy?13:57 - Choosing among APRIL and BAFF/APRIL inhibitors15:37 - Global access to new IgA nephropathy therapiesFor more: https://www.hcplive.com/view/kidney-compass-origin-3-final-egfr-data-for-atacicept-in-iga-nephropathy

In a special episode of Kidney Compass, Shikha Wadhwani, MD, MS, puts her regular co-host, Brendan Neuen, MBBS, PhD, in the "hot seat," asking him about results from FIND-CKD, the phase 3 trial showing finerenone slows eGFR decline and cuts cardiorenal risk by 23% in non-diabetic chronic kidney disease (CKD) over 32 months of follow-up, including the prespecified glomerulonephritis (GN) subgroup analysis he presented at the European Renal Association (ERA) Congress in June.For more: https://www.hcplive.com/view/kidney-compass-find-ckd-extends-finerenone-s-benefit-to-non-diabetic-ckd

At the European Renal Association (ERA) Congress in Glasgow, Scotland, results from the TURING trial offered long-awaited evidence that rituximab can meaningfully reduce relapse rates in adults with minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS).These conditions have been historically managed with prolonged, high-dose corticosteroid courses, carrying a substantial burden of adverse effects. In this episode of Kidney Compass, host Brendon Neuen, MBBS, PhD, spoke with Lisa Willcocks, MBBChir, MRCP, PhD, a consultant nephrologist who leads the primary glomerular disease service at Addenbrooke's Hospital in Cambridge, United Kingdom, about the trial she presented as a late-breaking clinical result at the congress.Read more: https://www.hcplive.com/view/kidney-compass-turing-trial-rituximab-relapse-risk-mcd-fsgs 

Hosts Brendon Neuen, MBBS, PhD, and Shikha Wadhwani, MD, MS, welcome Dana Rizk, MD, professor of medicine in the Division of Nephrology at the University of Alabama at Birmingham. Rizk walks through the 24-month eGFR and safety findings from the phase 3 VISIONARY trial of sibeprenlimab (Voyxact) in IgA nephropathy (IgAN) in the lastest episode of Kidney Compass.

At the World Congress of Nephrology 2026 in Yokohama, Japan, growing attention is being paid not just to whether therapies improve outcomes in chronic kidney disease, but how they work at a mechanistic level. In this episode of Kidney Compass, host Brendon Neuen, MBBS, PhD, spoke with David Cherney, MD, PhD, about the REMODEL trial, a mechanistic study designed to better understand the kidney-protective effects of semaglutide in patients with type 2 diabetes and chronic kidney disease.0:00:00 – Episode intro & guest setup0:00:54 – What is REMODEL & link to FLOW0:01:21 – Design, outcomes & mechanistic readouts of REMODEL0:04:30 – Additive effects with SGLT2 inhibitors0:07:17 – Perirenal fat, venous pressure & “toxic adiposity”0:10:28 – Relevance to non‑diabetic CKD & SMART trial link0:13:20 – Clinical messaging & patient communicationhttps://www.hcplive.com/view/kidney-compass-remodel-trial-provides-mechanistic-rationale-for-semaglutide-in-ckd

Iron deficiency is increasingly recognized as a clinically meaningful yet underexplored contributor to morbidity in kidney disease, extending beyond its traditional association with anemia. In populations such as kidney transplant recipients, where graft function may be stable, many patients continue to experience impaired physical function, reduced quality of life, and lingering fatigue.As evidence from other fields, particularly cardiology, has begun to demonstrate the benefits of intravenous iron on functional outcomes independent of hemoglobin, questions are emerging about whether similar strategies could improve how patients with kidney disease feel and function, not just how they measure on laboratory parameters.In this episode of Kidney Compass recorded on-site at World Congress of Nephrology in Yokohama, Japan, hosts Shikha Wadhwani, MD, MS, and Brendon Neuen, MBBS, PhD, spoke with Martin de Borst, MD, PhD, about his investigator-initiated randomized trial of intravenous iron in kidney transplant recipients.0:00:00 – Episode intro & topic framing0:01:11 – Rationale & observational signals0:03:03 – Choice of primary endpoint (6‑minute walk)0:04:35 – Trial design & blinding details0:05:11 – Inclusion criteria & population profile0:07:48 – Dosing regimen & primary outcome result0:09:03 – Secondary outcomes & “fixed labs, not patients”0:12:32 – Lessons learned & future trial directionshttps://www.hcplive.com/view/kidney-compass-iv-iron-and-functional-outcomes-in-kidney-transplant-recipients

The treatment landscape for IgA nephropathy (IgAN) continues to evolve at a rapid pace, and new data presented at the World Congress of Nephrology (WCN) in Yokohama, Japan, suggest a potential shift in how clinicians approach disease modification in high-risk patients. In this episode of Kidney Compass, hosts Shikha Wadhwani, MD, MS, and Brendon Neuen, MBBS, PhD, spoke with Vlado Perkovic, MBBS, PhD, about newly presented 2-year eGFR slope data from the phase 3 APPLAUSE-IgAN trial evaluating iptacopan.0:00:00 – Episode intro & trial topic0:00:52 – Overview of APPLAUSE trial & headline efficacy0:02:40 – Hard outcome composite & safety profile0:04:21 – Positioning iptacopan in guidelines & background therapy0:05:10 – Consistency across subgroups & need for biomarkers0:07:37 – Acute vs chronic eGFR slope with immunologic therapies0:11:29 – Rationale for combination immunologic therapy0:13:01 – Magnitude of effect, residual risk & early diagnosishttps://www.hcplive.com/view/kidney-compass-new-2-year-applause-igan-data-for-iptacopan-at-wcn-2026