Review window: 8–15 August 2026 (GMT+3)
Prepared for: NephroHub
Scope: JASN, AJKD, NEJM, The Lancet, NDT, Kidney International, CJASN, Nature Reviews Nephrology, and BMC Nephrology.
Editorial method: This is a selective clinical roundup, not a systematic review. Articles were included only when their publication date and source record could be verified during the review window. Summaries are concise, evidence-calibrated, and link directly to the original publication or its PubMed record.
At a glance
| Measure | This review |
|---|---|
| Review window | 8–15 August 2026 |
| Featured articles | 6 |
| Journals represented in featured articles | 4 |
| Monitored journals | 9 |
| Highest-priority themes | Dialysis modality, diabetic CKD, IgA nephropathy, transplant glomerulopathy, and CKD prevention |
This week’s strongest clinically relevant material is concentrated in JASN, NDT, AJKD, and BMC Nephrology. A direct, date-limited search did not identify a new PubMed-indexed Kidney International item for this window. NEJM, The Lancet, CJASN, and Nature Reviews Nephrology were monitored; relevant non-core nephrology or commentary items were not included in this focused practice roundup.
Featured articles
| Priority | Journal | Article | Topics | Why it matters |
|---|---|---|---|---|
| 1 | JASN | Hemodiafiltration versus high-flux hemodialysis and mortality | Large multinational target-trial emulation showing an association between sustained high-volume HDF and lower mortality. | |
| 2 | BMC Nephrology | BAFF/APRIL inhibitors in IgA nephropathy | Network meta-analysis supports substantial proteinuria reduction, but long-term kidney-failure benefit remains unproven. | |
| 3 | NDT | RAS inhibition in dialysis-dependent HFrEF | Meta-analysis suggests potential benefit, but evidence is predominantly observational. | |
| 4 | NDT | Recurrent C3 glomerulopathy after transplantation | Practical surveillance-first framework for a difficult, high-risk transplant complication. | |
| 5 | NDT | Individualising therapy in diabetic CKD | Clear reminder to combine proven therapies with monitoring and lifestyle management, without overclaiming evidence for combinations. | |
| 6 | AJKD | Blood pressure, kidney function, and kidney mortality | Large cohort reinforces blood-pressure control as a CKD-prevention priority. |
1. Hemodiafiltration versus high-flux hemodialysis and mortality
Source: Strippoli GFM, Tripepi G, Canaud B, et al. Journal of the American Society of Nephrology. Published online 13 August 2026. DOI: 10.1681/ASN.0000001225.
Concise AI summary. In a multinational, registry-based target-trial emulation of 19,539 eligible in-centre dialysis patients, sustained high-volume post-dilution hemodiafiltration (HDF) was associated with lower all-cause mortality than high-flux haemodialysis (hazard ratio 0.72; 95% CI 0.67–0.77). Two-year weighted mortality was 20.6% with HDF and 22.3% with high-flux HD, an absolute difference of 1.7 percentage points. [1]
Clinical relevance: High. The result strengthens the rationale for considering high-volume HDF where infrastructure, vascular access, water quality, and local expertise permit. However, it is an observational emulation rather than a randomised trial; selection and centre-level factors cannot be fully excluded.
2. BAFF/APRIL-pathway inhibition in IgA nephropathy
Source: Mansour N, Elbarody RMF, Kamel AM. BMC Nephrology. Published 11 August 2026. DOI: 10.1186/s12882-026-05267-4.
Concise AI summary. This systematic review and network meta-analysis included seven placebo-controlled trials involving 1,590 adults with biopsy-proven IgA nephropathy. BAFF/APRIL-pathway inhibitors (telitacicept, atacicept, and sibeprenlimab) reduced proteinuria versus placebo (standardised mean change −0.73; 95% CI −0.88 to −0.58) and showed a small short-term difference in eGFR favouring active treatment. Injection-site reactions were more frequent, whereas overall adverse-event rates were not higher. [2]
Clinical relevance: High. The analysis supports the biologic and antiproteinuric activity of this drug class. It should not yet be interpreted as proof of durable protection from kidney failure; long-term trials with hard renal outcomes remain necessary.
3. Renin–angiotensin system inhibition in dialysis-dependent HFrEF
Source: Sritharan A, Marchetti M, Antiochos P, et al. Nephrology Dialysis Transplantation. Published online 12 August 2026. DOI: 10.1093/ndt/gfag184.
Concise AI summary. This systematic review and meta-analysis assessed RAS inhibition in dialysis-dependent patients with heart failure with reduced ejection fraction. ARNI use was associated with lower all-cause mortality than non-ARNI regimens (pooled HR 0.78; 95% CI 0.71–0.87); ACE inhibitor/ARB use was also associated with lower all-cause mortality (HR 0.76; 95% CI 0.68–0.84) and cardiovascular mortality (HR 0.62; 95% CI 0.54–0.71). [3]
Clinical relevance: Moderate. This fills an evidence gap in a high-risk population but relies largely on observational studies. It supports careful, individualised use with monitoring for blood pressure, potassium, and residual kidney function rather than a universal prescribing mandate.
4. Management of recurrent C3 glomerulopathy after kidney transplantation
Source: Trujillo H, Cavero T, Moran SM, et al. Nephrology Dialysis Transplantation. Published online 11 August 2026. DOI: 10.1093/ndt/gfag183.
Concise AI summary. This practical review highlights that C3 glomerulopathy frequently recurs early after transplantation, sometimes before clinical manifestations are apparent. No validated biomarkers reliably predict recurrence and preventive strategies remain unproven. The authors favour a surveillance-driven approach, including consideration of protocol biopsies and evolving use of proximal complement inhibitors. [4]
Clinical relevance: High for transplant centres. The article is a useful framework for pre-transplant counselling, post-transplant monitoring, and specialist discussion of complement-directed therapy. It is not a replacement for individualised multidisciplinary management.
5. Individualising therapy for CKD associated with diabetes
Source: Zhang Z, Li L, Yang M, et al. Nephrology Dialysis Transplantation. Published online 8 August 2026. DOI: 10.1093/ndt/gfag179.
Concise AI summary. This review integrates RAS inhibitors, SGLT2 inhibitors, GLP-1 receptor agonists, and finerenone with blood-pressure management, individualised glycaemic goals, diet, exercise, weight management, and smoking cessation. It notes that no head-to-head trial has compared all drug classes and that phase 3 evidence for specific multi-class combinations improving hard outcomes beyond well-selected monotherapy is still incomplete. [5]
Clinical relevance: High. The central message is practical: layer proven treatments according to albuminuria, eGFR, comorbidities, tolerability, and monitoring capacity, while avoiding automatic polypharmacy. It is a review, not new comparative trial evidence.
6. Blood pressure, kidney function, and kidney mortality among Mexican adults
Source: Zhu D, Kuri-Morales P, Wade R, et al. American Journal of Kidney Diseases. Published online 13 August 2026. DOI: 10.1053/j.ajkd.2026.05.019.
Concise AI summary. In a prospective cohort of 133,470 Mexican adults without baseline CKD, each 20-mmHg lower systolic blood pressure was associated with lower kidney-failure mortality (HR 0.76; 95% CI 0.69–0.84). In a re-evaluated subset, lower baseline systolic BP was also associated with lower odds of CKD and albuminuria. [6]
Clinical relevance: High. This large cohort reinforces BP control as a key population-level CKD-prevention measure, including in settings with a high burden of undiagnosed hypertension. The associations are observational and should not be read as defining a personalised treatment target.
Practice takeaways
| Theme | Evidence-calibrated takeaway |
|---|---|
| Dialysis modality | High-volume HDF is associated with lower mortality in a large observational emulation; programme-level feasibility and patient-specific factors still matter. [1] |
| IgA nephropathy | BAFF/APRIL inhibition is an important emerging targeted approach because of consistent proteinuria lowering; durable kidney-outcome evidence is still developing. [2] |
| Dialysis with HFrEF | RAS blockade may be beneficial, but the current meta-analytic signal is primarily observational and requires careful safety monitoring. [3] |
| Kidney transplantation | For C3G, prioritise recurrence surveillance and early specialist review; proven prophylaxis is lacking. [4] |
| Diabetic CKD | Use an individualised, monitored, layered strategy rather than assuming every multi-drug combination has established hard-outcome benefit. [5] |
| CKD prevention | Sustained BP control remains central to preventing albuminuria, CKD, and kidney-failure mortality at population level. [6] |
References
- Hemodiafiltration versus High-flux Hemodialysis and Risk of Mortality: A Multinational Target Trial Emulation
- Efficacy and safety of BAFF/APRIL-pathway inhibitors versus placebo in adults with IgA nephropathy
- Renin–Angiotensin System Inhibition in Dialysis-Dependent Patients with Chronic Heart Failure due to Reduced Ejection Fraction
- Management of Recurrent C3 Glomerulopathy After Kidney Transplantation
- Individualizing pharmacologic and non-pharmacologic therapy for CKD associated with diabetes
- Blood Pressure, Kidney Function, and Kidney Mortality Among Mexican Adults
Educational notice: This review is intended for medical education and website content. It does not replace the original article, local protocols, professional guidelines, or patient-specific clinical judgement.