Journal of the American Society of Nephrology (JASN)
Highlighted article: Considerations for using eGFR slope as an endpoint in clinical trials
Publication info: Published Oct 2025
Journal of the American Society of Nephrology ():10.1681/ASN.0000000919, October 15, 2025. | DOI: 10.1681/ASN.0000000919
Summary: This piece evaluates strengths and limitations of using eGFR slope as a primary endpoint in CKD trials. Authors discuss that eGFR slope can offer earlier detection of treatment effects and greater statistical power, but heterogeneity in individual slopes, baseline reserve differences, and competing risks (cardiovascular events, death) complicate interpretation. The article recommends careful trial design: pre-specified slope models, sensitivity analyses, and linkage to hard clinical outcomes to ensure clinical meaningfulness. For regulators and trialists, this analysis suggests pragmatic adjustments to endpoint selection rather than a wholesale replacement of traditional outcomes.
Clinical impact: High — may influence trial design and regulatory endpoints for CKD therapeutics.
One-line takeaway: eGFR slope is promising for earlier signal detection, but requires robust design and linkage to clinical outcomes.
Kidney International
Highlighted article: Kidney Disease: Preventing CKD and maintaining kidney health (KDIGO conclusions & in-press items)
Publication info: October 2025 issue / Articles in Press
Kidney International, Volume 108, Issue 4, 555 – 571
Summary: Kidney International continues to emphasize prevention and systems-level strategies for CKD. Recent content and in-press items highlight genetic screens linking imaging-derived kidney volumes to genes associated with kidney function, and randomized trials addressing population-level interventions. The journal’s trending topics this week also underscored immunologic mechanisms (anti‑nephrin antibodies), CKD prevention in metabolic syndrome, and venous thromboembolism prevention in nephrotic syndrome. These pieces reinforce a mix of mechanistic discovery and pragmatic clinical trials that can affect screening and prevention programs.
Clinical impact: High — combines genetics, prevention, and translational science with direct clinical implications.
One-line takeaway: Emerging genetic and prevention data in KI strengthen prospects for targeted screening and population interventions.
Nature Reviews Nephrology
Highlighted article: Urine as a source of biomarkers and biological knowledge in chronic kidney disease
Publication info: Review Article — 07 Oct 2025
Citation: Source: Nature Reviews Nephrology. https://doi.org/10.1038/s41581-025-01008-2
Summary: This review synthesizes recent advances using urinary components (proteins, RNAs, metabolites, extracellular vesicles) as biomarkers for CKD diagnosis, prognosis, and therapy monitoring. The authors argue urine’s unique value: it directly reflects renal physiology and pathology, enabling minimally invasive access to kidney-derived signals. They discuss assay standardization, validation challenges, and promising biomarker candidates that could accelerate personalized nephrology—while warning that heterogeneity across cohorts and pre-analytical variability remain obstacles to clinical translation.
Clinical impact: High — clarifies pathways for translating urinary biomarkers into clinical practice.
One-line takeaway: Urine-based biomarkers are maturing, but standardization and validation across populations remain essential.
American Journal of Kidney Diseases (AJKD)
Highlighted article: Highlights from October 2025 issue — Primary Care Use and Clinical Outcomes among patients initiating hemodialysis
Publication info: October 2025 — AJKD current issue highlights
Citation: American Journal of Kidney Diseases, Volume 86, Issue 4, 437 – 447.e1
Summary: AJKD’s October issue includes practical studies examining real-world care pathways, such as primary care utilization patterns among patients initiating hemodialysis and their outcomes. The issue emphasizes health services research—how system-level factors (primary care engagement, care transitions) influence mortality and hospitalization after dialysis initiation. The practical, patient-centered analyses aim to inform quality improvement and healthcare delivery models rather than novel molecular targets.
Clinical impact: Moderate — informs care pathways and quality improvement rather than immediate therapeutic shifts.
One-line takeaway: Systems and primary-care engagement affect early outcomes after dialysis initiation and merit targeted intervention.
Clinical Journal of the American Society of Nephrology (CJASN)
Highlighted article: Addressing sex disparities in coronary revascularization among dialysis patients
Publication info: October 2025 — CJASN Volume 20 Issue 10
Citation: Clinical Journal of the American Society of Nephrology 20(10):p 1321-1322, October 2025. | DOI: 10.2215/CJN.0000000876
Summary: CJASN’s recent issue includes analyses of disparities (e.g., sex differences) in cardiovascular procedures and outcomes for dialysis patients. Articles call for equity‑focused approaches, showing that women on dialysis may be less likely to receive coronary revascularization and may experience different outcomes. These findings underline the need for guideline-directed, equity-informed cardiology‑nephrology collaborations and may prompt centers to audit local practices and referral patterns.
Clinical impact: Moderate — highlights equity and referral pathway issues that can change practice patterns.
One-line takeaway: Recognize and address sex disparities in cardiovascular care for dialysis patients to improve outcomes.
Clinical Kidney Journal (CKJ)
Highlighted article: Urinary extracellular vesicle RNAs as novel biomarkers for diagnosis and prognosis of lupus nephritis
Publication info: Volume 18 Issue 10 — October 2025
Citation: Clin Kidney J. 2025 Sep 22;18(10):sfaf295. doi: 10.1093/ckj/sfaf295
Summary: CKJ highlights translational biomarker work; a featured article evaluates urinary extracellular vesicle RNAs as diagnostic and prognostic markers in lupus nephritis. The study suggests that specific RNA signatures in urinary vesicles correlate with disease activity and could help stratify patients for treatment intensity or predict flares—although validation in larger cohorts is still required.
Clinical impact: Moderate — promising translational biomarker data with need for larger validation.
One-line takeaway: Extracellular vesicle RNAs in urine may offer noninvasive tools for lupus nephritis diagnosis and monitoring.
American Journal of Nephrology
Highlighted article: Cohort studies on GFR estimation differences and outcomes — Volume 56 Issue 5 (Oct 2025)
Publication info: October 2025 — AJN Volume 56 Issue 5
Citation: Source: Am J Nephrol (2025)https://doi.org/10.1159/000548582
Summary: The American Journal of Nephrology published cohort analyses comparing cystatin C– vs creatinine‑based eGFR equations and their associations with all‑cause and cardiovascular mortality in mixed populations. Results highlight that cystatin C–based estimates may reclassify risk in certain cardiometabolic populations, which has implications for risk stratification and patient counseling. The journal continues to publish population‑level analyses that inform risk prediction.
Clinical impact: Moderate — affects risk stratification and potential use of cystatin C in clinical practice.
One-line takeaway: Cystatin C approaches may refine prognostic stratification but require pragmatic implementation studies.