- Amir Kazory, MD 8-28-2026- “Rethinking Decongestion in Cardiorenal Syndrome: Emerging Sodium-Centric Strategies and Devices”
- I. David Weiner, MD 9-4-2026- “Alkali therapy for Acidosis: When, Why and How Much”
- Abdel All, PhD, MPH 9-18-2026- “Glyphosate-Induced Nephrotoxicity: adverse effects in glomerular and tubular epithelial cells”
- Hisham Ibrahim, MD 10-2-2026- “BK nephropathy, A review of Current Treatment Strategies and Upcoming Therapeutics”
Dr. Amir Kazory delivered a Renal Grand Rounds talk focused on new sodium-centric strategies and devices for managing acute heart failure. He emphasized that congestion is the main reason for hospitalization and that residual congestion is linked to poor outcomes, though he noted recent doubts about whether decongestion alone improves hard outcomes. Dr. Amir Kazory discussed the importance of monitoring urine sodium during diuresis, presenting studies that showed natuoresis-guided therapy could lead to better sodium removal and potentially better outcomes. He reviewed recent trials on using SGLT2 inhibitors like dapagliflozin as add-on diuretics, highlighting their potential to enhance diuresis with a safer biochemical profile compared to metolazone. Amir also covered the use of chloride solutions, the Reprieve closed-loop decongestion device, and several investigational renal assist devices aimed at reducing renal venous congestion. He concluded by urging proactive use of SGLT2 inhibitors in hospitalized patients and expressed cautious optimism about the potential of new device-based therapies.
Dr. David Weiner presented a comprehensive talk titled “Alkali Therapy for Acidosis: When and Why” examining the clinical benefits and indications for treating metabolic acidosis. He discussed how the renal response to acidosis is slow compared to other electrolyte disorders, questioning whether this indicates minimal short-term consequences or the need for aggressive intervention against long-term effects. David reviewed evidence showing that acute metabolic acidosis, particularly lactic acidosis from exercise, may have beneficial effects on muscle function and cardiovascular function through vasodilation and increased oxygen release. He presented data from recent clinical trials, including the BICAR ICU2 trial and the soda bicarbonate trial, which showed no mortality benefit from acute alkali therapy in critically ill patients with metabolic acidosis. For chronic metabolic acidosis, David presented evidence from multiple studies showing that treating chronic kidney disease patients with alkali therapy improves renal function progression, reduces mortality, and prevents complications including sarcopenia, osteoporosis, and insulin resistance. He concluded that for acute metabolic acidosis, clinicians may not be providing patient benefits but are potentially treating other physicians’ expectations, while for chronic metabolic acidosis, alkali therapy clearly improves patient outcomes and should be considered standard treatment.
Dr. Ali presented a comprehensive research talk on Glyphosate-Induced Nephrotoxicity, focusing on adverse effects in glomerular and tubular epithelial cells. The presentation covered multiple aspects of glyphosate toxicity, including its impact on BK channels in human mesangial cells, mitochondrial dysfunction in intermedullary collecting duct cells, and effects on membrane fluidity and permeability. Dr. Ali’s research team, including doctoral students Niharika Kabala, Ramesh Rafi, and others, conducted various experiments investigating how glyphosate alone and in combination with surfactants affects different kidney cell types. The studies revealed that Roundup (glyphosate with surfactant) causes more significant mitochondrial dysfunction, increases in bioactive lipids like ceramides and diacylglycerols, and induces cell death compared to pure glyphosate. Dr. Ali concluded that glyphosate with surfactant has greater potential to cause oxidative stress and cell death in various kidney cell types, and discussed future plans to investigate hyperuricemia in combination with glyphosate exposure.
The meeting focused on BK nephropathy in kidney transplantation, covering its virology, pathogenesis, diagnosis, and management. Hisham Ibrahim reviewed the natural history, risk factors, and epidemiology, noting that BK nephropathy peaks 6–12 months post-transplant and is associated with higher immunosuppression, use of tacrolimus, acute rejection, and donor-recipient serostatus. He described current management as primarily reducing immunosuppression, with limited evidence for adjuncts like fluoroquinolones, leflunomide, cidofovir, and IVIG, and highlighted that IVIG is not recommended for routine use per 2024 guidelines. He discussed promising new therapies, including monoclonal antibodies targeting VP1 (MAU868 and Patravita) with phase 2/3 data showing viral load reduction, and allogeneic BK-specific T cell therapy (Posolucel) with encouraging safety and efficacy signals. He also mentioned future directions such as BK serology, vaccines, and use of Torque teno virus as a biomarker of immunosuppression.