HIF-PH inhibitors raise VEGF modestly, with oedema the consistent signal

The edition in brief

A meta-analysis of 34 randomised trials of hypoxia-inducible factor prolyl hydroxylase inhibitors for anaemia in chronic kidney disease found a small but significant rise in VEGF, greater in dialysis patients, and a consistent increase in peripheral oedema, with no significant association with cancer, diabetic retinopathy or thrombosis over trial follow-up. An automated chemiluminescence assay for anti-nephrin antibodies in 121 children with minimal change disease or FSGS agreed with the research reference method in 87% of samples and detected antibodies more often; higher levels predicted shorter relapse-free survival, and positivity in remission was linked to relapse within three months. In 82 patients with newly diagnosed myeloma and renal impairment, adding pomalidomide to bortezomib–dexamethasone raised very good partial response or better from 21% to 72% and renal response from 46% to 76% in a phase 2 trial. Whole-genome sequencing in 1,052 people with congenital kidney and urinary tract anomalies found a monogenic cause in only 4.9%. A meta-analysis of 63 mostly retrospective studies found 53% of people with CKD are non-dippers, linked to higher mortality and faster progression. The pearl covers light-chain testing in unexplained kidney injury.