Across 49 trials and 66,449 patients, early eGFR and albuminuria changes tracked each other equally on drug and placebo

The edition in brief

An individual patient meta-analysis of 49 randomised CKD trials and 66,449 participants found no trial-level link between a treatment's acute effect on GFR and its effect on albuminuria. Within individuals, a larger early GFR decline came with a slightly larger albuminuria fall — about 8% per standard deviation on treatment and 6.6% on control — so these early changes in one patient largely reflect natural variation and disease course rather than drug response. A Cochrane review of 27 trials and 1,584 people on haemodialysis found music-based interventions may reduce short-term fatigue, pain and depressive symptoms, with low to very low certainty and no long-term data. Laser microdissection and mass spectrometry of 22 IgA nephropathy biopsies showed deposits of dimeric IgA1 and IgA2 with IgG1, and complement mostly from the alternative and terminal pathways, consistent with the targets of new complement-directed drugs. In 34 children with E. coli HUS and in mice, heme released by haemolysis activated factor XII and the kallikrein–kinin system, an effect blocked by C1-inhibitor in experiments.