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    <description>NephSpace makes new kidney research easy and fun to follow.

Every week, a practicing nephrologist picks the most interesting new papers and news in nephrology, and two hosts talk them through: the story, the key numbers, why it matters, and an honest take on what the study does and doesn't prove.

Weekly episodes (about 30 minutes) cover that week's picks from the kidney journals, the big general journals and the specialty news. Deep Dives (15 to 20 minutes) follow one question further: two treatments racing for the same goal, a trial worth arguing about, a case that a new paper answers.

Made for nephrologists, nephrology fellows and kidney-care clinicians. Curious, evenhanded, never condescending.

Physician-led, AI-assisted. Dr. Wael Hussein, an academic nephrologist in Memphis, chooses every paper, reviews and edits every script, and approves every episode. First drafts are written with AI from the full text of each paper, a separate AI check compares every number with the papers, and the hosts' voices are AI-generated. Authors' industry ties are named on air, and Dr. Hussein's own disclosures are in every episode's notes.

Educational content for healthcare professionals, not medical advice. Views are the creator's own and not those of his employer. Papers are summarized in our own words, with links to the originals.

nephspace.com · hello@nephspace.com</description>
    <copyright>© 2026 NephSpace</copyright>
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    <pubDate>Thu, 01 Oct 2026 20:33:19 -0500</pubDate>
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    <itunes:author>Wael Hussein</itunes:author>
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    <itunes:summary>NephSpace makes new kidney research easy and fun to follow.

Every week, a practicing nephrologist picks the most interesting new papers and news in nephrology, and two hosts talk them through: the story, the key numbers, why it matters, and an honest take on what the study does and doesn't prove.

Weekly episodes (about 30 minutes) cover that week's picks from the kidney journals, the big general journals and the specialty news. Deep Dives (15 to 20 minutes) follow one question further: two treatments racing for the same goal, a trial worth arguing about, a case that a new paper answers.

Made for nephrologists, nephrology fellows and kidney-care clinicians. Curious, evenhanded, never condescending.

Physician-led, AI-assisted. Dr. Wael Hussein, an academic nephrologist in Memphis, chooses every paper, reviews and edits every script, and approves every episode. First drafts are written with AI from the full text of each paper, a separate AI check compares every number with the papers, and the hosts' voices are AI-generated. Authors' industry ties are named on air, and Dr. Hussein's own disclosures are in every episode's notes.

Educational content for healthcare professionals, not medical advice. Views are the creator's own and not those of his employer. Papers are summarized in our own words, with links to the originals.

nephspace.com · hello@nephspace.com</itunes:summary>
    <itunes:subtitle>NephSpace makes new kidney research easy and fun to follow.</itunes:subtitle>
    <itunes:keywords>nephrology, kidney, dialysis, CKD, nephrology fellows, medical education, journal club</itunes:keywords>
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      <title>Deep Dive · Two Roads: Hemodiafiltration or Medium Cutoff Dialyzers?</title>
      <itunes:episode>2</itunes:episode>
      <podcast:episode>2</podcast:episode>
      <itunes:title>Deep Dive · Two Roads: Hemodiafiltration or Medium Cutoff Dialyzers?</itunes:title>
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        <![CDATA[<p>Two dialysis patients, same city, same week. One gets a new machine that filters and replaces more than 20 liters every session. The other gets the same old machine with a new filter. Both are told it's the future. Hemodiafiltration has a survival trial but needs new machines. Medium cutoff dialyzers drop into today's machines but have no survival evidence against standard dialysis. A detective story with a Fight Night verdict, including who makes, sells and funds each road.</p><p><br></p><p><strong>The takeaway:</strong> Both roads clear more middle molecules, but only hemodiafiltration has shown that people live longer, and only in patients who can get the dose.</p><p><br></p><p><strong>Disclosure:</strong> Dr. Hussein serves on the Fresenius Medical Care US Home Medical Advisory Board. Fresenius makes and sells the 5008X hemodiafiltration machine discussed in this episode. The episode names the industry ties of the review authors and of everyone quoted.</p><p><br></p><p><strong>Chapters</strong></p><ul><li>00:00 Cold open and disclosure</li><li>01:11 The mystery: what middle molecules are, and why clearing them might matter</li><li>02:47 Road one, change the treatment: CONVINCE, its quality-of-life and cost papers, and the JASN review</li><li>08:36 Road two, change the filter: Theranova, ELISIO-HX and the medium cutoff evidence</li><li>11:47 The showdown: MOTheR, the head-to-head trial</li><li>15:13 Follow the money: who makes, sells and funds each road</li><li>16:49 Fight Night verdict and the Monday-morning change</li></ul><p><br></p><p><strong>Papers discussed</strong></p><ul><li>Blankestijn PJ, et al. Hemodiafiltration: Clinical Practice of Today and a Look into the Future. JASN 2026 (ahead of print). <a href="https://doi.org/10.1681/ASN.0000001282">https://doi.org/10.1681/ASN.0000001282</a></li><li>Healio | Nephrology, September 24, 2026. Q&amp;A with DaVita's chief medical officer on medium cutoff dialyzers. <a href="https://www.healio.com/news/nephrology/20260924/qa-recent-fda-approval-prompts-expansion-of-medium-cutoff-dialyzers">https://www.healio.com/news/nephrology/20260924/qa-recent-fda-approval-prompts-expansion-of-medium-cutoff-dialyzers</a></li><li>Blankestijn PJ, et al. Effect of Hemodiafiltration or Hemodialysis on Mortality in Kidney Failure (CONVINCE). N Engl J Med 2023;389:700-709. <a href="https://doi.org/10.1056/NEJMoa2304820">https://doi.org/10.1056/NEJMoa2304820</a></li><li>Rose M, et al. CONVINCE quality-of-life results. Kidney Int 2024;106:961-971. <a href="https://doi.org/10.1016/j.kint.2024.07.014">https://doi.org/10.1016/j.kint.2024.07.014</a></li><li>Schouten AEM, et al. CONVINCE cost-utility analysis. Kidney Int 2025;107:728-739. <a href="https://doi.org/10.1016/j.kint.2024.12.018">https://doi.org/10.1016/j.kint.2024.12.018</a></li><li>Vernooij RWM, et al. Haemodiafiltration versus haemodialysis for kidney failure: an individual patient data meta-analysis of randomised controlled trials. Lancet 2024;404:1742-1749 (abstract only). <a href="https://doi.org/10.1016/S0140-6736(24)01859-2">https://doi.org/10.1016/S0140-6736(24)01859-2</a></li><li>Kandi M, et al. Clinical Outcomes With Medium Cut-Off Versus High-Flux Hemodialysis Membranes: A Systematic Review and Meta-Analysis. Can J Kidney Health Dis 2022;9. <a href="https://doi.org/10.1177/20543581211067087">https://doi.org/10.1177/20543581211067087</a></li><li>MOTheR trial (Theranova expanded hemodialysis vs online hemodiafiltration), presented at the ERA Congress, June 2026, not yet peer-reviewed. Healio, June 18, 2026. <a href="https://www.healio.com/news/nephrology/20260618/expanded-hemodialysis-noninferior-to-online-hemodiafiltration">https://www.healio.com/news/nephrology/20260618/expanded-hemodialysis-noninferior-to-online-hemodiafiltration</a></li><li>National Kidney Foundation. Medium Cut-Off Dialyzers for Expanded Hemodialysis: A Clinical Update. <a href="https://www.kidney.org/professionals/medium-cut-dialyzers-expanded-hemodialysis">https://www.kidney.org/professionals/medium-cut-dialyzers-expanded-hemodialysis</a></li></ul><p><br></p><p><strong>Company and provider statements cited (promotional sources, labeled as such on air)</strong></p><ul><li>Vantive, June 8, 2026 (MOTheR and CONCORDIA). <a href="https://www.globenewswire.com/news-release/2026/06/08/3308370/0/en/vantive-highlights-late-breaking-high-clinical-impact-data-at-era-indicating-hdx-therapy-is-a-practical-alternative-to-online-hemodiafiltration.html">https://www.globenewswire.com/news-release/2026/06/08/3308370/0/en/vantive-highlights-late-breaking-high-clinical-impact-data-at-era-indicating-hdx-therapy-is-a-practical-alternative-to-online-hemodiafiltration.html</a></li><li>Fresenius Medical Care, June 2026, "High-Volume Hemodiafiltration Remains the Benchmark for Survival Evidence in Dialysis". <a href="https://freseniusmedicalcare.com/en/media/insights/blog/high-volume-hemodiafiltration-remains-the-benchmark-for-survival/">https://freseniusmedicalcare.com/en/media/insights/blog/high-volume-hemodiafiltration-remains-the-benchmark-for-survival/</a></li><li>DaVita newsroom, August 5, 2026. <a href="https://newsroom.davita.com/davita-scales-expanded-hd-to-target-middle-molecules/">https://newsroom.davita.com/davita-scales-expanded-hd-to-target-middle-molecules/</a></li><li>U.S. Renal Care, July 30, 2026. <a href="https://www.prnewswire.com/news-releases/us-renal-care-drives-innovation-in-dialysis-with-increased-availability-of-medium-cut-off-dialyzers-to-support-expanded-hemodialysis-302839595.html">https://www.prnewswire.com/news-releases/us-renal-care-drives-innovation-in-dialysis-with-increased-availability-of-medium-cut-off-dialyzers-to-support-expanded-hemodialysis-302839595.html</a></li><li>Healio perspective, February 24, 2026, "Middle molecule moment" (Chan and Sonti). <a href="https://www.healio.com/news/nephrology/20260224/middle-molecule-moment-hemodiafiltration-and-expanded-hemodialysis-transform-us-dialysis">https://www.healio.com/news/nephrology/20260224/middle-molecule-moment-hemodiafiltration-and-expanded-hemodialysis-transform-us-dialysis</a></li></ul><p>Also cited by name: Baxter's August 2020 Theranova authorization announcement, Nipro's July and August 2026 ELISIO-HX releases, and Fresenius's 2025 and 2026 releases on the 5008X rollout.</p><p><br></p><p><strong>Physician-led, AI-assisted.</strong> Dr. Wael Hussein chooses the papers, reviews and edits every script, and approves every episode. The first draft is written with AI (Claude, by Anthropic) from the full text of each paper; a separate AI check compares every number with the papers; the hosts are AI voices (ElevenLabs). Everything is summarized in our own words; read the original before changing practice.</p><p><br></p><p>Educational content for healthcare professionals, not medical advice. Views are the creator's own and not those of his employer. No sponsors.</p><p><br></p><p><a href="https://nephspace.com">nephspace.com</a> · <a href="mailto:hello@nephspace.com">hello@nephspace.com</a></p>]]>
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        <![CDATA[<p>Two dialysis patients, same city, same week. One gets a new machine that filters and replaces more than 20 liters every session. The other gets the same old machine with a new filter. Both are told it's the future. Hemodiafiltration has a survival trial but needs new machines. Medium cutoff dialyzers drop into today's machines but have no survival evidence against standard dialysis. A detective story with a Fight Night verdict, including who makes, sells and funds each road.</p><p><br></p><p><strong>The takeaway:</strong> Both roads clear more middle molecules, but only hemodiafiltration has shown that people live longer, and only in patients who can get the dose.</p><p><br></p><p><strong>Disclosure:</strong> Dr. Hussein serves on the Fresenius Medical Care US Home Medical Advisory Board. Fresenius makes and sells the 5008X hemodiafiltration machine discussed in this episode. The episode names the industry ties of the review authors and of everyone quoted.</p><p><br></p><p><strong>Chapters</strong></p><ul><li>00:00 Cold open and disclosure</li><li>01:11 The mystery: what middle molecules are, and why clearing them might matter</li><li>02:47 Road one, change the treatment: CONVINCE, its quality-of-life and cost papers, and the JASN review</li><li>08:36 Road two, change the filter: Theranova, ELISIO-HX and the medium cutoff evidence</li><li>11:47 The showdown: MOTheR, the head-to-head trial</li><li>15:13 Follow the money: who makes, sells and funds each road</li><li>16:49 Fight Night verdict and the Monday-morning change</li></ul><p><br></p><p><strong>Papers discussed</strong></p><ul><li>Blankestijn PJ, et al. Hemodiafiltration: Clinical Practice of Today and a Look into the Future. JASN 2026 (ahead of print). <a href="https://doi.org/10.1681/ASN.0000001282">https://doi.org/10.1681/ASN.0000001282</a></li><li>Healio | Nephrology, September 24, 2026. Q&amp;A with DaVita's chief medical officer on medium cutoff dialyzers. <a href="https://www.healio.com/news/nephrology/20260924/qa-recent-fda-approval-prompts-expansion-of-medium-cutoff-dialyzers">https://www.healio.com/news/nephrology/20260924/qa-recent-fda-approval-prompts-expansion-of-medium-cutoff-dialyzers</a></li><li>Blankestijn PJ, et al. Effect of Hemodiafiltration or Hemodialysis on Mortality in Kidney Failure (CONVINCE). N Engl J Med 2023;389:700-709. <a href="https://doi.org/10.1056/NEJMoa2304820">https://doi.org/10.1056/NEJMoa2304820</a></li><li>Rose M, et al. CONVINCE quality-of-life results. Kidney Int 2024;106:961-971. <a href="https://doi.org/10.1016/j.kint.2024.07.014">https://doi.org/10.1016/j.kint.2024.07.014</a></li><li>Schouten AEM, et al. CONVINCE cost-utility analysis. Kidney Int 2025;107:728-739. <a href="https://doi.org/10.1016/j.kint.2024.12.018">https://doi.org/10.1016/j.kint.2024.12.018</a></li><li>Vernooij RWM, et al. Haemodiafiltration versus haemodialysis for kidney failure: an individual patient data meta-analysis of randomised controlled trials. Lancet 2024;404:1742-1749 (abstract only). <a href="https://doi.org/10.1016/S0140-6736(24)01859-2">https://doi.org/10.1016/S0140-6736(24)01859-2</a></li><li>Kandi M, et al. Clinical Outcomes With Medium Cut-Off Versus High-Flux Hemodialysis Membranes: A Systematic Review and Meta-Analysis. Can J Kidney Health Dis 2022;9. <a href="https://doi.org/10.1177/20543581211067087">https://doi.org/10.1177/20543581211067087</a></li><li>MOTheR trial (Theranova expanded hemodialysis vs online hemodiafiltration), presented at the ERA Congress, June 2026, not yet peer-reviewed. Healio, June 18, 2026. <a href="https://www.healio.com/news/nephrology/20260618/expanded-hemodialysis-noninferior-to-online-hemodiafiltration">https://www.healio.com/news/nephrology/20260618/expanded-hemodialysis-noninferior-to-online-hemodiafiltration</a></li><li>National Kidney Foundation. Medium Cut-Off Dialyzers for Expanded Hemodialysis: A Clinical Update. <a href="https://www.kidney.org/professionals/medium-cut-dialyzers-expanded-hemodialysis">https://www.kidney.org/professionals/medium-cut-dialyzers-expanded-hemodialysis</a></li></ul><p><br></p><p><strong>Company and provider statements cited (promotional sources, labeled as such on air)</strong></p><ul><li>Vantive, June 8, 2026 (MOTheR and CONCORDIA). <a href="https://www.globenewswire.com/news-release/2026/06/08/3308370/0/en/vantive-highlights-late-breaking-high-clinical-impact-data-at-era-indicating-hdx-therapy-is-a-practical-alternative-to-online-hemodiafiltration.html">https://www.globenewswire.com/news-release/2026/06/08/3308370/0/en/vantive-highlights-late-breaking-high-clinical-impact-data-at-era-indicating-hdx-therapy-is-a-practical-alternative-to-online-hemodiafiltration.html</a></li><li>Fresenius Medical Care, June 2026, "High-Volume Hemodiafiltration Remains the Benchmark for Survival Evidence in Dialysis". <a href="https://freseniusmedicalcare.com/en/media/insights/blog/high-volume-hemodiafiltration-remains-the-benchmark-for-survival/">https://freseniusmedicalcare.com/en/media/insights/blog/high-volume-hemodiafiltration-remains-the-benchmark-for-survival/</a></li><li>DaVita newsroom, August 5, 2026. <a href="https://newsroom.davita.com/davita-scales-expanded-hd-to-target-middle-molecules/">https://newsroom.davita.com/davita-scales-expanded-hd-to-target-middle-molecules/</a></li><li>U.S. Renal Care, July 30, 2026. <a href="https://www.prnewswire.com/news-releases/us-renal-care-drives-innovation-in-dialysis-with-increased-availability-of-medium-cut-off-dialyzers-to-support-expanded-hemodialysis-302839595.html">https://www.prnewswire.com/news-releases/us-renal-care-drives-innovation-in-dialysis-with-increased-availability-of-medium-cut-off-dialyzers-to-support-expanded-hemodialysis-302839595.html</a></li><li>Healio perspective, February 24, 2026, "Middle molecule moment" (Chan and Sonti). <a href="https://www.healio.com/news/nephrology/20260224/middle-molecule-moment-hemodiafiltration-and-expanded-hemodialysis-transform-us-dialysis">https://www.healio.com/news/nephrology/20260224/middle-molecule-moment-hemodiafiltration-and-expanded-hemodialysis-transform-us-dialysis</a></li></ul><p>Also cited by name: Baxter's August 2020 Theranova authorization announcement, Nipro's July and August 2026 ELISIO-HX releases, and Fresenius's 2025 and 2026 releases on the 5008X rollout.</p><p><br></p><p><strong>Physician-led, AI-assisted.</strong> Dr. Wael Hussein chooses the papers, reviews and edits every script, and approves every episode. The first draft is written with AI (Claude, by Anthropic) from the full text of each paper; a separate AI check compares every number with the papers; the hosts are AI voices (ElevenLabs). Everything is summarized in our own words; read the original before changing practice.</p><p><br></p><p>Educational content for healthcare professionals, not medical advice. Views are the creator's own and not those of his employer. No sponsors.</p><p><br></p><p><a href="https://nephspace.com">nephspace.com</a> · <a href="mailto:hello@nephspace.com">hello@nephspace.com</a></p>]]>
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      <pubDate>Thu, 01 Oct 2026 19:34:24 -0500</pubDate>
      <author>Wael Hussein</author>
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        <![CDATA[<p>Two dialysis patients, same city, same week. One gets a new machine that filters and replaces more than 20 liters every session. The other gets the same old machine with a new filter. Both are told it's the future. Hemodiafiltration has a survival trial but needs new machines. Medium cutoff dialyzers drop into today's machines but have no survival evidence against standard dialysis. A detective story with a Fight Night verdict, including who makes, sells and funds each road.</p><p><br></p><p><strong>The takeaway:</strong> Both roads clear more middle molecules, but only hemodiafiltration has shown that people live longer, and only in patients who can get the dose.</p><p><br></p><p><strong>Disclosure:</strong> Dr. Hussein serves on the Fresenius Medical Care US Home Medical Advisory Board. Fresenius makes and sells the 5008X hemodiafiltration machine discussed in this episode. The episode names the industry ties of the review authors and of everyone quoted.</p><p><br></p><p><strong>Chapters</strong></p><ul><li>00:00 Cold open and disclosure</li><li>01:11 The mystery: what middle molecules are, and why clearing them might matter</li><li>02:47 Road one, change the treatment: CONVINCE, its quality-of-life and cost papers, and the JASN review</li><li>08:36 Road two, change the filter: Theranova, ELISIO-HX and the medium cutoff evidence</li><li>11:47 The showdown: MOTheR, the head-to-head trial</li><li>15:13 Follow the money: who makes, sells and funds each road</li><li>16:49 Fight Night verdict and the Monday-morning change</li></ul><p><br></p><p><strong>Papers discussed</strong></p><ul><li>Blankestijn PJ, et al. Hemodiafiltration: Clinical Practice of Today and a Look into the Future. JASN 2026 (ahead of print). <a href="https://doi.org/10.1681/ASN.0000001282">https://doi.org/10.1681/ASN.0000001282</a></li><li>Healio | Nephrology, September 24, 2026. Q&amp;A with DaVita's chief medical officer on medium cutoff dialyzers. <a href="https://www.healio.com/news/nephrology/20260924/qa-recent-fda-approval-prompts-expansion-of-medium-cutoff-dialyzers">https://www.healio.com/news/nephrology/20260924/qa-recent-fda-approval-prompts-expansion-of-medium-cutoff-dialyzers</a></li><li>Blankestijn PJ, et al. Effect of Hemodiafiltration or Hemodialysis on Mortality in Kidney Failure (CONVINCE). N Engl J Med 2023;389:700-709. <a href="https://doi.org/10.1056/NEJMoa2304820">https://doi.org/10.1056/NEJMoa2304820</a></li><li>Rose M, et al. CONVINCE quality-of-life results. Kidney Int 2024;106:961-971. <a href="https://doi.org/10.1016/j.kint.2024.07.014">https://doi.org/10.1016/j.kint.2024.07.014</a></li><li>Schouten AEM, et al. CONVINCE cost-utility analysis. Kidney Int 2025;107:728-739. <a href="https://doi.org/10.1016/j.kint.2024.12.018">https://doi.org/10.1016/j.kint.2024.12.018</a></li><li>Vernooij RWM, et al. Haemodiafiltration versus haemodialysis for kidney failure: an individual patient data meta-analysis of randomised controlled trials. Lancet 2024;404:1742-1749 (abstract only). <a href="https://doi.org/10.1016/S0140-6736(24)01859-2">https://doi.org/10.1016/S0140-6736(24)01859-2</a></li><li>Kandi M, et al. Clinical Outcomes With Medium Cut-Off Versus High-Flux Hemodialysis Membranes: A Systematic Review and Meta-Analysis. Can J Kidney Health Dis 2022;9. <a href="https://doi.org/10.1177/20543581211067087">https://doi.org/10.1177/20543581211067087</a></li><li>MOTheR trial (Theranova expanded hemodialysis vs online hemodiafiltration), presented at the ERA Congress, June 2026, not yet peer-reviewed. Healio, June 18, 2026. <a href="https://www.healio.com/news/nephrology/20260618/expanded-hemodialysis-noninferior-to-online-hemodiafiltration">https://www.healio.com/news/nephrology/20260618/expanded-hemodialysis-noninferior-to-online-hemodiafiltration</a></li><li>National Kidney Foundation. Medium Cut-Off Dialyzers for Expanded Hemodialysis: A Clinical Update. <a href="https://www.kidney.org/professionals/medium-cut-dialyzers-expanded-hemodialysis">https://www.kidney.org/professionals/medium-cut-dialyzers-expanded-hemodialysis</a></li></ul><p><br></p><p><strong>Company and provider statements cited (promotional sources, labeled as such on air)</strong></p><ul><li>Vantive, June 8, 2026 (MOTheR and CONCORDIA). <a href="https://www.globenewswire.com/news-release/2026/06/08/3308370/0/en/vantive-highlights-late-breaking-high-clinical-impact-data-at-era-indicating-hdx-therapy-is-a-practical-alternative-to-online-hemodiafiltration.html">https://www.globenewswire.com/news-release/2026/06/08/3308370/0/en/vantive-highlights-late-breaking-high-clinical-impact-data-at-era-indicating-hdx-therapy-is-a-practical-alternative-to-online-hemodiafiltration.html</a></li><li>Fresenius Medical Care, June 2026, "High-Volume Hemodiafiltration Remains the Benchmark for Survival Evidence in Dialysis". <a href="https://freseniusmedicalcare.com/en/media/insights/blog/high-volume-hemodiafiltration-remains-the-benchmark-for-survival/">https://freseniusmedicalcare.com/en/media/insights/blog/high-volume-hemodiafiltration-remains-the-benchmark-for-survival/</a></li><li>DaVita newsroom, August 5, 2026. <a href="https://newsroom.davita.com/davita-scales-expanded-hd-to-target-middle-molecules/">https://newsroom.davita.com/davita-scales-expanded-hd-to-target-middle-molecules/</a></li><li>U.S. Renal Care, July 30, 2026. <a href="https://www.prnewswire.com/news-releases/us-renal-care-drives-innovation-in-dialysis-with-increased-availability-of-medium-cut-off-dialyzers-to-support-expanded-hemodialysis-302839595.html">https://www.prnewswire.com/news-releases/us-renal-care-drives-innovation-in-dialysis-with-increased-availability-of-medium-cut-off-dialyzers-to-support-expanded-hemodialysis-302839595.html</a></li><li>Healio perspective, February 24, 2026, "Middle molecule moment" (Chan and Sonti). <a href="https://www.healio.com/news/nephrology/20260224/middle-molecule-moment-hemodiafiltration-and-expanded-hemodialysis-transform-us-dialysis">https://www.healio.com/news/nephrology/20260224/middle-molecule-moment-hemodiafiltration-and-expanded-hemodialysis-transform-us-dialysis</a></li></ul><p>Also cited by name: Baxter's August 2020 Theranova authorization announcement, Nipro's July and August 2026 ELISIO-HX releases, and Fresenius's 2025 and 2026 releases on the 5008X rollout.</p><p><br></p><p><strong>Physician-led, AI-assisted.</strong> Dr. Wael Hussein chooses the papers, reviews and edits every script, and approves every episode. The first draft is written with AI (Claude, by Anthropic) from the full text of each paper; a separate AI check compares every number with the papers; the hosts are AI voices (ElevenLabs). Everything is summarized in our own words; read the original before changing practice.</p><p><br></p><p>Educational content for healthcare professionals, not medical advice. Views are the creator's own and not those of his employer. No sponsors.</p><p><br></p><p><a href="https://nephspace.com">nephspace.com</a> · <a href="mailto:hello@nephspace.com">hello@nephspace.com</a></p>]]>
      </itunes:summary>
      <itunes:keywords>nephrology, kidney, dialysis, CKD, nephrology fellows, medical education, journal club</itunes:keywords>
      <itunes:explicit>No</itunes:explicit>
      <podcast:chapters url="https://share.transistor.fm/s/5b3a2d4e/chapters.json" type="application/json+chapters"/>
    </item>
    <item>
      <title>Weekly · Oct 2: The Middle-Molecule Race, a Dipstick Adherence Check, and AI for Fellows</title>
      <itunes:episode>1</itunes:episode>
      <podcast:episode>1</podcast:episode>
      <itunes:title>Weekly · Oct 2: The Middle-Molecule Race, a Dipstick Adherence Check, and AI for Fellows</itunes:title>
      <itunes:episodeType>full</itunes:episodeType>
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      <description>
        <![CDATA[<p>Two ways to clear more middle molecules arrive in US dialysis units at once. A urine dipstick can show whether patients are taking their SGLT2 inhibitor. Two papers disagree about who should let AI write the notes. Nine picks from the week of September 21, 2026, each with the story, the numbers and a take.</p><p><br></p><p><strong>Disclosure:</strong> Dr. Hussein serves on the Fresenius Medical Care US Home Medical Advisory Board. Fresenius sells hemodiafiltration machines, which are discussed in this episode.</p><p><br></p><p><strong>Chapters</strong></p><ul><li>00:00 Cold open and running order</li><li>01:10 Hemodiafiltration: a JASN review makes the case for high-volume HDF as the global default, and how to prescribe it</li><li>05:06 Medium cutoff dialyzers: Nipro's ELISIO-HX is cleared in the US and DaVita is scaling it up. What the interview shows, and what it doesn't</li><li>08:13 Obinutuzumab: FDA approval for preventing relapse in frequently relapsing or steroid-dependent childhood-onset nephrotic syndrome, from age 2 into adulthood</li><li>11:08 Nephrology and CKM syndrome: an AJKD perspective on shifting the specialty from organ failure to prevention</li><li>13:59 Atherosclerosis in CKD: a CJASN review of mechanisms, risk prediction and the treatment menu</li><li>17:54 GLP-1 receptor agonists in CKD: a case-based CJASN "How I Treat" piece</li><li>21:03 The dipstick adherence check: glucosuria on routine urinalysis as a marker that patients are taking their SGLT2 inhibitor</li><li>24:31 AI in practice: where AI can take paperwork off the nephrologist's desk</li><li>27:44 Fellows and AI: training for the AI era without "never-skilling"</li><li>30:24 Close</li></ul><p><br></p><p><strong>Papers and news in this episode</strong></p><ul><li>Blankestijn PJ, et al. Hemodiafiltration: Clinical Practice of Today and a Look into the Future. JASN 2026 (ahead of print). <a href="https://doi.org/10.1681/ASN.0000001282">https://doi.org/10.1681/ASN.0000001282</a></li><li>Healio | Nephrology, September 24, 2026. Q&amp;A with DaVita's chief medical officer: recent FDA approval prompts expansion of medium cutoff dialyzers. <a href="https://www.healio.com/news/nephrology/20260924/qa-recent-fda-approval-prompts-expansion-of-medium-cutoff-dialyzers">https://www.healio.com/news/nephrology/20260924/qa-recent-fda-approval-prompts-expansion-of-medium-cutoff-dialyzers</a></li><li>Healio | Nephrology, September 25, 2026. FDA approves obinutuzumab (Gazyva) for idiopathic nephrotic syndrome. Background in this segment also came from FDA-approval coverage in Contemporary Pediatrics and HCPLive and from Genentech's trial release, not only from the Healio report. <a href="https://www.healio.com/news/nephrology/20260925/fda-approves-gazyva-for-idiopathic-nephrotic-syndrome-in-pediatric-patients">https://www.healio.com/news/nephrology/20260925/fda-approves-gazyva-for-idiopathic-nephrotic-syndrome-in-pediatric-patients</a></li><li>Sridhar VS, Levin A. AJKD perspective on the nephrologist's role in cardiovascular-kidney-metabolic syndrome. AJKD 2026 (ahead of print). <a href="https://www.ajkd.org/article/S0272-6386(26)01125-X/fulltext">https://www.ajkd.org/article/S0272-6386(26)01125-X/fulltext</a></li><li>Correa S, Cuningham JW, Mc Causland FR. Atherosclerotic Cardiovascular Disease in CKD: Contemporary Insights into Pathogenesis, Diagnosis, and Management. CJASN 2026 (ahead of print). <a href="https://doi.org/10.2215/CJN.0000001199">https://doi.org/10.2215/CJN.0000001199</a></li><li>Cheung DS. GLP-1 Receptor Agonists in CKD: A Case-Based Discussion of Translating Evidence into Practice. CJASN 2026 (ahead of print). <a href="https://doi.org/10.2215/CJN.0000001252">https://doi.org/10.2215/CJN.0000001252</a></li><li>Li Z, et al. Glucosuria as a Marker of Adherence to Sodium-Glucose Cotransporter 2 Inhibitors and Clinical Outcomes in Real-World Practice. JASN 2026 (ahead of print). <a href="https://doi.org/10.1681/ASN.0000001252">https://doi.org/10.1681/ASN.0000001252</a></li><li>Aiumtrakul N, Thongprayoon C, Cheungpasitporn W. Artificial Intelligence in Nephrology Practice: Practical Pathways to Improve Efficiency. Kidney360 2026 (ahead of print, open access). <a href="https://journals.lww.com/kidney360/fulltext/10.34067/kid.0000001424~artificial-intelligence-in-nephrology-practice-practical">https://journals.lww.com/kidney360/fulltext/10.34067/kid.0000001424~artificial-intelligence-in-nephrology-practice-practical</a></li><li>Fong JMN, Wang AYM. Equipping Nephrology Fellows with the Knowledge, Skills, and Attitudes for the Artificial Intelligence Era. CJASN 2026 (ahead of print). <a href="https://doi.org/10.2215/CJN.0000001239">https://doi.org/10.2215/CJN.0000001239</a></li></ul><p><br></p><p><strong>Physician-led, AI-assisted.</strong> Dr. Wael Hussein chooses the papers, reviews and edits every script, and approves every episode. The first draft is written with AI (Claude, by Anthropic) from the full text of each paper; a separate AI check compares every number with the papers; the hosts are AI voices (ElevenLabs). Everything is summarized in our own words; read the original before changing practice.</p><p><br></p><p>Educational content for healthcare professionals, not medical advice. Views are the creator's own and not those of his employer. No sponsors.</p><p><br></p><p><a href="https://nephspace.com">nephspace.com</a> · <a href="mailto:hello@nephspace.com">hello@nephspace.com</a></p>]]>
      </description>
      <content:encoded>
        <![CDATA[<p>Two ways to clear more middle molecules arrive in US dialysis units at once. A urine dipstick can show whether patients are taking their SGLT2 inhibitor. Two papers disagree about who should let AI write the notes. Nine picks from the week of September 21, 2026, each with the story, the numbers and a take.</p><p><br></p><p><strong>Disclosure:</strong> Dr. Hussein serves on the Fresenius Medical Care US Home Medical Advisory Board. Fresenius sells hemodiafiltration machines, which are discussed in this episode.</p><p><br></p><p><strong>Chapters</strong></p><ul><li>00:00 Cold open and running order</li><li>01:10 Hemodiafiltration: a JASN review makes the case for high-volume HDF as the global default, and how to prescribe it</li><li>05:06 Medium cutoff dialyzers: Nipro's ELISIO-HX is cleared in the US and DaVita is scaling it up. What the interview shows, and what it doesn't</li><li>08:13 Obinutuzumab: FDA approval for preventing relapse in frequently relapsing or steroid-dependent childhood-onset nephrotic syndrome, from age 2 into adulthood</li><li>11:08 Nephrology and CKM syndrome: an AJKD perspective on shifting the specialty from organ failure to prevention</li><li>13:59 Atherosclerosis in CKD: a CJASN review of mechanisms, risk prediction and the treatment menu</li><li>17:54 GLP-1 receptor agonists in CKD: a case-based CJASN "How I Treat" piece</li><li>21:03 The dipstick adherence check: glucosuria on routine urinalysis as a marker that patients are taking their SGLT2 inhibitor</li><li>24:31 AI in practice: where AI can take paperwork off the nephrologist's desk</li><li>27:44 Fellows and AI: training for the AI era without "never-skilling"</li><li>30:24 Close</li></ul><p><br></p><p><strong>Papers and news in this episode</strong></p><ul><li>Blankestijn PJ, et al. Hemodiafiltration: Clinical Practice of Today and a Look into the Future. JASN 2026 (ahead of print). <a href="https://doi.org/10.1681/ASN.0000001282">https://doi.org/10.1681/ASN.0000001282</a></li><li>Healio | Nephrology, September 24, 2026. Q&amp;A with DaVita's chief medical officer: recent FDA approval prompts expansion of medium cutoff dialyzers. <a href="https://www.healio.com/news/nephrology/20260924/qa-recent-fda-approval-prompts-expansion-of-medium-cutoff-dialyzers">https://www.healio.com/news/nephrology/20260924/qa-recent-fda-approval-prompts-expansion-of-medium-cutoff-dialyzers</a></li><li>Healio | Nephrology, September 25, 2026. FDA approves obinutuzumab (Gazyva) for idiopathic nephrotic syndrome. Background in this segment also came from FDA-approval coverage in Contemporary Pediatrics and HCPLive and from Genentech's trial release, not only from the Healio report. <a href="https://www.healio.com/news/nephrology/20260925/fda-approves-gazyva-for-idiopathic-nephrotic-syndrome-in-pediatric-patients">https://www.healio.com/news/nephrology/20260925/fda-approves-gazyva-for-idiopathic-nephrotic-syndrome-in-pediatric-patients</a></li><li>Sridhar VS, Levin A. AJKD perspective on the nephrologist's role in cardiovascular-kidney-metabolic syndrome. AJKD 2026 (ahead of print). <a href="https://www.ajkd.org/article/S0272-6386(26)01125-X/fulltext">https://www.ajkd.org/article/S0272-6386(26)01125-X/fulltext</a></li><li>Correa S, Cuningham JW, Mc Causland FR. Atherosclerotic Cardiovascular Disease in CKD: Contemporary Insights into Pathogenesis, Diagnosis, and Management. CJASN 2026 (ahead of print). <a href="https://doi.org/10.2215/CJN.0000001199">https://doi.org/10.2215/CJN.0000001199</a></li><li>Cheung DS. GLP-1 Receptor Agonists in CKD: A Case-Based Discussion of Translating Evidence into Practice. CJASN 2026 (ahead of print). <a href="https://doi.org/10.2215/CJN.0000001252">https://doi.org/10.2215/CJN.0000001252</a></li><li>Li Z, et al. Glucosuria as a Marker of Adherence to Sodium-Glucose Cotransporter 2 Inhibitors and Clinical Outcomes in Real-World Practice. JASN 2026 (ahead of print). <a href="https://doi.org/10.1681/ASN.0000001252">https://doi.org/10.1681/ASN.0000001252</a></li><li>Aiumtrakul N, Thongprayoon C, Cheungpasitporn W. Artificial Intelligence in Nephrology Practice: Practical Pathways to Improve Efficiency. Kidney360 2026 (ahead of print, open access). <a href="https://journals.lww.com/kidney360/fulltext/10.34067/kid.0000001424~artificial-intelligence-in-nephrology-practice-practical">https://journals.lww.com/kidney360/fulltext/10.34067/kid.0000001424~artificial-intelligence-in-nephrology-practice-practical</a></li><li>Fong JMN, Wang AYM. Equipping Nephrology Fellows with the Knowledge, Skills, and Attitudes for the Artificial Intelligence Era. CJASN 2026 (ahead of print). <a href="https://doi.org/10.2215/CJN.0000001239">https://doi.org/10.2215/CJN.0000001239</a></li></ul><p><br></p><p><strong>Physician-led, AI-assisted.</strong> Dr. Wael Hussein chooses the papers, reviews and edits every script, and approves every episode. The first draft is written with AI (Claude, by Anthropic) from the full text of each paper; a separate AI check compares every number with the papers; the hosts are AI voices (ElevenLabs). Everything is summarized in our own words; read the original before changing practice.</p><p><br></p><p>Educational content for healthcare professionals, not medical advice. Views are the creator's own and not those of his employer. No sponsors.</p><p><br></p><p><a href="https://nephspace.com">nephspace.com</a> · <a href="mailto:hello@nephspace.com">hello@nephspace.com</a></p>]]>
      </content:encoded>
      <pubDate>Thu, 01 Oct 2026 19:32:24 -0500</pubDate>
      <author>Wael Hussein</author>
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      <itunes:author>Wael Hussein</itunes:author>
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      <itunes:duration>1856</itunes:duration>
      <itunes:summary>
        <![CDATA[<p>Two ways to clear more middle molecules arrive in US dialysis units at once. A urine dipstick can show whether patients are taking their SGLT2 inhibitor. Two papers disagree about who should let AI write the notes. Nine picks from the week of September 21, 2026, each with the story, the numbers and a take.</p><p><br></p><p><strong>Disclosure:</strong> Dr. Hussein serves on the Fresenius Medical Care US Home Medical Advisory Board. Fresenius sells hemodiafiltration machines, which are discussed in this episode.</p><p><br></p><p><strong>Chapters</strong></p><ul><li>00:00 Cold open and running order</li><li>01:10 Hemodiafiltration: a JASN review makes the case for high-volume HDF as the global default, and how to prescribe it</li><li>05:06 Medium cutoff dialyzers: Nipro's ELISIO-HX is cleared in the US and DaVita is scaling it up. What the interview shows, and what it doesn't</li><li>08:13 Obinutuzumab: FDA approval for preventing relapse in frequently relapsing or steroid-dependent childhood-onset nephrotic syndrome, from age 2 into adulthood</li><li>11:08 Nephrology and CKM syndrome: an AJKD perspective on shifting the specialty from organ failure to prevention</li><li>13:59 Atherosclerosis in CKD: a CJASN review of mechanisms, risk prediction and the treatment menu</li><li>17:54 GLP-1 receptor agonists in CKD: a case-based CJASN "How I Treat" piece</li><li>21:03 The dipstick adherence check: glucosuria on routine urinalysis as a marker that patients are taking their SGLT2 inhibitor</li><li>24:31 AI in practice: where AI can take paperwork off the nephrologist's desk</li><li>27:44 Fellows and AI: training for the AI era without "never-skilling"</li><li>30:24 Close</li></ul><p><br></p><p><strong>Papers and news in this episode</strong></p><ul><li>Blankestijn PJ, et al. Hemodiafiltration: Clinical Practice of Today and a Look into the Future. JASN 2026 (ahead of print). <a href="https://doi.org/10.1681/ASN.0000001282">https://doi.org/10.1681/ASN.0000001282</a></li><li>Healio | Nephrology, September 24, 2026. Q&amp;A with DaVita's chief medical officer: recent FDA approval prompts expansion of medium cutoff dialyzers. <a href="https://www.healio.com/news/nephrology/20260924/qa-recent-fda-approval-prompts-expansion-of-medium-cutoff-dialyzers">https://www.healio.com/news/nephrology/20260924/qa-recent-fda-approval-prompts-expansion-of-medium-cutoff-dialyzers</a></li><li>Healio | Nephrology, September 25, 2026. FDA approves obinutuzumab (Gazyva) for idiopathic nephrotic syndrome. Background in this segment also came from FDA-approval coverage in Contemporary Pediatrics and HCPLive and from Genentech's trial release, not only from the Healio report. <a href="https://www.healio.com/news/nephrology/20260925/fda-approves-gazyva-for-idiopathic-nephrotic-syndrome-in-pediatric-patients">https://www.healio.com/news/nephrology/20260925/fda-approves-gazyva-for-idiopathic-nephrotic-syndrome-in-pediatric-patients</a></li><li>Sridhar VS, Levin A. AJKD perspective on the nephrologist's role in cardiovascular-kidney-metabolic syndrome. AJKD 2026 (ahead of print). <a href="https://www.ajkd.org/article/S0272-6386(26)01125-X/fulltext">https://www.ajkd.org/article/S0272-6386(26)01125-X/fulltext</a></li><li>Correa S, Cuningham JW, Mc Causland FR. Atherosclerotic Cardiovascular Disease in CKD: Contemporary Insights into Pathogenesis, Diagnosis, and Management. CJASN 2026 (ahead of print). <a href="https://doi.org/10.2215/CJN.0000001199">https://doi.org/10.2215/CJN.0000001199</a></li><li>Cheung DS. GLP-1 Receptor Agonists in CKD: A Case-Based Discussion of Translating Evidence into Practice. CJASN 2026 (ahead of print). <a href="https://doi.org/10.2215/CJN.0000001252">https://doi.org/10.2215/CJN.0000001252</a></li><li>Li Z, et al. Glucosuria as a Marker of Adherence to Sodium-Glucose Cotransporter 2 Inhibitors and Clinical Outcomes in Real-World Practice. JASN 2026 (ahead of print). <a href="https://doi.org/10.1681/ASN.0000001252">https://doi.org/10.1681/ASN.0000001252</a></li><li>Aiumtrakul N, Thongprayoon C, Cheungpasitporn W. Artificial Intelligence in Nephrology Practice: Practical Pathways to Improve Efficiency. Kidney360 2026 (ahead of print, open access). <a href="https://journals.lww.com/kidney360/fulltext/10.34067/kid.0000001424~artificial-intelligence-in-nephrology-practice-practical">https://journals.lww.com/kidney360/fulltext/10.34067/kid.0000001424~artificial-intelligence-in-nephrology-practice-practical</a></li><li>Fong JMN, Wang AYM. Equipping Nephrology Fellows with the Knowledge, Skills, and Attitudes for the Artificial Intelligence Era. CJASN 2026 (ahead of print). <a href="https://doi.org/10.2215/CJN.0000001239">https://doi.org/10.2215/CJN.0000001239</a></li></ul><p><br></p><p><strong>Physician-led, AI-assisted.</strong> Dr. Wael Hussein chooses the papers, reviews and edits every script, and approves every episode. The first draft is written with AI (Claude, by Anthropic) from the full text of each paper; a separate AI check compares every number with the papers; the hosts are AI voices (ElevenLabs). Everything is summarized in our own words; read the original before changing practice.</p><p><br></p><p>Educational content for healthcare professionals, not medical advice. Views are the creator's own and not those of his employer. No sponsors.</p><p><br></p><p><a href="https://nephspace.com">nephspace.com</a> · <a href="mailto:hello@nephspace.com">hello@nephspace.com</a></p>]]>
      </itunes:summary>
      <itunes:keywords>nephrology, kidney, dialysis, CKD, nephrology fellows, medical education, journal club</itunes:keywords>
      <itunes:explicit>No</itunes:explicit>
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