New kidney research, picked by a nephrologist and talked through out loud.
Each week, the papers and news worth your time: the story, the key numbers, why it matters, and what the study doesn't prove. Made for nephrologists, fellows and everyone in kidney care.
The Middle-Molecule Race, a Dipstick Adherence Check, and AI for Fellows
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.
Disclosure: Dr. Hussein serves on the Fresenius Medical Care US Home Medical Advisory Board. Fresenius sells hemodiafiltration machines, which are discussed in this episode.
Chapters and sources
Chapters
00:00 Cold open and running order
01:10 Hemodiafiltration: a JASN review makes the case for high-volume HDF as the global default, and how to prescribe it
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
08:13 Obinutuzumab: FDA approval for preventing relapse in frequently relapsing or steroid-dependent childhood-onset nephrotic syndrome, from age 2 into adulthood
11:08 Nephrology and CKM syndrome: an AJKD perspective on shifting the specialty from organ failure to prevention
13:59 Atherosclerosis in CKD: a CJASN review of mechanisms, risk prediction and the treatment menu
17:54 GLP-1 receptor agonists in CKD: a case-based CJASN "How I Treat" piece
21:03 The dipstick adherence check: glucosuria on routine urinalysis as a marker that patients are taking their SGLT2 inhibitor
24:31 AI in practice: where AI can take paperwork off the nephrologist's desk
27:44 Fellows and AI: training for the AI era without "never-skilling"
30:24 Close
Papers and news in this episode
Blankestijn PJ, et al. Hemodiafiltration: Clinical Practice of Today and a Look into the Future. JASN 2026 (ahead of print). doi.org
Healio | Nephrology, September 24, 2026. Q&A with DaVita's chief medical officer: recent FDA approval prompts expansion of medium cutoff dialyzers. www.healio.com
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. www.healio.com
Sridhar VS, Levin A. AJKD perspective on the nephrologist's role in cardiovascular-kidney-metabolic syndrome. AJKD 2026 (ahead of print). www.ajkd.org
Correa S, Cuningham JW, Mc Causland FR. Atherosclerotic Cardiovascular Disease in CKD: Contemporary Insights into Pathogenesis, Diagnosis, and Management. CJASN 2026 (ahead of print). doi.org
Cheung DS. GLP-1 Receptor Agonists in CKD: A Case-Based Discussion of Translating Evidence into Practice. CJASN 2026 (ahead of print). doi.org
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). doi.org
Aiumtrakul N, Thongprayoon C, Cheungpasitporn W. Artificial Intelligence in Nephrology Practice: Practical Pathways to Improve Efficiency. Kidney360 2026 (ahead of print, open access). journals.lww.com
Fong JMN, Wang AYM. Equipping Nephrology Fellows with the Knowledge, Skills, and Attitudes for the Artificial Intelligence Era. CJASN 2026 (ahead of print). doi.org
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.
The takeaway: Both roads clear more middle molecules, but only hemodiafiltration has shown that people live longer, and only in patients who can get the dose.
Disclosure: 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.
Chapters and sources
Chapters
00:00 Cold open and disclosure
01:11 The mystery: what middle molecules are, and why clearing them might matter
02:47 Road one, change the treatment: CONVINCE, its quality-of-life and cost papers, and the JASN review
08:36 Road two, change the filter: Theranova, ELISIO-HX and the medium cutoff evidence
11:47 The showdown: MOTheR, the head-to-head trial
15:13 Follow the money: who makes, sells and funds each road
16:49 Fight Night verdict and the Monday-morning change
Papers discussed
Blankestijn PJ, et al. Hemodiafiltration: Clinical Practice of Today and a Look into the Future. JASN 2026 (ahead of print). doi.org
Healio | Nephrology, September 24, 2026. Q&A with DaVita's chief medical officer on medium cutoff dialyzers. www.healio.com
Blankestijn PJ, et al. Effect of Hemodiafiltration or Hemodialysis on Mortality in Kidney Failure (CONVINCE). N Engl J Med 2023;389:700-709. doi.org
Rose M, et al. CONVINCE quality-of-life results. Kidney Int 2024;106:961-971. doi.org
Schouten AEM, et al. CONVINCE cost-utility analysis. Kidney Int 2025;107:728-739. doi.org
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). doi.org
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. doi.org
MOTheR trial (Theranova expanded hemodialysis vs online hemodiafiltration), presented at the ERA Congress, June 2026, not yet peer-reviewed. Healio, June 18, 2026. www.healio.com
National Kidney Foundation. Medium Cut-Off Dialyzers for Expanded Hemodialysis: A Clinical Update. www.kidney.org
Company and provider statements cited (promotional sources, labeled as such on air)
Healio perspective, February 24, 2026, "Middle molecule moment" (Chan and Sonti). www.healio.com
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.
Follow NephSpace in Spotify or Apple Podcasts and new episodes arrive on their own. Episodes have chapters, so you can skip straight to the paper you care about.
WeeklyThe literature update: the week's picks from the kidney journals, the big general journals and the specialty news.
Deep DiveIn between, one question in depth: two treatments racing for the same goal, a trial worth arguing about, a case a new paper answers.
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About
NephSpace started as one nephrologist's way to replace doom-scrolling with something worth the time: the week's new kidney research, in a form you can take on a run, a drive or the walk to clinic.
Each week Dr. Hussein goes through the new issues and ahead-of-print articles, picks the papers and news that matter, and edits every script himself before anything is recorded. Two hosts then talk each pick through the way colleagues would: what was asked, what was found, the numbers that matter, and an honest take on what it does and doesn't change.
The aim is to be curious, evenhanded and never condescending, for nephrologists, nephrology fellows and kidney-care clinicians alike.
About the host
Dr. Wael Hussein is an academic nephrologist in Memphis. Before returning to academic practice he led clinical research at Satellite Healthcare, a nonprofit dialysis provider, as Chief Medical Officer for Research and Development. He trained in nephrology in Ireland and at Stanford, holds an MBA and an MSc in health informatics, and has published widely in peer-reviewed journals.
Questions, corrections and paper suggestions are welcome at hello@nephspace.com.
How it's made
NephSpace is physician-led and AI-assisted. Dr. Hussein is the show's editor: he decides what is covered, reviews and edits every script, and signs off on every episode. AI tools help him draft, check and voice it.
Dr. Hussein chooses. He goes through the week's new literature and picks every paper and news item.
AI writes a first draft. The draft script is written with AI (Claude, by Anthropic) from the full text of each paper, not from press releases. Papers are summarized in our own words; abstracts and articles are not reproduced.
Every number is checked. A separate AI check compares each figure and claim in the draft with the papers.
Dr. Hussein reviews and edits. He reads the script against the papers and edits it for accuracy, emphasis and clinical relevance: correcting, cutting and rewriting until it says what he wants it to say.
AI voices record it. The two hosts are AI-generated voices (ElevenLabs), and so is the theme music.
Dr. Hussein signs off. He listens to the finished episode and sends back changes when something isn't right. Nothing is published without his approval.
Coming soon: Dr. Hussein in his own voice. Alongside the AI-voiced episodes, NephSpace will add reviews Dr. Hussein writes himself, and audio and video he records himself.
Every episode's notes link to the original papers. NephSpace is a way to keep up, not a substitute for reading the paper: read the original before changing practice.
Educational content for healthcare professionals, not medical advice. Views are the creator's own and not those of his employer.
Disclosures
Relevant disclosures, including Dr. Hussein's own, are stated with each episode: printed in the episode notes, and said on air when they bear on the topic.
How we handle potential conflicts of interest.
Competing approaches get an evenhanded hearing, with the evidence for each laid out side by side.
The industry ties of the papers' authors, and of anyone quoted, are named on air.
Company statements and press releases, when cited, are labeled as promotional sources.
