Matthew Weir, MD: An Exciting Time in Nephrology

During the American Society of Nephrology (ASN) Kidney Week in Washington, D.C., Matthew Weir, MD, director of the Division of Nephrology in the Department of Medicine at the University of Maryland Hospital, explained in an interview with MD Magazine® the current state of nephrology and what some of the highlights of the meeting were.

MD Magazine: On the right balance of dosing in nephrology.

Weir: Well, the decisions about ESA dosing obvious are predicated in large part on where you want to stabilize the hemoglobin level. Typically, we target 10 to 11, but often we make multiple adjustments throughout the clinical course of the patient without fully realizing that many of the adjustments may not even be necessary.

And often people will choose doses of ESAs based on maybe distance from goal. So, if your hemoglobin is 8 and you want to have them 10.5 you might give them a larger dose.

Or if it's 7.5 and you really want to get them up to it. But again, we found that it really didn't matter if you gave low dose, consistent dosing in iron replete patients it really did not make a difference.

MD Magazine: On major advances in treatment in recent years.

Weir: I think things are remarkably improving from a clinical therapeutic standpoint.

I mean there's so many new opportunities, whether it's using SGLT2 inhibitors in people with diabetic kidney disease, the advent of hip stimulators or prolyl hydroxylase inhibitors for people with anemia due to chronic kidney disease, the development of new monoclonal for example for treating ANCA vasculitis.

I mean there are just so many opportunities that are opening up now with the development of newer products and opportunities. I think this is probably 1 of the more exciting ASN meetings I've been to in a number of years with regard to in a sense the new opportunities.

MD Magazine: What has been the buzz at Kidney Week?

Weir: I think most of the buzz that I have heard from a clinical translational standpoint probably centers on the use of SGLT2 inhibitors for people with diabetic kidney disease as well as also for those with heart failure with reduced ejection fraction.

I think also the hip stimulators prolyl hydroxylase inhibitors really making some inroads in terms of their clinical trials and reporting out efficacy and safety.

I think there's a lot more conversation now about using for example some of the newer potassium binders to facilitate the use of optimum guideline-based renin-angiotensin system blockade in people with kidney disease and heart failure.

They're really many therapeutic areas where you know substantial efforts are being made to improve the overall quality of care especially with newer therapeutic agents but even newer diagnostic agents.