Kidney Week 2025 Annual Meeting-High-Impact Clinical Trials

Video Transcription

Video Summary

This high-impact clinical trials session at ASN featured several major nephrology studies.<br /><br />The PISCES trial tested daily fish oil (4 g EPA/DHA) versus corn oil placebo in 1,228 maintenance hemodialysis patients across Canada and Australia. Over 3.5 years, fish oil significantly reduced the rate of serious cardiovascular events (MI, stroke, peripheral vascular disease requiring amputation, and cardiovascular death) by about 40%, with consistent benefit regardless of prior cardiovascular disease. Secondary outcomes were generally favorable, adherence was supported by measured increases in EPA/DHA levels, and bleeding rates were similar between groups. The discussant praised the first large dialysis trial showing cardiovascular risk reduction but urged confirmation in larger studies and noted limited all-cause mortality impact and U.S. access issues.<br /><br />The LIBERATED trial addressed stopping dialysis in severe AKI requiring dialysis. In 218 analyzed patients, a “conservative” strategy (dialysis only for specific metabolic/clinical triggers) versus routine thrice-weekly dialysis increased recovery at discharge (64% vs 51%) and shortened time to recovery, without clear safety differences, though adjusted analyses were less definitive.<br /><br />A Yale trial tested individual treatment effect (uplift) modeling to target AKI electronic alerts. Among ~2,000 patients, targeted alert allocation did not improve AKI progression/dialysis/mortality, though readmissions and nephrology consults were lower.<br /><br />The OPTIMIZED transplant trial in recipients >65 found low-dose tacrolimus plus everolimus did not improve a composite “successful transplantation” outcome versus standard tacrolimus plus mycophenolate; outcomes were good in both arms.<br /><br />A SMART-C meta-analysis of eight SGLT2 inhibitor trials showed kidney and hospitalization benefits were similar regardless of diabetes or albuminuria above/below 200 mg/g, supporting broader guideline recommendations.<br /><br />Finally, SURPASS-CVOT kidney analyses suggested tirzepatide versus dulaglutide reduced composite kidney events and slowed eGFR decline in high-risk CKD subgroups, with more GI side effects but similar serious adverse events.

Asset Subtitle

Moderator(s): Meg Jardine, Akinlou Ojo

Presentation(s):

Protection Against Incidences of Serious Cardiovascular Events Study with Daily Fish Oil Supplementation in Patients on Dialysis (PISCES) - Charmaine Lok
Discussant + Q&A - David Charytan
LIBERation from AcuTE Dialysis (LIBERATE-D) - Kathleen Liu, Chi-yuan Hsu
Individual Treatment Effect Modeling for AKI Alerts: A Randomized Trial - Laura Aponte Becerra
Randomized Clinical Trial in Older Adult Kidney Transplant Recipients Comparing Everolimus and Reduced-Dose Tacrolimus with Mycophenolate and Tacrolimus Immunosuppression: The OPTIMIZE Study - Stefan Berger
Net Effects of SGLT2 Inhibitors by Diabetes Status and Albuminuria - Natalie Staplin
Tirzepatide vs. Dulaglutide Is Associated with Reduced Major Kidney Events in Patients with Type 2 Diabetes, CVD, and Very High-Risk Kidney Diseases - Sophia Zoungas

Note: Continuing education credits are not being offered for this session.

Meta Tag

Date 11/7/2025

Pathway 1 Other

Session ID 525616

Keywords

ASN clinical trials

PISCES trial

fish oil EPA DHA

maintenance hemodialysis

cardiovascular events reduction

LIBERATED trial

acute kidney injury dialysis discontinuation

conservative dialysis strategy

AKI electronic alerts

individual treatment effect modeling

OPTIMIZED transplant trial

tacrolimus everolimus regimen

SGLT2 inhibitor meta-analysis SMART-C

SURPASS-CVOT tirzepatide kidney outcomes