A pinch of salt - A podcast by ERA

In this episode, we step into the future of transplantation with Valentin Goutaudier. Discover how precision diagnostics and artificial intelligence are coming together to enable more personalised, proactive care for renal transplant recipients and what this means for the future of medicine.

In this episode, Karlien François helps us dismantle the barriers to Peritoneal Dialysis. From structural challenges to patient perceptions, she introduces a practical “solution toolbox” designed to make PD a more accessible and flexible therapy for CKD patients worldwide. It’s time to turn obstacles into opportunities.

In this episode, we explore the reality of clinical practice. It’s relatively easy to be a doctor when everything goes according to plan, but what happens when things get complicated? That’s where true experience comes into play. Join us as Sana F. Khan shares valuable insights on how to tackle Peritoneal Dialysis complications and build confidence in challenging situations.

In this very interesting episode with Thomas Wilkinson we talk about sarcopenia — its prevalence, the outcomes associated with it, the available tools for screening and assessment, the most effective interventions, and the importance of a multidisciplinary approach to care.

In this episode we’ll be talking to Tamara Jemcov, the current president of the Vascular Access Society, about novelties in the field of vascular access. If you haven’t checked out the programme from the last Vascular Access Congress which was held in 2025 Padova, you should take look. The field is really expanding and growing, and Tamara discussed the new approaches that were presented at the Congress. We also talked about the appropriate timing of vascular access construction, the immensely useful role of ultrasound in following fistulas and grafts and how it is possible for us to learn this relatively easily, tunnelled vs. non-tunnelled catheters and so on. Definitely worth listening to if you are not an expert in vascular access. 

In this episode we will be talking with Thomas Rimmele, an expert in treating acute kidney injury in the ICU, about the role of the new extracorporeal adsorption techniques in ICU patients. We’ll be discussing who are the candidates, when to start treatment, how long should a single session last, how long should we continue doing it, which parameters to check to see if we are successful or not and much, much more. If you are unsure on how to use these techniques to benefit the sickest of patients, this one is for you. 

In this episode of A pinch of salt we’ll be talking to Paul Cockwell about patient-reported outcomes in clinical practice. You may or may not be aware of these issues and their importance but one might argue, and we certainly would, that every doctor should be mindful of what their patients consider to be an important outcome and whether they are achieving it or not. Paul is a champion of this field, and he provided some very useful pointers on how a beginner in this field might get to know it and start working on these issues in his or her clinical practice. The SONG initiative will be mentioned, as well as a useful systematic review on symptom burden and health-related quality of life in CKD, and a shout out to a recent important paper published in CKJ (doi: 10.1093/ckj/sfaf112). Learn about the art of trying to meet the patients’ needs in this knowledge-packed episode. 

In this episode of A pinch of salt, we welcome Pierre Delanaye for a forward-looking discussion on how we should assess kidney function in 2026. Together, we explore the strengths and limits of today’s GFR equations (MDRD, CKD-EPI, cystatin C-based approaches), the promise of emerging biomarkers and AI-driven tools, and the crucial question of fairness and accuracy across diverse populations.

Join A pinch of salt, as we sit down with David Jayne to trace the rapid transformation of ANCA-associated vasculitis care. From the historic cyclophosphamide–glucocorticoid backbone to biologics like rituximab and newer targeted strategies such as complement inhibition (including avacopan), this episode unpacks how clinicians can balance efficacy, safety, and quality of life—while looking ahead to what may define the next decade of treatment. 

In this episode of A pinch of salt, Allon N. Friedman will talk about possibly the hottest topic in medicine at this moment – the treatment of obesity, with a particular focus on treating the CKD population. Obesity is finally being recognized as a disease and not merely an unfortunate, somewhat shameful consequence of personalities with weak minds and lack of willpower. But how do we treat it? Does changing lifestyle have any impact, should everybody start taking weight lowering medications, what about surgery? As always, we’ll be trying to provide you with some helpful clinical information that might help you and your patients in regular clinical practice.

In this episode of A pinch of salt, Shuchi Anand will talk about chronic kidney disease of unknown etiology, the mysterious kidney disease that is devastating some agricultural communities in hot environments. Dr Anand will talk about what might be causing this disease, does a kidney biopsy help, is it mandatory, and how to treat these patients both on the individual level and on the population level to tackle this disease locally and globally. Learn more about this true medical mystery, with stories from the literature and stories from the field. 

In this episode of A pinch of salt, Beatriz Sanchez Alamo will talk about tubulointerstitial nephritis (TIN), the Cinderella of nephrology, a beautiful and interesting topic that is not easily noticeable in congresses and webinars. Some recent data looking at long-term prognosis has shown that patients with TIN might have a long-term prognosis that is comparable to lupus nephritis and ANCA vasculitis. Are we ignoring TIN and if so, what should we be doing differently? In this episode we’ll be talking about diagnosis, new tests that might identify precisely the drug that is causing TIN, what the treatment and follow-up should be and much more. Dedicated to everybody and anybody who is not entirely glomerulocentric. 

In this episode we will be talking to Giovanni Tripepi, an expert in biostatistics. Medicine is not just an art but also a science grounded in biostatistics, which is why it is crucial to understand it in order to conduct and interpret research properly. In this episode you will hear about the most common mistakes made by medical researchers when planning a project, the most common mistakes when interpreting data, why a p-value below 0.05 is not always significant and a whole lot more. By the end you will understand statistics better and it won’t be painful at all. 

In this episode we will be talking to Luca Quartuccio, a rheumatologist and a renowned expert in cryoglobulinemia. You will hear about how we diagnose cryoglobulinemic vasculitis, whether we can have cryoglobulinemia without vasculitis, the types of cryoglobulinemia and their clinical significance, how to tackle secondary cryoglobulinemia with hepatitis C or B, first line therapy, the role of plasma exchange and maintenance therapy and much, much more. Dedicated to everybody who takes care of these difficult patients. 

In this episode we had the honor and privilege to talk to Camille Kotton, a world-renowned expert in BK nephropathy. The fabulous recent International Consensus Guidelines have been a breakthrough in this field, and we will talk about all the new approaches and recommendations described in them, including how to screen for BK nephropathy, how to act when screening is positive, when to do a biopsy, and different strategies of changing immunosuppression. We’ll also be talking about very difficult situations, like taking care of BK nephropathy in patients with high immunological risk and the odd case where a patient might have BK nephropathy and rejection at the same time. Be sure not to miss this gem of transplantation education.   

In this episode, Charles Ferro from Birmingham, United Kingdom, presents the ERA’s Strong Kidneys Task Force. Learn how this Task Force is raising global awareness about kidney health, building partnerships with national societies, and inspiring people to take care of their kidneys.

In this episode, we head to New Orleans, USA where Juan Carlos Q. Velez helps us unravel the mystery of hepatorenal syndrome. We’ll explore its mechanisms, the two distinct types, and evolving treatment strategies that might finally improve outcomes for patients with advanced liver disease.

In this episode, we chat with Alice Sabatino from the Karolinska Institute in Stockholm, Sweden about diet and hyperkalemia. How have new potassium binders and RAAS inhibitors changed the way we manage potassium? And do patients really need to cut out fruits and vegetables anymore? Alice shares practical diet tips and fresh insights from recent research.

Ivo Laranjinha and Susi Knöller from the ERA Sustainable Nephrology Task Force share insights on practical actions that can make a measurable difference in nephrology. By the end of the conversation, it became clear that green nephrology isn’t boring, it represents the opportunity of this generation.In this episode, we refer to an article featured in Clinical Kidney Journal (CKJ), you can find the link here.

In this episode we navigate another difficult disease to treat, that is antibody-mediated rejection of kidney transplants, a disease that currently has no effective standard treatment. Luckily, new therapy is on the horizon, and the sunrise will be coming soon. Georg Böhmig has been involved in most of the exciting new research done in this field and will inform us of all the novelties that are just around the corner.

In this episode we explore a very rare, but devastating disease called primary hyperoxaluria, which usually destroys the kidneys when patients are still very young and afterwards, the calcium oxalate crystals deposit in the bones, joints, vessel walls, the heart and other organs, leading to a dramatic shortening of life. Effectively the patient is slowly turning into stone. Justine Bacchetta, a world-renowned expert, will help us understand this disease and navigate the new and very effective therapies that have recently become available.  In this episode, we refer to an article featured in Nephrology Dialysis Transplantation (NDT), you can find the link here.

Jolanta Małyszko takes us through a condition that sits at the crossroads of hematology and nephrology. She explains how these protein abnormalities can quietly damage the kidneys, why early recognition is essential, and how collaboration between specialties can improve outcomes. 

In this episode we dive into the rapidly expanding world of onconephrology with Kenar D. Jhaveri. He explains the scope of this emerging subspecialty, identifies the top oncologic agents linked to kidney complications, and shares resources to help nephrologists stay ahead in this ever-changing field. 

Marieta Theodorakopoulou reveals why excess weight is a silent but powerful driver of chronic kidney disease. With obesity rates soaring, especially among younger generations, she guides us through the mechanisms of obesity-associated renal  lesions, how to tailor treatments for obese CKD patients, and what we know about the renal safety of anti-obesity drugs.

We have the honour to chat with David Cooper, a living legend in xenotransplantation, who has followed this field for over half a century. This is a captivating discussion about the evolution of xenotransplantation, exploring the scientific, ethical, and practical aspects of building this emerging ecosystem, a field we all observe with great curiosity and high expectations.

Ilaria Gandolfini, from the Department of Medicine and Surgery, University of Parma, Italy — not far from the ERA headquarters — unpacks the changing landscape of infection prophylaxis for renal transplant recipients in 2025. In this dense and informative episode, she highlights the current infectious challenges in renal transplantation, the emergence of new infectious risks, the development of novel treatment options, and reviews both prophylactic and preemptive strategies.

Christophe Mariat, from Saint-Étienne, France, and Chair of the ERA DESCaRTES Working Group, takes us through the complex topic of adapting anti-rejection treatment in the context of a failing renal graft. He shares valuable insights on renal graft survival rates, strategies for adjusting immunosuppressive treatments when the kidney starts failing, and the adaptations needed in antirejection strategies once dialysis is resumed.

Everything about atypical HUS is atypical, and frankly a bit annoying. The differential diagnosis is as wide as the ocean and when it comes to genetics, well that would make even a psychologically stable fellow nervous. Luckily, we’ve found help of the highest degree. Neil Sheerin has been tackling this animal for ages and has gotten to know all of its tricks and dirty plays. Tune in to our atypical HUS episode and gain the upper ground on this beast. Learn about diagnosis, lab testing, treatment, stopping treatment, genetics and transplantation in this easy-to-follow episode of A Pinch of Salt. You’ll see clearly now the pain is gone. 

We know, C3 glomerulopathy is a difficult subject. All this complement talk will make a person tired and slightly confused. Here’s your chance to discover this disease in an easy yet comprehensive and meaningful way. Marina Vivarelli, C3G-s enemy in chief, is going to share the most important information about this disease, everything from the pathophysiology and genetics, to diagnostics, differential diagnosis, the link between C3G and immune complex GN, treatment and so much more. And all of this explained in a way that even we could understand. You’ll C3. Dive in and find out for yourself.

Ever wanted to attend a master class on IgG4-related disease? Even if your answer is no, you still won’t want to miss this episode of A Pinch of Salt. John Stone, a world renowned expert in IgG4RD, is going to share all the clinically relevant details on how to diagnose IgG4RD, how to do the staging, how important is a biopsy, which lab tests to use to assess disease activity, how to treat these patients and how to assess the response to therapy. Everything you never knew you wanted to know about IgG4RD in one place. Your patients will be grateful. 

In this episode of A Pinch of Salt, you'll get the unique opportunity of trying to experience what it's actually like to be a dialysis patient, a kidney failure patient, what are the issues they're dealing with and how can we as physicians help them get through the day. I think it's one of the valuable opportunities that you really shouldn't miss because at the end of the day we really want to help them, don’t we? Listen to the episode with Malene Deele, a kidney failure patient, also chairman of the Danish Kidney Association.

We’re focusing on a challenging topic: anticoagulation in CKD patients with atrial fibrillation. With up to 25% of CKD patients affected, managing this common arrhythmia is no easy task. How do we balance stroke prevention and bleeding risks? What’s the role of DOACs versus vitamin K antagonists? And should dialysis patients even receive anticoagulation? Are there any new treatment options? To help us untangle these questions, we’re joined by Frida Welander from Karolinska University, Sweden, an expert on the field. Don’t miss this insightful discussion.

Steroids have long been a cornerstone in treating ANCA-associated vasculitis, but their toxicity remains a significant challenge. Could Avacopan, a selective oral C5a receptor antagonist, provide a safer and more effective alternative? In this episode, you’ll hear about what’s new in the pathophysiology of ANCA vasculitis, current remission induction therapies, the place of Avacopan in the treatment protocols and future possibilities for managing this complex condition. Guiding us through these topics is Lorraine Harper, a distinguished specialist from the University of Birmingham, whose expertise in immunology and vasculitis offers invaluable insights into the latest advancements. 

In this episode, we explore sex and gender disparities in the epidemiology and outcomes of chronic kidney disease. Did you know that women are less likely to receive a CKD diagnosis, visit a nephrologist, or access guideline-recommended therapies—even in developed countries?To help us unpack these critical issues, we're joined by Professor Adeera Levin, Head of the Division of Nephrology at the University of British Columbia in CanadaTogether, we’ll discuss the biological, societal, and systemic barriers driving these disparities and, more importantly, how we can overcome them. 

Today, we address a crucial and evolving topic: the Approach to Conservative Care for ESKD Patients. This area has garnered increasing attention at national and international levels, reflecting the need for better detection, diagnosis, and therapeutic strategies tailored to this growing patient population.We’re joined by Prof. Holly Koncicki, Associate Professor at Mount Sinai Health System, New York, USA, who will help us explore whether conservative care could be considered a legitimate therapeutic option for ESKD, how do we define and engage the target population and what tools and approaches can optimize conservative care delivery.

We’ve probably all noticed that our nurses have a different perspective of our patients than the one we do ourselves and maybe we can say that often their perspective is closer to what the patient is feeling, so it’s definitely a fresh outlook. We will be talking about this with Jeanette Finderup in our episode on the nurse’s perspective, where you can expect to hear about what she thinks the role of the nurse is, what she thinks the role of the nurse is not, and how we could collaborate for the benefit of our patients to provide them with the most comprehensive healthcare that we can.