The American Society of Nephrology Kidney Week 2026 convened in Denver from Oct. 21-25, drawing clinicians and researchers to discuss emerging data. Among the presenters, nephrologist Andrew A. Moses, MD of Northwell Health’s Lenox Hill Hospital offered commentary on several late-breaking abstracts, highlighting both promising advances and persistent gaps.
Prehabilitation and Exercise in Transplant Candidates
The randomized, 12-month trial titled Smart & Fit for Kidney Transplantation (S&F4KTx) examined a personalized pre-rehabilitation program for patients awaiting kidney transplants. Participants were assigned to an intensive, three-week inpatient regimen designed to boost skeletal muscle mass before surgery.
A three-week inpatient rehabilitation program is not simple and would be difficult to do for many patients, limiting its scalability in routine clinical settings.
Although the primary endpoint—improved transplant readiness—did not reach statistical significance, investigators reported a measurable increase in muscle mass among those who completed the program. Dr. Moses noted that the trial likely suffered from selection bias, as patients willing to enroll may differ from the broader wait-list population.
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In routine practice, Dr. Moses continues to refer all dialysis patients for physical therapy, observing that those who engage in regular exercise tend to fare better on the transplant list. He emphasized the need for a more accessible model, suggesting that a dialysis-unit-based program could be replicated on a larger scale.
Portable Hemodialysis Advances
Early results from the RENEW-HD trial presented data on the Neokidney portable hemodialysis system, a modern take on concepts dating back to the 1970s. The phase-1/2 study highlighted a sorbent-based filtration method with built-in exhaustion detection, and reported no serious adverse device events across the cohort.
Weighing in at 13 kg (28 lb), the device promises patient-controlled treatment at home or even while mobile. Dr. Moses raised practical questions about ultrafiltration tolerance, sorbent depletion, alarm reliability, and the logistical burden of supplying consumables such as dialysate bags outside well-funded centers.
The ATTACK trial evaluated aspirin for primary cardiovascular prevention in chronic kidney disease (CKD). Dr. Moses cautioned that CKD alone does not justify aspirin therapy. He stressed that clinicians must weigh disease stage, arterial calcification, existing ASCVD risk factors, and bleeding potential before prescribing preventive aspirin.
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High-Dose Vitamin D in Dialysis
During the meeting, a large trial evaluating high-dose cholecalciferol in dialysis patients was presented. The study enrolled a broad dialysis population without restricting enrollment to specific subgroups.
Results indicated no reduction in overall mortality, yet a subgroup analysis revealed fewer major cardiovascular events among participants who identified as non-white. Researchers described this observation as hypothesis-generating rather than practice-changing.
Consequently, the nephrologist expressed that vitamin D deficiency remains one of many factors affecting outcomes in dialysis. He indicated that additional trials focusing on patients with heightened mineral bone disease risk or raised cardiovascular risk could clarify the potential benefit.
Early eGFR Changes with Semaglutide
A subgroup analysis from the FLOW trial examined estimated glomerular filtration rate trends in the first twelve weeks of semaglutide therapy. Dr. Moses noted that early declines in eGFR may reflect volume depletion or inadequate hydration. In his practice, he routinely uses point-of-care ultrasound to evaluate volume status when serum creatinine rises after initiating a GLP-1 receptor agonist.
