Clinician's Roundtable

Delayed diagnosis and limited treatment options have historically been barriers to optimal management of IgA nephropathy (IgAN), but that paradigm may be shifting. A paper published in Kidney International in April 2025 points out that significant nephron loss often occurs before diagnosis, making early, targeted treatment essential. The paper makes the case for lowering proteinuria thresholds, minimizing steroid use, and employing safer, more effective therapies in combination. Joining Dr. Charles Turck to discuss this developing approach to IgAN care is Dr. Jonathan Barratt, the Mayor Professor of Renal Medicine at the University of Leicester in the UK and a coauthor of the study.

Reference:

Floege J, Bernier-Jean A, Barratt J, Rovin B. Treatment of patients with IgA nephropathy: a call for a new paradigm. Kidney International. 2025;S0085-2538(25)00076-6.

IgA nephropathy (IgAN) has a decades-long progression that requires careful monitoring of key biomarkers to optimize management. Hematuria, proteinuria, and estimated glomerular filtration rate levels are all critical to tracking the progression of the disease, and understanding how they’re connected can not only improve prognostication but also guide earlier, more targeted interventions to preserve kidney function. Joining Dr. Gates Colbert to walk through these markers and their importance is Dr. Abdallah Geara. He's an Associate Professor of Clinical Medicine, Clinical Director of the Glomerular Diseases Program, and the Director of Onconephrology at Penn Medicine in Philadelphia.

Every moment counts when meningitis is suspected. To help reduce the risk of poor neurologic outcomes, Dr. Jessica Snowden is here to review age-based considerations that guide empiric antibiotic and antiviral choices—from neonatal infections acquired at delivery to risks in unvaccinated older children. Dr. Snowden is a Professor of Pediatrics and Vice Chancellor for Research at the University of Tennessee.

Despite the success of meningitis vaccination programs, pediatricians must remain vigilant as cases still occur and can be life-threatening if missed. That’s why Dr. Jessica Snowden joins us to share how we can identify subtle behavioral cues, understand age-specific presentations, and diagnose patients using the gold-standard approach of lumbar puncture and CSF analysis. Dr. Snowden is a Professor of Pediatrics and Vice Chancellor for Research at the University of Tennessee.

For dermatologists, treating psoriasis patients who use e-cigarettes can be challenging, particularly because of a lack of education about its risks, mental health concerns, and impacts on treatment efficacy. That being said, there are ways to address these challenges to support patients and improve outcomes. Join Dr. Joe Tung, a board-certified dermatologist who currently serves as the Medical Director of UPMC Falk Dermatology, Director of the Clinical Trials Unit, and Associate Director of the Dermatology Residency Program, as he discusses these barriers and potential solutions.

While cigarette smoking is known to be linked to psoriasis, it was unclear whether or not e-cigarette use also carries risk. To address this research gap, a recent study analyzed data from over 28,000 United States adults, and, after adjusting for potential confounding variables, found that there is a statistically significant association between e-cigarette use and psoriasis. Hear Dr. Joe Tung, a coauthor of the study, break down its design and results, as well as potential reasons for this connection. Dr. Tung is a board-certified dermatologist who currently serves as the Medical Director of UPMC Falk Dermatology, Director of the Clinical Trials Unit, and Associate Director of the Dermatology Residency Program.

Biologic therapies have helped significantly improve outcomes and quality of life for patients with psoriasis. With several IL-17 and IL-23 inhibitors now available, choosing between biologics often depends on the dermatologist’s experience, the patient’s needs, and potential side effects. Hear Dr. Robert Gniadecki, a Professor of Dermatology and the Director of the Division of Dermatology at the University of Alberta, discuss these treatment options and best practices for therapeutic decision-making.

In post-surgical wound management, multidisciplinary collaboration is key in minimizing readmissions, reducing infection risk, and improving healing outcomes. Hear from Dr. Karen Bauer as she highlights the importance of early specialist involvement, standardized protocols, and digital tools to improve both clinical outcomes and patient experiences. Dr. Bauer is a certified nurse practitioner and wound specialist at Emory Heart and Vascular Center in Atlanta.

Communication breakdowns during care transitions can compromise recovery—but they’re often preventable. Initiating multidisciplinary planning before surgery can help streamline post-surgical wound and skin management. Hear from Dr. Karen Bauer as she explains how how proactive use of care navigators, EMR tools, and tailored care pathways can strengthen coordination across settings and reduce risk during handoffs. Dr. Bauer is a certified nurse practitioner and wound specialist at Emory Heart and Vascular in Atlanta.

Gaps in patient education and care coordination after surgery often hinder postoperative wound recovery. Join Dr. Karen Bauer as she discusses the importance of health literacy, access, and evidence-based care algorithms in engaging patients and support systems across the continuum. Dr. Bauer is a certified nurse practitioner and wound specialist at Emory Heart and Vascular Center in Atlanta.