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In patients with CKD and gout, acute flares should avoid NSAIDs and consider either dose-adjusted colchicine, oral steroids, or intra-articular steroids; for urate lowering, start low and go slow with allopurinol.
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Gout Management in Patients With CKD. Am J Kidney Dis. 2025 Jul 1:S0272-6386(25)00924-2. doi: 10.1053/j.ajkd.2025.04.020. Epub ahead of print. PMID: 40609855
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This CHEST review summarizes common considerations and pitfalls in pleural fluid analysis.
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Pleural Fluid Analysis: Maximizing Diagnostic Yield in the Pleural Effusion Evaluation. Chest. 2025 Jun 14:S0012-3692(25)00694-4. doi: 10.1016/j.chest.2025.06.001. Epub ahead of print. PMID: 40523559
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This American Diabetes Association (ADA) consensus report addresses how to improve screening and early intervention for metabolic-dysfunction-associated steatotic liver disease (MASLD) in patients with prediabetes or type 2 diabetes.
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Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) in People With Diabetes: The Need for Screening and Early Intervention. A Consensus Report of the American Diabetes Association. Diabetes Care. 2025 Jul 1;48(7):1057-1082. doi: 10.2337/dci24-0094. PMID: 40434108
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This meta-analysis suggests that patients with hypernatremia may have a mortality and length of stay benefit with a faster correction goal than current guidelines.
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Systematic review and meta-analysis of the treatment of hypernatremia in adult hospitalized patients: impact on mortality, morbidity, and treatment-related side effects. J Crit Care. 2025 Jun;87:155012. doi: 10.1016/j.jcrc.2024.155012. Epub 2025 Jan 6. PMID: 39765195
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This review outlines our current understanding of iron deficiency—with or without anemia—focusing on screening, accurate diagnosis, and treatment.
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Iron Deficiency in Adults: A Review. JAMA. 2025 May 27;333(20):1813-1823. doi: 10.1001/jama.2025.0452. PMID: 40159291
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A self-guided digital mental health intervention app significantly outperformed usual care in reducing depressive symptoms over 12 weeks.
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A Digital Depression Treatment Program for Adults Treated in Primary Care: A Randomized Clinical Trial. JAMA Intern Med. 2025 Jun 1;185(6):692-701. doi: 10.1001/jamainternmed.2025.0494. PMID: 40227715
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Glucagon-like peptide-1 receptor agonists (GLP1 agonists) are not conclusively linked to an increased risk of thyroid cancer in observational trials.
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Risk of Thyroid Tumors With GLP-1 Receptor Agonists: A Retrospective Cohort Study. Diabetes Care. 2025 Jun 4:dc250154. doi: 10.2337/dc25-0154. Epub ahead of print. PMID: 40465422
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GLP-1 receptor antagonists likely increase the risk of cholelithiasis and GERD when compared to placebo, but this meta-analysis of RCTs suggests that the risk of pancreatitis, cholecystitis, and intestinal obstruction may be lower than previous studies.
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Glucagon-Like Peptide-1 Receptor Agonists and Gastrointestinal Adverse Events: A Systematic Review and Meta-Analysis. Gastroenterology. 2025 Jun 9:S0016-5085(25)00845-5. doi: 10.1053/j.gastro.2025.06.003. Epub ahead of print. PMID: 40499738
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Oral semaglutide decreased major adverse cardiovascular events in patients with diabetes and cardiac comorbidities.
Source
Oral Semaglutide and Cardiovascular Outcomes in High-Risk Type 2 Diabetes. N Engl J Med. 2025 May 29;392(20):2001-2012. doi: 10.1056/NEJMoa2501006. Epub 2025 Mar 29. PMID: 40162642
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When starting a patient with gout on urate-lowering therapy, preferentially choose colchicine over NSAIDs for gout flare prophylaxis, since NSAIDs are associated with increased cardiovascular risk.
Source
Comparative Cardiovascular Safety of NSAID versus Colchicine Use When Initiating Urate-Lowering Therapy Among Patients with Gout: Target Trial Emulations. Arthritis Rheumatol. 2025 May 26. doi: 10.1002/art.43259. Epub ahead of print. PMID: 40415645