Chest CT in this young woman with a history of smoking and chronic hypoxemia of unknown cause shows diffuse ground-glass opacities and some areas of peripheral consolidation with no basilar reticulations or honeycombing. Biopsy showed extensive alveolar filling with pigment-laden macrophages. What’s your diagnosis?

A young woman with progressive autosomal dominant PKD is seen for follow up. She had a recent infected kidney cyst. Except for a palpable right kidney, the exam is unremarkable. Labs show a decrease in eGFR from a year prior. She is on lisinopril. What is your approach to treatment now?

In a study of 256,288 individuals who tested positive for COVID-19 and had at least one risk factor for developing severe COVID, regardless of immunization, booster, or prior infection history, treatment with nirmatrelvir reduced rates of hospital admission or death at 30 days.

Key practice-changing points from the latest guidelines: • 1st line therapy is sacubitril plus valsartan, as this combination increases survival and reduces hospitalizations versus ACE inhibitors and ARBs.• ACE inhibitors should be used only in patients who cannot tolerate sacubitril-valsartan, and ARBs used only in those who cannot tolerate either the 1st- or 2nd-line recommended therapies.• Patients whose ejection fraction increases to more than 40% under therapy should continue to receive therapy.

In this target trial emulation involving nearly 44,000 patients with primary hyperparathyroidism (PHPT), similar declines in kidney function at 5 and 10 years were seen in patients managed with parathyroidectomy and in those managed nonoperatively. Thus, in this study, parathyroidectomy had no effect on long-term kidney function in older adults with PHPT.

This summary of a recent French study highlights that patients enabled to infuse apomorphine at home improved QoL more quickly and became more autonomous in managing the device compared with a hospital infusion group. The findings could be helpful to patients who would benefit from continuous subcutaneous apomorphine infusion (CSAI) but are deterred “by the wait for an appointment and the length of the subsequent hospital stay, as well as the physical distance from the nearest specialist center.”