A recent study published by the Clinical Journal of Nephrology (CJASN) found that employment was low among patients starting dialysis throughout the study period at 23% to 24%, and 38% of patients who were employed six months prior to being diagnosed with kidney failure stopped working by the time they initiated dialysis.

HuBMAP  aims to accelerate the development of the next generation of tools and techniques to generate 3D tissue maps through an open data platform established in partnership with other funding agencies, programs, and the biomedical research community.

2017 is drawing to a close, marking the end of a year that saw ASN Communities hit its stride within the nephrology social media landscape. Providing an interactive learning experience for nephrologists around the world has become the sites primary strength. Interacting on Communities reminds many practicing nephrologists of the iterative case conferences they had in residency. Both complicated and mundane discussions provide a springboard for nephrologists to finding their own answers and improving their own knowledge base.

"Salk scientists have created a new version of the CRISPR/Cas9 genome editing technology that allows them to activate genes without creating breaks in the DNA, potentially circumventing a major hurdle to using gene editing technologies to treat human diseases.

“Patients with type 2 diabetes and stage 3 or 4 chronic kidney disease who attended a joint endocrinologist-nephrologist diabetic kidney disease clinic were less likely to progress to end-stage renal disease after 3 years vs. similar patients seen at a diabetes center, according to findings from a nested, case-control study”.

At Kidney Week in New Orleans, I presented a session on the impact of growing stress and burnout in Nephrologists and how it might affect physician attitudes and behaviors toward patient care. The main point of my talk was to recognize how serious an issue physician dissatisfaction, stress, and burnout is, the causes and the barriers, and what can be done to help our physicians (and staff) better adjust to the pressures of today’s health care environment.

Let me explain.

See the full list of all Late-breaking clinical trials updated as they are released.

A peer-reviewed study from Taiwan released in the Public Library of Science (PLOS), concluded that “rosacea is an independent risk factor for CKD. High rosacea severity and old age further increased CKD risk in patients with rosacea".

Mike Spigler, vice president of patient services at the American Kidney Fund, said that it is an ‘extremely tenuous situation’ for the roughly 5,000 people on the island who rely on dialysis to stay alive. The dialysis centers need diesel fuel to power their generators and ‘a lot of them are down to a day or two of fuel’ he said”.

Reducing the number of breaches is paramount for protecting patients and physicians, yet remains an extremely challenging task.

The New York State Nurses Association “voted overwhelmingly in favor of the latest contract offer from Fresenius Medical Care” which provides NYSNA workers with “increased pay and protects their employer-paid union pension and health funds”.

“The new platform, operated by Ambra Health, uses the cloud to make all imaging such as X-rays, CT, MRI, etc. available to all 80 transplant centers across the country in real-time".

California Senate Bill 349, the Dialysis Patient Safety Act, which is an effort to better staff dialysis clinics in order to maintain safety standards for patients was amended on June 29th. It passed through the California Assembly Committee on Health and is now being considered by the California Assembly Appropriations Committee.

The National Institutes of Health’s (NIH) All of Us Research Program is collecting data from more than one million people to accelerate health research and medical innovation through precision medicine. This historic project aims to generate new knowledge with the goal of developing more effective therapies to treat diseases by leveraging the statistical power of a cohort of this size.

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Full contest guidelines and eligibility requirements are now available at

Indian Society of Nephrology

Female nephrologists are working to create a separate women’s charter within the Indian Society of Nephrology (ISN). They hope to serve the underrepresented number of female nephrologists throughout India.


An examination into potential effects of an older workforce on academic research by Kurtis Pivert, ASN"s Data Science Officer.


Becker's Hospital Review published this article about physician burnout and suggest hospitals are incorrectly engaging with the issue.

What's In; What's Out; What's Happening in Congress? ASN's Zach Cahill and David White provide this week's update.

Tax credits, Medicaid expansion, 5 principles outlined by the president -- Zach Cahill and David White keep you informed.

"Engagement hinges upon authenticity."

Clinical decision support systems: hindrance, help -- both?

Kidney News Online begins a series of interviews with nephrologists who trained in the United States as International Medical Graduates (IMGs). To launch this series, we turn to two brothers, Fahim and Naeem Rahim, nephrologists who have changed the landscape for kidney patients in southeastern Idaho.

ASN President Eleanor Lederer, MD, FASN talks with ASN Executive Vice President Tod Ibrahim about recent advances in nephrology, her career path, and music -- from the Grateful Dead to the Dandy Warhols to the Hives.



Dr. Avnish Seth recommends building exchanges between cornea and organ donation systems in India to increase opportunities for transplants.

One doctor notes that exhaustion doesn't stem from the patient load, but from "external factors like increased paperwork, insurance hassles, and ever-increasing regulation."

True interoperability? Not here yet. Added physician burden? That's definitely here.

True interoperability? Not here yet. Added physician burden? That's definitely here.

St. Louis Review article highlights work of Dr. Stuart Slavin and the SLU Medical School: making concrete changes to reduce depression rates and stress among medical students.

Also of interest:

Medical Students and Depression: Identifying the Causes

Some practical advice for rural practices transitioning to value-based payments, including focusing on population health.

"Dialysis and transplantation represent extraordinary therapeutic milestones.... However, many fellows and trainees are looking for new therapies comparable to what they see taking place in other fields."



"When I was a medical student, I suffered an episode of depression and refused to seek treatment for weeks. My fears about licensing applications were a major reason I kept quiet."

Harvard Medicine Magazine takes a close look at current transplant policy and the dead donor rule.

Nice summary of the MIPS benefits and pick-your-pace options from EMR and EHR.

KN Online MACRA resources here.

Terrific column by Christine Sinsky, MD on what is lost when physicians must spend so much time interacting with a computer screen.

This study found that cognitive changes occur early in CKD, and skills decline at different rates.


Does "publish or perish" pressure undermine -- or encourage -- quality?

Interesting perspective in Genetic Engineering News on recent gene editing advances by scientists in CHINA.

Also of interest:

KN Online resources on gene editing technologies

The Office of the Inspector General has noted ongoing weaknesses among healthcare organizations despite growth in ransomware attacks and other breaches.

A number of viral infections can result in glomerular damage, including a spectrum of lesions with differing pathogenetic mechanisms.

"There has been a dramatic shift in our understanding of potential patient outcomes following AKI."

The Australian government is assessing undergraduate medical slots: predictions indicate an excess number of doctors in cities, and a shortage in rural areas.

New payment models may require completely new approaches to data and outcomes management.

It's been one year since Wales launched presumed consent for organ donation; results so far are positive.

Premier Brad Wall hopes to bring presumed consent to Saskatchewan, and believes the province should serve as a model for the rest of Canada.

Doctors used to climbing the career ladder are used to saying "yes" -- in this AMA post, some suggestions for saying "no."

Physicians suffer higher-than-average rates of depression and suicide. Mayo Clinic study addresses what can be done from an organizational perspective to promote physician well being.

Don't miss Dr. Amit X. Garg, 2016 recipient of the ASN-AHA Young Investigator Award, presenting at Sunday's plenary (8:05 am W375C-E). Learn more about his research here.

Saturday's State-of-the-Art lecture features Ross L. Cagan, PhD; read about Dr. Cagan. 8:45 am W375C-E

Patients will help determine the future of kidney treatment. Kevin J. Fowler will present at 4:30 -- read his recent article on the patient voice in transplant care.

A closer look at the Health IT requirements associated with the MACRA final rule.

Kevin J Fowler, a recipient of a preemptive kidney transplant, discusses an FDA meeting focused on organ transplant recipients, and his insights regarding the value of the patient voice in improving care.


This article by Craig DeGarmo is the first in a series of perspectives from experts working to address disparities in faculty compensation, and improve approaches to faculty recruitment and retention.

ASN Data Science Officer Kurtis Pivert takes a look at a new survey of American physicians: regulatory and administrative pressures are taking a big bite out of the joy of practicing medicine.

Are young scientists facing undue pressure to publish and get funding? Is the system interfering with the science? A feature news article in Nature explores the landscape for young basic scientists.

ASN President Raymond C. Harris, MD, FASN comments on the concerns highlighted in this article:

Well-known healthcare CIO offers insights on making MACRA work for your practice and your patients.

Do PHPs help physicians, or does the US need to develop and implement standards for these programs?

Some physicians vote to unionize, voicing a desire for more negotiating authority re patient care.

Usability, functionality, helpful to patient care? EHR vendors are not scoring well.

Flawed tools, flawed research? Lack of reproducibility of some studies linked to custom-built antibodies.

Do electronic communications and web portals benefit or challenge physician/patient communications? Or both?

What can NRMP Match data tell us about specialty choice? ASN Data Science Officer Kurtis Pivert takes a look.


This survey of small practices in New Jersey indicates the small practice is not in danger of disappearing completely, especially for those who are embracing new technologies.

Are science and medicine on the verge of developing a two-tiered system of policies regarding private health information?

ASN President Raymond C. Harris, MD, FASN notes the profound contributions of nurses to advancing care of patients with kidney diseases.

ASN Data Science Officer Kurtis Pivert takes a look at the nephrologists' responses in the Medscape Young Physicians Compensation Report.

Dr. George Veletsianos, Canada Research Chair in Innovation and Technology, offers some practical advice regarding highlighting your research

The Indian Society of Organ Transplantation is trying to standardize the cost of transplants.

Match season is upon us. Take a look at the variety of careers in nephrology, and ASN's Match resources.

What opportunities, challenges and pressures will clinicians face under MACRA?

The Office of Research Integrity will always face criticism, but right now a good measure seems to be coming from inside.

The Office of Research Integrity will always face criticism, but right now a good measure seems to be coming from inside.

"Laughter doesn't mean you're not depressed." Physicians have higher rates of stress, and sucide risk, than the general public. 

doc ofc b w - Copy.jpg​"The way MACRA is structured now, the large practices will do well..."

EHRs: lagging too far behind available technology to be useful to patient care?

The new Editor-in-Chief of "Science" thinks scientists in the US are at risk of becoming just "another special interest group."

This perspective piece argues "the MACRA definition of interoperability is based on an aging IEEE statement from 1990 and that definition was never intended to describe the interoperability of health data records nor interoperation of EHR or HIT systems.”​

Do physicians in Australia need more oversight?

Doctoral degree but not a doctor -- interesting case from Canada highlighted in CMAJ.

Shifts in health care requirements will also affect physician compensation. Learn more about compensation models and how they may be affected by changing policies regarding value-based care.

"I believe all digital health tools that can improve the experience for patients must be deployed. They have a role, they add value, they improve the experience, and they make the healthcare seeking process more dignified. But I’d be kidding if I expect these tools today to give me the insights and clinical acumen that Dr. JK brought to bear during our consultation."

Some institutions are beginning to enact programs designed to better support medical residents as they begin their training.

Doctors and nurses employed by a health insurer -- is this model workable?

The International Committee of Medical Journal Editors says study data should be shared within six months of publication. Is that the best approach?

Employed physicians face sometimes interesting challenges balancing their individual approaches with organizational priorities.

Physician trainees and physicians experience higher-than-average levels of stress and depression. What can be done to expand support? Stethoscope - Copy.jpeg

Leveraging digital technologies for research may limit participant diversity.

Many clinics, including those without physicians leading them, are seeking "legitimacy by association." 

There are almost 400,000 hemodialysis patients just in the US, with a mortality rate approaching 50% at three years from the start of hemodialysis. Pragmatic trials, conducted under real-world conditions, may help improve routine care for these vulnerable patients. 

Are doctors "escalating care" to move patients up the list? Read this commentary by Matthew Movsesian, MD.

Will expanding requirements for IT infrastructure further reduce the number of independent practices?

Security protections for  patient health information don't seem to be keeping up with the dissemination of PHI.

The US Department of Health and Human Services has issued a report summarizing gaps in health data privacy and security. But is anything being done to close those gaps?

Survey says: Patients like their physicians, but are increasingly concerned about whether they can afford to see them.

Is cost sharing forcing some patients to delay care? The American College of Physicians issues recommendations regarding cost sharing and its potential effects on patient care.

“For the first time we’ll have some regularity in research funding in Greece,” says Nektarios Tavernarakis, director of the FORTH Institute of Molecular Biology and Biotechnology (IMBB).

Doctors are more likely than the general public to experience depression or take their own lives. Some medical institutions are working to make a difference.

Can doctors effectively assess a patient just by reviewing a file? Ontario's workers compensation board says yes.

Older researchers are applying more often than younger investigators. This Cell Stem Cell study addresses that among other factors influencing the aging of the average NIH funded independent investigator.

Health insurers say proposed mergers are an outcome of the Affordable Care Act. Opponents say the mergers will negatively impact quality and cost of care.

In this opinion piece Prof. Bernd Huber, President of LMU Munich and former Chair of the League of European Universities, addresses how research in Europe will be affected by the Brexit vote.

"As a physician, I can share the sense of loss that many feel as they mourn the passing of an era of independence....On the other hand, I celebrate the new direction toward more value and better outcomes for patients." 

"Even when residents recognize their stress and want to seek support or treatment, they may be discouraged by the professions's culture of stoicism...." This article from HopkinsMedicine discusses the challenges residents face, and potential approaches to better supporting trainees.

The Canadian Institutes of Health Research, the federal grant funding agency, cancelled in-person peer review of funding applications.

Is their new system broken, and what does that mean for scientists in Canada?

In this month's column, ASN President Raymond C. Harris, MD, FASN discusses initiatives that are changing the practice landscape in nephrology.

When I think back over the time that I have been in nephrology, I am struck by how many advances we have made in our understanding of kidney function and the pathogenesis of kidney disease.

Dr. Lilia Maria Rizo Topete (Monterrey, Mexico) shares one of her memorable training experiences.

Nephrologists have always been considered among the best educators in medicine. Our commitment to excellence in patient care and research extends to finding innovative ways to teach students, residents and fellows about some of the most complex (and interesting) issues physicians and scientists face. Nephrologists also provide complete care for a complex patient population in ways that most other specialties do not.

In celebration of ASN's 50th anniversary, a number of ASN leaders have taken the time to remember what it was like to attend their first ASN annual meeting. We will continue to update this section throughout the year, and encourage you to send in your recollections of your first ASN annual meeting ( 

During a discussion about the William and Sandra Bennett Clinical Scholars Program,  Dr. William Bennett asked Dr. Jane Schell,  the first recipient of the Bennett Scholars Grant, why she chose to go into nephrology. Their ensuing  discussion, including Dr. Bennett’s look back at very early dialysis care, is compelling and inspiring. 


Nephrology program directors lead the best, and most dedicated, educators in medicine. This is an exciting time of year as applicants and programs begin the match process.

Raymond C. Harris, MD, FASN is ASN’s 50th president. Each month, he will share his thoughts on items of interest to ASN members and others in the kidney community, and request your insights on specific issues.