ASN in 2009: Directions and Advances

Educational Programs

Renal Week

The members of the Program Committee (chaired by Raymond C. Harris, MD, FASN) and the Postgraduate Education Committee (chaired by Mark E. Rosenberg, MD, who is also ASN Renal Week Education Director) developed clinical and basic science symposia as well as clinical nephrology conferences that address key issues in kidney biology and disease.

Four featured topics will be highlighted at this year’s meeting: epithelial transport and cell biology; renal immunology and transplantation; glomerular structure and function; and kidney development and stem cells. Each day’s program provides a number of choices designed to appeal to a broad spectrum of clinical and scientific interests.

A vital part of the education at Renal Week 2009 is available in the ASN Scientific Exposition. The exposition enhances the understanding of the latest advancements in pharmaceuticals, devices, imaging, and services that are needed to help provide high quality patient care. ASN provides an unparalleled international venue for the demonstration of products and services supporting kidney care. The ASN Scientific Exposition is also the venue for the display of well over 3000 basic, clinical, and educational research posters during the course of the annual meeting.

ASN has consolidated participant resources into “ASN Services.” ASN Services will be located in the exposition hall and will include the cyber center; general Renal Week information; information about continuing medical education (CME) credits and maintenance of certification (MOC) points; ASN membership support; Career Center; and ASN publication material including CJASN, JASN, ASN Kidney News, and NephSAP.

The newest addition to the ASN Renal Week exposition hall is the exhibitor spotlight. ASN has built a special theater in the hall to spotlight some of the advances in nephrology practices, products, services, and technologies during 30-minute presentations.

ASN has moved toward producing less waste. Continuing a practice started last year, the Clinical Nephrology Conferences (CNC) syllabus will produce an electronic, online-only publication. This year, the traditional “Abstract Issue” of JASN will only be available in an electronic edition. These changes will afford attendees easy access to these valuable educational resources, any time and any place, and support a “greener” Renal Week.

Renal WeekEnds

ASN held six Renal WeekEnds in 2009. Under the leadership of Renal WeekEnds Education Director Jerry Yee, MD, FASN, these meetings provided an exceptional review of key topics presented during Renal Week 2008 in Philadelphia. Locations included Chicago, Dallas, Miami, New York, San Francisco, and Washington, DC.

New this year: an Acute Kidney Injury session, a “Meet-the-Professor” pre-dinner reception providing attendees a chance to spend one-on-one time with faculty, and the ability to download lectures from the program after the conclusion of the six meetings.

In 2010, ASN will hold Renal WeekEnds in six cities (Atlanta, Chicago, Dallas, Los Angeles, New York, and Washington, DC) and produce an online version of the program.

Annual Board Review Course & Update (BRCU)

After a national search, ASN selected John M. Burkart, MD, and Mark A. Pohl, MD, as BRCU Co-Education Directors, succeeding Patrick T. Murray, MD, FASN. New in 2009, BRCU topic sections and time allocations were redesigned after the American Board of Internal Medicine (ABIM) nephrology examination blueprint. Lectures, interactive case discussions, and panel Q&A sessions were integral parts of the 2009 program. Relevant physiology and pathophysiology blended with clinical discussions to prepare participants for ABIM examinations.

For the first time, ASN will offer to its members an online version of BRCU, scheduled to launch in January 2010. This web-based product is a valuable resource for those unable to attend the BRCU live activity. The online program includes presentations from the meeting, audio recordings of the lectures, and the option to complete the practice final exam. This program is offered for CME credit.

Communications and Publications

Journal of the American Society of Nephrology

The leading kidney journal in the world, the Journal of the American Society of Nephrology (JASN) is the highest-ranked journal in urology and nephrology, according to the latest Thomson/ISI impact factor ratings. The JASN impact factor increased to 7.505. Led by Editor-in-Chief Eric G. Neilson, MD, JASN averages 144,897 monthly website visitors viewing 330,270 page titles.

Under Dr. Neilson’s leadership, JASN continues to forge new ground with innovative approaches to content and journal design, enhanced quality and readability, and new features including Brief Reviews, Occasional Observations, JASN Debates, Science in Renal Medicine, Pathophysiology of the Renal Biopsy, and Clinical Commentaries.

Clinical Journal of the American Society of Nephrology

Led by Editor-in-Chief William M. Bennett, MD, the Clinical Journal of the American Society of Nephrology (CJASN) continued its rapid ascent as the primary resource for breaking clinical nephrology studies, nearly doubling its impact factor from 2.236 to 4.361—a 95 percent increase. Despite its recent entry in the market, CJASN already ranks seventh in urology and nephrology.

CJASN transitioned to a monthly publishing schedule in January. Also, for the second year in a row, CJASN increased original manuscript submissions by 35 percent.

New features include the “Hall of Fame” series, which highlights the seminal contributions of nephrologists, and “Biology of Renal Disease: Laboratory to Clinic,” which debuted in July with an article on microRNAs. This series updates clinicians on advances in basic science with a focus on transition of research findings to the clinic setting.

Nephrology Self-Assessment Program

The Nephrology Self-Assessment Program (NephSAP) continues to provide ASN members with CME credits and MOC points through print and online formats. New in 2009, the program is available in a podcast format (Audio NephSAP). With 15,000 online visits and 5500 subscribers (and counting) to its podcast during the first six months of 2009, NephSAP’s page is the second most popular on the Society’s website. Editor-in-Chief Stanley Goldfarb, MD, FASN, and Editor Jeffrey S. Berns, MD, FASN, also added interventional nephrology, renal pharmacology, and primary care medicine for the nephrologist to the list of topics published on a two-year schedule.

ASN Kidney News

In January 2009, ASN Kidney News debuted as the premier news publication for kidney specialists with Pascale H. Lane, MD, FASN, as its Editor-in-Chief. Published every other month, the society’s newsmagazine analyzes research findings, policy changes, and emerging trends in industry, medicine, and training that impact practitioners in kidney health and disease. Issues examined include new conditions for coverage of dialysis, a proposed system for allocating kidneys for transplantation, factors driving students toward (or away from) careers in nephrology, and the impact the changing workforce will have on patient care and the advancement of the field.

ASN Kidney News Podcasts debuted in May 2009, and their online home is currently the most popular page on the ASN website, with over 30,500 downloads in the first three months. The ASN Kidney News Podcast will evolve in 2010 with content created from the newsmagazine, JASN, CJASN, the ASN Public Policy Board, and the general medical community.

The Indian edition of ASN Kidney News debuted in July; the publication compiles articles from previous editions of ASN Kidney News for nephrologists and other medical professionals in India.

ASN Kidney News will begin monthly publication in 2010. Online material to supplement the printed magazine will continue to evolve through the coming year, including a website and discussion forums.

Kidney Daily

ASN Kidney Daily—an exclusive service to the Society’s members that compiles breaking news from journals, newspapers, and other sources into a daily email—continues to be popular among members, with a daily open rate (percentage of members who read the briefing daily) that exceeds the industry average for comparable news briefings. Among ASN members, 25–30 percent consistently read Kidney Daily.

Press Promotion

During the past year, ASN communications staff members improved press promotion efforts to better identify studies that promote important clinical and research findings and address public interests in compelling ways. In addition, ASN highlighted its signal achievements, such as developing the first geriatric nephrology curriculum and initiating the ASN podcast program.

In advance of Renal Week, staff members worked with program committee members and other ASN leaders to identify newsworthy items, cutting-edge advances in nephrology, and an expanded list of experts to speak to the media.

Policy

Since 2006, ASN has significantly expanded its work representing the Society’s members on the most important issues in kidney care, research, and education. This year, ASN has focused on reforming health care, implementing the kidney care provisions in the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008, increasing research funding, and expanding educational programs for nephrology fellows and other ASN members.

Reforming Health Care

To help improve care for patients with kidney disease, ASN monitors all current health care legislation. Such legislation addresses comparative-effectiveness research and proposed policies specific to kidney care: follow-on biologics (biosimilars), immunosuppressive drug coverage, and bundling for end stage renal disease (ESRD). The ASN Public Policy Board developed an ASN ESRD/Health Care Reform Task Force to support appropriate legislation for kidney disease patients and providers, with special focus on ESRD.

Like ESRD bundling, the patient-centered medical home (PCMH) concept has received substantial attention from lawmakers. ASN formed a PCMH Task Force to study the issue and generated a report that included four in-depth case study scenarios involving renal patients (published in JASN in April 2009). Additionally, Thomas D. DuBose, Jr., MD, FASN, Chair of the Society’s PCMH Task Force, participates in the American College of Physicians’ Council of Subspecialty Societies PCMH workgroup.

Implementing MIPPA

Since the U.S. Congress approved MIPPA in 2008, ASN and other renal organizations, including the Kidney Care Partners (KCP), have worked to develop recommendations for implementing MIPPA provisions on ESRD. ASN staff and leaders serve on two KCP committees that oversee policy and implementation for payment and quality issues.

First, the KCP Payment Committee addresses MIPPA payment issues related to the scope of services, items in the ESRD bundle, and how to establish the unit of payment. Second, the KCP Quality Committee maintains responsibility for all MIPPA quality issues, such as identifying appropriate measures for the law’s ESRD quality program. KCP Payment and Quality Committees collaborate to address application of mandated “quality incentive” payment reductions.

In March 2009, KCP approved its first recommendation on new Medicare prospective payment system (PPS) elements for an expanded bundle. Such recommendations will enable the nephrology community to respond quickly to a proposed rule from the Centers for Medicare and Medicaid Services (CMS) on MIPPA, or a potential standalone ESRD bundled payment rule.

ASN met with CMS earlier this year to discuss potential education benefits and other ESRD-related issues and participated in a stakeholders’ meeting on the topic convened by the Agency for Healthcare Research and Quality (AHRQ) in December 2008. At the AHRQ meeting, participants examined ESRD education issues: criteria for diagnosis of stage IV chronic kidney disease (CKD), appropriate modalities to include in educational sessions (such as frequency and duration), existing programs, resources, and best practices.

Increasing Research Funding

ASN in 2009 advocated to Congress to increase National Institutes of Diabetes and Digestive and Kidney Diseases (NIDDK) funding commensurate with the growth of the National Institutes of Health (NIH). The Society also advocated to boost funding for basic research on the major causes of kidney disease, particularly diabetes, hypertension, aging, and obesity. ASN informed legislators about key studies aimed at improving mortality statistics in patients with kidney disease, including those treated for failure by dialysis.

Additionally, ASN recommended expanding loan-repayment programs for physician-scientists, promoted more funding for health disparities research and increased support for underrepresented minority investigators. The Society provided key information to legislators about disease-specific registries and clinical trial networks that might bridge the gap from bench to bedside. Similarly, ASN supported funding of the AHRQ comparative effectiveness research program, which received substantial resources under the economic stimulus package.

ASN advocated for $65 million in funding for the VA Medical and Prosthetic research program, to keep pace with inflation, support new programs for soldiers returning from Iraq and Afghanistan, advance genomic research, and maintain investigation into chronic disease and aging population health. Moreover, the Society recommended that Congress set aside $145 million for VA infrastructure improvements (long placed on hold due to internal competition for funds).

In March 2009, more than 20 members of ASN, its policy board, and staff traveled to Washington, DC, to commemorate World Kidney Day. Participants encouraged congressional representatives to support sustained NIH funding for kidney disease. Following World Kidney Day, Public Policy Board Chair Jonathan Himmelfarb, MD, FASN; ASN President Thomas Coffman, MD, FASN; and other leaders met with representatives from NIDDK; the National Heart, Lung, and Blood Institute (NHLBI); and the National Institute on Aging (NIA) to discuss the institutes’ focus on kidney disease and its associated co-morbidities.

As a result of these efforts, NHLBI representatives will consider the relationship between kidney disease and cardiovascular disease when designing clinical trials and discuss a future conference on the interrelationship between the two diseases. In August, NIA and NIDDK released two funding opportunity announcements (FOAs) on “Renal Function and Chronic Kidney Disease (CKD) in Aging.” The FOAs request research applications in “both animal models and in humans, addressing the etiology, pathophysiology, risk factors, consequences, prevention, or treatment of CKD in older patients.”

ASN organized a working group to revise the Society’s 2005 Renal Research Report for 2009. Led by John R. Sedor, MD, the group worked with ASN advisory groups, who unanimously voiced support for developing new disease biomarkers, imaging technologies, and a robust clinical trials infrastructure for management of kidney diseases. The working group summarized essential long-term research priorities for NIDDK, including development of cross-disciplinary and multicenter groups that collect data on new patient cohorts for comparative effectiveness and outcomes studies, and recommended that NIDDK optimize data-mining strategies.

Expanding Educational Programs

Leading the effort to increase ASN’s involvement with nephrology training, Donald E. Kohan, MD, PhD, FASN, this year became the first ASN Education Director for Fellowship Training. Dr. Kohan brought great energy to the position, and the Training Program Directors (TPDs) worked together to improve their programs and the education of nephrology fellows.

In May 2009, TPDs held a retreat in Chicago and shared insights on how to “survive” a site visit by the Accreditation Council for Graduate Medical Education (ACGME). A course for new TPDs included presentations on financing fellowship positions and how (and where) to file online reports.

ASN launched the In-Training Examination (ITE) for Nephrology Fellows. A task force led by Mitchell H. Rosner, MD, worked with the National Board of Medical Examiners to create a multiple choice test modeled after the ABIM’s certifying exam in nephrology. In April, 693 fellows completed the online ITE. Results show that participants gained tremendous insight into which subject areas they should focus on in the future. The exam will again take place April 8 and 9, 2010.

ASN also launched the first ever Online Curriculum in Geriatric Nephrology. Hosted on the ASN website, this curriculum presents 38 chapters covering all aspects of kidney disease in the elderly and is based on the six core competencies put forth by ACGME. It was supported by a grant from the Association of Specialty Professors.

In the spring of 2009, ASN conducted a survey of its fellow membership. Fellows provided information about their background and training and shared insights regarding the Society resources they find most useful. Among those fellows who responded, 92.6 percent were “very satisfied” or “somewhat satisfied” with the services provided by ASN, and 98.8 percent indicated they will continue ASN membership after completing their training. The information from the more than 400 respondents will help guide the efforts of the Society in 2010.

Continuing the ASN Public Policy Board in 2010

ASN will continue to advocate for improvements in patient care, research, and education related to kidney disease. After a national search, ASN selected Thomas H. Hostetter, MD, to succeed Jonathan Himmelfarb, MD, as Chair of the Society’s Public Policy Board. A former ASN President, Dr. Hostetter has served on the public policy board since its inception in 2006.

In addition, the Society has hired two new individuals to contribute to policy agendas that affect ASN members and advance patient care and kidney research. Reporting to ASN Director of Policy and Public Affairs Paul Smedberg, Rachel N. Shaffer will specialize in clinical and patient care issues, Christine Keersmaekers will focus on research, and Susan Owens will continue to address education issues.

Grants and Funding

After a national search, Detlef O. Schlondorff, MD, was selected this year as the new ASN Research Grants Program Director. Under the direction of Dr. Schlondorff, ASN received 63 career development applications—the highest number ASN has received since the inception of this program. ASN funds approximately 20 grants per year and provides nearly $3 million to support advances in clinical and basic research in kidney disease.

In 2009, the Society also funded 12 medical students to complete research in nephrology labs across the United States. ASN will support more than 300 trips for members to attend ASN Renal Week or other scientific meetings sponsored by other organizations in 2009, including a partnership with Boehringer Ingelheim to support fellows seeking to attend Renal Week.

All grant applications are now available online, providing a streamlined process for applicants and reviewers. Also, ASN has created a task force charged with “developing a vision for how ASN’s travel support programs help the Society accomplish its mission.”

Member Services

Membership

Continuing to expand its membership in 2009, ASN is on track to meet or exceed last year’s total of 11,000 members in 82 countries, with 68 percent of ASN members residing in the United States. Eighty-six percent of members have earned MDs (or equivalent), 15 percent have earned PhDs, and 10 percent of members hold both MD and PhD degrees. More than eight in 10 ASN members have an academic appointment, including both part- and full-time faculty members. Nearly 55 percent of members are involved in clinical research, and 45 percent are involved in laboratory research.

ASN continues to make joining and renewing membership easy by providing online membership renewal on the ASN website. ASN remains committed to increasing services for its members while providing membership at a low cost. To date, nearly 1000 ASN members have earned the distinction of becoming Fellows of ASN (FASN).

Web Services

During the first six months of 2009, the ASN website received 565,680 unique visits, a 32 percent increase over the same time period last year. Part of this increase results from new content on the website and activity on the ASN Career Center, viewed over 8000 times by members.

Building on an enhanced design and new infrastructure, ASN now offers several new publication supplements, including the Audio NephSAP Podcast, ASN Kidney News Podcast, and new educational offerings such as the Online Geriatric Nephrology Curriculum.

ASN expanded its web services to mobile devices by offering mobile-optimized and iPhone/iPod versions of the ASN website. These versions are formatted for easy viewing “on-the-go.” This upgrade ensures viewing compatibility across all browsers, contributing to ASN’s goal of making the website accessible to everyone including those with disabilities. In the future ASN will provide more web services and interactivity to ASN members, including calendar options for the upcoming Renal Week Program and further integration with ASN’s multimedia educational materials.

Finally, ASN Administrative Assistant Mark Kerlin was named ASN Information Services Coordinator. In this new role, Mr. Kerlin will advance the Society’s technological capabilities by providing technical support to help ASN members navigate the Society’s website, add content to the site, and help administer the ASN database.

Administration

ASN Council and Board of Advisors

The ASN Council repopulated most of the Society’s 26 committees, advisory groups, and other panels for 2010. More than 150 ASN members volunteered to fill open positions on these panels. Of those selected to fill positions, approximately one-third renewed terms, one-third were appointed, and one-third volunteered. In addition to existing panels, ASN created the Geriatric Nephrology Advisory Group, the Interventional Nephrology Advisory Group, and the Physiology and Cell Biology Advisory Group.

Consisting of the chairs of ASN’s committees, advisory groups, and other panels—as well as other key leaders (such as the editors-in-chief of the Society’s publications)—the ASN Board of Advisors (BOA) provides essential insights, advice, and counsel. To improve communications among BOA members, ASN staff created an email listserve for BOA members and provided a midyear report.

Notes

[1] With the input and support of its members, ASN continues to lead the fight against kidney disease. ASN provides the highest caliber and widest range of educational offerings, promotes and disseminates research, highlights clinical advances, and addresses the concerns that will most benefit patients.