Kidney Watch 2016

Kidney Watch 2016

As health care moves forward in defining a system of accountable and valued care, aligning health care cost inflation with overall economic growth, and ensuring access to appropriate evidence-based services for all, physicians are being called upon to break down many barriers to achieving accountable valued care. These include right-sizing our outsized delivery system, correcting unwarranted variations in care, decreasing unnecessary health care spending, and improving patient-centered outcomes.

Happy New Year from Kidney News. We are delighted to provide you comprehensive coverage of what is new and influential in the world of kidney disease. Please look for major innovations in how we present information and news stories in upcoming editions. We welcome your input into how we can best serve your need for information and communication, and can always be reached at kidneynews@asn-online.org.

Be on the lookout for increased use of SGLT-2 inhibitors in 2016 after a recent study published in the New England Journal of Medicine demonstrated a lower composite rate of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke in high risk type 2 diabetics (n = 7020) treated with empagliflozin compared to placebo.

After the signing into law of the Affordable Care Act in 2010, the Centers for Medicare & Medicaid Services developed the idea of accountable care organizations (ACOs) as a way to improve health care outcomes while controlling costs. ACOs are legal entities composed of physicians, other providers, clinics, and hospitals, with shared governance toward providing patient care. The idea is to share risk in the management of a given population toward providing high-quality, cost-effective care.

Imagine putting your meal on a special plate. Its built-in scales and cameras identify your food and its quantity, and then send nutritional information to your smartphone. It may sound like science fiction, but such a product will be shipping soon! Now add a twist for patients. If you have diabetes, an app could tell you how much insulin to take. If you want to lose a few pounds, your phone may alert you to calorie intake.

Patients and physicians have new choices for treating hyperkalemia in 2016. The FDA recently approved patiromer calcium sorbitex (Relypsa, Redwood City, CA) and will likely reach a decision on sodium zirconium cyclosilicate (ZS-9) (ZS Pharma, San Mateo, CA) this year.

The past several years have seen a decline in the number of applicants for nephrology fellowship positions with about half of all programs having unfilled slots. It is anticipated that a further decline will be found for the current recruiting season.

Ever since deceased donor kidney transplantation became practical and accessible to all, several competing factors have shaped the kidney allocation system (KAS) in the US. On one hand, scientific progress has allowed vastly improved preservation techniques, and cross-matching has made it possible to increase the allograft half-life significantly. On the other hand, there continues to be a moral obligation to achieve equitability and fairness in organ allocation practices.