Leading Edge: Policy-Advocacy
Changes to chronic kidney care Medicare coverage in passed House legislation
A last-minute addition to the legislative package in the House would extend by three months the period people with chronic kidney failure must wait before they become eligible for Medicare coverage. Lawmakers inserted the change, which is projected to save the government $290 million over a decade, to help pay for their slew of new initiatives aimed at curbing opioid misuse. The bill passed the House by a vote of 396-14.
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Leading Edge: Policy-Advocacy
New Rule on Association Health Plans Could Weaken Affordable Care Act
The Trump Administration on Tuesday, June 19, unveiled the final rule allowing potentially millions of small businesses and self-employed workers to buy health-insurance plans exempt from many Affordable Care Act (ACA) consumer protections. The American Society of Nephrology (ASN) is reviewing the details of the rule now.
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Leading Edge: Policy-Advocacy
Quality Payment Program Look-Up Tool Now Includes 2018 MIPS Eligibility and Predictive Qualifying APM Participant Data
The Centers for Medicare & Medicaid Services (CMS) updated its ...
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Leading Edge: Policy-Advocacy
ASN's policy priorities advance by joining MedPAC and PEHRC
The American Society of Nephrology (ASN) member, Jonathan Jaffery, MD, MS, MMM, is one of the five newest members who will serve on the Medicare Payment Advisory Commission (MedPAC). Dr. Jaffrey was appointed to serve on MedPAC by Gene L. Dodaro, Comptroller General of the United States and head of the U.S. Government Accountability Office (GAO), on May 30. At the same time, ASN announced that it has joined the Physicians’...
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Perspectives
New NephSAP Issue - "Interventional Nephrology and Dialysis Access"
NephSAP Volume 17, Number 2, June 2018
Please read the full issue.
Interventional Nephrology and Dialysis Access
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Communities Weekly Rewind: ABO incompatible kidney transplant; role and significance of IgM antibody titers
Query
Is it safe to proceed with this transplant without lowering the anti-B IgM titers? Is this risking early post-transplant antibody mediated rejection?
Perspectives
Communities Weekly Rewind: Bilateral Renal Infarctions
Query
How does a relatively young healthy person suddenly develop bilateral renal infarcts?
Perspectives
Communities Weekly Rewind: Burnout in Nephrology
Burnout. This topic evokes such a varied range of emotions and opinions from doctors in many fields. It is a condition that is inherently understood though it presents in multiple ways. At its core it signifies loss. It could be a loss of energy, of compassion, of hope or any number of things we hold valuable and important in our lives, both personal and professional.
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Perspectives
Nephrology facing workforce shortage issue
“Amidst the rising tide of [chronic kidney disease] CKD, the global nephrology workforce has shrunk and is failing to meet the growing health care needs of this vulnerable patient population,” Muhammad U. Sharif, Mohamed E. Elsayed, and Austin G. Stack, wrote in Clinical Kidney Journal.
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Communities Weekly Rewind: IgG1-lambda mesangial proliferative GN
Query
PGNMID is an uncommon diagnosis, and without any evidence of a circulating paraprotein or cell clonality in the bone marrow, what is the pathophysiology of this lesion and how do we go about treating it?
Perspectives
Communities Weekly Rewind: Hope and Innovation in Nephrology
Months of efforts by ASN staff culminated on April 26, 2018, when ASN signed a Memorandum of Understanding with the Department of Health and Human Services to establish the Kidney Innovation Accelerator, KidneyX.
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Communities Weekly Rewind: Liver transplant alone vs. simultaneous liver-kidney transplant
Query
Should this patient receive a liver transplant alone (LTA) or simultaneous liver and kidney transplant (SLK).
Perspectives
BMJ: Archive of Research Methods & Reporting notes
The BMJ compiled an archive on their website entitled “Statistics notes”. The archive includes numerous notes and articles that examine different research methods and statistical reporting, which are useful resources for anyone conducting their own research.
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Communities Weekly Rewind: Normal Saline vs. Balanced Solution
This Communities discussion compared the results of two randomized clinical trials (SMART and SALT-ed) reported on in the New England Journal of Medicine that compared the effects of normal saline and a “balanced solution” in preventing AKI. Isotonic saline (0.9% NS) is the main crystalloid solution used for resuscitation of hypovolemic critically or non-critically ill patients.
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Resources
Data Visualizations: Considering color choices
Lisa Charlotte Rost delves into what you should consider when choosing colors for data visualization. With the powerful potential of visualizations in relaying conclusions within a short burst of attention, color choices can make or break their effectiveness.
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Resources
A Call for Kidney Week Abstract Submissions
Only two weeks left to submit your research or clinical case report for the 2018 Kidney Week, the largest nephrology meeting in the world.
Submission will be accepted through 2:00 PM EDT on May 31.
Don't miss this valuable opportunity to present to nephrologists and thought leaders in the field from around the globe.
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Catalog of Biases in health studies
The culmination of collaborative work between the Centre of Evidence-Based Medicine and the University of Oxford, the website, Catalogue of Biases, is a complete database of possible biases that inadvertently make their way into scientific research.
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Donald W. Seldin, who built UT Southwestern into a medical powerhouse, dies at 97
His innovations included an approach to medicine that placed an equal emphasis on medical research, teaching and the treatment of patients — a tripartite method that “wasn’t obvious to a lot of people at the time,” Braunwald said.
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Resources
How to Design an Award-Winning Conference Poster
In this humorous piece by Dr. Tullio Rossi, How to Design an Award-Winning Conference Poster, a conference poster is described as being two things simultaneously: a networking tool and a communication tool.
The poster should attract people’s attention and serve as a conversation starter. It should also be accessible and drive attention to your research. “A scientific poster is simply a visual abstract”.
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CVS Health announces a new initiative focused on kidney care and home dialysis treatment
On April 4th, 2018, CVS Health “announced a new initiative focused on chronic kidney disease and dialysis, which builds upon the company's focus on driving innovation in the management of chronic disease to help improve patient health outcomes while managing costs. This new program will focus on early identification of kidney disease and expansion of home dialysis in order to optimize care for patients with chronic kidney disease. CVS Health's unique enterprise assets along with...
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Resources
Which statistical tests should I use?
In a piece published by Evidence-Based Nursing, Allison Shorten and Brett Shorten describe different research scenarios and detail which statistical tests may be the most appropriate for the researchers to utilize.
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Resources
New NephSAP Issue - "Hypertension"
NephSAP Volume 17, Number 1, March 2018
Find the full issue here.
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In Practice
Outside ASN: Nigeria addressing rising cases and high cost of treating CKD
"Nigeria, on March 8, joined the rest of the world to celebrate the World Kidney Day (WKD). A day set aside to raise awareness on the plight of people living with Chronic Kidney Disease (CKD) and how to better prevent, treat and manage 'the disease'".
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In Practice
NY Times: The Challenge of Doctor-Patient Relations in the Internet Age
A recent article by Doris Iarovicic, a psychiatrist at Hardvard University's Counseling and Mental Health Services, details her experience with patients who prefer the "expertise" of the digital world to the expertise of in-person physicians.
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In Practice
Fewer international doctors seeking U.S. jobs – potentially due to ongoing immigration shakeup
National healthcare recruiting company The Medicus Firm said it placed the lowest percentage of internationally trained physicians in 2017 in at least seven years. The percentage of internationally trained physicians placed by Medicus dropped to 24%, down seven points from nearly 32% in 2016, according to the report.
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In Practice
Kidney Health Initiative (KHI): Prioritizing Symptoms of ESRD Patients for Developing Therapeutic Interventions workshop
The “Prioritizing Symptoms of ESRD Patients for Developing Therapeutic Interventions” workshop took place from January 8th through January 10th in Washington, DC. The meeting convened various stakeholders, including patients and care givers. Discussion centered around three symptoms of ESRD that were identified as priorities through previous patient focus groups: Fatigue, Insomnia, and Muscle Cramps.
The goal of the meeting was to:
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Resources
NY Times: Diabetes in Pregnancy Raises Risk of Heart Disease
The women who had gestational diabetes were 20 times as likely as controls to develop Type 2 diabetes, consistent with previous studies, and the risk was highest in the first year after giving birth. In addition, these women were 2.8 times as likely to have heart disease, and nearly twice as likely to develop high blood pressure. The researchers controlled for age, body mass index, ethnicity, smoking and other variables.
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PLOS Blogs: 6 tips for deciphering outcomes in health studies
As studies published become more convoluted with jargon and specific measurement techniques that can be confusing and/or misleading, it’s important to be able to get down to the measured outcomes quickly and with clarity.
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Negotiating for Leadership Success
This past spring, ASN joined with Women in Nephrology (WIN) to develop a series of webinars designed to help you advance your career. In one of these presentations, Dr. Yasmin Davidds, Psy. D, M.C.C., and CEO of the Women’s Institute of Negotiation, provides advice on negotiating for leadership success.
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Resources
FDA approved new type II diabetes drug
The new drug, developed by Merck & Co and Pfizer Inc., is an oral drug known generically as ertugliflozin and in the class of SGLT2 inhibitors, which work to expel excess glucose through urine.
The US Food and Drug Administration (FDA) approved the drug early this week. The drug is expected to be available for sale in early 2018.
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Resources
ASN Data Bytes: AY 2018 Nephrology Match - Déjà vu all over again
December 6th was Match Day for nephrology, with overall results closely mirroring those from last year. A total of 285 of the 474 positions offered for appointment year (AY) 2018 were filled in the nephrology Match, part of the National Resident Matching Program’s (NRMP’s) Medical Specialties Matching Program.
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Resources
Outside ASN: Designing ‘attention points’ in academic work
Professor Patrick Dunleavy at the London School of Economics writes about “four principles for improving how you display tables, graphs, charts and diagrams” in academic or scientific research.
The four principles include:
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Resources
Reminder: PQRS Physician Compare 30-day preview period ends Friday, December 1 at 8pm ET
"The Physician Compare 30-day preview period ends this Friday, December 1, 2017 at 8 pm ET. Don’t miss your chance to preview your 2016 performance data before it is publicly reported on Physician Compare profile pages later this year and in the Physician Compare Downloadable Database.
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Resources
New NephSAP issue - "Transplantation"
NephSAP Volume 16, Number 4, November 2017
Find the full issue here.
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Resources
Diabetes Prevention Program (MDPP) to be added to Medicare benefits in 2018
The Medicare Diabetes Prevention Program (MDPP) expanded model is a structured behavior change intervention that aims to prevent the onset of type 2 diabetes among Medicare beneficiaries with an indication of prediabetes.
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Resources
New tool, HIPAA Alliance Marketplace, helps find HIPAA compliant business associates
"Healthcare organizations are only permitted to use business associates that agree to comply with HIPAA Rules and sign a business associate agreement, but finding HIPAA compliant business associates can be a challenge.
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In Practice
Inside the UCLA voucher program that is overcoming chronological incompatibility and saving lives
The UCLA Kidney Transplant Program started a voucher program in 2014 which has already proven its utility and saved 25 lives. “The program works like this: The voucher donor gives a kidney to a stranger on dialysis. Often that recipient had a friend or family member who had wanted to be a donor but couldn’t due to incompatibility.
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Resources
Conducting Trials in Nephrology: Challenges and Conclusions
"The Kidney Disease: Improving Global Outcomes (KDIGO) group convened a meeting of stakeholders in September 2016 to identify challenges and make recommendations to improve trial data in nephrology[1] Their conclusions were made public nearly 8 months later and are briefly reported in the full article on Medscape".
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Resources
American Heart Association (AHA) to announce 130/80 mm Hg as new BP guideline
It’s been revealed ahead of the November announcement at the American Heart Association (AHA) in Anaheim, that the new guideline for blood pressure target will be 130/80 mm Hg.
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Resources
The Undifferentiated Medical Student: 2 recent podcasts on Nephrology
The Undifferentiated Medical Student is a podcast started in November 2016 with the goal of “doing interviews with one physician from each of the 120+ specialties and subspecialties listed on the AAMC’s Careers in Medicine website” in order to empower medical school students to think about choosing their specialty and planning their careers.
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Resources
Comments and advice on how to read a journal’s rejection letter
Stephen Heard, an evolutionary ecologist and entomologist at the University of New Brunswick and previously faculty at the University of Iowa, recently published a short blog detailing how best to read and react to a rejection letter after submitting your work to a journal.
Click here if you’d like to read the full blog.
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Resources
New NephSAP issue - "Chronic Kidney Disease and Progression"
NephSAP Volume 16, Number 3, September 2017
Find the full issue here.
Chronic Kidney Disease and Progression
Over 20 million people in the U.S. have CKD stages 1-5, and costs for advanced CKD exceed $47 billion annually. The 2017 Chronic Kidney Disease issue of NephSAP guides readers through the latest advances in clinical research for this...
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Targeting Zero Infections: Multi-Drug Resistant Organisms (MDROs) and Antimicrobial Stewardship in the Dialysis Facility
Registration is now open for the second webinar in the Nephrologists...
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In Practice
Join the conversation on Hurricane Harvey
To join the conversation on the affects of Hurricane Harvey on dialysis and kidney care, please sign in and see the "Supporting our Texas Colleagues" forum on ASN Communities. Share your experience and knowledge with peers.
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In Practice
JAMA: "Risk factors for Melanoma in renal transplant recipients"
An original investigation published online by JAMA Dermatology on July 26, 2017 found that "renal transplant recipients had greater risk of developing melanoma compared with their non-renal transplant counterparts. Risk factors for developing melanoma included older, age, male sex, recipient white race, living donors, sirolimus therapy, and cyclosporine therapy".
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In Practice
Quality Payment Program Hardship Exception Application for the 2017 Transition Year Is Now Open
Clinicians can now submit Quality Payment Program Hardship Exception Applications
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Resources
7 CRISPR projects in US receive $65 million total funding from DARPA
The Defense Advanced Research Projects Agency (DARPA) announced $65 million in funding on July 19th, 2017 to seven projects in the US to further improve safety and accuracy of gene editing.
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Resources
HHS Office for Civil Rights warns of potential risks with file sharing, HIPAA
“The Department of Health and Human Services’ Office for Civil Rights has recently issued a reminder to covered entities and business associates of the potential risks associated with file sharing and collaboration tools, explaining the risks these services can introduce and how covered entities can use these services and remain in compliance with HIPAA Rules”.
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Resources
MACRA Resources: What Physicians Need to Know
In April 2015, the the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was signed into law, repealing the Sustainable Growth Rate (SGR) physician payment system. In April of 2016, HHS Issued a Proposed Rule. In October of 2016, CMS Issued a Final Rule. Below are some resources to help you understand more about MACRA.
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Resources
CMS Released Proposed Rule, Quality Payment Program (QPP) for 2018
The Centers for Medicare & Medicaid Services (CMS) released the Quality Payment Program (QPP) proposed rule for 2018 on Tuesday, June 20. While we are only beginning to go through the proposed rule, all 1,058 pages, it does appear that CMS is concerned about the burden of participating in the program on small practices leading to a significant proposed rise in the low-volume threshold.
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Resources
NIH Launches Next Generation Researchers Initiative
As a result, NIH has shifted its strategy to support early and mid-career investigators by launching the Next Generation Researchers Initiative. This new program will go into effect immediately.
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Resources
VA Center for Innovation Releases Broad Agency Announcement for Funding Pioneering Kidney Projects
Building upon momentum from the Kidney Innovation Summit hosted earlier this year by the Department of Veterans Affairs (VA), along with support from the American Society of Nephrology, the VA Center for Innovation (VACI) released a Broad Agency Announcement (BAA) this week designed to source and fund early stage research, development, prototyping, and piloting of pioneering ideas in the kidney space.
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Resources
Making Scientific Presentations
Making great abstracts and posters, and presenting your studies so you hold your audience's interest -- some excellent resources for making your work stand out.
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Open Payments Physician and Teaching Hospital Review and Dispute Period Ends Next Week
Physicians and teaching hospitals have until May 15, 2017 to review data reported by drug and medical device makers about them and, if necessary, dispute the payments before the data is made public on June 30, 2017.
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JASN - Gene Editing: Powerful New Tools for Nephrology Research and Therapy
In the October 2016 issue of JASN the following article was published focused on new technology, especially the CRISPR/Cas system, and how it may be used for nephrology research and therapy.
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Gene Editing Technology
Check out the resources on gene editing: background, pros and cons, potential clinical applications.
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Resources
ASN Data Bytes: Academics Offer Diverging Opinions on Nephrology Procedures
A recent ASN Flash Poll found differing opinions among academic nephrologists over procedures, specifically catheter placements and kidney biopsies. Stewart Lecker, MD, PhD, on behalf of the ASN Workforce and Training Committee, developed the survey to capture current perspectives on procedural competence among training program directors (TPDs), associate TPDs (APDs), and division chiefs.
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Resources
Resources for Authors: Writing Well, Navigating Peer Review
Set yourself and your work up for success: tell the story well, and choose the right journal.
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Physician Contract Negotiation
Physician protect thyself: whether negotiating a first-time contract or renegotiating or amending a contract -- make sure you're informed in advance.
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On Site at Kidney Week
Check out these photos from Kidney Week, including some of the things you may not know about, or may have missed.
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Resources
NTDS Town Hall Generates Interest at Kidney Week
Thursday's Town Hall meeting on the new Nephrologists Transforming Dialysis Safety (NTDS) project drew a lot of interest and some great questions.
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Resources
ASN Kidney Week 2016
ASN Kidney Week 2016: participants from more than 115 countries, coming together to advance care and research.
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Physician Reentry
Physicians reentering the resource face challenges; resources to help them are expanding.
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Clinical Research
Kidney News Online has compiled a list of clinical research resources that may be useful to you.
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Resources
Telehealth Resources
Treatment, research and practice are being profoundly changed by a wide range of technological advances. Below are some resources to help kidney professionals consider the ramifications of this rapidly moving field. Send suggestions for other resources to info@kidneynews.org, as well as topics in telehealth you would like to know more about.
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Directory of State Medical and Osteopathic Boards
From the Federation of State Medical Boards (FSMB): http://www.fsmb.org/state-medical-boards/contacts
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ICD 10 Resources
Pain free implementation? Challenges? Suggest other resources that may be useful to your colleagues, or send in your thoughts and observations about ICD 10 implementation. (info@kidneynews.org)
CMS ICD 10 Coordination Center: https://www.cms.gov/Medicare/Coding/ICD10/ICD10OmbudsmanandICD10CoordinationCenterICC.html
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Communities at ASN
ASN Communities offer multiple opportunities to connect with colleagues working in the areas that interest you most. Check out this rapidly growing and dynamic ASN initiative here.
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Nephrology Fellowship Match Resources
Training the next generation of nephrologists is exciting and vital to advancing care for millions of people with kidney diseases. ASN sponsors the Nephrology Match and provides information for applicants and programs here.
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Resources
Nephrology Workforce
ASN and researchers at the George Washington University Health Workforce Institute continue to break ground analyzing trends and key factors.
Detailed workforce analyses and fellows' surveys are available here: http://www.asn-online.org/workforce/
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