The American Kidney Fund (AKF) has awarded its 2022 Clinical Scientist in Nephrology Program fellowships to two deserving researchers: Jillian Caldwell, DO, a nephrology fellow with Stanford University School of Medicine, and Janewit Wongboonsin, MD, MS, a clinical and research fellow with the Brigham and Women's Hospital (BWH)-Massachusetts General Hospital (MGH) Renal Fellowship Program, conducting his postdoctoral research at Boston Children's Hospital (BCH). Kidney News is honored to present an interview with these awardees.
Jillian Caldwell, DO
Fellowship project: How immunologic matching in kidney transplantation can affect equitable access to organs
Modality selection for treatment of end stage kidney disease (ESKD) is a complex, life-changing decision that patients with chronic kidney disease (CKD) must address. Offering conservative, or non-dialysis therapy, as an option continues to be a challenge for nephrologists. Conversations to discuss this option are held infrequently, due to prognostic uncertainty, a lack of an organizational care framework, and significant emotional attachments (1, 2). In a recent article, Hamroun and colleagues (3) highlight another possible compelling reason: a disproportionate belief in physicians’ ability to communicate effectively with patients.
Physicians tend to overestimate their communication
In oncology, survivorship focuses on the health and well-being of a person with cancer from the time of diagnosis until the end of life (1). Hypertension is a growing global public health problem and a contributor to cardiovascular disease (CVD) (2). The relationship among hypertension, cancer, chronic kidney disease (CKD), and CVD is multifaceted, sharing common risk factors, such as smoking, obesity, and metabolic syndrome. For the same reasons, oncohypertension is an emerging subspecialty focusing on the close interplay between hypertension and cancer (3, 4). Hypertension in patients with cancer can be
The field of onconephrology has recently begun to take shape, and thus, education aimed at onconephrology is still evolving. Importantly, onconephrology was galvanized in the age of social media; thus, non-traditional media is playing a pivotal role in shaping education in onconephrology. For example, the American Society of Onconephrology (ASON) was largely materialized by a group of nephrologists all over the world using WhatsApp to discuss and share cases and forge research collaborations.
The first textbook devoted solely to onconephrology topics was published in 2005 (1) and subsequently, two additional in 2015 (2) and 2019 (
Lauren Floyd, Madelena Stauss, and Alexander Woywodt
Page charges have been in existence across many fields of science for a century or longer, and journals have to cover their costs. Historically, journals have relied on income from subscriptions to cover costs associated with printing, distribution, and other overhead fees, whereas peer review and editorial board activities were free. The funding model for such journals has now undergone unprecedented change. Originally, many journals transitioned gradually into an online-only, paywall-protected existence, as both institutional and individual subscriptions declined. As a result of this development, many researchers and clinicians in low- and middle-income countries lost access to published research or
Latin America is a vast region of primarily middle- and low-income countries with approximately 660 million people who share a Latin extraction and language (Spanish or Portuguese). The area exhibits extreme diversity in socioeconomic status and access to quality health care. The prevalence of chronic kidney disease (CKD) seems to be growing in Latin America (1). Population aging, suboptimal treatment of comorbidities such as hypertension, and the growing epidemic of type 2 diabetes affect many people in this region. In addition, Latin Americans often live in poverty and follow unhealthy diets, lack physical exercise, and have precarious working
Over the past few decades, there has been rapid advancement in the care of cancer patients with a steady flow of novel therapeutics introduced into clinical practice. Accompanying the new therapies are myriad unintended treatment-related effects, some of which have involved the kidneys, electrolytes, acid-base balance, and blood pressure control. There has also been a shift in the mindset of the treating physicians (oncologists and nephrologists) to attempt a pathophysiological understanding and nuanced management of such treatment-related effects rather than binary labeling of drugs into “nephrotoxic” and “non-nephrotoxic” and discontinuation of therapy thought to be nephrotoxic. This evolution in thinking
In the past decades, the field of hematology-oncology has greatly evolved, bringing to practice the routine use of novel therapies with various mechanisms of action, including chemotherapeutic, immunotherapeutic, and targeted agents, which are often combined into complex regimens (Figure 1).
Examples of cancer-directed therapies
With these ongoing advances, unique drug-drug interactions, treatment timing, dosing challenges, as well as toxicity profiles have emerged, requiring more advanced expertise from our subspecialty consultants who co-manage these patients. My practice focuses on patients with hematologic malignancies, with a particular interest in plasma cell dyscrasias. These encompass a large spectrum of
Fresenius Medical Care announced in March that it was forming a separate company as part of a three-way merger with InterWell Health and Cricket Health. Through the merger, the largest dialysis provider in the United States will combine with two value-based care companies: a physician organization of more than 1600 nephrologists and a technology start-up. The start-up, Cricket Health, created a patient platform, care-support program, and machine-learning program aimed at identifying kidney disease and predicting disease progression.
“We see value-based care as the future of health care, and this new company will make a dramatic difference for thousands of people,”
Earlier this year, ASN received requests from the American Board of Internal Medicine (ABIM) and Accreditation Council for Graduate Medical Education (ACGME) that taken separately would impact the future training of nephrologists. After careful consideration and thought, the ASN Council responded with a request for 8 months to convene the community and reconsider all aspects of the future of the specialty of nephrology.
“This is a unique opportunity to respond to the requests of ABIM and ACGME. Nephrology has evolved over the last 5 to 10 years as more options to treat patients earlier have become available,” said former ASN