Twenty percent of Americans live in rural areas. Many face health disparities caused by geographic isolation, transportation limitations, and a lack of access to local specialty health care (1, 2). Americans living in rural areas also are more likely to be uninsured, to have lower rates of access to preventive health services, and to engage in unhealthy behaviors (such as tobacco use) (2–5). They also have greater incidence rates of potentially preventable diseases, including heart disease and stroke, and higher mortality rates than their urban counterparts (2, 4,
Lesbian, gay, bisexual, transgender, queer or questioning, and/or other sexual and gender minority (SGM) individuals (LGBTQ+) represent a diverse range of people who experience disparities in health outcomes and other health-promoting resources and opportunities and are served by kidney care professionals (1–3).
Although there have been advances in civil rights legislation, including same-sex marriage equality aimed to equalize some sociopolitical opportunities, there are innumerable persistent social, economic, legal, health, and health care-related disparities facing SGM individuals (2, 4). These challenges are exemplified by a patchwork of non-discrimination policies across the United States
The challenges for women in medicine are well documented: Women get paid less than men (1, 2). Women are under-represented in leadership positions at academic institutions (3, 4). Women bear more of the burden at home in dual professional households (5). The headlines are so familiar that it can be difficult for one to muster outrage. Although there are increasing victories in the struggle for equality, such as the inclusion of female voices on academic panels, systemic changes are needed to level what has historically been an uneven playing field.
It's March, spring is in the air, and periodic bracket fever has caught up with the nephrology community for the 10th year in a row! What is NephMadness, you may ask? NephMadness is a medical education event held in your practice, your division, and on social media to celebrate all things kidney.
NephMadness is a single-elimination tournament consisting of 32 nephrology concepts, divided into 8 regions, representing the most exciting topics in nephrology. The purpose of the game is to discuss and debate each of these concepts during the month of March. Throw a NephMadness party for your group, and
In 1960, my father immigrated to the United States to avoid religious persecution, experienced racism in Ohio, overstayed his student visa, and was considered “illegal.” My mother—whose family has deep, often racist, roots in the United States—eloped with my father, helped him become a US citizen, experienced sexism (especially in the workplace), worked for two female members of Congress, and volunteered as a counselor during the AIDS crisis.
Their individual and shared experiences shape my commitment to diversity, equity, inclusion, and justice. The American Society of Nephrology (ASN) was a pacesetter—and is now an advocate—in this arena because its members,
A recent study illustrates the critical role that hemodialysis units can play to break down barriers for patients on dialysis with vaccine hesitancy.
Despite being 2 years into the pandemic, COVID-19 continues to be a top health concern. Our patients on dialysis are at heightened risk of severe illness or death due to lowered immunity and multiple comorbidities. Vaccination remains the most important tool we have against COVID-19. That means breaking down misinformation and systemic barriers contributing to vaccine hesitancy are top priorities.
Recent research from Tummalapalli et al. (1) suggests that although our work can have an
Despite improvements in long-term allograft survival in the United States, at least one-quarter of deceased donor kidney transplant recipients will experience allograft failure in their lifetime (1). Studies have shown that the period of transition back to dialysis is marked by increased morbidity and mortality, and recipients with failing allografts receive suboptimal care (2, 3). Transplant communities are starting to recognize the challenges that these recipients face.
The British Transplantation Society and more recently, the American Society of Transplantation released recommendations providing guidance on issues such as immunosuppression withdrawal and preparation for dialysis or
Mythri Shankar's “The Birth of Understanding Glomerulonephritis” in the February Kidney News is a comprehensive walk through the history of our understanding of kidney diseases. Pivotal points were the discovery of the glomerulus and subsequent recent insights into the pathobiology and genetics of glomerular diseases.
The visual here, prepared by Paolo Nikolai So, MD, pulls it all together.
Chronic kidney disease (CKD) is a significant cause of morbidity and mortality worldwide. The global burden of CKD is estimated at 500 million people worldwide, with the majority of people with CKD (80%) living in low- and middle-income countries (LMICs) (1). In 2017, 1.2 million people died from CKD, with the all-age mortality rate increasing 41.5% between 1990 and 2017 and a global prevalence of 9.1%. The global all-age prevalence of CKD also represented an increase of 29.3% since 1990 (2). Along with the noted increases, there is inequity in the distribution of CKD; people living
It had only been 5 years into my taking lithium when my urine turned from golden yellow to a consistent translucent lemonade. As an internal medicine resident and incoming nephrology fellow living with bipolar disorder, I had hoped to have at least 20 years before any renal concentrating deficits began. Lithium had always been my “hero,” albeit imperfect, and hand tremors and nausea seemed a paltry price to pay for the drug's mood-stabilizing and anti-suicidal effects (1). Ironically, soon after choosing the field of nephrology, my polyuria and nocturia began.
For many years, I have been intentionally transparent