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
You would be hard pressed to find a more capable, resilient, and diverse team of heroes than today's kidney health care workforce. From physicians and nurses to technicians and therapists…from researchers to clinicians to administrative professionals…our field is replete with talented individuals who bring their “all” to achieve equitable, high-quality patient care for the millions of those living with kidney diseases worldwide.
This issue of Kidney News is special, because in it, we are highlighting a key ingredient to achieving equitable, high-quality care for children and adults with kidney diseases: our diversity. We acknowledge the ongoing imperative to
In recent years, cardiologists have taken an approach to intravenous (IV) iron that is very different from that of nephrologists. In kidney disease, the role of IV iron is contemplated solely in relation to anemia, to improve hemoglobin, and as a support for erythropoietin-stimulating agent (ESA) therapy. This is a narrow view that fails to recognize that iron is not just important to manage anemia but that it is a basic health need for humans through its much broader significance for muscular function, energy creation, and storage as adenosine triphosphate.
In cardiology, this approach has led to a series of
With more than 37 million people in the United States affected, chronic kidney disease (CKD) is arguably one of the largest threats to public health outside of the current COVID-19 pandemic. The American Society of Nephrology (ASN) aims to create a world without kidney diseases. To achieve this goal, health equity for all patient populations must be realized, which requires the vanquishing of racial and ethnic disparities in kidney health.
Much like the realities revealed by the COVID-19 pandemic, race-associated disparities in prevalence, morbidity, and mortality outcomes in people with CKD are glaring. These disparities stem directly from structural racism—a
The four-variable kidney failure risk equation (KFRE) is a better predictor of end stage kidney disease (ESKD) risk compared with the estimated glomerular filtration rate (eGFR) alone, with or without adjustment for race, reports a study in the Annals of Internal Medicine.
The researchers used data from the Chronic Renal Insufficiency Cohort to evaluate different eGFR equations for prediction of ESKD, defined as dialysis initiation or transplantation. The analysis included data on 3873 participants with chronic kidney disease (CKD), with a total of 13,902 2-year risk periods.
For each participant, eGFR was calculated using the CKD Epidemiology Collaboration
Raising awareness of kidney diseases worldwide and empowering people living with them are the focus of campaigns launching in March.
One in three adults in the United States is at risk for kidney diseases. To shed light on the prevalence of this condition, the National Kidney Foundation (NKF), in honor of National Kidney Month, asks, “Are you the 33%?”
The slogan is part of a strategic digital campaign focused on reaching, educating, and empowering Americans who are Hispanic and of Black race, as well as individuals over age 35 or those who have one or more risk factors for kidney
Strive Health (Strive) has launched contracted partnership models under the Medicare program, Comprehensive Kidney Care Contracting (CKCC). Strive has partnered with 260 nephrology providers in five states in federally defined Kidney Contracting Entities (KCEs) to serve 8200 patients. Goals include delaying the progression of chronic kidney disease (CKD) to end stage kidney disease (ESKD) and supporting patients transitioning to dialysis and those going through the transplant process. Such efforts should reduce Medicare costs; a percentage of savings will return to the KCE partners.
Strive also announced that, to date, the company is managing 44,000 complex CKD and ESKD patients through