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Recent research suggests a potential expanded role for monitoring of donor-derived cell-free DNA (dd-cfDNA) in the early identification of graft injury after kidney transplantation.

In the Assessing Donor-Derived Cell-Free DNA Monitoring Insights of Kidney Allografts with Longitudinal Surveillance (ADMIRAL) study, published in Kidney International, 1092 kidney transplant recipients were monitored for dd-cfDNA for 3 years after transplantation. The researchers used a targeted sequencing assay that quantified dd-cfDNA using highly polymorphic single nucleotide polymorphisms without the need for separate donor or recipient genotyping. The findings of 5873 dd-cfDNA measurements were analyzed for association with histologic evidence of allograft rejection.

Charuhas V. Thakar
The effort conundrum

Let me dive right in! A traditional business plan equates one full-time equivalent (FTE) to 8 out of 10 half-day sessions of direct clinical work, which expects the physician to complete an average of 12 patient visits in a 4-hour clinic session (a typical visit is 15 minutes for follow-up and 30 minutes for a new patient). There are three recipients of the deliverables during a clinic visit: 1) the recipient of the clinical care is the patient; 2) the recipient of the professional billing is the practice plan; and 3) the recipient of most of the

Bridget M. Kuehn

As a family physician and diabetes team lead in Juneau working for the Southeast Alaska Regional Health Consortium, Mary Owen, MD, could audit the care received by all of the diabetes patients served by her tribal clinic. The Special Diabetes Program for Indians (SDPI) funded this population-based approach through the Indian Health Service (IHS), which contracted with the clinic.

The audits allowed Owen, now director of the Center of American Indian and Minority Health at the University of Minnesota Medical School, to assess blood pressure and blood sugar control among patients and to gauge how many patients were receiving guideline-directed

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

Tell us about yourself and something
Antonio Gabriel D. Corona and Holly M. Koncicki

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

Prakash Gudsoorkar

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

Mohamed E. Elrggal and Mohammed Abdel Gawad

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

Verônica T. Costa e Silva and Gregorio T. Obrador

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

Omar Mamlouk, Marco Bonilla, and Shveta Motwani

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