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For dialysis patients with nonvalvular atrial fibrillation (AF), anti-coagulation with apixaban—at both standard and below-label doses—lowers the risk of bleeding events compared with warfarin, concludes a study in the
Using US Renal Data System data from 2013 to 2018, the researchers identified 17,156 Medicare beneficiaries with nonvalvular AF receiving maintenance hemodialysis. All patients (12,517) had a new prescription for warfarin, and 2382 patients had apixaban at a label-concordant dose of 5 mg twice daily, or 2257 patients had apixaban at a lower dose of 2.5 mg twice daily. Outcomes, including stroke or systemic
Discovery of the genetic association between
The US health care workforce is facing a shortage impacting those seeking kidney care. In 2019, the Association of American Medical Colleges projected that demand for physicians will continue to outpace supply, and the United States will see a shortage of up to 122,000 physicians by 2032 (
In patients with advanced chronic kidney disease (CKD), the decision to pursue invasive strategies for treatment of coronary artery disease involves careful consideration. Data from the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA)-CKD trial may better inform these decisions. The National Heart, Lung, and Blood Institute (NHLBI)-funded ISCHEMIA-CKD trial was a randomized clinical trial that included 777 patients from 30 countries, predominantly in the United States, Russia, Poland, India, and China. Inclusion criteria included aged ≥21 years, kidney failure on maintenance dialysis or estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m2, and at
As the health care community looks to home hemodialysis to improve the quality of life and overall management of patients with kidney diseases, all work should start by centering patient experiences and realities. I was diagnosed with kidney failure at the age of 2 in 1968 and luckily fell into the care of pioneer pediatric nephrologist Richard Fine, MD, who saved my life more than once with his innovative spirit. I was the first child to experience peritoneal dialysis in California, and I successfully managed my own home dialysis for 10 years. I have since founded the Renal Support Network
Although allogeneic hematopoietic stem cell transplant (HSCT) is the curative treatment for many patients with hematologic conditions, these patients are at a higher risk of acute kidney injury (AKI) and chronic kidney disease (CKD) as a result of conditioning therapies, exposure to radiation therapy, and chronic treatment with calcineurin inhibitors (
The short period of 2020 to 2022 has felt like its own era in the field of kidney transplantation, with significant advances in the field on various fronts. The next two editions of
The kidney allocation policy within the United States was initially established in 1987 to promote the equitable and utilitarian distribution of deceased donor kidneys (
Oxalate or oxalic acid is a dicarboxylic acid formed in the human body from exogenous dietary sources and endogenous metabolism of ascorbic acid and some amino acids. It is essentially a terminal metabolic product that is produced by the liver, absorbed by the intestine from dietary sources, and freely filtered by the kidneys (
Regional disparity in deceased donor kidney transplant rates
During the past few months, I have participated in several meetings that included in-depth discussions about the future of the health care workforce in the United States. Each time, the discussion started with predictions about shortages of every kind of health professional—from physicians to nurses to physician assistants/associates to other clinicians—and then shifted to concerns about the ability to provide high-quality patient care in the future as a result.
Although this editorial will focus on the future of nephrologists in the United States, I recognize that the situation is dire throughout the world, particularly for nurses. Earlier this year, the
