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
Solid-organ transplant recipients can maintain peripheral immunity for up to 6 months after SARS-CoV-2 infection—especially with greater clinical severity—reports a pre-proof paper in Kidney International.
The researchers evaluated serologic and functional T-cell and B-cell immune memory against major immunogenic SARS-CoV-2 antigens. The cross-sectional study included two groups of COVID-19 convalescent patients: 53 solid-organ transplant recipients (38 kidney recipients) and 49 immunocompetent patients.
In both groups, patients were classified as having severe COVID-19, requiring hospitalization and supplemental oxygen; mild COVID-19, not requiring hospitalization; or asymptomatic infection. Immunologic assessments included SARS-CoV-2-specific serologic memory and immunoglobulin G (IgG)-producing memory B cells
In the United States, diabetes is the leading cause of kidney failure, and the prevalence of diabetes among American Indians and Alaskan Natives (AIs/ANs) is one of the highest among any racial and ethnic group. In the United States, diabetes accounts for 69% of new cases of end stage renal disease (ESRD; diabetes-associated ESRD [ESRD-D]) among the AI/AN population (1).
The roots of this disparity began in the 1950s and 1960s, when the epidemic of diabetes among the AI/AN population was soon followed by a dramatic increase in diabetic kidney disease and subsequent kidney failure, first described in
According to 2019 Association of American Medical Colleges (AAMC) data, international medical graduates (IMGs) comprise 23% of all actively practicing doctors in the United States (1). In nephrology, that number rises to 51% and in the coming years, is expected to grow, given that IMGs now make up nearly 60% of trainees entering the specialty. In the most recent fellowship match (appointment year [AY] 2022), 38% of all matched applicants were non-US IMGs, and most are likely to be on visas (2). The growing number of IMGs on visas (J-1 and H1-B; Table 1)
For patients with chronic kidney disease (CKD), discontinuing renin-angiotensin-aldosterone system inhibitors (RAASi) during episodes of hyperkalemia is associated with increased mortality and cardiovascular events, reports a pre-proof paper in the American Journal of Kidney Diseases.
The retrospective study included data on adult CKD patients with new episodes of RAASi-related hyperkalemia with a serum potassium level 5.5 mM or higher. Drawn from Canadian provincial databases, the analysis included 7200 patients in Manitoba and 71,290 patients in Ontario. The mean ages were 72.39 and 79.48 years, respectively. Several types of comorbidity were more frequent in the Manitoba cohort.
Historically, there has been low use of palliative care in patients with acute kidney injury (AKI), even when requiring kidney replacement therapy, but does this trend hold true in patients with AKI who also have COVID-19? That's the question posed by a recent study in CJASN that analyzed New York University (NYU) Langone Health's electronic health data of COVID-19 hospitalizations between March 2, 2020, and August 25, 2020.
“This research is important because palliative care is often an untapped resource that can help patients and families cope with difficult situations. Serious acute illness is an overwhelming time for
In December 2019, when Chinese authorities alerted the World Health Organization of cases of pneumonia in Wuhan City, for which they were unable to identify a known cause, little did we know that this was just the tip of the iceberg that would leave us with (to quote a Lin-Manuel Miranda song title in “Hamilton”) a “world turned upside down.”
None of us signed up for this. There was a realistic fear of death to health care workers who were already taxed beyond what anyone could imagine. They may have questioned, “Will my patient die because of a bed or
In a procedure designed to closely mimic a human-to-human kidney transplant, Jayme Locke, MD, MPH, director of the Division of Transplantation at The University of Alabama, Birmingham, and her colleagues tested the safety and feasibility of transplanting a genetically engineered pig kidney into a human patient with a non-functioning brain.
The results were reported in January 2022 and showed that the genetically modified pig kidneys did not trigger a hyper-rejection reaction, could support human blood pressure, and could produce urine (1). The procedure was one of a string of recent attempts to test the potential of using pig