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Bridget M. Kuehn

When Alfred Cheung, MD, co-chair of the Kidney Disease Improving Global Outcomes (KDIGO) 2021 Clinical Practice Guideline update on the Management of Blood Pressure (1), and his colleagues were preparing to release their new guideline on blood pressure management in patients with chronic kidney disease (CKD), they knew it might “ruffle some feathers.”

But after careful consideration, their workgroup came to a conclusion that they should make the right recommendation to shoot for a target systolic blood pressure of less than 120 for patients with CKD, a recommendation supported by the results of the Systolic Blood Pressure Intervention

Most dialysis patients who have been infected with SARS-CoV-2 maintain protective antibody levels over 6 months' follow-up, including subgroups at risk of impaired immunity, reports a study in Annals of Internal Medicine (1).

The study investigators used remainder plasma samples from 2215 hemodialysis patients from 1200 dialysis facilities across the United States. Fifty-three percent of patients lived in majority-minority neighborhoods and 44% in low-income neighborhoods (at least 20% below the federal poverty level).

All samples included in the study were positive for SARS-CoV-2 receptor-binding domain (RBD) total antibodies, tested using the highly sensitive and specific Siemens

Mayuri Trivedi and Vivekanand Jha

The unfolding story of COVID-19 in India has shown how a narrative can change quickly. It was only a few months ago that experts around the world were wondering what explained India's relatively cheap escape (until then) from the ravages of the COVID-19 pandemic. India is now back in the news, but this time, the reports are highlighting the utter collapse of the healthcare system, shortage of critical supplies and hospital beds, people dying on the curbsides, and striking images of over-busy cremation and burial grounds. Amid this chaos, care of patients with chronic illnesses like kidney diseases has been

Eric Seaborg

The National Kidney Foundation-American Society of Nephrology (NKF-ASN) Task Force on Reassessing the Inclusion of Race in Diagnosing Kidney Disease released its highly anticipated interim report at the start of April. Published concurrently in JASN and the American Journal of Kidney Diseases (AJKD), the report lays out the process the task force is following.

It will take a couple more months to formulate the recommendations, according to a joint statement from the presidents of ASN and NKF, issued on March 9, 2021.

Although many stakeholders expressed hope for a recommended replacement for the use

Ruth Jessen Hickman

Before the National Institutes of Health (NIH) Revitalization Act, women were largely underrep-resented in clinical trials, partly out of concerns for teratogenic effects. The act, passed in 1993, made it mandatory that clinical trials funded through NIH include data from women and minorities (1).

The percentage of women included in clinical trials has improved significantly since that time (2), although women are still underrepresented with respect to disease prevalence in some reports (3). However, data from men and women are often still aggregated together, and analyses based on sex are often not reported.

Clinical

One approach to lessening racial inequity in access to kidney transplants could be to allow Black patients onto the transplant waiting list at a higher level of estimated glomerular filtration rate (eGFR) than is currently needed to qualify, according to a study published in JASN.

Patients are normally eligible to be added to the kidney transplant waiting list when their eGFR drops to 20 mL/min per 1.73 m2, but the study authors estimated that registering Black people on the waitlist “as early as an eGFR of 24–25 mL/min per 1.73 m2 might improve racial

Eric Seaborg

The percentage of test-takers who passed the nephrology certification exam on their first try increased by 6% in 2020, after dropping to an all-time low in 2019. However, the 2020 pass rate of 80% is still below the 83% rate of 2018 and is the second-lowest rate ever.

The large drop in 2019 set off a dismayed discussion on Twitter and other venues about what was going wrong, and the reaction to 2020’s improvement was much more restrained.

“I am relieved we are not seeing a continued drop in the pass rate, but nephrology still has the lowest pass rate

Bridget M. Kuehn

Amassive mid-February winter storm and a week of freezing temperatures disrupted dialysis care for thousands of patients and temporarily shuttered many dialysis clinics across Texas.

Together, the cold and loss of water and power for millions of people in Texas created a “perfect storm” of crises for dialysis patients and providers, said Rajeev Raghavan, MD, FASN, associate professor of medicine at Baylor College of Medicine in Houston. Icy roads prevented dialysis patients and staff from getting to clinics or hospitals. The loss of power shut down many dialysis clinics, and as pipes froze and burst across the state, it led

Higher levels of physical activity were associated with a one-half reduction in risk of death among patients with advanced chronic kidney disease (CKD) in a recent study

The prospective study included 579 adults with stage 4 to 5 CKD treated at four Canadian multi-disciplinary kidney health clinics between 2012 and 2018. Patients were not receiving kidney replacement therapy at baseline. The study was published in the American Journal of Kidney Diseases.

Physical activity was assessed using the Physical Activity Scale for the Elderly (PASE) questionnaire, which addresses occupational, household, and leisure activities over the past week. Based on

Eric Seaborg

Even among patients with similar levels of kidney function, an algorithm that considers a host of characteristics—including demographics, biomarkers from blood and urine, health status and behaviors, and medication use—can categorize patients into three clinically distinguishable clusters associated with distinct outcomes, such as chronic kidney disease (CKD) progression, cardiovascular disease, and death, according to a new study in JASN.

This style of “subtyping” of CKD using “multi-dimensional patient data holds the key to precision medicine,” the authors write in “Subtyping CKD Patient by Consensus Clustering: The Chronic Renal Insufficiency Cohort (CRIC) Study.” The approach could provide a better