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Richard Lafayette

We are very proud to bring you Kidney News, issue after issue.

Kidney News strives to present you what is new and exciting in the world of kidney health and disease, and to support that information with reviews and opinions on how to usher that news into present day understanding and action.

As we approach a decade of serving our readership with the very best of kidney news, perspectives, and observations, we are making some changes. With this issue, we present a fresh new design for the magazine, including a more eye-catching cover and easier navigation. You

Amy Williams

Over the past 10 years, much has changed in the specialty of nephrology and for nephrologists in all career tracks and professional settings. We have a deeper understanding of underlying mechanisms of disease and how to target therapy. Kidney Week 2017 was full of excitement and examples of discovery and translation to improve clinical care.

New care models have grown and matured, and there has been continued exploration of how to manage those with chronic kidney disease (CKD) and to identify those at risk for kidney disease earlier in their disease trajectory. Plus, there certainly is a market for our

Sonali Gupta and Joseph Mattana

The prevalence of diabetes is rapidly increasing and is projected to affect more than 400 million people by 2030 worldwide. Diabetic nephropathy remains the most serious microvascular complication and most frequent cause of end stage renal disease in the United States. There has been a pressing need for newer therapeutic agents to halt this expanding population and to limit the disease’s associated morbidity, mortality, and expense. Newer antidiabetic medications acting via novel pathways are gaining increased acceptance in medical practice and their renal effects have been the subject of much recent study.

Although the sodium glucose cotransporter (SGLT) inhibitor called

Treatment with angiotensin-converting enzyme (ACE) inhibitors, statins, or both does not affect albumin excretion in adolescents with type 1 diabetes, concludes a trial in The New England Journal of Medicine.

In a screening study of 4407 adolescents with type 1 diabetes, 1287 had increased albumin excretion, defined as the upper third of the albumin-to-creatinine ratio. Of these, 443 were randomly assigned to treatment with an ACE inhibitor, statin, or matching placebos in a 2-by-2 factorial design. The main outcome of interest was change in albumin excretion, assessed every 6 months over 2 to 4 years. Secondary outcomes included

David White

Shedding further light on disparities in, and the impact of discrimination on, kidney disease rates and care was the focus of a Kidney Week 2017 session titled “Context Is King: Neighborhood and Social Networks as a Risk Factor for Chronic Disease.”

Many studies about income and race disparities in the incidence of kidney diseases are well known, including higher incidence rates for lower income blacks and whites (1) and the heightened proportion of ESRD incidence across neighborhood poverty levels (2).

Deidra C. Crews, MD, ScM, FASN, outlined some of the more nuanced research on this subject

Even with modern antiretroviral therapy (ART), survival on dialysis is significantly lower for non-white patients with HIV infection, according to a study in Kidney International.

Using data from a nationwide dialysis provider, the researchers identified two groups of HIV-positive dialysis patients: 5348 patients who had HIV only and 1863 patients with HIV and hepatitis C virus (HCV) coinfection. In both groups, a large majority of patients were African American: 74.3% of the HIV-positive group and 81.6% of the HIV/HCV-positive group. Percentages of Caucasian patients were 13.2% and 9.0%, respectively.

A cohort of 410,545 HIV/HCV-negative patients were studied for

David White

One of the more challenging decisions in nephrology is if and when to initiate dialysis and the timing of that initiation for patients with acute kidney injury (AKI). Because the initiation of renal replacement therapy (RRT) is a crucial decision for patients with life-threatening changes in fluids, electrolytes, and acid–base balance, expect this to remain a topic of discussion and debate in 2018.

Ashita Tolwani, MD, MSc, laid out the advantages and drawbacks when considering early initiation of dialysis in patients with AKI in her talk “Timing of AKI Dialysis: Why the Answer Is Not That Simple” at Kidney Week

Consuming caffeine—the more the better—may help reduce the risk of early death among patients with chronic kidney disease, suggests a study presented at Kidney Week.

Drinking coffee has previously been shown to reduce the risk of an early death among the general population. Caffeine consumption has also been linked to better outcomes from some chronic diseases. For example, studies have shown that coffee and tea consumption help reduce the risk of death in patients with liver disease (Modi AA, et al. Hepatology 2010; 51:201–209), by exerting beneficial effects on the liver (Louise JM, et al. J Hepatol

Bridget M. Kuehn

By adolescence, individuals who were born prematurely and low birth weight are already showing signs of kidney impairment, according to an abstract presented at Kidney Week.

Improved care in the neonatal intensive care unit has allowed many babies born prematurely to survive and thrive into adulthood. But some evidence has emerged that individuals who were born prematurely have an increased risk of developing chronic kidney disease later in life (Carmody JB and Charlton JR. Pediatrics 2013; 131:1168–1179).

“There is a growing recognition that individuals born preterm are vulnerable to renal disease,” said Jennifer Charlton, MD, a pediatric nephrologist

Bridget M. Kuehn

A drug used to treat osteoporosis accumulates excessively in the bones of rats with chronic kidney disease, (CKD), according to a study presented at Kidney Week.

Bisphosphonates are currently not recommended in patients with CKD—despite the elevated risk of osteoporosis—because of potential safety concerns. The drug is cleared by the kidney, so in patients with impaired kidney function there is a concern about excess accumulation of the drug, said Mohammad Walid Aref, an MD/PhD candidate at the Indiana University-Purdue University-Indianapolis School of Medicine. But other experts point to the risk of more brittle bone rather than reduced excretion.

“The main