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Summer Dyer and Linda Awdishu

Patients with chronic kidney disease (CKD) and end stage kidney disease have complex medication regimens and multiple comorbidities and can take in excess of 12 medications daily (1). High pill burden and multiple care providers place CKD and dialysis patients at risk for medication-related problems (MRPs). It has been shown that for every $1 spent on detecting and addressing MRPs in the dialysis population, $4 may be saved by the health care system (2). The Centers for Medicare & Medicaid Services (CMS) now requires monthly medication reconciliation in the End-Stage Renal Disease Quality Incentive Program (ESRD

Bridget M. Kuehn

For nephrologists working in Hawaii, like David Na’ai, MD, it's not uncommon to have caseloads of nearly 200 patients—double the 75 to 100 recommended. Na’ai, associate professor at the John A. Burns School of Medicine at the University of Hawai’i in Honolulu, described the situation as “near crisis levels.”

The island is home to approximately one-quarter of the Native Hawaiians and Pacific Islanders (NHPIs) living in the United States (1), according to the US Department of Health and Human Services Office of Minority Health. Asian Americans are the largest racial or ethnic group on the island (2

Christin Giordano McAuliffe

The number of patients requiring nephrology subspecialty care has grown tremendously. Unfortunately, while fellowship applicants have increased nearly 10% since 2019, nephrology has only had an increase of about 3% (1). This gap between workload and workforce has led to an increase in the use of non-physician practitioners (NPPs), the Centers for Medicare & Medicaid Services’ term that includes nurse practitioners (NPs) and physician assistants (PAs). Within our specialty, however, there has not been adequate discussion regarding proper utilization of NPPs.

While physicians understand their own personal background, they may not understand the wide range of experiences of

Christin Giordano McAuliffe

The number of patients requiring nephrology subspecialty care has grown tremendously. Unfortunately, while fellowship applicants have increased nearly 10% since 2019, nephrology has only had an increase of about 3% (1). This gap between workload and workforce has led to an increase in the use of non-physician practitioners (NPPs), the Centers for Medicare & Medicaid Services’ term that includes nurse practitioners (NPs) and physician assistants (PAs). Within our specialty, however, there has not been adequate discussion regarding proper utilization of NPPs.

While physicians understand their own personal background, they may not understand the wide range of experiences of

Distinctions in delivery are notable between two options—either attending Kidney Week in-person in Orlando or attending in a fully virtual capacity—but both experiences promise to be enlightening and rewarding.  

ASN also renews its call for a systemwide set of improvements for the organ transplantation program.

Susan E. Quaggin

As we move into the second half of 2022, almost 29 months since a pandemic changed the world, the time to reflect on how nephrology and our field have evolved seems fitting. My pledge to run 850 miles each year to raise awareness for the 850 million people living with kidney diseases provides me ample time for reflection. This weekend, as I hit mile 3, a single word formed in my mind—courage. This word defines our approach to one of the most complex—and rewarding—areas in medicine.

Courage has many definitions. The one I like the best is “mental and moral

Suneel M. Udani

Can targeting the cathepsin C (CatC) in proteinase-3 (PR3)-anti-neutrophil cytoplasmic antibody (ANCA) vasculitis prevent the inflammatory injury associated with ANCA-associated vasculitis (AAV) (1)? Recognizing that neutrophils from individuals with a loss-of-function mutation in a non-serine protease—CatC—maintain bactericidal activity but have limited ANCA reactivity, the authors of a recent study propose pharmacologic inhibition of CatC as a therapeutic target for anti-PR3 antibody (anti-PR3 Ab) AAV (1).

Genetic CatC deficiency is associated with the autosomal recessive condition known as Papillon-Lefèvre syndrome (PLS). After previously noting that mice with CatC deficiency were protected from AAV, the authors designed a

In patients with hemodialysis-dependent kidney failure, treatment with the macrolide antibiotic azithromycin is associated with an increased risk of sudden cardiac death (SCD), reports a preproof paper in Kidney International.

Using data from the US Renal Data System, the researchers performed a cohort study to assess the cardiac safety of azithromycin compared with amoxicillin-based antibiotics in patients on hemodialysis from 2007 through 2017. A separate cohort study compared azithromycin with levofloxacin, a fluoroquinolone antibiotic that, like azithromycin, is known to prolong the QT interval.

The two studies included 381,306 treatment episodes with azithromycin versus 344,125 with amoxicillin-based antibiotics

Yumeng Wen and Chirag R. Parikh

In the United States, approximately 40,000 new patients are added to the waitlist for kidney transplantation each year, yet in 2021, only 19,000 on the waitlist received deceased donor kidney transplants (1). Because of the burdens of dialysis and the kidney shortage, nearly 8000 waitlisted patients died or became too sick to receive a transplant in 2021 (1). From 2010 through 2020, 18%–21% of procured kidneys were not transplanted, and kidney discards are on the rise (2). In 2021 alone, a total of 5080 kidneys were procured and then discarded. A minority of donor