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Eric Seaborg

Some nephrology fellowship programs are not providing all fellows the required training in several procedures, ASN and the American Board of Internal Medicine (ABIM) charge in a letter to the programs’ accrediting agency.

The two organizations sent a formal letter to the Accreditation Council for Graduate Medical Education (ACGME) expressing concern that some accredited nephrology training programs provide little or no experience in performing kidney biopsies, placing temporary vascular access for hemodialysis, and placing dialysis catheters for continuous renal replacement therapy.

“Despite the debates in recent years about the need to retain requirements for competency in biopsies and temporary hemodialysis

Timothy O’Brien

Independently and together, changes in estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR) predict the risk of kidney and cardiovascular events and death in patients with type 2 diabetes, reports a study in a recent issue of CJASN.

“Our overall results suggest that a combined approach of determining clinically meaningful magnitudes of earlier change in both eGFR and UACR in type 2 diabetes may add substantial prognostic value to that associated with eGFR or albuminuria change alone,” concludes the report by John Chalmers, MD, PhD, of The George Institute for Global Health, University of New South

Debbie S. Gipson and Howard Trachtman

Chronic kidney disease (CKD) in children involves a host of rare diseases affecting children of all ages. The therapeutic needs of these children are largely unmet because of limited disease- and age-specific drug development. The absence of pediatric testing to document appropriate pediatric dosing, safety, and efficacy has many consequences:

■ Few drugs are labeled for use in children with CKD.

■ Off-label prescribing is often extrapolated from product labels written for adult patients with kidney disease or other non–kidney-related conditions.

■ Little progress has been made to fill the information gaps required to guide the pharmacologic treatment of children

Nephrologists from the American Society of Transplantation (AST) Kidney Pancreas Community of Practice (KPCOP) and the American Society of Nephrology (ASN) Quality Committee are partnering in consensus-building and educational efforts to improve the care of kidney patients after failed allograft—a vulnerable and growing group of kidney patients in need of more coordinated care. These efforts include formation of a cross-cutting “Kidney Recipients with Allograft Failure—Transition of Care (KRAFT)” workgroup.

Formed in 2018 by KPCOP Chair Darshana Dadhania, MD, the KRAFT workgroup seeks to address gaps in evidence and consensus for clinical care when kidney allograft function is declining and return

Pneumococcal vaccination is a cost-effective intervention for adults with chronic kidney disease (CKD) under age 65, in the absence of other clinical indications, reports a study in the American Journal of Kidney Diseases.

Using data from the National Health and Nutrition Examination Survey 1999 to 2004, the researchers estimated the prevalence of pneumococcal vaccination among patients with CKD, based on age and clinical indications. For patients aged 65 to 79–for whom the vaccine is indicated by age–vaccination prevalence was 56.6%. For CKD patients aged 50 to 64, prevalence was 28.5% for those with clinical indications (such as diabetes,

Women who develop pre-eclampsia during pregnancy are at increased risk of developing kidney disease later in life, reports a study in the British Medical Journal.

Using national registry data, the researchers identified all women in Denmark who had at least one pregnancy lasting at least 20 weeks between 1978 and 2015. Hazard ratios for later diagnosis of kidney disease were compared for women with and without a history of pre-eclampsia, stratified by gestational age at delivery. The analysis included more than 1 million women, average follow-up of 18.6 years.

Kidney disease was diagnosed in 14,816 women, 7.2% of

The University of Washington Center for Dialysis Innovation (CDI), a collaboration between the Northwest Kidney Centers and UW Medicine, is hosting the 2nd Annual IDEAS Conference: Innovations in Dialysis—Expediting Advances Symposium. The meeting will take place August 18–20, 2019, in Seattle, WA, on the University of Washington campus.

Nearly 500,000 Americans have kidney failure treated with dialysis and 50,000 die each year from kidney disease. There has been little significant innovation advancing dialysis technology since chronic hemodialysis was launched 59 years ago in Seattle.

IDEAS brings together innovators of wearable, portable, and implantable dialysis technologies, including researchers, entrepreneurs, physicians, patients,

Bridget M. Kuehn

Sexual dysfunction and fertility are major concerns for patients with kidney disease that are important for clinicians to discuss, according to Silvi Shah, MD, FASN, assistant professor of nephrology at the University of Cincinnati.

More than half of both male and female patients with kidney disease experience some form of sexual dysfunction, which can be linked to their disease or its treatment, noted Shah. Many also face concerns about fertility, and women may require counseling about pregnancy or contraception. Yet, many nephrologists feel ill-prepared to discuss women’s health and often neglect these conversations, according to the results of a survey

Eric Seaborg

Critics have expanded their tactics challenging maintenance of certification (MOC) requirements by filing several class-action lawsuits against the boards that administer MOC tests and programs.

The first of these suits was filed in December 2018 against the American Board of Internal Medicine (ABIM) by four internists who allege they have been harmed by ABIM’s anti-competitive practices regarding MOC.

On Feb. 19, 2019, three physicians in California proposed a class-action lawsuit against the American Board of Medical Specialties, American Board of Anesthesiology, and American Board of Emergency Medicine for antitrust violations. On Feb. 26, 2019, a radiologist in Tennessee filed a

Close to 40% of deaths in young adult patients with kidney failure (ESRD) result from cardiovascular disease (CVD), according to an analysis of US Renal Data System data published in JAMA Cardiology.

Lack of preemptive transplantation and lack of pre-ESRD nephrology care are strongly associated with a higher risk of cardiovascular mortality in the 22- to 29-year-old ESRD age group, reports the study by Zubin J. Modi, MD, a pediatric nephrologist at the University of Michigan, Ann Arbor, and colleagues. They write, “We show that young adults began ESRD care with a higher burden of preexisting CVD and