"Michelle was an incredible physician scientist and human being. She was the heart and soul of our podocyte community. To me, she was the perfect role model, and exemplified everything that is good in medicine and the world. I feel privileged to have counted her as a colleague, a confidante and most of all, my friend. Her passing left many of us heartbroken. To her tribute, her legacy lives on in her many groundbreaking discoveries and amazing nephrologists like Dr. Gentzon." --Susan E. Quaggin, MD, FASN, President, American Society of Nephrology
Laura Maursetter, Laura McCann, Riley Hoffman, and Keisha Gibson
Osteopathic medicine has a tradition of training primary care doctors (1). Although the mission statements of many osteopathic institutions are explicit about this charge, students enter training with a variety of career goals, not all focused on primary care (2). Nephrology is one field seeing a rise in osteopathically trained learners (Figure 1). Noting this trend, members of the ASN Council have been asked to develop an action plan to foster further support for osteopathic nephrology careers among medical students. Focus groups of osteopathic physicians were developed to share common and unique experiences to
Malaria, a potentially life-threatening disease, is the most prevalent endemic infectious disease worldwide, affecting millions of people in tropical areas. In European and Western countries, malaria is acquired during travel to areas in which the disease is endemic. Kidney involvement, including acute kidney injury, is seen in up to 60% of patients with severe malaria and is frequently observed with Plasmodium falciparum and Plasmodium malariae. However, the modern era has seen the spectrum of glomerular damage associated with malaria infection widened.
In a retrospective study performed in France (1), we identified 23 patients (22
Recent data demonstrate that primary aldosteronism is much more common than previously believed (1). Despite common perceptions among many providers, most patients with primary aldosteronism do not have hypokalemia (2, 3). Importantly, patients with treatment-resistant hypertension have a particularly high prevalence of primary aldosteronism (∼20%) (1, 4). Primary aldosteronism is associated with increased risk of development and progression of chronic kidney disease, heart disease, and mortality (5). Nonetheless, primary aldosteronism responds to treatment with a mineralocorticoid receptor antagonist and is curable with adrenalectomy in some patients (i.e., those
Joel Topf, Anna Burgner, Timothy Yau, Pascale Khairallah, Samira S. Farouk, and Matthew A. Sparks
The 9th annual NephMadness is a social media and medical education campaign focused on all things kidney. You can participate in NephMadness during the entire month of March, National Kidney Month. NephMadness adopts the single elimination brackets that are a hallmark of the popular March Madness (the college basketball tournament held yearly in the United States), but with a nephrology twist. Instead of basketball teams, the bracket is populated with 32 nephrology concepts from eight different regions. This year’s regions are: Liquid Biopsy, the return of Animal House, COVID-19, ICU Nephrology, Workforce, Anemia, Primary Care, and Artificial Kidney. Each region
Novel therapeutics remain urgently needed to treat severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 2019 (COVID-19), including associated acute kidney injury. Angiotensin-converting enzyme 2 (ACE2), the SARS-CoV-2 spike protein-binding site, is expressed in numerous tissues, including the lungs and kidneys. Soluble ACE2 is a potential therapeutic with dual roles: 1) binding SARS-CoV-2 to attenuate infection and replication and 2) shifting the renin-angiotensin system away from the pro-inflammatory angiotensin II and bradykinin pathways. There is precedent for using recombinant soluble ACE2 clinically. A pilot randomized clinical trial in 44 patients with acute respiratory distress syndrome (pre-COVID-19
After promoting the prevention of kidney diseases for several years, steering committee members for World Kidney Day now are taking a different approach. This year’s celebration, on Thursday, March 11, will instead focus on living well for patients already diagnosed with kidney diseases and for these patients’ families and care partners.
Chronic kidney disease (CKD) and its associated symptoms and treatments can disrupt and constrain daily living and impair overall quality of life for patients and their family members, steering committee members wrote in an editorial in the journal Kidney International (1). Yet despite their level
More than 35 years ago, continuous arteriovenous hemofiltration (CAVH) was introduced by Kramer and colleagues (1) in order to optimize volume in hemodynamically compromised individuals with insufficient urine output. The successful treatment of congestive heart failure, despite cardiogenic shock, was heralded as a major advance, but soon limitations in solute clearance and complications of critical limb ischemia had clinicians looking for better solutions. This ushered in an era of multiple continuous dialytic techniques, including slow continuous ultrafiltration (SCUF), continuous venovenous hemofiltration (CVVH), continuous venovenous hemodiafiltration (CVVHDF), and sustained low-efficiency dialysis (SLED), which have become commonplace in intensive care
Throughout the COVID-19 pandemic, nephrologists have made adjustments to best care for patients. Now they are taking stock of how kidney care has changed and considering which of those changes might stick moving forward.
The challenges of delivering kidney care during the pandemic underscored the need for innovation. The experience of meeting those challenges also showed nephrologists that some improvements are well within reach and that emergency protocols adopted during the pandemic may become a new normal.
“I’ve stopped thinking that this is temporary,” says Jeffrey Perl, MD, SM, FRCP, associate professor of medicine at the University of Toronto and
Peritoneal dialysis (PD) is associated with improved quality of life, is cost effective, and has outcomes comparable with those of hemodialysis (HD). Despite this, there is a big discrepancy in the percentage of US patients using PD: 10.1% versus HD at 89.9% (1). One reason for this difference is likely the number of myths surrounding appropriate PD candidates. These myths are often based on tradition or authority as opposed to evidence. Ready acceptance of such beliefs without re-examining them can lead to improper care. A myth we noted in a previous article in this series is the negligible