CKD burden continue to remain high in the United States and Medicare spending for all beneficiaries who had CKD exceeded $79 billion in 2016. The 2019 Chronic Kidney Disease issue of NephSAP guides readers through the latest advances in clinical research for this common and costly disease. This issue of NephSAP provides a background of the clinical research published during the years 2017 and 2018, and covers several major areas of CKD research: epidemiology, biomarkers relevant to incidence and progression, genetic variants, cardiovascular disease, weight loss interventions, and novel tools to improve CKD care measures. There have been exciting developments in our understanding of the pathogenesis and treatment options for diabetic kidney disease in the recent years. Several relevant clinical trials that demonstrated improvements in outcomes for those with diabetic kidney disease have been highlighted in this issue. Along with it, several novel risk factors for progression of kidney disease have also been discussed. Cardiovascular disease remains the principal cause of death for adults with CKD. This NephSAP outlines advances in management of atrial fibrillation and the use of device therapy in CKD. The epidemiology and conseqeuences of pulmonary hypertension, peripheral artery disease and congnitive function in those with CKD are also discussed. Clinical practitioners will also be provided with insight into topics ranging from management of obesity along with understanding about novel methodology and tools that have been tested to help improve CKD care delivery. Finally, readers can also test their knowledge with a series of 30 questions.
Acute kidney injury, primarily caused by acute tubular necrosis, leads to significant morbidity and mortality in hospitalized patients. AKI also increases the risk of progression of chronic kidney disease to end-stage kidney disease and affects other health resource outcomes such as length of stay and readmissions.
ASN has opened a search for the next Nephrology Self-Assessment Program (NephSAP®) Editorial Director. The current NephSAP Co-Directors’, Gerald A. Hladik, MD and Jerry Yee, MD, FASN, conclude their successful leadership of NephSAP on December 31, 2019.
Nephrology Self-Assessment Program is one of the premiere ASN educational activities, and among the most highly accessed. Its primary goals are self-assessment, education, and the provision of Continuing Medical Education (CME) credits and Maintenance of Certification (MOC) points for individuals certified by the American Board of Internal Medicine (ABIM).
The kidney, more specifically the glomerulus, is often injured during systemic diseases. These secondary glomerulonephritides often manifest with proteinruia, heamturia, and impaired kidney function occasionally. Diagnosis is challenging, and treatments frequently incorporate immunomodulatory drugs with potential for severe side-effects. The 2018 Secondary Glomerular Diseases issue of NephSAP presents the reader with the latest updates on diagnosis, treatment, and outcomes of a wide range of glomerular diseases likely encountered in practice. Recommendations are offered based on the best available evidence. All relevant, randomized, controlled clinical trials are discussed. The reader will also be introduced to reasearch-based findings of special clinical relevance such as biomarkers of disease activity and response. Gaps in knowledge are indicated, and considered in the context of future investigation. After studying this issue of NephSAP, readers are invited to test their knowledge in a series of challanging case studies and questions, accompanied by detailed explanations of the best answers.
Taking care of dialysis access remains part and parcel of day-to-day nephrology practice. As the ‘lifeline’ of the dialysis patient, it poses multiple challenges related not only to its creation and maintenance, but also to its impacts on safety and the expenses associated with managing access complications. Increasing involvement of nephrologists in access care, including diagnostic ultrasound and interventional procedures, demands better education of general nephrologists to be able to interact intelligently and collaboratively with their interventional colleagues. Transformative technology now provides better tools and will soon allow percutaneous creation of vascular access by nephrologists. These advances and an emphasis on placing peritoneal dialysis access will facilitate attainment of the goals of the ‘Fistula First, Catheter Last’ paradigm to improve patient outcomes.