In Practice

The Nephrology and Hospice & Palliative Medicine fellowship training programs of the University of Pennsylvania, Yale University, and the University of North Carolina have collaborated to create a combined 2-year training program through the ACGME’s Advancing Innovation in Residency Education (AIRE) program.

The following statement was released today:

Washington, DC (June 1, 2020)—The American Society of Nephrology (ASN) is proud of its efforts to promote diversity, equity, and inclusion among kidney health professionals. This commitment is hollow, however, if ASN fails to oppose racism. ASN strongly supports and will advance efforts to achieve equality to reduce the adverse impact of racism, especially on health and in health care.

kenar_jhaveri-headshot.jpgKenar D. Jhaveri, MD, FASN, Professor of Medicine at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell and Associate Chief of the Division of Kidney Disease and Hypertension at Northwell Health, NY, has been selected as Editor-in-Chief of ASN Kidney News.

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May is National Nurses Month

Those who work in nephrology, or receives kidney care, understand that excellence of care depends directly upon the professionals who chose to become nephrology nurses.

KHI_Logo-Horizontal-Color.jpgClinical trials often exclude people with kidney diseases. This means that 37 million people in the United States are rarely represented in the kind of research that advances change in treatment and care. The challenges that result from such exclusion are highlighted by the current COVID-19 crisis.

KHI_Logo-Horizontal-Color.jpgThe Coronavirus – 2019 (COVID-19) pandemic is unmasking the shortcomings of in-center hemodialysis for people with kidney failure. Individuals with kidney failure who rely on in-center dialysis do not have the luxury of social distancing during a pandemic. In-center dialysis exposes people with kidney failure and healthcare workers to potential infection.

This podcast includes an interview with Suzanne Watnick, MD, FASN. Dr. Watnick is the Chief Medical Officer at Northwest Kidney Centers in Washington state and Professor of Medicine at the University of Washington. She discusses the steps her organization took to protect kidney patients and health care workers once the Coronavirus hit her state.

Developments in the kidney community in recent years, including the KidneyX and the Advancing American Kidney Health initiative, have accelerated development of transformative devices for kidney replacement therapy.

Gretchen Brandt MD, FASN - Washington, DC
 

While there are many incentives to invest in rare diseases, well designed clinical trials are critical to getting the new therapies conceived by pharmaceutical companies to the people who need them.  

With the current spread of COVID-19 (Coronavirus) and due to the American Society of Nephrology’s international outreach representing 21,000 members in 131 countries, the organization has responded to the developments in the following ways in order to share important information with the nephrology community:

The Centers for Disease Control and Prevention (CDC) and Nephrologists Transforming Dialysis Safety (NTDS) have partnered to develop a fresh, new online learning module, Managing Infection in an Outpatient Dialysis Facility.

The module is available to all members of the nephrology care team, including physicians, nurses, fellows, technicians, patients, and kidney educators, via an open-access platform.

KHI_Logo-Horizontal-Color_1.jpgThe Kidney Health Initiative (KHI) sent a congratulatory letter to Stephen Hahn, MD, on his recent confirmation as Commissioner of the US Food and Drug Administration (FDA).

KHI_Logo-Horizontal-Color_0.jpgThe Advancing American Kidney Health initiative made developing an artificial kidney a national priority. The increased interest, investment, and innovation brought about by this policy highlight the need for new and improved infrastructure to facilitate innovation.

The fourth annual NephJC Kidneys awards were hosted in Washington, DC on Friday, November 8 to coincide with ASN Kidney Week 2019. NephJC is an online medical journal club. They utilize social media and, in particular, the Twitter community to generate discussion and review current literature related to nephrology. It is open to anyone: nephrologists, residents, fellows, cardiologists, internists, urologists, radiologists, pharmacologists, and patients contribute to the discussion. Many contributors attended the NephJC event and took part in the Tweet-up.

WASHINGTON, DC -- Biopsies remain the gold standard for diagnosing post-transplant kidney disease but they are imperfect, a speaker said here during Kidney Week 2019. Emerging biomarkers may provide a complement to helping nephrologists diagnose and manage disease. The session entitled, "Needle Phobia: Kidney Transplant Biopsy Alternatives", included four speakers on the topic.

Announced on October 7th, the Nobel Prize in Medicine was jointly awarded to a trio of scientists, William G. Kaelin Jr., Peter J. Ratcliffe, and Gregg L. Semenza, for their work on “how cells sense and adapt to oxygen availability,” The New York Times reports.

These “investigators uncovered detailed genetic responses to changing oxygen levels that allow cells in the bodies of humans and other animals sense and respond to fluctuations, increasing and decreasing how much oxygen they receive.”

The U.S. Department of Health and Human Services (HHS) has awarded a contract to a KidneyX award winner to provide hemodialysis systems in communities hit by natural disasters. The HHS Office of the Assistant Secretary for Preparedness and Response has stated it will be prepared to use the systems by the end of this year.

On September 27th, the Patient-Centered Outcomes Research Institute (PCORI) announced the appointment of Josephine P. Briggs, MD, as PCORI’s Interim Executive Director, starting on November 1, 2019. Briggs will lead the organization during its search for a replacement for Joe Selby, MD, MPH, who announced plans to retire as Executive Director by year’s end. She will continue her work as JASN Editor-in-Chief during this time.

The U.S. FDA has now approved INVOKANA® (canagliflozin) as the only type 2 diabetes (T2D) medicine indicated to treat diabetic kidney disease (DKD) and reduce the risk of hospitalization for heart failure in patients with T2D and DKD.  Approximately 1 in 3 patients with T2D also has DKD, which can ultimately lead to kidney failure. Once patients reach kidney failure, the average 5-year survival is less than 40%, largely due to cardiovascular-associated morbidity and mortality.

Announced July 25, Dr. Reshma Kewalramani will be promoted to president and CEO of Vertex Pharmaceuticals. She is currently the chief medical officer for the company and was previously a practicing nephrologist who earned her medical doctorate at Boston University and trained at Bigham & Women’s Hospital.

Dr. Kewalramani will be the first woman to run a large biotechnology firm. Vortex’s share price “rose 360% and its sales doubled to $3 billion annually” under the previous CEO, largely due the company’s pharmaceuticals used to treat cystic fibrosis.

The new prize competition seeks to identify ideas and solutions patients and care partners have developed to improve their daily life with kidney disease. The KidneyX Patient Innovator Challenge, funded by the National Kidney Foundation (NKF) invited individuals, communities, businesses, institutions, and not-for-profit organizations, among others, to submit ideas on how to improve therapeutic options and quality for life for people living with kidney disease.

The American Society of Nephrology (ASN) today announced the appointment of Michael Allon, MD, as the first Editor-in-Chief of Kidney360, ASN’s new online journal launching in January 2020.

Several initiatives have been implemented by NIDDK and ASN in order to foster kidney research and encourage research investigators as the NIH Division of Kidney, Urologic, & Hematologic Diseases (KUH) saw a 2% decrease in funding from the 2019 NIH budget.

This article includes a list of initiatives taken from an upcoming article in Kidney News March issue.

Outlined in a recent report from CNBC by Lori Ioannous (@Loriloannou1), chronic kidney disease is a “modern-day plague in the United States, driven in large part by the nation’s obesity epidemic”. 30 million Americans, or 1 in 9 adults, have chronic kidney disease, with diabetes and hypertension being major causes. “More than 510,000 kidney patients are now on dialysis, and over 100,000 are on the kidney transplant list”.

“Resident macrophages reprogram toward a developmental state after acute kidney injury” was published today, January 24th, in JCI Insight. The study with co-first authors and trainees in the NIH-funded UAB Medical Scientist Training Program, Jeremie M. Lever and Travis D. Hull, M.D., Ph.D., found that “during acute kidney injury (AKI) in a mouse model, kidney-resident macrophages are reprogrammed to a developmental state, resembling these same cells when they are found in newborn mice.

ima_thumb.pngIn early December 2018, Prabir Roy-Chaudhury, MD, PhD, FASN, the outgoing American Society of Nephrology Co-Chair for KHI, and Raymond C. Harris, MD, FASN, who began his term as Co-Chair for KHI in 2019, recorded a discussion with ASN Executive Vice-President Tod Ibrahim.

The following articles are brief Q&A sessions with American Society of Nephrology (ASN) grant recipients. The sessions explore what research the individual is undertaking with the grant funds, their hopes for the research, career goals, and advice for others interested in applying for these grant funds.

Past Recipient Profiles

“Exome sequencing in a cohort of over 3,000 patients demonstrated genetic causes of chronic kidney disease in about 10% of cases and genetic testing may aid in the treatment of these patients”.

In a recent study published by the Journal of the American Society of Nephrology (JASN), set out to examine the “immediate and longer-term effects of hemodialysis on cerebral circulation, cerebral structure, and cognitive function as they are currently poorly understood.

97 hemodialysis patients, with a median age of 59 years, were included in the study and the tests occurred over a 12-month period. During which transcranial Doppler ultrasounds were used to “measure cerebral arterial mean flow velocity (MFV) throughout dialysis, as well as cognitive scores, and MRI imaging.

"Nigeria, on March 8, joined the rest of the world to celebrate the World Kidney Day (WKD). A day set aside to raise awareness on the plight of people living with Chronic Kidney Disease (CKD) and how to better prevent, treat and manage 'the disease'".

A recent article by Doris Iarovicic, a psychiatrist at Hardvard University's Counseling and Mental Health Services, details her experience with patients who prefer the "expertise" of the digital world to the expertise of in-person physicians.

Read the full article at the New York Times (soft paywall).

National healthcare recruiting company The Medicus Firm said it placed the lowest percentage of internationally trained physicians in 2017 in at least seven years. The percentage of internationally trained physicians placed by Medicus dropped to 24%, down seven points from nearly 32% in 2016, according to the report.

The “Prioritizing Symptoms of ESRD Patients for Developing Therapeutic Interventions” workshop took place from January 8th through January 10th in Washington, DC. The meeting convened various stakeholders, including patients and care givers. Discussion centered around three symptoms of ESRD that were identified as priorities through previous patient focus groups: Fatigue, Insomnia, and Muscle Cramps.

The goal of the meeting was to:

The UCLA Kidney Transplant Program started a voucher program in 2014 which has already proven its utility and saved 25 lives. “The program works like this: The voucher donor gives a kidney to a stranger on dialysis. Often that recipient had a friend or family member who had wanted to be a donor but couldn’t due to incompatibility.

To join the conversation on the affects of Hurricane Harvey on dialysis and kidney care, please sign in and see the "Supporting our Texas Colleagues" forum on ASN Communities. Share your experience and knowledge with peers.

An original investigation published online by JAMA Dermatology on July 26, 2017 found that "renal transplant recipients had greater risk of developing melanoma compared with their non-renal transplant counterparts. Risk factors for developing melanoma included older, age, male sex, recipient white race, living donors, sirolimus therapy, and cyclosporine therapy".

Of 105,174 patients (64,151 or 60.7% male, mean age 49.5, standard deviation 15.3 years) "who received kidney transplants between 2004 and 2012, 488 or 0.4% had a record of melanoma after transplantation".

 Clinicians can now submit Quality Payment Program Hardship Exception Applications