Cover Stories

But Data from First Nine Months Show Mixed Results

At the end of 2014, a new deceased donor kidney allocation system (KAS) was introduced, with the goal of improving organ equity and graft-recipient longevity matching. A series of simulations suggests that the KAS is expected to meet at least some of those goals—while cutting the average waiting list time by about six months.

Crystals play a role in the development and progression of a wide range of diverse diseases, from gout to atherosclerosis to kidney disease. New experimental findings suggest that these crystallopathies may involve a “regulated process” of crystal-induced cell death called necroptosis, according to a report in Nature Communications.

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During her nephrology fellowship, Jane Schell, MD, was surprised at how unprepared she felt to talk with elderly and very ill patients about their poor prognoses and the probably disturbing trajectory of their diseases.

Ongoing advances in technology and drug discovery continue to transform numerous aspects of health, but making such breakthroughs available to all who may benefit from them is often not possible, especially in the early days of their use. Furthermore, as society strives to address rising healthcare costs and consider responsible distribution of limited healthcare dollars, many questions arise regarding the most appropriate use of expensive tests and therapies.

Nephrologists entering practice in 2015 encountered a mixed job market, according to the latest report authored by George Washington University (GWU) and published by the American Society of Nephrology. GWU’s analysis of the 2015 Nephrology Fellows Survey noted job search experiences continued to differ substantially between US medical graduates (USMGs) and international medical graduates (IMGs), the latter comprising the majority of physicians choosing the specialty (1).

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Can dialysis patients benefit from having a primary care physician (PCP) or a more patient-centered approach to care? Updated data from a study presented at Kidney Week 2015 suggest improvements in some aspects of preventive care associated with PCP involvement.

Small clinical trials have shown that reducing dietary acid load can slow the progression of chronic kidney disease (CKD), but long-term, population-based studies have been lacking. Now, in an analysis of the 1988–1994 National Health and Nutrition Examination Survey (NHANES III), investigators revealed that patients with CKD who consumed high-acid diets were three times more likely to experience ESRD than were patients who consumed low-acid diets.

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Patients referred to nephrologists for evaluation of chronic kidney disease (CKD) undergo a lot of laboratory tests. But which tests contribute the most clinically relevant information? An analysis of nearly 1500 patients suggests that many tests performed for initial evaluation of CKD—including some tests ordered in a majority of patients—have little or no effect on patient diagnosis and management.

The development of kidney stones is a common problem that has traditionally been recognized as no more than an isolated and painful condition. Yet epidemiological studies have revealed links between nephrolithiasis and conditions such as the metabolic syndrome, hypertension, chronic kidney disease, and cardiovascular disease.

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