Cover Stories

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Collaboration between primary care physicians (PCPs) and nephrologists in the care of patients with chronic kidney disease (CKD) is widely advocated, but how do these clinicians prefer to collaborate? That was the focus of recent research on CKD care (Diamantidis CJ et al. Primary Care-Specialist Collaboration in the Care of Patients with Chronic Kidney Disease. Clin J Am Soc Nephrol, February 2011).

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Measuring blood levels of the protein cystatin C can help identify individuals with chronic kidney disease (CKD) who have a poor prognosis, new research finds (Peralta CA, et al. Cystatin C identifies CKD patients at higher risk for complications. J Am Soc Nephrol, Janaury 2011).

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The Supreme Court ruling upholding the constitutionality of the Affordable Care Act (ACA) gave the green light to a host of reforms that will affect the practice of kidney care.

On November 2, 2015, President Barack Obama signed into law the Bipartisan Budget Act, a top ASN policy priority that opens the door for a funding increase for kidney research at the National Institutes of Health (NIH) and Department of Veterans Affairs (VA). The act raises the overall federal discretionary spending levels for 2016 and 2017. However, Congress still needs to pass a budget for 2016 that details exactly how much funding all the federal agencies—including NIH and the VA—can spend.

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The inflammatory/immune biomarker soluble urokinase receptor (suPAR) may offer a valuable new tool for identifying patients at increased risk of chronic kidney disease (CKD), according to a study in The New England Journal of Medicine.

Questions continue to plague recommendations for daily sodium intake. Recently, both high and low sodium levels have been linked to increased cardiovascular risk in patients with established cardiovascular disease.

“We know that high sodium is certainly bad for you,” said Andrew Mente, PhD, assistant professor of clinical epidemiology and biostatistics at McMaster University in Hamilton, Ontario, Canada. “What’s interesting is that we also found that too little sodium was also a significant predictor of increased cardiovascular events.”

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Patients who survive an episode of acute kidney injury (AKI) and have persistently diminished kidney function are infrequently referred to a nephrologist, according to a recent study in the Journal of the American Society of Nephrology. The findings indicate that efforts are needed to identify and treat kidney injury patients who require subsequent care.

End stage renal disease (ESRD) patients receiving peritoneal dialysis (PD) usually have lower morbidity than hemodialysis (HD) patients, but other factors play a role as well.

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