Cover Stories

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Diabetes and sleep problems often go hand in hand. It has been known for some time that diabetes-associated factors such as neuropathy and nighttime hypoglycemia can contribute to sleep problems in patients. Research is now providing growing evidence that insufficient sleep can also contribute to diabetes risk. The most recent studies reveal some of the potential mechanisms behind this link.

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The US Food and Drug Administration (FDA) could approve the first biosimilar drug for use in dialysis patients later this year, a prospect that could shake up the market with an alternative to Amgen’s dominant anemia biologic drug Epogen (epoetin alfa) that has been used in Europe for several years.

The market for home-based hemodialysis is growing and is poised to expand, nephrologists and industry representatives reported. Changes required by the Medicare Improvements for Patients and Providers Act (MIPPA), the Centers for Medicare and Medicaid Services (CMS), and a trend toward home health care may all help shift the winds in favor of home dialysis.

Increasing efforts are being made to prevent and treat chronic kidney disease (CKD) in children, before serious complications develop during adolescence and adulthood. One recent research endeavor has focused on characterizing proteinuria in children.

By assessing this condition, which is a hallmark of kidney dysfunction, investigators hope to not only slow the progression of CKD in children, but also to find new insights into disease progression that might be used to develop novel treatments for all kidney patients—adults and children.

“Change” was the mantra of President Barack Obama’s campaign, and health care was a main arena he pledged to reform.

“The time has come for affordable, universal health care in America,” Obama said when he introduced his health-care initiative at the outset of the campaign. However, most observers agree that his plan would expand the reach of health insurance coverage, but not come close to making it universal. His strategy also includes measures aimed at decreasing costs, improving efficiency, and increasing the focus on chronic diseases.

Knowledge of phosphate crystals such as those shown from a 19th century urological dictionary aided yesterday’s practitioners. Advanced understanding of phosphates’ role in health may change how today’s clinicians practice.

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Courtesy History and Special Collections for the Sciences, UCLA Louise M. Darling Biomedical Library.

Applications to Nephrology fellowships have declined significantly since 2010, yet the number of training opportunities has increased. Nephrology fellowship programs increased from 127 in 2000 to 147 in 2013, and the number of fellows in the first or second year of training jumped from 626 to 930 in that time period. However, the number of applicants participating declined from 576 in 2010 to an all-time low of 254 in the Match for the 2015 appointment year.

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Many patients with chronic kidney disease (CKD) and end stage renal disease exhibit coronary artery calcification as well as low bone mass. A new study published in the Journal of the American Society of Nephrology now shows that monitoring bone loss in dialysis patients may provide early warning signs of cardiovascular problems.

Patients on dialysis have a higher risk of dying from cardiac arrest compared with individuals in the general population, but the factors involved are unknown. Coronary artery disease is often at play in the general population, but investigators found no significant difference in the prevalence of coronary artery disease, decreased left ventricular ejection fraction, valvular heart disease, or left ventricular hypertrophy between dialysis patients who died of cardiac death vs. those who died of other causes.

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