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David White

One of the more challenging decisions in nephrology is if and when to initiate dialysis and the timing of that initiation for patients with acute kidney injury (AKI). Because the initiation of renal replacement therapy (RRT) is a crucial decision for patients with life-threatening changes in fluids, electrolytes, and acid–base balance, expect this to remain a topic of discussion and debate in 2018.

Ashita Tolwani, MD, MSc, laid out the advantages and drawbacks when considering early initiation of dialysis in patients with AKI in her talk “Timing of AKI Dialysis: Why the Answer Is Not That Simple” at Kidney Week

David White

Shedding further light on disparities in, and the impact of discrimination on, kidney disease rates and care was the focus of a Kidney Week 2017 session titled “Context Is King: Neighborhood and Social Networks as a Risk Factor for Chronic Disease.”

Many studies about income and race disparities in the incidence of kidney diseases are well known, including higher incidence rates for lower income blacks and whites (1) and the heightened proportion of ESRD incidence across neighborhood poverty levels (2).

Deidra C. Crews, MD, ScM, FASN, outlined some of the more nuanced research on this subject

David White

The numbers speak for themselves. There are currently 121,678 people waiting for life-saving organ transplants in the US. Of these, 100,791 await kidney transplants. A patient is added to the kidney waitlist every 14 minutes and 13 people die every day waiting for a kidney transplant (1). These numbers and their implications led to the Kidney Week 2017 session, Political Correctness? Public Policy Influences on Transplantation, moderated by Roy D. Bloom, MD, and Michelle A. Josephson, MD.

In the segment Kidney Allocation Changes: Past, Present, and Future, Richard N. Formica, MD, of the Yale School of

Rachel Shaffer and David White

Policymakers and public health officials are sounding the alarm about the opioid overdose crisis nationwide. More than 115 people die each day due to opioid-related drug overdoses, and the Department of Health and Human Services (HHS) Secretary Alex Azar has made combatting this epidemic one of his top priorities. White House and HHS officials have met with representatives of the American Society of Nephrology (ASN) and peer medical societies to discuss strategies to confront the epidemic and have also launched a public service campaign to help educate Americans about the highly addictive nature of opioids.

The Trump administration has launched

David L. White

Nephrology faces challenges. Clinically, other internal medicine specialties increasingly are managing diseases traditionally considered in the domain of the nephrologist. Funding for kidney research is less per patient than every other major disease, such as cancer, cardiovascular disease, and diabetes. And the next generation is less interested in nephrology careers than any previous generation.

The American Society of Nephrology (ASN) is committed to working with every member of the kidney community—particularly the society’s more than 20,000 members—to overcome these challenges, assert the value of nephrology, and articulate a positive, bold vision for the specialty’s future. The question is no longer

Eleanor D. Lederer and David White

Medical care in the United States is poised to undergo one of the most comprehensive transformations in the past 50 years, prodded by ever-rising costs and poor population health performance. To address these and other challenges, Congress—with support from President Barack Obama—passed the Medicare Access and CHIP Reauthorization Act (MACRA) in 2015. MACRA has led to Medicare’s creation of a new physician reimbursement system, the Quality Payment Program (QPP). QPP represents the most significant step to date in transitioning from a volume-based reimbursement system to a value-based one. Transitions of this magnitude engender anxiety among patients about legitimate concerns for