Much has been written in the past few years about the nephrology workforce crisis. Fellowship positions go unfilled; some recent graduates choose to work as hospitalists instead. However, there are many bright spots on the horizon. Exciting new therapies, such as the sodium-glucose cotransporter-2 (SGLT2) inhibitors, offer the chance to help keep more people from reaching kidney failure. Meanwhile, recent policy advances, especially the Advancing American Kidney Health Executive Order in the United States, will help shift the practice of nephrology toward more comprehensive care of patients living with kidney diseases.
Nephrologists in private practice tend to value their independence
Veverimer is a novel agent for the treatment of metabolic acidosis in chronic kidney disease (CKD). It is a nonabsorbable polymer that selectively binds hydrochloric acid, leading to excretion of excess acid via the gastrointestinal tract. Veverimer completed a phase 3 clinical trial, demonstrating correction of serum bicarbonate when compared to placebo (1). However, in August 2020, the US Food and Drug Administration (FDA) declined to approve veverimer, requesting additional information on the likelihood of clinical benefit. This prompted manufacturer Tricida to create the VALOR-CKD trial. This ongoing trial will evaluate veverimer’s efficacy against placebo on progression of