2020 was a challenging year in nephrology education. In-person annual meetings shifted virtual, and many of us learned firsthand the concept of “Zoom fatigue,” as our institutional meetings and conferences moved virtually. The National Institutes of Health (NIH) made a big announcement that will likely have a long-lasting impact on research training. Home dialysis education was front and center. How will the nephrology education landscape continue to evolve in 2021?
Virtual conferences are here to stay
There is no denying that virtual education is here to stay. Coronavirus infectious disease 2019 (COVID-19) resulted in an almost complete shift to the
The past year has been an arduous one. Amid the pandemic, we swiftly evolved in delivering our primary mission: patient care and education. The need for physical distancing did not culminate into any separation of trainees from education, with the majority of trainees agreeing that the educational endeavors of their programs were unaffected as a result of the pandemic (1). Local institutions and national organizations, led by prominent educators, continued to conduct conferences via innovative virtual platforms with high-quality content reaching audiences all over the globe. This edition of Kidney News is dedicated to trainees and
The year 2019 proved an incredibly important year for the treatment of patients with diabetic kidney disease (DKD). The Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE) trial was a game changer; it demonstrated impressive cardiovascular- and kidney-protective effects of the sodium glucose co-transporter-2 (SGLT2) inhibitor canagliflozin in patients with DKD (1). CREDENCE was important because it was the first trial of SGLT2 inhibitors to include kidney endpoints as primary targets of the trial and led to the US Food and Drug Administration (FDA) extending the indication for canagliflozin specifically for reducing the risk
Severe acute respiratory coronavirus 2 (SARS-CoV-2) uses angiotensin-converting enzyme 2 (ACE2) to enter host cells. Early in the pandemic, several basic science studies were often cited and suggested that ACE inhibitors (ACEis) and angiotensin receptor blockers (ARBs) may have an effect to increase the abundance of ACE2 (1). Thus, logic would prevail that if anyone on ACEis or ARBs is at risk of infection, becomes infected, or develops coronavirus infectious disease 2019 (COVID-19), then these should be discontinued. However, the science of the renin angiotensin system (RAS) is far more intricate and interesting. The correct answer is that
Drugs that are derived from nature are prevalent in nephrology. For example, the first angiotensin-converting enzyme inhibitor (captopril) was isolated from the venom of the Brazilian pit viper, Bothrops jararaca (1). Interestingly, the first sodium glucose co-transporter (SGLT) inhibitor (phlorizin) was isolated from the bark of the apple tree (2). What else does nature have in store?
An unlikely place to look is the saliva of Heloderma suspectum, better known as the Gila monster. This is a venomous lizard native to the United States and Mexico. It turns out that the Gila monster only
Novel therapeutics remain urgently needed to treat severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 2019 (COVID-19), including associated acute kidney injury. Angiotensin-converting enzyme 2 (ACE2), the SARS-CoV-2 spike protein-binding site, is expressed in numerous tissues, including the lungs and kidneys. Soluble ACE2 is a potential therapeutic with dual roles: 1) binding SARS-CoV-2 to attenuate infection and replication and 2) shifting the renin-angiotensin system away from the pro-inflammatory angiotensin II and bradykinin pathways. There is precedent for using recombinant soluble ACE2 clinically. A pilot randomized clinical trial in 44 patients with acute respiratory distress syndrome (pre-COVID-19
Basic science is fundamental to advancing medicine and improving health outcomes. It is an exciting time to be engaged in basic and translational research focusing on kidney diseases. Novel research tools and methodologies are available to answer questions that have long eluded scientists. Moreover, we are seeing investments in kidney-related research by pharmaceutical companies, industry, societies, and governments. Examples of these investments include the Kidney Precision Medicine Project (KPMP), funded by the National Institute of Diabetes and Digestive and Kidney Diseases; the Transformative Research in Diabetic Nephropathy (TRIDENT) study, which is a private-public partnership; the Kidney Innovation Accelerator (KidneyX) prize;
Elinor C. Mannon, Matthew A. Sparks, and Samira S. Farouk
Mentorship and early educational experiences play critical roles in influencing trainees' long-term career goals, and the field of nephrology is no exception. Like any specialty, one's decision to pursue nephrology likely results from a combination of clinical experiences, nephrology education, and mentorship both during medical school and residency. A majority of nephrology fellows previously reported deciding to pursue a nephrology fellowship during residency (1), and 33% of US internal medicine subspecialty fellows who did not choose nephrology identified the lack of a clear mentor as being one of the reasons for not doing so (2). Additionally,
Deepti Torri, Matthew Sparks, Kellie Calderon, Hitesh Shah, and Kenar Jhaveri
The outlook for securing a job after nephrology training has become increasingly more difficult. A glance at the New England Journal of Medicine classifieds shows that the number of jobs advertised for nephrology trainees is decreasing. To assess the current job market for graduating nephrology fellows, we conducted an Internet-based, nine-question anonymous survey.
The survey was created online using SurveyMonkey.com, and a hyperlink was placed on popular nephrology fellow blogging sites such as the Renal Fellow Network (http://www.renalfellow.blogspot.com), Nephron Power (http://www.nephronpower.com), and Uremic Frost (http://www.uremicfrost.com) and the ASN Kidney