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  • Author or Editor: Richard A. Lafayette x
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Cover Kidney News
Moving Nephrology Care and Caregivers Forward
Richard A. Lafayette

As I considered possible developments in nephrology for this coming year, I could not help but think a bit further forward to the year 2020. This led me to think more about the Centers for Disease Control and Prevention’s Healthy People 2020 initiative (1), the national blueprint designed to bring about effective preventive care and improved health to the U.S. population by 2020. This ongoing initiative started decades ago, issuing 10-year plans and starting with general interventions such as ensuring a clean environment, drinkable water, good nutrition, increased exercise, and access to high-quality healthcare. The plan then moved
Cover Kidney News
Controversy in Nephrology: Has Continuous Kidney Replacement Failed Its Promise?
Richard A. Lafayette

More than 35 years ago, continuous arteriovenous hemofiltration (CAVH) was introduced by Kramer and colleagues (1) in order to optimize volume in hemodynamically compromised individuals with insufficient urine output. The successful treatment of congestive heart failure, despite cardiogenic shock, was heralded as a major advance, but soon limitations in solute clearance and complications of critical limb ischemia had clinicians looking for better solutions. This ushered in an era of multiple continuous dialytic techniques, including slow continuous ultrafiltration (SCUF), continuous venovenous hemofiltration (CVVH), continuous venovenous hemodiafiltration (CVVHDF), and sustained low-efficiency dialysis (SLED), which have become commonplace in intensive care
Cover Kidney News
Advancing Understanding and Treatment of Glomerular Disease
Richard A. Lafayette
Primary glomerular disease is an important cause of chronic and end stage renal disease

Chronic kidney disease (CKD) is increasingly recognized as a growing global challenge, affecting up to 16 percent of the adult population (1,2). Although the veritable explosion in type II diabetes is largely responsible for this growth in developed and many developing countries, primary glomerular disease continues to contribute meaningfully to the CKD epidemic (2). These diseases account for roughly 10 percent of CKD cases in the United States and up to 50 percent in other countries (3,