Black individuals, who are at a two- to fourfold higher risk of developing end stage kidney disease in the United States, are simultaneously less likely to be referred for transplantation, to be waitlisted, or to receive a kidney transplant (KT) (1–3).
The murders of countless Black individuals sparked uprisings in 2020 throughout the United States. This included efforts spearheaded by medical students around the country to remove race as a factor in estimated glomerular filtration rate (eGFR) calculation at their institutions (4). Racialized algorithms, which include race in eGFR equations, result in higher values
#NoMoreManels, a hashtag that continues to trend on social media in 2021, both within and outside nephrology, is used to draw attention to panels of all-men speakers and moderators, despite an active US physician workforce that is over one-third women (1).
As with its inception as a field more than 50 years ago, nephrology remains a man-dominated discipline, with 30% women nephrologists (2). There exist gender disparities, not only in representation of women nephrologists but also in significant imbalances in compensation and leadership positions. Women earn a mean of $31,000 per year less than their male
During my rotation as a nephrology fellow at a high-volume liver transplantation center, I vividly remember an afternoon consultation from the medical team’s intern: “Our patient needs a simultaneous liver-kidney transplant (SLKT).”
Several questions came to mind. How do they know he needs both a liver and a kidney? Are there guidelines for this seemingly monumental decision? What determines whether and when a patient receives a kidney from the donor pool—an increasingly scarce resource, with wait times approaching a decade? I found no rules to guide me. No criteria existed to aid me in the determination of
Most nephrologists learn early in their training that the most common immunosuppressant regimen for patients with a kidney transplant consists of a calcineurin inhibitor (CNI), mycophenolic acid (usually mycophenolate mofetil [MMF]), with or without some corticosteroid. Let’s take a quick look at two emerging outside-the-box immunosuppression tools.
The new kid on the block
CNIs have long been a thorn in kidney transplantation’s side—with a laundry list of adverse effects ranging from tremors to electrolyte disturbances to paradoxical nephrotoxicity (1). One newer drug that has provided a CNI-free option in some patients is belatacept (approved
The short period of 2020 to 2022 has felt like its own era in the field of kidney transplantation, with significant advances in the field on various fronts. The next two editions of Kidney News will highlight some of these advances in kidney transplantation, which push the barriers of science and society. This first and current edition will focus on racial inequities in transplantation and measures to address them, the new kidney transplant allocation system, updates from the Apolipoprotein L1 (APOL1) Long-term Kidney Transplantation Outcomes (APOLLO) study, and groundbreaking advances in xenotransplantation and finally,
As featured in the July edition of Kidney News, this issue again highlights advances in kidney transplantation. The July issue included articles on the new kidney transplant allocation system, updates from the apolipoprotein L1 (APOL1) Long-term Kidney Transplantation Outcomes (APOLLO) study, recent groundbreaking advances in xenotransplantation, racial inequities and measures to address them, and a review of the increasingly encountered challenge of oxalosis in kidney transplantation. We now turn our attention to genomics, biomarkers, new insights into thrombotic microangiopathy (TMA), focal segmental glomerulosclerosis recurrence in transplantation, and finally, updates on the use of belatacept.
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,
Joel Topf, Anna Burgner, Timothy Yau, Pascale Khairallah, Samira S. Farouk, and Matthew A. Sparks
The 9th annual NephMadness is a social media and medical education campaign focused on all things kidney. You can participate in NephMadness during the entire month of March, National Kidney Month. NephMadness adopts the single elimination brackets that are a hallmark of the popular March Madness (the college basketball tournament held yearly in the United States), but with a nephrology twist. Instead of basketball teams, the bracket is populated with 32 nephrology concepts from eight different regions. This year’s regions are: Liquid Biopsy, the return of Animal House, COVID-19, ICU Nephrology, Workforce, Anemia, Primary Care, and Artificial Kidney. Each region