ASN President’s Column

Raymond C Harris
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Raymond C. Harris, MD, FASN

Citation: Kidney News 8, 12

In my last column I looked back at nephrology in 1966, the year ASN was founded, and marveled at the advances made in the past 50 years. In this column I’ve described my thoughts of what will be roles and activities of the nephrologist of the future, and the way in which kidney professionals will transform that future.

A Look into the Future

There will be an increasing reliance on “big data” to inform our understanding of underlying mechanisms of kidney pathophysiology, and we will have new and more precise tools to analyze the data so that we can break down barriers between basic and clinical research and between disciplines.

  • Precision medicine initiatives will provide a better understanding of the interactions of genetic and environmental factors in kidney diseases and will help in the design of more focused clinical trials and more targeted therapies.

  • “Telehealth” will no longer be separated from “health.”

  • Transplant waiting lists will shrink as the range, type, and usability of artificial organs grows.

  • EHR documentation will transform continuing education as it has the patient record, allowing providers to spend time learning about new advances, or areas new to their practices.

Nephrologists Transforming the Landscape

Nephrologists are uniquely suited to apply their skills, talents, and interests to propel transformative change to assure that the profession will remain vibrant.

  • Nephrologists may be uniquely suited to bring credibility to big data:

    • ○ As data explodes, so do the opportunities for misinterpretation across a variety of “borders.”

    • ○ Nephrologists have always excelled at data interpretation.

  • Having access to large datasets about human kidney disease will allow more focused preclinical studies by MDs and PhDs and better integration with, and design of, meaningful clinical studies.

  • It is imperative that nephrologists work in concert with all health care agencies, providers, and governmental agencies to decrease disparities in access to care for our kidney patients both in this country and around the world. One concrete step that we can take is to continue to advocate strongly for increased funding for, and utilization of, telehealth, which can help to provide access to health care for patients in remote or under-resourced areas.

  • We must work to overcome the current problem of insufficient organs for our potential transplant patients. Although improved allocation strategies may incrementally increase the number of suitable kidneys for transplant, ultimately transplant medicine will be transformed by technology, and in the future new technologies, either xenotransplantation or stem cell based technologies, will give all potential kidney transplant patients the chance to receive a functioning organ.

  • Nephrology, with its focus on the holistic care of our patients and mastery of the complex data involved in their care, is well suited to lead advances in care that alter the lives of all patients, not just those with kidney diseases. We must ensure that all kidney professionals are trained and ready to take on this challenge to shape dramatic and positive changes in the future of medicine and science.