Sevelamer versus Calcium Acetate in Elderly Hemodialysis Patients

Compared with treatment with calcium acetate, treatment with sevelamer for managing hyperphosphatemia in elderly incident hemodialysis patients was associated with similar or slightly lower risk of death and similar risk of hospitalization. Those were the main findings of an observational cohort study conducted recently by Akeem A. Yusuf, PhD, and colleagues. The researchers utilized the US Renal Data System data ... Read More »

The Nephrology Workforce Crisis

It is not an exaggeration to say that nephrology is in the midst of a workforce crisis. According to two surveys commissioned by the American Society of Nephrology (ASN) and recently published on its website,1,2  there has been a steep increase in the number of unfilled US nephrology training programs: In 2010, there were 15 unfilled programs (10.6% of 142), ... Read More »

Relative Energy Intake and Mortality in CKD Patients

There was an association with increased all-cause mortality in patients with estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 and increasing relative energy intake. That was the major finding of a prospective cohort study conducted recently by Samuel Iff, MD, and colleagues. Previous studies have demonstrated that death from events related to cardiovascular disease increased inversely with decreasing eGFR; patients ... Read More »

ACEi/ARB Use and AKI-D after Major Surgery

Preoperative use of an angiotensin converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB) was associated with a lower risk of acute kidney injury treated with dialysis (AKI-D) compared with nonuse. That was one of the findings of a large population-based retrospective cohort study conducted by Mitesh Shah, MBBS, MSc, and colleagues. The researchers reported study results in BMC Nephrology ... Read More »

Lowering of LDL Cholesterol and Progression to End-Stage Renal Disease

One in 10 adults are affected by chronic kidney disease (CKD), a condition that increases the risk of cardiovascular disease, end-stage renal disease (ESRD), and death. The increased morbidity and mortality of ESRD and its effects on patient quality of life and high healthcare costs create a need to identify therapies that can safely slow progression of CKD. Results of ... Read More »

Proximity to Dialysis Center Associated with Use of CVC

Incident dialysis patients who lived further from a dialysis center were more likely to use a central venous catheter (CVC) than those residing closer. That was the main finding of a Canadian study conducted recently by Lisa M. Miller, MD, et al. Study results were reported in BMC Nephrology [2014,15:40]. CVCs are used as the first-line vascular access in incident ... Read More »

CKD on Primary Care EHR Problem List

Documentation of chronic kidney disease (CKD) on the electronic problem list section of an electronic health record (EHR) had a positive association with stage-appropriate monitoring of CKD; however, documentation of CKD on the electronic problem list was uncommon in a recent study reported in BMC Nephrology [2014.doi:10.1186/1471-2369-15-70]. Lipika Samal, MD, and colleagues conducted the cross-sectional observational study to determine whether ... Read More »

No BP Improvement with 6 Months of Cholecalciferol

There was no improvement in 24-hour ambulatory blood pressure (24-h BP) with 6 months of cholecalciferol treatment in chronic dialysis patients in a study conducted recently by Frank H. Mose, MD, and colleagues. Study results were reported in BMC Nephrology [doi:10.1186/1471-2369-15-50]. Patients with chronic kidney disease are at increased risk of vitamin D deficiency, with profound reductions in plasma levels ... Read More »

When the Stars Aren’t Aligned: The Dialysis Facility Rating System

Most nephrologists will be surprised to hear that a new dialysis facility rating system will be launched January 1, 20151. Over 6000 dialysis facilities in the US will receive star rankings using a forced Bell curve method. The Centers for Medicare & Medicaid Services (CMS) claim that this rating system will provide a simple way for patients and families to ... Read More »


Almost every dialysis facility and nephrology practice treats self-pay patients. While the care given to these patients is a simple matter of diagnosis and treatment, how they are handled on the financial side of the business varies wildly. Self-pay patients almost always lack coverage because they lack funds to pay for coverage, are undocumented, or both. Some patients fall into ... Read More »