News

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 »

FINDING FINANCIAL HELP FOR SELF PAY PATIENTS

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 »