Two articles in this issue relay new findings on one of the most pressing and controversial issues in nephrology: increasing the number of donor kidneys available for transplantation. The solution examined in each article is the use of more kidneys from expanded criteria donors (ECD).

The kidney-care community can point to more than 30 years of clinical accomplishments. In particular, the past 10 years have been marked by steady improvement in patient access to dialysis centers and improvement in clinical outcomes. Still, important challenges remain. The renal community must understand these challenges and continue the tradition of developing innovative programs to assist nephrologists in overcoming them in the future.

DURING THE past five years, the da Vinci robot has increasingly been used to perform radical prostatectomies. This robotic technology has revolutionized prostate cancer surgery. Among other benefits, the robot enables the surgeon to perform the operation in three dimensions (3D). Assisting surgeons, however, have had to view the procedure in two dimensions (2D).

AS PATIENTS, physicians, dialysis providers, and payers search for more favorable outcomes in patients with end-stage renal disease (ESRD), alternative dialysis regimens have gained popularity. Among these therapies are dialysis treatments that are performed more frequently, for longer periods of time, and/or at the patient's home.

On September 11, 2007, an FDA panel of health experts declined to recommend the quasi-expected restrictions on the use of the erythropoietin stimulating agents (ESA) in CKD patients. For years, the three FDA-approved ESAs (Aranesp, Epogen, and Procrit) have been heavily prescribed for anemia without much concern about serious adverse effects.

While comparing summer "must read" lists, a friend suggested I pick up a copy of "Good to Great" (Jim Collins, Harper Collins 2001). My friend argued the premise of this book (that companies and indivi-duals who leap from "good to great" follow a consistent formula) has important implications in medicine.

UROLITHIASIS afflicts 7%-13% of the population and has a recurrence rate of up to 50% at five years. In the United States, the economic burden of treatment and lost productivity was estimated at $2.1 billion in 2001. Stone size and location determined from non-contrast CT and plain radiographs have long been used to triage patients for either shock wave lithotripsy (SWL) or endoscopic management.

Nephrologists and dietitians spend a significant amount of their time managing hyperphosphatemia. Phosphorus retention, which occurs in moderate to advanced CKD, is thought to contribute to secondary hyperparathyroidism and excessive vascular calcification. Diet counseling to reduce phosphorus intake is usually the first step in management. In most cases, however, the physician feels compelled to prescribe a so-called “phosphorus binder” to reduce GI absorption of phosphorus in the food.

The term “targeted therapy” has entered the oncologic lexicon over the past five years, with primary applications in medical and radiation oncology.

THE PAST two decades have witnessed the introduction a dizzying array of minimally-invasive surgical alternatives to the gold standard treatments for BPH—transurethral resection of the prostate (TURP) and the open simple prostatectomy.