Most physicians in this country provide patient care in busy private practice offices or non-teaching hospitals. Practicing physicians often try to adhere to relevant guidelines to optimize patient care and achieve better outcomes. The guidelines, however, are usually developed by certain groups of opinion leaders and experts who are mostly, if not exclusively, academicians from renowned universities or research centers.

The 2008 Genitourinary Cancers Symposium in San Francisco featured a session on anticipating failure in the patient with advanced prostate cancer. Anthony Zietman, MD, the Jenot and William Shipley Professor of Radiation Oncology at Harvard Medical School in Boston, made his case for the use of adjuvant external beam radiation therapy. Adam Kibel, MD, associate professor of surgery in the division of urologic surgery at Washington University School of Medicine in St. Louis, argues in favor of systemic treatment.

The broad application of cross-sectional imaging has led to the incidental discovery of small renal masses (SRM) as the most common presentation for localized kidney cancer. As this stage migration unfolded, technological efforts at nephron preservation via open, laparoscopic, and robotic assisted techniques have evolved. Moreover, excision by partial nephrectomy is associated with excellent long term oncologic success.

Research developments that have implications for nephrology and urology certainly are not limited to the meetings and journals targeting these specialties. That is why our news coverage extends to meetings that nephrologists and urologists usually do not attend and journals they usually do not read.

Through millions of years of evolution, nature has created a fantastic array of plant and animal species, each with specific adaptations to survive. These adaptations have resulted in an incalculable number of organic compounds unique to each living thing.

Physicians practice medicine with great sincerity. They want to help their sick patients get well and stay well, and they dole out treatments in good faith and with the best of intentions. From time to time, however, data emerge suggesting that the treatments upon which they rely are of little or no benefit.

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.