Commentary

The Ebola Threat: Why Not an Outbreak Here?

The Ebola Threat: Why Not an Outbreak Here?

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The separation of continents no longer provides a secure buffer against the spread of communicable diseases from far-flung places.

Big Data, Transparency and Accountability

Big Data, Transparency and Accountability

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We crave clinical and scientific data, yet we grieve the performance-based data increasingly directed toward us.

"Doc, Did You Check My Cholesterol?"

"Doc, Did You Check My Cholesterol?"

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Many patients still insist that I need to check and manage their cholesterol.

Medicare Payments Exposed

Medicare Payments Exposed

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For the first time, the federal CMS has made public a database showing what it pays out to individual physicians.

Nutrition Advice Challenged — Again

Nutrition Advice Challenged — Again

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Human beings are unique in the animal kingdom when it comes to nutrition.

Personalized Medicine in 2014

Personalized Medicine in 2014

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The term "personalized medicine" remains an overused promise to apply specific treatment plans.

Nephrologists Woefully Underpaid in U.S vs. Canada

Nephrologists Woefully Underpaid in U.S vs. Canada

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This higher level of dialysis care in Canada is partly owed to substantially higher reimbursement fees for nephrologists.

Why Not A Federal Medical License?

Why Not A Federal Medical License?

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When we move from one state to another, typically we must obtain a driver's license from the state to which we are relocating.

Placing Very Elderly Patients on RRT

Placing Very Elderly Patients on RRT

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As a venue for presenting important research on kidney disease to the world, Kidney Week never disappoints.

Medical Research and the Federal Shutdown

Medical Research and the Federal Shutdown

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After the end of 16-day federal shutdown in October, media headlines touted the financial impact on America and the cost of restarting the government.

The Future of Dialysis in the U.S.

The Future of Dialysis in the U.S.

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Over the past 10 years the annual ESRD incidence rate per million U.S. population has remained stagnant or even shown sporadic downward trends.

Genetic Risk and PCa Treatment: A New Era Dawning

Genetic Risk and PCa Treatment: A New Era Dawning

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For men at risk of developing prostate cancer (PCa), prophylactic prostatectomy seems almost irrational for several reasons

Another Nutritional Warning: Omega-3s

Another Nutritional Warning: Omega-3s

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Once again, a study offers evidence that one of the keys to good nutrition is avoiding excess.

Self-Cannibalizing for Peritoneal Dialysis Growth?

Self-Cannibalizing for Peritoneal Dialysis Growth?

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In the nephrology community, there have been heightened discussions and apparent enthusiasm about the revival of PD as the prototype for home dialysis.

Let's End the Small Renal Mass Dilemma

Let's End the Small Renal Mass Dilemma

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The vow never to treat SRMs may seem hard to believe and self-defeating.

Hemoglobin Levels Fall, Transfusions On the Rise

Hemoglobin Levels Fall, Transfusions On the Rise

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Two studies presented at the recent NKF Spring Clinical Meetings provide more evidence of a trend toward decreasing use of ESAs and decreasing hemoglobin levels.

Reflections on the EAU Annual Congress

Reflections on the EAU Annual Congress

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Having just returned from the always-stimulating European Association of Urology annual congress, I'd like to share a few impressions.

Why Not 24/7 Dialysis Urgent Care?

Why Not 24/7 Dialysis Urgent Care?

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Almost half a million Americans depend on chronic dialysis therapy to survive.

Physicians: Managers of Risk

Physicians: Managers of Risk

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Physicians are more often defined by their ability to diagnose, treat, and research a disease than their willingness to manage its spectrum of risk.

The Rise of the Coffee Shop Doctor

The Rise of the Coffee Shop Doctor

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How often have you met for business in a Starbucks, Coffee Bean, or any other coffee shop?

Highlights of Kidney Week 2012

Highlights of Kidney Week 2012

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Kidney Week 2012, held in San Diego, is now history and as usual I like to reflect on the world's biggest and most prestigious meeting for kidney specialists.

Obesity and Prostate Cancer Risk

Obesity and Prostate Cancer Risk

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Although data suggest that cancer rates are also higher in obese patients, the associations are largely based on observational/population studies.

A Rising Epidemic of Foamy Urine

A Rising Epidemic of Foamy Urine

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Historically, foamy urine is considered a warning sign for probable kidney disease.

CT and Stones: Can We Do Better with Less?

CT and Stones: Can We Do Better with Less?

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Cross-sectional imaging now substitutes for physical diagnosis in most emergency rooms.

How About Twice-Weekly Hemodialysis?

How About Twice-Weekly Hemodialysis?

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In recent trips to India, China, Brazil, and other countries, I was intrigued by large numbers of patients with end-stage renal disease who underwent hemodialysis (HD) less frequently than three times a week.

Outlook Brightens for CRPC Patients

Outlook Brightens for CRPC Patients

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In the past few years, urologists have seen some significant developments related to the treatment of metastatic castration-resistant prostate cancer (CRPC).

Put Women Back on the Research Agenda

Put Women Back on the Research Agenda

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Unfortunately, in the past few years, very few studies have looked at issues regarding gender and CKD, and of most concern, looking at response to therapy.

Prostate Cancer Screening: Moving Beyond PSA

Prostate Cancer Screening: Moving Beyond PSA

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More than 1 million prostate biopsies are performed annually in the United States, predominantly driven by elevations in PSA.

Is U.S. Nephrology Lagging Behind?

Is U.S. Nephrology Lagging Behind?

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As practicing clinicians in the United States, we generally feel privileged, with access to a highly developed and pioneering medical care system along with an advanced and cutting-edge technology in the world's largest economy.

Highlights of the GU Cancers Symposium

Highlights of the GU Cancers Symposium

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The March issue features coverage of the 2012 Genitourinary (GU) Cancers Symposium, which was held in San Francisco.

Let Patients Sleep During Rounds

Let Patients Sleep During Rounds

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How often do you face with the unpleasant task of waking a sleeping patient during your busy rounds? It happens frequently to many clinicians during their inpatient rounds in the hospital.

Highlights of 2011, The Promise of 2012

Highlights of 2011, The Promise of 2012

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The start of 2012 is a good time to look back on the previous year to see the current state of nephrology. What have been the important findings that occurred in the past year, and what do we have to look forward to in the year ahead?

Kidney Stone Prevention: 'Fact versus Fiction'

Kidney Stone Prevention: 'Fact versus Fiction'

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According to current estimates, kidney stones will develop in one in 10 people during their lifetime. This translates into nearly 30 million people in the United States. Clearly, prevention is paramount when dealing with kidney stones.

ACOs and Productivity Metrics in Medicine

ACOs and Productivity Metrics in Medicine

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Individuals, businesses and nations grapple with how to measure success. Are similar productivity measures warranted in medicine?

The Institute Model: Integrating to Improve Care

The Institute Model: Integrating to Improve Care

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Renal & Urology News was established in 2002 based on recognition of natural synergies of nephrology and urology. The insight was not immediately intuitive, as care delivery remained largely specialty-based.

Should We Start Dialysis As Late As Possible?

Should We Start Dialysis As Late As Possible?

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Traditional nephrology training makes us believe that it is good practice to start maintenance dialysis therapy sooner rather than later. Nevertheless, recent data indicate that we may encounter yet another "old-practice-was-wrong" paradigm shift.

Kidney Cancer vs. ESRD

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Incidentally detected renal tumors are increasingly diagnosed in patients with chronic kidney disease.

CKD Stage 3 Needs To Be Redefined

CKD Stage 3 Needs To Be Redefined

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Nephrologists should rethink the screening level and offer a more conservative and meaningful cutoff level, such as an eGFR of 45.

Are All Acute Kidney Injuries "Acute on Chronic"?

Are All Acute Kidney Injuries "Acute on Chronic"?

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Practicing nephrologists are frequently consulted to evaluate acute kidney injury (AKI) as inpatient cases.

The Negative Prostate Biopsy Dilemma

The Negative Prostate Biopsy Dilemma

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The role of PSA as a cancer screening tool has recently been evaluated by several large high profile studies with varying interpretations of the data. Regardless of where one stands on the debate, among the clinical dilemmas of PSA-based screening is the negative biopsy conundrum where the reality remains that the best one can offer is, "Good news Mr. Smith, I don't think you have prostate cancer."

The Pros and Cons of Interventional Nephrology

The Pros and Cons of Interventional Nephrology

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The advantages of this emerging specialty are clear to those involved in vascular access care, but some potential downsides must be considered.

HGPIN: Precursor, Marker, or Meaningless?

HGPIN: Precursor, Marker, or Meaningless?

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The ongoing controversy as to whether premalignant, prostatic lesions are associated with increase risk of developing cancer.

Nephrology In Canada Is Well Supported

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Many Americans harbor fears about the Canadian health care system, and I would like to clear up some misconceptions.

A Call to Service For Nephrologists

A Call to Service For Nephrologists

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The pending legislation on health care reform can be polarizing, but the motivation supporting it is not.

Renin Mutations As a Cause of Inherited Interstitial Kidney Disease

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An international research team have identified a number of families suffering from a mutation in the signal peptide of the renin gene that lead to the development of autosomal dominant CKD.

Paid for Good Outcomes Measures

Paid for Good Outcomes Measures

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Who could have guessed that one day physicians would be paid based on the outcomes of patients under their care? This is the imminent reality in nephrology.

If Fat is Good, Is Muscle Better?

If Fat is Good, Is Muscle Better?

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One of recent challenges in nephrology and other internal medicine subspecialties is providing care to an increasing number of patients with chronic disease states and wasting syndrome.

The '30-20-10' Rule for Renal Care

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Nephrologists propose critical action eGFR thresholds to guide management of kidney disease patients.

A More Rational Approach To Renal Mass Surgery

A More Rational Approach To Renal Mass Surgery

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In the absence of level I evidence, physician treatment recommendations are subject not only to the objective (interpretations of the cohort literature and practice guidelines) but also the subjective (training patterns, comfort levels, biases and individual experiences).

Why Not Meals During Dialysis?

Why Not Meals During Dialysis?

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Overnutrition is a major problem in the general population and a serious risk for metabolic syndrome, cardiovascular disease, and death.

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