The vow never to treat SRMs may seem hard to believe and self-defeating.
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.
Having just returned from the always-stimulating European Association of Urology annual congress, I'd like to share a few impressions.
Almost half a million Americans depend on chronic dialysis therapy to survive.
Physicians are more often defined by their ability to diagnose, treat, and research a disease than their willingness to manage its spectrum of risk.
How often have you met for business in a Starbucks, Coffee Bean, or any other coffee shop?
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.
Although data suggest that cancer rates are also higher in obese patients, the associations are largely based on observational/population studies.
Historically, foamy urine is considered a warning sign for probable kidney disease.
Cross-sectional imaging now substitutes for physical diagnosis in most emergency rooms.
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.
In the past few years, urologists have seen some significant developments related to the treatment of metastatic castration-resistant prostate cancer (CRPC).
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.
More than 1 million prostate biopsies are performed annually in the United States, predominantly driven by elevations in PSA.
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.
The March issue features coverage of the 2012 Genitourinary (GU) Cancers Symposium, which was held in San Francisco.
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.
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?
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.
Individuals, businesses and nations grapple with how to measure success. Are similar productivity measures warranted in medicine?
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.
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.
Incidentally detected renal tumors are increasingly diagnosed in patients with chronic kidney disease.
Nephrologists should rethink the screening level and offer a more conservative and meaningful cutoff level, such as an eGFR of 45.
Practicing nephrologists are frequently consulted to evaluate acute kidney injury (AKI) as inpatient cases.
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 advantages of this emerging specialty are clear to those involved in vascular access care, but some potential downsides must be considered.
The ongoing controversy as to whether premalignant, prostatic lesions are associated with increase risk of developing cancer.
Many Americans harbor fears about the Canadian health care system, and I would like to clear up some misconceptions.
The pending legislation on health care reform can be polarizing, but the motivation supporting it is not.
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.
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.
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.
Nephrologists propose critical action eGFR thresholds to guide management of kidney disease patients.
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).
Overnutrition is a major problem in the general population and a serious risk for metabolic syndrome, cardiovascular disease, and death.
Many nephrologists feel increasingly bewildered by heightened discussion about the upcoming bundling system for dialysis patients. The dialysis industry is a unique and giant enterprise serving nearly a half million Americans with end-stage renal disease (ESRD).
The imperfections of our nation's delivery of health care have long been recognized. From poor access for the underinsured and uninsured to potential overutilization by the worried well-insured, the issue has risen to political prominence, with its costs front and center.
In light of changes in Medicare policies related to ESRD, nephrologists will be called on to play an expanded leadership role in dialysis centers.
The growth in the number of patients with end-stage renal disease (ESRD) has tapered and is being offset by continuous improvements in survival. The result is a continued steady increase in the number of patients requiring renal replacement therapy.
Two articles in the December 2008 issue of Renal & Urology News add to mounting evidence of the need for medical liability reform, specifically no-fault compensation for medical injuries.
The Medicare End-Stage Renal Disease (ESRD) Program is one of the most significant developments in the history of U.S. health care and an unqualified success.
The risk of a man's developing prostate cancer is approximately 18%. Whereas it has been estimated that as much as 60% of this risk is due to environmental exposure (J Urol. 2007;178:S9-S13), developing strategies to mitigate this risk is an important public heath concern.
In the past year, an important landmark study demonstrated therapeutic equivalence of the ACE inhibitor ramipril and the angiotensin receptor blocker (ARB) telmisartan in reducing the risk of all forms of atherosclerotic events.
A highly respected senior nephrologist and renowned opinion leader, who also happened to be my good old friend and colleague, asked me why I and some other academicians are involved in supporting such non-peer-reviewed journals as Renal & Urology News (RUN).
In mid-July 2008, 90,000 Americans were listed by the Organ Procurement and Transplant Network (OPTN) as waiting for a deceased donor kidney.
Nephrologists want to improve outcomes and quality of life for renal disease patients through research, but we are faced with major hurdles.
With upper tract transitional cell carcinoma (UTTCC), vigilance is the watchword. Detecting this cancer earlier may directly impact patient survival. According to the American Cancer Society, 54,390 new cases and 14,100 deaths in the United States will occur during 2008.
Decreases in glomerular filtration rate (GFR) are associated with higher risks of cardiovascular events, hospitalizations, and premature death (N Engl J Med. 2004;351:1296-1305).
Practicing evidence-based medicine can be difficult in nephrology, where randomized controlled trials are few and far between. In general, the more that trials use hard outcomes such as morbidity and mortality, the greater our confidence that the therapies will have an impact on patients' lives. Using end points such as these, however, often require large sample sizes.