As this issue goes to press, thousands of rescue personnel from the United States and other countries throughout the world are engaged in relief efforts in earthquake-ravaged Haiti, where the death toll exceeded 100,000.

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).

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.

Kidney stone disease represents a substantial portion of the urologist's surgical practice. High recurrence rates, intermittent compliance with stone prevention regimes, and young age at presentation lead to repeated diagnostic imaging with a substantial risk of cumulative radiation exposure for a disease that is inherently benign and rarely life threatening.

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.