Many Americans harbor fears about the Canadian health care system, and I would like to clear up some misconceptions. A fundamental premise of the system is that all Canadians are entitled to health care as a right, not a privilege.

The pending legislation on health care reform can be polarizing, but the motivation supporting it is not. Operating under the assumption that use of preventative and therapeutic health care services improves outcomes, it is hard to imagine who, in the medical community, would not favor improved health care access and utilization for those who are uninsured.

An international research team led by Stan Kmoch, PhD, of the Center for Applied Genomics and Institute for Inherited Metabolic Disorders of Charles University in Prague, Czech Republic, 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. As part of the Medicare Improvements for Patient and Providers Act (MIPPA), dialysis clinics will have incentives to improve outcomes, including adjustable composite rates.

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.