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To Sell or Not to Sell

May 16, 2012

Consultants offer advice on key issues to consider when selling a medical practice to a hospital.
 

Optimal Sequencing of the New Prostate Cancer Drugs: An Interview with E. David Crawford, MD

May 15, 2012

Several new drugs have become available for treating advanced prostate cancer in the past year and a half. E. David Crawford, MD, head of urologic oncology at University of Colorado (UC) Hospital and an investigator at the UC Cancer Center, both in Aurora, and UC colleague Thomas W. Flaig, MD, recently published a review of these agents. Dr. Crawford talks to Renal & Urology News about the possible ways in which these drugs might be used.
 

Prostate Cancer Screening: Moving Beyond PSA

May 01, 2012

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

Bargain Price Stocks for Technology Companies

May 01, 2012

In recent months, investors have been eagerly pursuing shares of Facebook, Groupon, and other hot technology companies.
 

After Radical Prostatectomy, Patient Learns He Never Had Prostate Cancer

May 01, 2012

Dr. B, 57, was a urologist with a busy private practice. One of his patients was Mr. O, 69, who had an abnormal PSA result.
 

Page Kidney Resulting in New Onset Hypertension

, May 01, 2012

A 55-year-old Caucasian woman initially presented to one of Cleveland Clinic's regional outpatient urology clinics with gross hematuria and an obstructing right ureteral stone.
 

High Protein Intake May Elevate Levels of Advanced Glycation End Products

, May 01, 2012

Advanced glycation end products (AGEs) are byproducts of non-enzymatic chemical reactions between sugars and amino acids, lipids, or DNA.
 

Managing Bone Disease in 
Kidney Transplant Recipients

By Miklos Z. Molnar, MD, PhD, and Kamyar Kalantar-Zadeh, MD, MPH, PhD May 01, 2012

Pre-existing renal osteodystrophy at the time of transplantation, reduced renal 
function, and transplantation-specific therapies are the main contributing factors.
 

Assessment and Diagnostic Strategies for Neurogenic Bladder: Part I

By David A. Ginsberg, MD May 01, 2012

Diagnostics and treatment options for NGB are continually advancing, and clinicians need to remain up-to-date to accurately assess and optimally manage patients
 

Sperm Banking To Remote Sites

, April 01, 2012

Infertility is a stressful experience for many couples, a situation made particularly difficult by the need to produce a semen sample in a clinical setting.
 

Sickle Cell Trait and Medullary Renal Carcinoma

, April 01, 2012

Since the discovery of Hemoglobin S (HbS), it has been known that the abnormal polymerization of deoxy-HbS is the main cause for vaso-occlusive crisis involving many organs including the kidneys in sickle cell disease (SCD).
 

Oral Adsorbents, Probiotics an Inexpensive Way to Eliminate Uremic Toxics in CKD Patients

April 01, 2012

Patients on a traditional renal diet often find that they are consuming a relatively "unhealthy diet," meaning the diet is low in fresh fruits and vegetables, whole grain, and dairy products.
 

Setting Up a Home Hemodialysis Program

April 01, 2012

As you develop and grow a home HD program, not only will you have wonderful successes, but there will also be challenges and disappointments.
 

Is U.S. Nephrology Lagging Behind?

April 01, 2012

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.
 

Part II: Clinical Challenges and Renal Considerations in Managing Gout

By James W. Lohr, MD April 01, 2012

A case study involving a 65-year-old man with chronic kidney disease and acute attacks of pain, swelling, and erythema in the first metatarsophalangeal joint.
 

The Impact of Bundling on Clinical Practice

March 22, 2012

This is the title of a scheduled May 12 session (3:30-5:00 p.m.) at the National Kidney Foundation's 2012 Spring Clinical Meetings, which is being held at the Gaylord National in National Harbor, Md., May 9-13.
 

Current and Future Approaches to Renal Protection through Blood Pressure Control

, , March 14, 2012

This is the title of a scheduled May 11 session (8:30-10:00 a.m.) at the National Kidney Foundation's 2012 Spring Clinical Meetings.
 

The Case for Brachytherapy: An Interview with Michael F. Sarosdy, MD

March 14, 2012

Having performed more than 1,200 brachytherapy treatments since 1996 and conducting research in this field, urologic oncologist Michael F. Sarosdy, MD, founder of South Texas Urology & Urologic Oncology, in San Antonio, is convinced that this is a far better choice than surgery for most men with prostate cancer, regardless of the patient's age or tumor characteristics.
 

Coping with ICD-10

March 08, 2012

Making the leap from 14,000 codes to almost 69,000, topped with the huge cost to make that change, is understandably daunting.
 

Hyponatremia: New Insights into Risks, Prevention, and Treatment

, March 01, 2012

Hyponatremia is the most common electrolyte abnormality in both children and adults. New research has begun to challenge some traditionally held views regarding this common condition.
 

Highlights of the GU Cancers Symposium

March 01, 2012

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

Clinical Challenges and Renal Considerations In Managing Gout

By William F. Finn, MD March 01, 2012

A case study examines the treatment of hyperuricemia and gout in a 57-year-old postmenopausal renal transplant recipient with intermittent gout attacks.
 

Target-Date Funds Enable Investors to Own a Diverse Portfolio

February 29, 2012

The fund you should pick depends on your tolerance for volatility. Either aggressive or cautious funds can work. Pick one that suits your temperament.
 

Lessons from "The Hemodialysis Marathon Man"

February 29, 2012

An impressive story of a dialysis survivor who watched his daughters grow and getting married, and had the joy of knowing several grandchildren.
 

Unusual Manifestation of an Aldosterone-Producing Adenoma

, , February 29, 2012

Primary aldosteronism was first described by Jerome Conn in 1955 in a patient with an aldosterone-producing adrenal adenoma. It's now a widely recognized cause of secondary hypertension.
 

Resistant Hypertension Secondary to Primary Aldosteronism

, , , February 29, 2012

A 43-year-old man was evaluated for uncontrolled hypertension (HTN) despite multiple drug therapy, which included amlodipine 10 mg daily, clonidine 0.3 mg BID, and metoprolol XL 200 mg BID.
 

Health Care Workers Should Promote Dietary Salt Reduction

February 29, 2012

Historically, salt has been a commodity, a preservative, and a flavor enhancer. The salt shaker has a special place in most kitchens or dining room tables.
 

Potential of FGF-23 Yet to Be Unleashed: An Interview with Orlando M. Gutiérrez, MD

February 15, 2012

Although it does not yet have a place in everyday practice, fibroblast growth factor 23 (FGF-23) may one day be an important marker of and therapeutic target for very early-stage chronic kidney disease for the clinical nephrologist. Orlando M. Gutiérrez, MD, Assistant Professor of Medicine in the Division of Nephrology at the University of Alabama at Birmingham, has studied in depth this bone-derived hormone, which regulates phosphorus and vitamin D.
 

Remote Care: How to Use Telemedicine

February 09, 2012

Telemedicine, the use of electronic communication to provide health care, has been relatively slow to catch on in some places, but many physicians who have incorporated telemedicine into their practice believe it can be advantageous.
 

Exercise Enhances Body Composition, Nutritional Status in Dialysis Patients

February 01, 2012

Research has shown that individuals who exercise have lower risk for chronic diseases than individuals who do not exercise.
 

The Management of Patients After Renal Transplantation

By Daniel C. Brennan, MD, FACP February 01, 2012

Patients who undergo renal transplantation require complex care that involves a diligent, multidisciplinary approach.
 

The Lowdown on HIFU: An Interview with David Y.T. Chen, MD, FACS

January 13, 2012

Although high-intensity focused ultrasound (HIFU) has not yet been approved in the United States for the treatment of prostate cancer, a growing number of the nation's urologists are offering this noninvasive surgical procedure at centers located outside the country. Renal & Urology News asked urologic oncologist David Y.T. Chen, MD, FACS, of Fox Chase Cancer Center in Philadelphia, about his impressions of HIFU as an investigator in a trial featuring the treatment.
 

Highlights of 2011, The Promise of 2012

January 01, 2012

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?
 

CKD Patients at Higher Risk for Zinc Deficiency

January 01, 2012

Inflammation and oxidative stress are two etiologies that may contribute to poor nutritional status and ultimately increased mortality rates in patients with chronic kidney disease (CKD). Interventions that can blunt or ameliorate inflammation and oxidative stress are relevant to these patients.
 

An Update on Robotic-Assisted Partial Nephrectomy

By Rosalia Viterbo, MD January 01, 2012

Short-term outcomes from early institutional experiences have confirmed the safety and feasibility of RPN, even for anatomically complex tumors.
 

The Case for Neonatal Male Circumcision: An Interview with Aaron Tobian, MD, PhD

December 01, 2011

Less than a decade ago, Aaron Tobian, MD, PhD, would not have been a proponent of male circumcision. But now the benefits of this procedure are undeniable to the Johns Hopkins Center for Global Health pathologist, who has studied the matter extensively both in the United States and in Uganda. Dr. Tobian spoke with Renal & Urology News hours after returning from his most recent trip to sub-Saharan Africa.
 

Conservative Investors, Consumer Companies in a Sluggish Economy

December 01, 2011

Make no mistake: Consumer stocks do not lead the markets every year. During bull markets, investors often ignore consumer goods, which may seem dull compared to technology or finance. But over the long haul, consumer stocks tend to deliver competitive results.
 

Urologist Facing Charges After Reusable Needle Guards Sales Pitch

December 01, 2011

Dr. M, 59, was an experienced urologist with a busy private practice. He had been in the field for close to 30 years and was well known and respected in the community. His office was staffed by several nurses, some of whom had been working there for decades.
 

Volume Loss as the Predominant Determinant of Ultimate Renal Function after PN

, December 01, 2011

The objectives of partial nephrectomy (PN) for kidney cancer are to optimize cancer control by obtaining negative margins while preserving as much renal function as possible.
 

Renal ATPV for Intractable Stone Disease

, , , , , December 01, 2011

Some patients have recurrent nephrolithiasis that may prove refractory to all known preventive strategies. Such individuals can experience frequent bouts of renal colic that result in narcotic dependency, long-term disability, and depression.
 

Dialysis Care in the Post-Bundling Era

December 01, 2011

For the ninth straight year, I came away from Kidney Week (formerly Renal Week), the annual scientific meeting of the American Society of Nephrology, feeling badly that Renal & Urology News can only report on a fraction of the thousands of studies presented at the meeting.
 

A Nephrologic Perspective on the Management of Gout

By Anthony J. Bleyer, MD December 01, 2011

Gout is increasingly recognized in patients with chronic kidney disease, but the proper dosing regimen for traditional agents has not been well-studied in this patient group.
 

Demystifying Medical Codes

November 23, 2011

For many doctors, coding, documentation and medical necessity are tedious administrative issues they would rather not have to worry about. Here are a handful of tips to correct common coding woes.
 

Kidney Stone Prevention: 'Fact versus Fiction'

November 21, 2011

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.
 

Transitioning to Electronic Health Records

November 16, 2011

No matter how hard they try, health care providers are finding it increasingly difficult to ignore electronic health records, and transitioning from paper charts to computers is not easy. Here are some tips to help work through that process.
 

Transitional Urology: Caring for the Urological Needs of Adults and Adolescents Born with Complex Congenital Anomalies

, , November 01, 2011

The genitourinary tract is the system most frequently affected by congenital defects. Such defects can be solitary or involve multiple organ systems.
 

Nephrologists and Urologists Collaborate on Implantable Artificial Kidney

, , November 01, 2011

Four years ago, a joint effort was established between nephrologists and urologists at the Cleveland Clinic Glickman Urological and Kidney Institute to develop and implant a bioartificial kidney.
 

CKD Patients Not Receiving Dietitian Intervention

November 01, 2011

Intensive dietary interventions in patients with chronic kidney disease (CKD) has been controversial in the United States. It is interesting to note that even though evidence abounds on the effectiveness of dietitian interventions and government money is available for these services, patients are not receiving them.
 

CROWNWeb: Expanding Facilities' Ability to Report Patient-Based Data

November 01, 2011

An overview of how CROWNWeb, CMS' Web-based end-stage renal disease (ESRD) data-collection system, has been updated with vaccination, hospitalization, and infection data to help CMS, the ESRD Networks, and dialysis facilities better analyze patient care efforts.
 

ACOs and Productivity Metrics in Medicine

November 01, 2011

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

Putting Money Into Mutual Funds

November 01, 2011

Hotel occupancy is improving, and office rents are climbing in strong markets such as New York and Washington, D.C.
 

Better Lithotripsy On the Horizon: An Interview with James E. Lingeman, MD

November 01, 2011

A leading authority on kidney stone disease, James E. Lingeman, MD, of Indiana University Health, updates Renal & Urology News on the state of urinary stone treatment, including a possible rebirth of extracorporeal shock wave lithotripsy and the pursuit of the "holy grail" in flexible ureteroscopy.
 

Examining the Pharmacoeconomics of Advanced Prostate Cancer

By Daniel P. Petrylak, MD November 01, 2011

In determining prostate cancer treatment, physicians should discuss preferences, values, and expectations with patients, including life expectancy, adverse events, and costs
 

Avanafil and PDE-5 Inhibitors: An Interview with Wayne J. G. Hellstrom, MD, FACS

October 15, 2011

Dr. Hellstrom, Professor of Urology and Chief of Andrology at Tulane University School of Medicine in New Orleans, is one of the principal investigators involved in studies of avanafil, an investigational phosphodiesterase-5 (PDE-5) inhibitor that in phase 3 trials has demonstrated efficacy and potential advantages over other PDE-5 inhibitors. In an interview with Renal & Urology News, he discusses avanafil and PDE-5 inhibitors in general.
 

AKI Patients Require Strong Assessment to Prevent Protein-Energy Wasting

October 11, 2011

Recent reports have demonstrated a link between acute kidney injury (AKI) and chronic kidney disease (CKD). Individuals with AKI are more likely to have CKD and eventually progress to end-stage renal disease.
 

HIV-Positive Organ Donors for HIV-Positive Recipients: An Interview with Dorry Segev, MD, PhD

October 01, 2011

Human immunodeficiency virus (HIV) is no longer a contraindication to transplantation, contends Dorry Segev, MD, PhD. The Associate Professor of Surgery and Epidemiology and Director of Clinical Research at Johns Hopkins Comprehensive Transplant Center in Baltimore tells Renal & Urology News that kidney transplantation is a particularly strong contender for consideration in this matter.
 

Hyponatremia: An Update on the Management of SIADH

By Mitchell H. Rosner, MD, FACP October 01, 2011

Therapeutic options for SIADH have been significantly enhanced with the introduction of specific vasopressin receptor antagonists
 

Omega-3 Fatty Acids May Decrease Inflammation and Mortality in CKD Patients

September 12, 2011

Lower ratios of omega-6 to omega-3 fatty acids are better for hemodialysis patients in terms of inflammation and survival, new data suggest.
 

Dialysis in the U.S. and Abroad

September 09, 2011

Four nephrologists weigh in about the substantive differences in dialysis implementation in this country and worldwide.
 

Issues in Hypertension: An Interview with George Bakris, MD

September 01, 2011

George Bakris, MD, Professor of Medicine and Director of the Hypertensive Diseases Center at the University of Chicago Medical Center, is an internationally recognized hypertension expert who specializes in complicated or refractory cases. He spoke with Renal & Urology News about various aspects of treating hypertension in patients with chronic kidney disease.
 

Intermittent ADT in Prostate Cancer: A Step-by-Step Approach

By Leonard G. Gomella, MD, FACS September 01, 2011

In select patients, use of intermittent therapy does not appear to negatively affect overall survival and is associated with fewer adverse events.
 

Novel Drug Could Prevent Deaths in CKD Patients

August 08, 2011

Clinical trials show that bardoxolone methyl not only maintains renal function, but improves it.
 

Prostatitis and Chronic Pelvic Pain Syndrome: An Update

By Naji J. Touma, MD, FRCS(C) and J. Curtis Nickel, MD, FRCS(C) August 01, 2011

Etiology and treatment are clearly defined for infectious prostatic syndromes, but not for chronic pelvic pain syndrome.
 

The Robotic Prostatectomy: An Interview with Mani Menon, MD

August 01, 2011

Mani Menon, MD, is a urologist and Director of the Vattikuti Institute at Henry Ford Hospital in Detroit. Dr. Menon is a pioneer in the development of robotic surgery, especially the robotic prostatectomy. In this interview, Dr. Menon discusses the place of robotic prostatectomy in the treatment of localized prostate cancer.
 

Novel Biologics for Castration-Resistant Prostate Cancer

, July 26, 2011

Sipuleucel-T and abiraterone acetate are two of the newest therapeutic options available to patients, but other promising agents are on the horizon.
 

Plant-Based Diets May Need to Be Reconsidered

July 11, 2011

A new paradigm may be needed whereby plant-based or vegetarian diets are promoted to preserve GFR and maintain phosphorus homeostasis in CKD patients.
 

Cause-Specific Outcomes Associated with Hypovitaminosis D

By Csaba P. Kovesdy, MD July 01, 2011

The complex biological actions of vitamin D suggest its involvement in various pathologies. (This is the second of a two-part CME article.)
 

Objectifying Risk in Patients with Localized Prostate Cancer

, June 13, 2011

The Fox Chase Cancer Center in Philadelphia has launched a novel Web-based portal.
 

Estimating Lean Body Mass in Hemodialysis Patients

June 08, 2011

Near infrared, skinfolds, and hand-grip strength are portable assessment techniques that can be done at the dialysis center and used post-treatment.
 

Vitamin D and Clinical Outcomes in Patients With and Without CKD: Part I

By Csaba P. Kovesdy, MD June 01, 2011

Research has shown that vitamin D deficiency has a role in the progressive loss of kidney function as well as increased mortality.
 

Why I Donated a Kidney Anonymously

May 23, 2011

After extensive medical and psychological testing over many months, a Canadian citizen parted with one of her kidneys to help somebody she did not know. Click on the title to read a detailed account of her experience.
 

Carnitine for Chronic Inflammation

May 10, 2011

Data show that carnitine, an inexpensive therapy with little to no adverse effects, can lower C-reactive protein levels.
 

Relationships of Testosterone and Prostate Cancer: A 2011 Perspective

By Kelly Chiles, MD and Stanton Honig, MD May 01, 2011

A history of prostate cancer has generally been a contraindication for testosterone therapy, but the clinical model may be changing.
 

Lessons Lived: Ailments Get Personal for Some Docs

April 18, 2011

Physicians' experiences as patients may cause them to reflect on the medical care they provide.
 

Hypernatremia Due to Hypovolemia in Dementia

Ves Dimov, MD April 15, 2011

An 86-year-old black female was admitted to the hospital after she had a seizure while waiting for a swallow evaluation as an outpatient.
 

Energy Expenditure in CKD Patients

April 09, 2011

Monitoring CKD patients' weight and visceral protein status is more important than estimating kilocalorie needs.
 

IgA Nephropathy: An Update on Diagnosis and Management

By Richard J. Glassock, MD, MACP April 01, 2011

Following a renal biopsy diagnosis of IgA nephropathy, clinicians need to estimate prognosis and design an appropriate short- and long-term treatment strategy.
 

CKD Patients May Suffer from Selenium Deficiency

March 04, 2011

Supplementation with selenium with foods rich in selenium, such as Brazil nuts, has been shown to correct the condition.
 

Classifying Histologic Subtypes of Renal Cell Carcinoma

By Lara R. Harik, MD and Maria Alexandra Ordoñez, MD March 01, 2011

Recent advances in understanding genetic changes associated with kidney tumor 
formation have led to new pathologic classifications.
 

Better Tools Needed for Nutrition-Related Screening

February 08, 2011

The currently available tools do not include parameters for other important nutrition abnormalities such as elevated serum phosphorus, serum potassium, and serum lipid levels.
 

Managing Patients Following a Negative Prostate Biopsy

By J. Stephen Jones, MD, FACS February 01, 2011

This article addresses the issues that must be understood to navigate the scenario posed by patients that have had a prior negative biopsy.
 

Nutrition Important for Physical Functioning in CKD Patients

January 11, 2011

In patients with kidney disease, poor nutritional status impacts muscle and physical functioning, and, ultimately, quality of life.
 

Parathyroid Hormone, Alkaline Phosphatase and Fibroblast Growth Factor 23

By Orlando M. Gutiérrez, MD January 01, 2011

The management of chronic kidney disease-mineral bone disorder (CKD-MBD) is central to the care of patients with kidney disease. Key to these efforts is the availability of clinically accessible biomarkers that can help distinguish between a wide variety of bone and mineral disturbances related to kidney failure.
 

Standardization: The Future of Testosterone Testing

December 15, 2010

Endocrinologist William Rosner, MD, Professor of Medicine at Columbia University in New York, explains to Renal & Urology News what impending testosterone-testing standardization—and the current lack of it—means to urology practice and research.
 

Protein-Energy Wasting Could Impair Wound Healing

December 14, 2010

CKD patients, especially those with diabetes, may be at increased risk for developing non-healing wounds.
 

Dialysis Providers Prepare for Bundled Payments

November 16, 2010

Nephrologists will be largely unaffected by the new rule, but small dialysis centers could be hit hard financially
 

Peritoneal Dialysis: Does It Have a Brighter Future?

November 15, 2010

Regulatory changes have enhanced clinicians' ability to recommend the modality, which offers long-term survival similar to that of hemodialysis.
 

Nutritional Care Before Renal Transplantation

November 11, 2010

Eating monounsaturated fats, legumes and nuts, and high-fiber foods may be beneficial in lowering the risk of post-transplant comorbidities.
 

Have MD, Will Travel: Locum Tenens Docs Today

October 11, 2010

Fed up with the frustrations of private practice, some urologists and nephrologists have chosen the life of an itinerant professional.
 

Chewing Gum Could Aid in Phosphorus Control

October 11, 2010

Chitosan gum could offer dialysis patients an inexpensive way to control phosphorus nonsystemically without adding to their daily pill burden.
 

Low Vitamin D Linked to Higher Risk of Anemia, Death

September 13, 2010

Vitamin D levels can be affected by season of the year and latitude.
 

Ambiguities of the Prostate: Searching for Beacons in the Fog

August 31, 2010

Twenty years ago, a man I revered calmly shared the news that he had just been diagnosed with metastatic prostate cancer.
 

Unique Treatment Raises Tricky Bioethical Issues

August 12, 2010

Vaccine for advanced castration-resistant prostate cancer prolongs life by a median of four months, but at an extremely high cost.
 

Managing Metabolic Acidosis in CKD Patients

August 12, 2010

The condition occurs frequently in both pre-dialysis and dialysis patients, but correction with either sodium bicarbonate or sodium citrate is safe and effective.
 

The Ethics of Discontinuing Dialysis

July 12, 2010

One practitioner's perceived good deed for a dying patient could be another's definition of homicide.
 

Keto Acid Supplements May Help CKD Patients

July 12, 2010

New evidence supports CKD patient use of keto acid supplements, which provide protein without overloading the kidneys.
 

Curtailing Unnecessary Imaging

June 10, 2010

This article is the second in a two-part series on the expanding use of imaging studies.
 

Dialysis Patients May Benefit from Omega-3 Fatty Acids

June 10, 2010

Supplementation could provide a low-cost way to protect against cardiovascular events.
 

Imaging Use Up, But the Reasons Are Debatable

May 11, 2010

This article is the first in a two-part series examining the expanding use of diagnostic imaging in urology.
 

Teaching Dialysis Patients About Phosphorus

May 11, 2010

They need to know how to identify phosphate additives on food labels.
 
Popular Topics
Acute Kidney Injury AKI Androgen Deprivation Anemia Benign Prostatic Hyperplasia Bladder Cancer BPH Cardiovascular Disease Chronic Kidney Disease Circumcision CKD CVD Diabetes Dialysis End-stage Renal Disease Hemodialysis Kidney Cancer Overactive Bladder Prostate Cancer Renal Cell Carcinoma Reproductive Medicine Secondary Hyperparathyroidism Transplantation Urinary Incontinence Urology

 

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