Commentary Archive

The Looming Battle for ESRD Fountains

The Looming Battle for ESRD Fountains

As the rate of acceleration in ESRD incidence decline, physicians should expect heightened battles for the ESRD fountains.

The Psychological Impact of Prostate Cancer

The Psychological Impact of Prostate Cancer

Patients diagnosed with prostate cancer often struggle with their diagnosis.

The Promise of the New Hyperkalemia Drugs

The Promise of the New Hyperkalemia Drugs

Renal & Urology News interviewed Matthew R. Weir, MD, director of the division of nephrology and professor of medicine at the University of Maryland School of Medicine in Baltimore.

Artificial Kidney Technology Moves Forward

Artificial Kidney Technology Moves Forward

If ESRD patients face increasing difficulty getting a kidney transplant in coming years, they may see an artificial kidney as the next best alternative.

Recent Developments in Prostate Cancer Management

Recent Developments in Prostate Cancer Management

Additional novel medical therapies to treat prostate cancer and earlier use of the existing medical therapies are the future of prostate cancer management.

Important Prostate Cancer Advances of the Last 10 Years

Important Prostate Cancer Advances of the Last 10 Years

Advances in prostate cancer screening, management and therapeutics have vastly improved patient care.

Therapeutic Non-adherence: An Ongoing Problem

Therapeutic Non-adherence: An Ongoing Problem

No matter how much pharmacologic therapy advances, patient behavior will remain a significant factor in the outcomes achieved.

Should We Always Treat Edema?

Should We Always Treat Edema?

We may feel good treating a patient's edema, but is fluid retention always harmful?

Whatever Happened to the AIDS Crisis?

Whatever Happened to the AIDS Crisis?

Chronic diseases such as end-stage renal disease (ESRD) have now surpassed opportunistic infections as the leading cause of death among HIV-infected patients.

In a New Light: NBI for Bladder Cancer

In a New Light: NBI for Bladder Cancer

Daniel Canter, M.D., discusses narrow-band imaging (NBI) for visualization of bladder cancer.

Prostate Cancer Genetics: Ready for Clinical Use?

Prostate Cancer Genetics: Ready for Clinical Use?

For decades, prostate cancer risk (PCa) stratification was based primarily on the architectural pattern of the tumor.

The Renal & Urology News Top 5 Lists for 2014

The Renal & Urology News Top 5 Lists for 2014

Among the most important challenges in producing a medical newspaper is deciding what studies or topics on which to report.

Emerging MRA-Based Treatments for End-Stage Renal Disease (ESRD) Patients on Dialysis

Emerging MRA-Based Treatments for End-Stage Renal Disease (ESRD) Patients on Dialysis

Recently, increasing attention focused on mineralocorticoid receptor antagonists (MRAs) in treating chronic kidney disease (CKD).

Offer Ebola Victims Dialysis If They Need It

Offer Ebola Victims Dialysis If They Need It

Dr. Kalantar-Zadeh: Patients with Ebola deserve to be offered renal replacement therapy, even if odds of survival are slim.

Physicians and the Medical-Industrial Complex

Physicians and the Medical-Industrial Complex

Eisenhower warned Americans to beware of the "military-industrial complex" as it can overwhelm us.

The Ebola Threat: Why Not an Outbreak Here?

The Ebola Threat: Why Not an Outbreak Here?

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

Why Not Business Class Dialysis?

Why Not Business Class Dialysis?

Would any heterogeneity in the choice of additional services be unethical or implausible?

Big Data, Transparency and Accountability

Big Data, Transparency and Accountability

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

The Need for a Kidney Research Prize: Interview with Sharon Moe, MD

The Need for a Kidney Research Prize: Interview with Sharon Moe, MD

Dr. Moe spoke about the importance of nephrology research and how a prize competition can facilitate the process.

"Doc, Did You Check My Cholesterol?"

"Doc, Did You Check My Cholesterol?"

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

Ultrasonic Propulsion of Kidney Stones: Interview with Jonathan Harper, MD

Ultrasonic Propulsion of Kidney Stones: Interview with Jonathan Harper, MD

Jonathan Harper, MD, of the UW School of Medicine in Seattle, explains his "Rolling Stones" concept as a feasible office procedure.

Medicare Payments Exposed

Medicare Payments Exposed

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

J. Francois Eid, MD: Penile Implant Therapy & Options

We sat down with Dr. Eid at his New York City office to ask him about the latest developments in penile implant therapy.

Renal Stenting and the CORAL Study: Interview with Lance Dworkin, MD

Renal Stenting and the CORAL Study: Interview with Lance Dworkin, MD

CORAL study chair Lance Dworkin, MD, discusses the controversial finding with Renal & Urology News.

Nutrition Advice Challenged — Again

Nutrition Advice Challenged — Again

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

Sidestepping Sepsis via TP Biopsy: Interview with Jeremy Grummet, MBBS

Sidestepping Sepsis via TP Biopsy: Interview with Jeremy Grummet, MBBS

Rising readmission rates of subsequent sepsis have given urologic surgeon Jeremy Grummet, MBBS, MS, FRACS, pause.

Personalized Medicine in 2014

Personalized Medicine in 2014

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

Immunosuppression-Free Transplant: Interview with Suzanne Ildstad, MD

Immunosuppression-Free Transplant: Interview with Suzanne Ildstad, MD

Immunologic mismatch may no longer be a barrier between living kidney donors and recipients.

Nephrologists Woefully Underpaid in U.S vs. Canada

Nephrologists Woefully Underpaid in U.S vs. Canada

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

PCa Control Similar with RT, Radical Surgery: Interview with Frank Critz, MD

PCa Control Similar with RT, Radical Surgery: Interview with Frank Critz, MD

Some may find it surprising that Dr. Critz generally considers RP to be the go-to treatment for localized disease.

Why Not A Federal Medical License?

Why Not A Federal Medical License?

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

New Albumin Self-Testing Platform: Interview with Aydogan Ozcan, PhD

New Albumin Self-Testing Platform: Interview with Aydogan Ozcan, PhD

A digital sensing platform could allow patients with chronic kidney ailments or diabetes to test their own urine albumin levels.

Placing Very Elderly Patients on RRT

Placing Very Elderly Patients on RRT

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

A Hematuria Risk Index: Interview with Ronald Loo, MD

A Hematuria Risk Index: Interview with Ronald Loo, MD

Urologist Ronald K. Loo, MD, of Southern California Permanente Medical Group and colleagues created and validated a Hematuria Risk Index.

Medical Research and the Federal Shutdown

Medical Research and the Federal Shutdown

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.

What You Don't Know About Hyponatremia: Interview with Juan Carlos Ayus, MD

What You Don't Know About Hyponatremia: Interview with Juan Carlos Ayus, MD

Hyponatremia authority Dr. Juan Carlos Ayus receives calls all the time from fellow nephrologists who have questions.

The Future of Dialysis in the U.S.

The Future of Dialysis in the U.S.

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

An Update on New Therapies for mCRPC: Interview with Oliver Sartor, MD

An Update on New Therapies for mCRPC: Interview with Oliver Sartor, MD

Radium-223 was approved in May 2013 for the treatment of mCRPC with symptomatic bone metastases and no visceral disease.

Genetic Risk and PCa Treatment: A New Era Dawning

Genetic Risk and PCa Treatment: A New Era Dawning

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

New Noninvasive Gold Standard for PCa Diagnosis: Interview With Vikram Dogra, MD

New Noninvasive Gold Standard for PCa Diagnosis: Interview With Vikram Dogra, MD

A nascent technology combines laser optics and ultrasound to distinguish between benign and malignant prostate tissue.

Another Nutritional Warning: Omega-3s

Another Nutritional Warning: Omega-3s

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

Active Surveillance of Renal Masses: Interview with Paul Crispen, MD

Active Surveillance of Renal Masses: Interview with Paul Crispen, MD

Dr. Crispen highlights the advantages and challenges of active surveillance for small renal masses.

Self-Cannibalizing for Peritoneal Dialysis Growth?

Self-Cannibalizing for Peritoneal Dialysis Growth?

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

Botox for Urinary Incontinence: Interview with David Sussman, DO

Botox for Urinary Incontinence: Interview with David Sussman, DO

David O. Sussman, DO, has been ready to educate urology colleagues on the appropriate use of Botox.

Let's End the Small Renal Mass Dilemma

Let's End the Small Renal Mass Dilemma

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

Membranous Nephropathy: Interview with Daniel Cattran, MD

Membranous Nephropathy: Interview with Daniel Cattran, MD

The MENTOR study is poised to change first-line-treatment recommendations for idiopathic membranous nephropathy.

Hemoglobin Levels Fall, Transfusions On the Rise

Hemoglobin Levels Fall, Transfusions On the Rise

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.

Study Could Extend Survival Benefit of Provenge: Interview with Samir Khleif, MD

Study Could Extend Survival Benefit of Provenge: Interview with Samir Khleif, MD

Provenge is a breatkthrough treatment option for men with asymptomatic or minimally symptomatic metastatic, hormone-resistant PCa.

Reflections on the EAU Annual Congress

Reflections on the EAU Annual Congress

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

In Search of Kidney-Saving Treatments for FSGS: Interview with Fernando Fervenza, MD

In Search of Kidney-Saving Treatments for FSGS: Interview with Fernando Fervenza, MD

The scar tissue that forms on sections of some glomeruli in FSGS will lead to kidney failure if left untreated.

Why Not 24/7 Dialysis Urgent Care?

Why Not 24/7 Dialysis Urgent Care?

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

New Center for All-Around Prostate Cancer Treatment: Interview with Ashutosh Tewari, MB

New Center for All-Around Prostate Cancer Treatment: Interview with Ashutosh Tewari, MB

Ringing in the new year was especially exciting this time around for Ashutosh K. Tewari, MB, BS, head of the new Center for Prostate Cancer at New York-Presbyterian.

Physicians: Managers of Risk

Physicians: Managers of Risk

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

Serious AKI On the Rise: Interview with Chi-yuan Hsu, MD, and Raymond Hsu, MD

Serious AKI On the Rise: Interview with Chi-yuan Hsu, MD, and Raymond Hsu, MD

The incidence of AKI requiring dialysis is now higher than the incidence of ESRD requiring dialysis or transplant.

The Rise of the Coffee Shop Doctor

The Rise of the Coffee Shop Doctor

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

Implantable Artificial Kidney Could Help Tens of Thousands: Interview with Shuvo Roy, PhD

Implantable Artificial Kidney Could Help Tens of Thousands: Interview with Shuvo Roy, PhD

A promising hybrid device that works from the inside to provide renal functions beyond dialysis 24 hours a day, seven days a week, has the potential to change a lot of lives.

Highlights of Kidney Week 2012

Highlights of Kidney Week 2012

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.

Calcium for ADT Bone Loss May Worsen PCa: Interview with Gary Schwartz, PhD

Calcium for ADT Bone Loss May Worsen PCa: Interview with Gary Schwartz, PhD

Considering that bone loss is a known side effect of ADT for men with PCa, it might seem logical that calcium and vitamin D supplementation would help manage this consequence.

Obesity and Prostate Cancer Risk

Obesity and Prostate Cancer Risk

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

The Pregnant Kidney Patient: Interview with Madeleine Pahl, MD

The Pregnant Kidney Patient: Interview with Madeleine Pahl, MD

Focusing on nephrology patients who become pregnant may seem to be a niche business, but as specialist Madeleine Pahl, MD, tells Renal & Urology News, this population is increasing.

Obama, Romney Debate Health Care in NEJM

Obama, Romney Debate Health Care in NEJM

President Obama and Mitt Romney square off on American health reform in the New England Journal of Medicine.

A Rising Epidemic of Foamy Urine

A Rising Epidemic of Foamy Urine

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

UI Surgery Rates Rise Years After RP: Interview with Robert Nam, MD

UI Surgery Rates Rise Years After RP: Interview with Robert Nam, MD

Robert K. Nam, MD, MSc, and colleagues helped to shed light on the impact of UI in men who have undergone RP by studying rates of UI-corrective surgery.

CT and Stones: Can We Do Better with Less?

CT and Stones: Can We Do Better with Less?

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

Value of Frequent Dialysis for Physical Health Questioned: Interview With Yoshio Hall, MD

Value of Frequent Dialysis for Physical Health Questioned: Interview With Yoshio Hall, MD

Nephrologist and study coauthor Yoshio Hall, MD, discusses his team's findings with Renal & Urology News.

How About Twice-Weekly Hemodialysis?

How About Twice-Weekly Hemodialysis?

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.

The Urologist Who Became a Dean: Interview with Ralph Clayman, MD

The Urologist Who Became a Dean: Interview with Ralph Clayman, MD

Dr. Clayman continues to make his mark as one of only two urologists in the nation to become a medical school dean.

Outlook Brightens for CRPC Patients

Outlook Brightens for CRPC Patients

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

Electronic Health Records Are For You: Interview with Oliver Khakmahd, MD

Electronic Health Records Are For You: Interview with Oliver Khakmahd, MD

Nobody had to ask Oliver Khakmahd, MD, twice to implement an EHR system in his large, busy nephrology practice.

Put Women Back on the Research Agenda

Put Women Back on the Research Agenda

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.

Optimal Sequencing for New Prostate Cancer Drugs: Interview with E. David Crawford, MD

Optimal Sequencing for New Prostate Cancer Drugs: Interview with E. David Crawford, MD

Several new drugs have become available for treating advanced prostate cancer in the past year and a half.

Prostate Cancer Screening: Moving Beyond PSA

Prostate Cancer Screening: Moving Beyond PSA

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

With ESAs, Let Your Patient Be Your Guide: Interview with Alan Kliger, MD

With ESAs, Let Your Patient Be Your Guide: Interview with Alan Kliger, MD

When using ESAs to correct anemia in patients with chronic kidney disease, focus less on hitting a given hemoglobin target.

Is U.S. Nephrology Lagging Behind?

Is U.S. Nephrology Lagging Behind?

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 Case for Brachytherapy: Interview with Michael Sarosdy, MD

The Case for Brachytherapy: Interview with Michael Sarosdy, MD

Having performed more than 1,200 brachytherapy treatments, Michael F. Sarosdy, MD, is convinced that this is a far better choice than surgery.

Highlights of the GU Cancers Symposium

Highlights of the GU Cancers Symposium

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

Lessons from "The Hemodialysis Marathon Man"

Lessons from "The Hemodialysis Marathon Man"

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

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

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

FGF-23 may one day be an important marker of and therapeutic target for very early-stage CKD for the clinical nephrologist.

Let Patients Sleep During Rounds

Let Patients Sleep During Rounds

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 Lowdown on HIFU: Interview with David Chen, MD

The Lowdown on HIFU: Interview with David Chen, MD

Although HIFU has not yet been approved in the US, a growing number of the nation's urologists are offering this noninvasive surgical procedure.

Highlights of 2011, The Promise of 2012

Highlights of 2011, The Promise of 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?

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

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

Less than a decade ago, Aaron Tobian, MD, PhD, would not have been a proponent of male circumcision.

Dialysis Care in the Post-Bundling Era

Dialysis Care in the Post-Bundling Era

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.

Kidney Stone Prevention: 'Fact versus Fiction'

Kidney Stone Prevention: 'Fact versus Fiction'

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

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

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

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

A leading authority on kidney stone disease, James E. Lingeman, MD, updates Renal & Urology News on the state of urinary stone treatment.

Avanafil and PDE-5 Inhibitors: Interview with Wayne Hellstrom, MD

Avanafil and PDE-5 Inhibitors: Interview with Wayne Hellstrom, MD

Dr. Hellstrom, is one of the principal investigators involved in studies of avanafil, an investigational phosphodiesterase-5 inhibitor.

Keeping Up with Quality and Patient Safety Measures in Urology and Nephrology

There has recently been a tremendous increase in emphasis on quality and patient safety within American medicine. Much of this is due to an improved ability to look at and evaluate results from large numbers of patients and determine "best practices" shown to improve outcomes.

Renal Function Preservation for Patients with Kidney Cancer

The renal function preservation clinic for patients with kidney cancer represents a new multidisciplinary approach to an old problem.

Some Thoughts on Patient Education

Some Thoughts on Patient Education

Physicians are indeed spending less face time with patients, according to studies and to what doctors have told me in conversation. One consequence of this could be less time to educate patients about their illness.

High BMI and Kidney Transplant Waitlisting

High BMI and Kidney Transplant Waitlisting

Many obese dialysis patients are asked to lose weight to qualify for kidney transplantation. If such usual weight reduction programs as dieting or anti-appetite medications do not work, some patients will be introduced to more aggressive interventions such as bariatric surgery.

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

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

HIV is no longer a contraindication to transplantation, contends Dorry Segev, MD, PhD.

Issues in Hypertension: Interview with George Bakris, MD

Issues in Hypertension: Interview with George Bakris, MD

George Bakris, MD, spoke about various aspects of treating hypertension in patients with chronic kidney disease.

Should We Start Dialysis As Late As Possible?

Should We Start Dialysis As Late As Possible?

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.

The Robotic Prostatectomy: Interview with Mani Menon, MD

The Robotic Prostatectomy: Interview with Mani Menon, MD

Mani Menon, MD, discusses the place of robotic prostatectomy in the treatment of localized prostate cancer.

Kidney Cancer vs. ESRD

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

Second-Line Hormone Therapies for Prostate Cancer: An Update

New biological knowledge has provided an understanding of why these treatments remain effective.

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