Back in August 2012, I wrote a provocative editorial in this space titled, “How About Twice-Weekly Hemodialysis?” This was the first time the topic of dialysis provided less frequently than 3 times a week was brought up in the 21st century. I argued that because kidney function worsens gradually, dialysis treatment should be gradual and…
I recently had reason to survey the progress made in renal cell cancer (RCC) over the last 70 or more years. In 1950, a patient who presented with metastatic RCC had a 0%-5% overall response rate (ORR) to the therapies of the time, with an anticipated overall survival (OS) of approximately 10 months. By 2005,…
Many nephrologists and other healthcare providers (HCPs) have enthusiastically embraced the July 10 presidential executive order titled, “Advancing American Kidney Health Initiative.” The 3 main components include a reduction in the end-stage renal disease (ESRD) rate by 25% by 2030; a substantial increase in home dialysis so that 80% of new ESRD patients can receive…
The benefits of early diagnosis of chronic kidney disease (CKD) are significant, as patients in whom CKD is diagnosed in the early stages have the chance to make lifestyle changes, learn how to manage their disease, and extend their lives while avoiding or postponing the need for dialysis or transplant.
Non-dialysis patients with advanced CKD diagnosed with renal malignancies grapple with the dual threat of renal failure and cancer progression. When choosing between functional or oncologic risks, many patients will ask about renal transplantation. Discussions of this option are complicated by statistical realities: According to UNOS, of nearly 1 million solid organ transplants performed over…
Hyperkalemia, defined as a serum potassium level above 5.3 mmol/L, develops in many patients with chronic kidney disease (CKD). The abnormality can precipitate serious adverse outcomes, including dysrhythmias and sudden cardiac death, so patients with elevated blood potassium levels may be referred to emergency departments or urgent care facilities for immediate therapy. As a result,…
During a session at the 2019 Genitourinary Cancers Symposium (GUCS) held recently in San Francisco, researchers presented findings from phase 3 studies showing that immunotherapy-based combination regimens are superior to sunitinib alone at improving progression-free survival among patients with previously untreated advanced kidney cancer. One study demonstrated improved overall survival. The study presenters concluded that…
