Expanding Options for Kidney Failure Patients
Gradual transition to dialysis and palliative dialysis should be alternatives offered to patients with advanced chronic kidney disease, according to an editorial.
Commentary
COMMENTARY
Race ‘Correction’ in Clinical Algorithms Needs Re-examination
Clinicians should consider whether a race correction will relieve or exacerbate inequities, according to editorialists.
The COVID-19 Pandemic Proves the World Is Small
The rapid spread of coronavirus disease 2019 (COVID- 19) caught the world by surprise. Whatever becomes the new normal, the United States will be a different country from what it was on March 13, when President Donald J. Trump declared a national emergency. At this writing on May 28, more than 100,000 people in the…
Ode to Burton ‘Bud’ Rose, MD
Like many of my colleagues, I was very saddened to hear of the passing of Dr Burton “Bud” Rose on April 24, 2020 at the age of 77 years. There were two important sides of Dr Rose: First, he was well known in the nephrology community as an extremely modest, brilliant nephrologist who published 2…
Twice-Weekly Hemodialysis Is Gaining Acceptance
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…
Basic Science: The Tail That Wags the RCC Dog
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,…
Kidney Health Initiative Offers Promise, Unknowns
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…
Fighting a Silent Killer: Identifying Chronic Kidney Disease at Stage 1
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.
RCC in Advanced CKD: A Transplant Dilemma
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…
Could Potassium-Restricted Diets Come to an End?
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,…
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