Urology & Nephrology Expert Reviews | Patient Care & Quality Concerns, opinions

Expert Reviews

Anthony J. Bleyer, MD, MS

Genetic Renal Disease Easily Missed

Autosomal dominant interstitial kidney disease is an under-recognized cause of kidney failure. Characterized by a very strong family history of kidney disease, it is a slowly progressive condition that leads to dialysis when patients are in their 40s or older.

Vasectomy: What the Evidence Shows

Even though the American Urological Association has developed guidelines for numerous conditions, there are none for vasectomy. Yet this is one of the most common procedures performed by urologists, with more than 500,000 done annually in the United States.

Medical Management of Urolithiasis

IN THE United States, the incidence of urinary stone disease is about 12% in men and 7% in women, and evidence suggests that these numbers are increasing. For patients who form stones, the likelihood of a recurrence is nearly 50% within five years and up to 95% over a lifetime.

CKD Screening Lags in Many Nations

CKD is arguably emerging as a major threat to the developing world. The word ‘arguably” is used deliberately because while we know that CKD in the United States affects approximately 5%-10% of the population (Am J Kidney Dis. 2003;41:1-12) and is a major risk factor for CVD and all-cause mortality, similar data from the developing world is unavailable.

Diabetic Nephropathy Care Is Lacking

Kidney disease linked to diabetes, hypertension, and obesity is increasing throughout the world. It is estimated that diabetes leading to end-stage renal disease (ESRD) accounts for 40% of the patients who require kidney transplants in the United States, Europe, Japan, Australia, and New Zealand.

Acute Renal Failure: Finally, Some Progress

Acute renal failure (ARF) mortality remains stubbornly high, especially among patients in the ICU. The history of ARF is marked by high-profile failures, persistent clinging to discredited treatments, and an almost comical proliferation of definitions for the condition.

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