ERA organizes the largest annual Nephrology Congress in Europe, welcoming thousands of attendees coming from all over the world, focusing on key learning features both in the clinical field as well as the scientific and latest innovations.
The 59th ERA Congress will take place on May 19-22, 2022, both virtual and live in Paris
PRESIDENT’S MESSAGE: Continue reading “2022 CSN AGM | May 12-14 2022”
Abstract
Purpose of review: Quality improvement (QI) work is a cornerstone of health care, and a growing area within nephrology. Continue reading “Dr. Claire Harris | PUBLISHED (CSN): ‘Quality Improvement in Canadian Nephrology: Key Considerations in Ensuring Thoughtful Ethical Oversight”
Bridge the knowledge gap to better kidney care Continue reading “World Kidney Day 2022”
Editorial in the JASN about strengthening the argument for prevention of CKD.
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Published: December 11, 2020
DOI: https://doi.org/10.1016/j.kint.2020.10.042
Megumi Oshima, Meg J. Jardine, Rajiv Agarwal, George Bakris, Christopher P. Cannon, David M. Charytan, Dick de Zeeuw, Robert Edwards, Tom Greene, Adeera Levin, Soo Kun Lim, Kenneth W. Mahaffey, Bruce Neal, Carol Pollock, Norman Rosenthal, David C. Wheeler, Hong Zhang, Bernard Zinman, Vlado Perkovic and Hiddo J.L. Heerspink
Canagliflozin slows the progression of chronic kidney disease in patients with type 2 diabetes and induces a reversible acute drop in estimated glomerular filtration rate (eGFR), believed to be a hemodynamic effect. Predictors of the initial drop and its association with long-term eGFR trajectories and safety outcomes are unknown. To assess this, we performed a post-hoc analysis of 4289 participants in the CREDENCE trial with type 2 diabetes and chronic kidney disease equally split into treatment and placebo groups who had eGFR measured at both baseline and week three. The eGFR was categorized at week three as greater than a 10% decline; between 0 and 10% decline; and no decline. Long-term eGFR trajectories and safety outcomes were estimated in each category of acute eGFR change by linear mixed effects models and Cox regression after adjustment for baseline characteristics and medications use. Significantly more participants in the canagliflozin (45%) compared to the placebo (21%) group experienced an acute drop in eGFR over 10%. An over 30% drop occurred infrequently (4% of participants with canagliflozin and 2% with placebo). The odds ratio for a drop in eGFR over 10% with canagliflozin compared to placebo was significant at 3.03 (95% confidence interval 2.65, 3.47). Following the initial drop in eGFR, multivariable adjusted long-term eGFR trajectories, as well as overall and kidney safety profiles, in those treated with canagliflozin were similar across eGFR decline categories. Thus, although acute drops in eGFR over 10% occurred in nearly half of all participants following initiation of canagliflozin, the clinical benefit of canagliflozin was observed regardless. Additionally, safety outcomes were similar among subgroups of acute eGFR drop.
Canadian Journal of Kidney Health and Disease
Published: February 5, 2021
DOI: https://doi.org/10.1177/2054358120988446
Amanda Cunningham, Wayne Hung, Adeera Levin, Abeed Jamal
The COVID-19 pandemic has widespread implications not only for clinical practice but also for academic medicine and postgraduate training. The need to promote physical distancing and flexibility within our department has generated important revisions to the core curriculum for the Adult Nephrology Training Program in Vancouver, Canada. We reviewed available educational resources and objectives to develop curricular adaptations informed by staff and trainee feedback. We describe existing changes to formal training in British Columbia (BC), which will be tailored as the pandemic evolves, and anticipate them to have lasting impact on the way we structure training programs in the future. Standardization and harmonization of modified curriculum may be possible across Canada with sharing of these learnings.
Journal of the American Society of Nephrology
Published: March, 2021
DOI: https://doi.org/10.1681/ASN.2020121811
Beginning in 2023, the Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act (H.R. 5534; also known as the Immuno bill) in the United States, will add a new Medicare option solely to cover immunosuppressive drugs for kidney transplant recipients. Patients may enroll beginning 36 months after a transplant if they have no other health insurance and are otherwise ineligible for Medicare. Enrollees will pay a monthly premium equal to 35% of standard immunosuppressive drug costs currently estimated to be $243/mo. For prevalent kidney transplant recipients who have lost or will lose Medicare benefits due to the 3-year post-transplant time limit on coverage in the Medicare ESKD program, the bill will provide access to essential drugs to prevent allograft rejection for the life of their transplant. An analysis by the Department of Health and Human Services (HHS) estimated that the Immuno bill will prevent approximately 375 allograft failures annually, and the Congressional Budget Office (CBO) projects Medicare savings of $400 million over 10 years. Legislation proposing extension of immunosuppressive drug coverage have been introduced in Congress for the past two decades, and the passage of the Immuno bill represents a huge victory for current and future transplant recipients. The entire kidney community is indebted to the primary bill sponsors Senator Bill Cassidy, MD (Republican LA); Senator Dick Durbin (Democrat IL); Rep. Michael Burgess, MD (Republican TX); and Rep. Ron Kind (Democrat WI) and the many House and Senate members for their enduring support.
World Kidney Day 2021 is all about “Living Well with Kidney Disease.”
The objective is to increase education and awareness about effective symptom management and patient empowerment, with the ultimate goal of encouraging meaningful participation in every-day life. Whilst effective measures to prevent kidney disease and its progression are important, patients with kidney disease – including those who depend on dialysis and transplantation – and their care-partners should also feel supported, especially during pandemics and other challenging periods, by the concerted efforts of kidney care communities.
WKD calls for the inclusion of life participation as a key focus in the care of patients with CKD and as a building block towards delivering the ultimate goal of
living well with kidney disease.
To learn more, visit the World Kidney Day website>>