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Lana Dykes is the editor of HCPLive Rheumatology. She is an experienced editor and technical writer with a demonstrated history of working in the banking and publishing industries. In her free time, she enjoys cooking, yoga, listening to podcasts, and drawing. She can be reached via email at LDykes@mjhlifesciences.com.

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The nephrology condition center is a comprehensive resource for clinical news and expert insights on nephrology. Read more at HCPLive.


Nephrology | Medical News & Expert Insight | HCPLive

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clinical page is a resource for content on every specialty, disease, and topic available on our medical news site.

Clinical Topics

The HCPLive nephrology page is a resource for medical news and expert insights on kidney disease. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments in nephrology, and more.

Researchers continue to study the cardiovascular benefits associated with the DASH diet. Patients with CKD should adjust potassium intake.

ASN 2010: The DASH Diet, Cardiovascular Health, and Patients with CKD

Patients with chronic kidney disease treated by a nephrologist earlier in the care process face decreased risk of end-stage renal disease and death.

ASN 2010: Early Nephrologist Care Reduces Risk of ESRD in CKD Patients

Study showing racial differences in rate of kidney function decline may point to new opportunities for kidney disease prevention.

ASN 2010: CKD May Progress Faster in African Americans and Hispanics

Evidence-based strategies can alleviate gaps in providers' knowledge of chronic kidney disease and diabetes in underserved patient populations.

ASN 2010: How Can We Reduce Racial Disparities in CKD and Diabetes?

Type 2 diabetics with silent cerebral infarction are more than twice as likely to develop or die from end-stage kidney disease. 

'Silent Strokes' Linked to Kidney Failure in Diabetics 

Research shows that early-stage CKD is related to atherosclerosis; therefore, management of CKD might lower the incidence of coronary spastic angina

Decreased Kidney Function May be Associated with Coronary Spastic Angina

Dr. Rasheed Balogun discusses the risk factors and rising worldwide incidence rates of chronic kidney disease.

Chronic Kidney Disease

Some of the leading drug classes in modern 

 care now carry indications—and even more seek implicative data—for the co-treatment of renal outcomes in comorbid patients.

As the understood capability of agents like SGLT-2 inhibitors evolves with newer cardiorenal outcomes, so does the team dedicated to treating such patients.

’s newest monthly multimedia series, Heart Team, is dedicated to highlighting the research, principles, and practice insights that define the current cardiology care team.

The show will focus on topics on recent news in research, FDA developments, emerging literature, their own case studies, their personal experiences as caregivers and prescribers, and what more is yet to be learned in the rapidly expanding field. Its first episode, published this week, provides insight into the emerging role of nephrology in heart care.

In this special, downloadable podcast from the first episode, the Heart Team co-hosts—a pair of cardiologists—discuss these topics and more with a nationally-leading nephrologist.

Jorge Plutzky, MD, Director of Preventive Cardiology at Harvard Medical School, and Michael Farkouh, MD, Director of the Peter Munk Clinical Trials Unit and Vice Chair of Medicine at the University of Toronto, speak with Matthew Weir, MD, director of the division of nephrology at the University of Maryland School of Medicine, on simultaneously treating the kidney and the heart.

To watch the full video episode of this Heart Teams, follow this link.

In this podcast episode, Jorge Plutzky, MD, and Michael Farkouh, MD, speak with University of Maryland's Matthew Weir, MD, about the growing involvement of renal care in modern heart disease patients.

Cardiology & Nephrology Collaborations with Dr. Matthew Weir

 confirmed a higher prevalence of non-alcoholic fatty liver disease (NAFLD) in pediatric patients than previously thought.

The data was part of the ongoing observational study called TARGET-NASH, which included participants with NAFLD and/or alcoholic steatohepatitis (NASH).

The study, which included 660 pediatric patients, cited an increase in liver disease following evaluation of alanine aminotransferase.

Notably, pediatric patients with greater than 250 U/L ATL had an eight-fold greater risk of developing cirrhosis.

, Miriam Vos, MD, MSPH, Department of Pediatrics, School of Medicine, Emory University, sat down with assistant managing editor Kenny Walter to discuss the data from TARGET-NASH as well as the implications of NAFLD in pediatric patients.

Vos has studied the disease for 16 years, and the database included in the trial followed the children for an average of 5 years. She noted that current information on NAFLD in children is limited, and that the ongoing trial data could lead to a greater understanding of the disease.

“We don't have a lot of studies that cover from childhood to adulthood; we have many studies in kids, following them for a number of years, and in this study we have data from about 3 years of follow up,” Vos said. “So, I don't know that we really know if there's a difference in management. Is an adult who has had the disease starting in childhood, do they have a more severe disease? Possibly, but we still are collecting the data as these children aged into adulthood to try to answer that question.”

She added that while most children are not affected by advanced fibrosis, the medical community would benefit from markers that look at steatosis and additional testing to measure inflammation levels in the liver.

“That adds to the information from the ALT, and then a noninvasive marker of fibrosis would be critical,” Vos said. “Because the ones with more fibrosis in childhood certainly are the ones that we would want to tailor medicines for.”

Currently, there is no therapeutic approved by the Food and Drug Administration for pediatric nephrology.

Dr. Miriam Vos details the TARGET-NASH study, which indicated a higher prevalence of NAFLD in pediatric patients than previously thought.

NAFLD Prevalence Increasing in Pediatric Patients

The second episode of Heart Trials, the newest specialty podcast series from 

, features a look into an agent from possibly the most dynamic drug class in all of 

In this episode of the monthly cardiovascular research series, study author Mikhail Kosiborod, MD, director of Cardiometabolic Research at Saint Luke's Mid America Heart Institute, and professor of Medicine at the University of Missouri-Kansas City, joins to discuss the DAPA-HF trial, as well as the application of dapagliflozin in COVID-19 patients with respiratory failure from the DARE-19 trial.

Share your thoughts on the meeting, and the state of cardiology, with our 2-minute survey!

Published in November 2019, DAPA-HF showed patients with established heart failure with reduced ejection fraction (HFrEF) with and without diabetes, benefitted from dapagliflozin in reduced risk of heart failure worsening or death form cardiovascular disease versus placebo.

The trial followed US Food and Drug Administration (FDA) application-supporting evidence of glycemic benefit among patients with diabetes given the SGLT-2 inhibitor—and preceded growing evidence of other cardiometabolic, cardiovascular, and renal outcome benefits among patients with heart disease.

Kosiborod joined to discuss the unique properties of the SGLT-2 inhibitor drug class, their potential ceiling in treating millions of at-risk Americans, the data which inspired DAPA-HF, and the lasting impact of his and his colleagues’ research.

Following DAPA-HF, Kosiborod turned attention to the DARE-19 trial, which he presented data for at the 

American College of Cardiology (ACC) 2021 Scientific Sessions

Listen to Heart Trials on your favorite podcast platforms, including 

American College of Cardiology

The SGLT-2 inhibitor drug class is expanding into treatment indications experts could not have predicted. Learn how DAPA-HF contributed to the understanding of dapagliflozin.

DAPA-HF, with Mikhail Kosiborod, MD

“Imagine every cell in your body has this buildup of trash that has been building up since birth,” explained nephrologist Eric Wallace, MD, Director of Telehealth, University of Alabama at Birmingham, in regard to Anderson-Fabry disease.

“Well, now, later on in life, the organs don’t work as well,” he continued.

Resulting from mutations of the α-galactosidase A (GLA) gene, Fabry disease is marked by the impairment of lysosome function. As a result, particular compounds and intracellular structures are unable to be digested or be broken down.

The big-picture result of this disorder is pain as well as potential nephrological, cardiological, neurological, and dermatological complications.

As a multisystemic disorder, Fabry can increase risk for an enlarged heart, kidney disease, Alzheimer’s disease, gastrointestinal involvement, angiokeratomas—to name just a few symptoms.

In this episode of the Rare Disease Report podcast, Wallace discussed the cause of Fabry disease, which populations or types of patients are most likely to be diagnosed with the genetic disorder, current screening methods and gaps, and any ongoing research.

He provided essential perspective as a nephrologist with hands-on experience working with such patients.

Wallace has advocated for a stronger focus on maintaining and treating kidney health, thus calling for ensuring regular monitoring as part of the standard of care among Fabry patients.

 are proud to present the second installment of a new podcast series that will provide a platform for experts and advocates to share their knowledge, tell their story, and augment the discussion surrounding diseases that have—for too long—fallen beneath the radar.

Eric Wallace, MD, discusses Anderson-Fabry disease and the difficulties associated with screening, testing, and treatment. 

The Rare Disease Report Podcast: Fabry Disease

The American Diabetes Association (ADA) recently published 

 which provide clinicians perspective on diagnosing, screening, and managing hypertension and cardiovascular risks in patients with 

The guidelines, which feature collaborative perspective from the American College of Cardiology (ACC), serve as a point of reflection on all the various advances being made in treating comorbid cardiovascular risk among the growing diabetes population.

They also provide context on the comprehensive utility of drug classes such as GLP-1 agonists and SGLT-2 inhibitors, which have been increasingly investigated for various health outcomes in cardiometabolic patients for a decade now—and continue to be assessed for more benefits now.

There’s much to address in the single mention of the state of cardiometabolic care. The first DocTalk episode of the year aims to tackle all the facets of the new guidelines, and more.

, George Bakris, MD, professor of medicine and director of the Comprehensive Hypertension Center at the University of Chicago School of Medicine, shared perspective on the new ADA guidelines and trials which influenced it, the evolving cardiometabolic care team, and the current issues burdening the field at this moment.

The University of Chicago hypertension expert discusses new ADA recommendations for cardiovascular risk management.

Cardiovascular Guidelines in Diabetics with Dr. George Bakris

There has been great progress in recent years in the field of nephrology with the advent of new treatment options.

For example, many investigators during the 

American Society of Nephrology (ASN) Kidney Week in Washington, D.C.

, said that using SGLT2 inhibitors to treat chronic kidney disease could be a game changer in the field. The CREDENCE study also showed positive results in treating chronic kidney disease patients with diabetes who at a higher risk for a cardiovascular event.

During the meeting, Michael Spigler, vice president of Patient Services and Kidney Disease Education for the American Kidney Fund, explained to 

what some of the major challenges are in the field and how the American Kidney Fund is working on improving patient outcomes in nephrology.

Hello and welcome to this special edition of the DocTalk podcast from the American Society of Nephrology’s annual meeting in Washington, D.C. Today, I'm joined by Michael Spigler of the American Kidney Fund to talk about the current state of nephrology in America. Mr. Spigler, if you wouldn't mind introducing yourself to our listeners and then we can dive into our discussion.

Sure, my name is Mike Spigler. I'm the Vice President of patient services and kidney disease education and I'm with the American Kidney Fund.

My first question is, what do you think is preventing better patient outcomes in the field of nephrology?

Inadequate diagnosis and early detection and early interventions in kidney disease patients. 37 million Americans with kidney disease, only 10% of them with advanced kidney disease even though they have it.

If we could find these patients earlier, and help deal with some of their comorbidities, maybe slow the progression of the kidney disease and also give them better choices for their options should they end up in kidney failure?

If they know that they're going to end up there they may choose a home modality they like home hemodialysis, peritoneal dialysis. They might be able to get a living donor transplant before they even have to start dialysis.

So, to us at the kidney fund, that is the main challenge that we have is finding these patients early enough.

Okay. How important is it in nephrology for doctors in different fields to work together and catch some of these diseases early?

It's very important for specialists to work together but not only working together but really, really important is to work with the general practitioner. And actually, even the reverse of that, that general practitioner identifying to say, ‘you know what, this person has some signs of kidney disease, some comorbidities I'm having difficulty treating.

‘I've got to get them referred to an endocrinologist, just get them referred to a nephrologist, or cardiologist.’

That doesn't always happen. So that, to me is really an issue.

I’ll give you one example that I have in my own life. I'm the primary caregiver for my mother who has dementia, I went to her primary care doctor, and they're going through all the list of her blood test results and instead of creatinines little high not to worry and kind of moved on.

And luckily, I was in the room and said, ‘Whoa, time out you got the wrong guy in the room to kind of blow by that.’

And we stopped and talked about it and we made some changes to her medications. We got a different referral to a specialist, and we're able to keep her where she was in her kidney disease.

So, had we not by now, you know, four or five years later, she may have been on dialysis herself. So, it's really that GP, the general practitioner, family practitioner, making that referral to the specialist. I think it's actually even more important.

MD Mag: Is there any segment of the population, whether it is age, race, or sex that is overlooked or disproportionately harmed by some of these diseases?

 Yeah, so for chronic kidney disease, the people that are mostly harmed by it are minority populations. Primarily African Americans, who are the most at risk for kidney disease.

Hispanics, Latin Americans, Asian Americans, anyone over the age of 60 has higher risk for kidney disease as well, those with heart disease. All of those things play a role in it.

And just from a comorbidity standpoint, other disease state standpoint, those with diabetes and high blood pressure, a much higher risk for kidney failure as well, especially the diabetics. You look at a typical dialysis center, almost half of those in there are there because of diabetes, uncontrolled diabetes that have caused their kidney disease and kidney failure.

MD Mag: Ok, on a more positive note, what has you excited that some of the outcomes are going to start improving?

Well, there's a lot of innovation in the space. So, I've been coming to kidney week, I guess this is my 10

And starting last year, I think was the first time we really started to see some new innovation in the space, all the way from diagnostics to medication interventions, to the way in which we give dialysis the way in which we do transplant.

Last year was a really exciting year, this year is even better. The meetings that I've had with some of the innovators in the space, some of the pharma companies, some of the biotech firms, the diagnostic companies, genetic testing companies, all of them have really started to take an interest in kidney disease, because there's a huge unmet need that's there.

So, I think that is what is most exciting right now. You know, the new SGLT2 inhibitors that will hopefully help stop the progression of diabetic neuropathy for patients will go a long way towards that.

But I mean those drugs while they seem to be really kind of a miracle drug for these patients, I went to a talk where someone said that you know in 5-years from now not giving an SGLT2 inhibitor to someone with chronic kidney disease probably be viewed as malpractice.

I mean there it's really, really life changing, but you have to still give it to those patients early on in their kidney disease before they get deep down into their stage 4, stage 5 kidney disease. So again, back to what I think what I we've been saying it the kidney fund for so long, we've got to find these patients early.

MD Mag: Are there a lot of patients in the US currently waiting for transplants?

So, you know, there's 100,000 people waiting for a kidney transplant, but we don't have 100,000 kidneys coming out, you know, available to people right now.

So that's why there's so many people on dialysis, part of the reason why. And there are some innovations coming out in that space.

There's some companies looking at how someone that may have particular characteristics about their body, their blood, that would prevent them from getting a good kidney match that are making some changes.

Now, there's lots of new innovation coming down the pike there, so that patients that you know, maybe have top the list and just sit there for a year after year because there is no available Can you for them, starting to have some hope now.

MD Mag: Are there enough people available for clinical trials to test all of the drugs currently in the pipeline?

So, 1 of the challenges is getting patients in the clinical trials, especially those clinical trials that are working on chronic kidney disease.

So, the earlier stages of kidney disease, 96% of people in the earliest stages of kidney disease, have no idea that they have it, 10% or even advanced kidney disease know they have it.

You're taking already a difficult thing of getting someone into clinical trials, and then cutting the vast majority of them off because they don't even know they have it. Or they're going to a general practitioner that's not aware of a clinical trial and not getting them in or referring them.

Michael Spigler, vice president of Patient Services and Kidney Disease Education for the American Kidney Fund, talks about the challenges and future of nephrology during Kidney Week.

Nephrology

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