ASN Kidney Week: American Society of Nephrology Kidney Week

An increasing emphasis on prevention is shifting the mindset around pediatric nephrology, and findings from ongoing studies will further expand the evidence base, said Tammy Brady, MD, PhD, medical director of the Pediatric Hypertension Program and associate professor of pediatrics at Johns Hopkins University.

Better blood pressure measurement techniques, electronic health record alerts, and simpler clinical practice guidelines can all help primary care clinicians identify hypertension in children, said Tammy Brady, MD, PhD, medical director of the Pediatric Hypertension Program and associate professor of pediatrics at Johns Hopkins University.

Including an exercise physiologist or physical therapist on a multidisciplinary nephrology care team can make it easier to include exercise as part of routine care for chronic kidney disease (CKD), said Danielle Kirkman, PhD, assistant professor at Virginia Commonwealth University.

Implementing screening for chronic kidney disease (CKD) in the primary care setting can help identify patients who may benefit from upstream interventions and medications to reduce their risk of kidney failure, said Joseph Vassalotti, MD, clinical professor at Icahn School of Medicine at Mount Sinai and chief medical officer of the National Kidney Foundation.

Correctly diagnosing hypertension in children is crucial for identifying other underlying conditions and allowing for earlier treatment and better outcomes, explained Tammy Brady, MD, PhD, medical director of the Pediatric Hypertension Program and associate professor of pediatrics at Johns Hopkins University.

Population health screening involves risk stratification that allows interventions to be targeted to appropriate patients, as was demonstrated in a study of a chronic kidney disease (CKD) intervention published in the November issue of The American Journal of Managed Care®, said lead author Joseph Vassalotti, MD, clinical professor at Icahn School of Medicine at Mount Sinai and chief medical officer of the National Kidney Foundation.

Evidence suggests that exercise reduces blood pressure, and some of the mechanisms by which this occurs can include a reduction in salt sensitivity and effects on vascular structure, according to Danielle Kirkman, PhD, assistant professor at Virginia Commonwealth University.

Nephrologists treating children with kidney disease or metabolic syndrome have different challenges and opportunities than when treating adults, according to Tammy Brady, MD, PhD, medical director of the Pediatric Hypertension Program and associate professor of pediatrics at Johns Hopkins University.

A poster presented at the American Society of Nephrology's (ASN) Kidney Week 2019 sought to understand more about patient knowledge of anemia and its impact on patient quality of life, their understanding of the disease, as well as how their anemia is managed.

As Kidney Week closed, nephrologists gathered to hear policy updates and information about forthcoming payment models from CMS and seemed pleased with what they heard.

The federal government wants to lower the rate of end-stage renal disease (ESRD) and improve kidney care outcomes, but such efforts will require earlier identification of chronic kidney disease (CKD), especially in veterans. At the American Society of Nephrology's (ASN) Kidney Week 2019, one poster described the gaps in identifying CKD in this population.

The Advancing American Kidney Health initiative launched by HHS has a broad range of focus that includes kidney disease awareness, early diagnosis, and improvements in transplantation, according to Holly Kramer, MD, MPH, professor of medicine and public health sciences at Loyola University Chicago and president of the National Kidney Foundation.

What should providers do about intentional nonadherence, and what strategies should they try to get their patients to take their hypertension medicine? At a session at the American Society of Nephrology (ASN)’s Kidney Week 2019, physicians discussed direct observation therapy (DOT), drug monitoring, case studies, and other published work about patients who don’t take their medications. Then they heard from a directly from a patient who shared why she stopped taking her medication and the scary consequence that developed as a result.

Patients receiving dialysis living in communities with a high percentage of black residents are known to have worse morbidity and mortality outcomes, and a study presented Saturday at the American Society of Nephrology Kidney Week 2019 meeting found that patients receiving dialysis in those communities also had higher hospitalization rates.

The results of phase 3 studies of roxadustat, a drug in the new class of hypoxia-inducible factor stabilizers, are satisfying in terms of both efficacy and safety, said Jay Wish, MD, professor of clinical medicine at Indiana University and chief medical officer for dialysis at Indiana University Health.

The risk of major adverse cardiovascular events was comparable with placebo in patients not treated with dialysis who received the investigational drug roxadustat, according to pooled cardiovascular safety data about the first-in-class oral therapy for patients with chronic kidney disease (CKD).

The large number of patient participants at the American Society of Nephrology’s Kidney Week 2019 meeting reflects the understanding that patients should be elevated in the conversations around kidney care, said Paul Conway, chair of global affairs and public policy and immediate past president, American Association of Kidney Patients.

A simple risk-assessment tool that helps physicians with early identification of patients at increased risk of chronic kidney disease (CKD) could lead to improved and targeted surveillance strategies, according to research published Friday.

Some of the most common safety risks for patients receiving dialysis include medication safety, infections, and falls, according to Alan Kliger, MD, clinical professor of medicine at Yale University School of Medicine.

A study published in the November issue of The American Journal of Managed Care® provides evidence from an intervention for chronic kidney disease (CKD), explained lead author Joseph Vassalotti, MD, clinical professor at Icahn School of Medicine at Mount Sinai and chief medical officer of the National Kidney Foundation.

Investigators presented data about 3 phase 3 trials of roxadustat at a national nephrology meeting to a standing-room only crowd, but the information the audience is really waiting to hear will have to wait until early Friday afternoon. While the trials showed promising results, day 2 of American Society of Nephrology's (ASN) Kidney Week 2019 will see the release of highly anticipated efficacy and pooled cardiovascular safety data about the first-in-class oral drug to treat chronic kidney disease in patients with anemia.

Clinicians treating kidney disease should view patients as stakeholders whose opinions can help drive a holistic approach to care, said Cynthia Delgado, MD, associate professor of medicine at the San Francisco Veterans Affairs Medical Center and University of California San Francisco Medical Center.

Because exercise capacity is known to be linked with several key outcome measures in patients with chronic kidney disease (CKD), routine exercise testing can help clinicians prescribe individualized exercise interventions, said Danielle Kirkman, PhD, assistant professor at Virginia Commonwealth University.

Pediatric nephrologists are a key piece of the care team for children with metabolic syndrome because they have continual opportunities to identify and treat risk factors for cardiovascular disease, according to Tammy Brady, MD, PhD, medical director of the Pediatric Hypertension Program and associate professor of pediatrics at Johns Hopkins University.

HHS is taking additional steps to improve care for those with end-stage renal disease (ESRD), Secretary Alex Azar announced Thursday. Speaking at a tightly packed session during the American Society of Nephrology’s Kidney Week 2019, Azar said HHS is looking to speed organ transplants to those who need them as part of an overall shift away from dialysis in kidney care centers and as part of its overall desire to lower spending while improving outcomes.