• Patients with kidney failure who are undergoing dialysis—whether at dialysis clinics or at home—face a higher risk of developing COVID-19 and a higher risk of dying from the disease.
• Among adults with kidney failure undergoing hemodialysis in New York City, Black and Hispanic patients were more likely to develop symptomatic COVID-19 than White patients. • Neighborhood-level social vulnerability factors were associated with COVID-19 incidence among White patients, but these factors did not explain racial/ethnic disparities.
• Among individuals with kidney failure who received dialysis at clinics several times each week, COVID-19 risks were higher in patients who were older, had diabetes, lived in local communities with higher COVID-19 rates, and received dialysis at clinics that served a larger number of patients. • Risks were lower in patients who received dialysis in clinics with a higher number of available side rooms and that had mask policies for asymptomatic patients.
• Among individuals with healthy kidneys, those with more frequent depressive symptoms were more likely to show signs of rapid kidney function decline over a median follow-up of 4 years.
• Among patients receiving dialysis in the Southeastern United States, those at for-profit dialysis facilities were less likely to be referred for kidney transplantation than those at non-profit facilities. • Rates of starting medical evaluations soon after referral and placing patients on a waitlist after evaluations were similar between the groups.
• Clinical equations that estimate individuals’ kidney function include an adjustment for Black race. This study examined the impact of dropping this race adjustment on patient care. • The estimated prevalence of chronic kidney disease among Black adults would double if race adjustments were eliminated. • Eliminating race adjustments could lead to major changes in medication prescribing for Black patients, but it would not negatively affect the accuracy of kidney failure predictions.
Highlights • Twenty percent of patients undergoing dialysis who responded to a survey were hesitant to receive a COVID-19 vaccine. • Vaccine acceptability was lower among younger age groups, women, and among individuals who were Black, and Native American and Pacific Islander.
• A pharmacist-led smartphone health app helped prevent medication errors, medication-related side effects, and hospitalizations in a study of kidney transplant recipients.
Adults with kidney failure are employed for fewer years during their lifetime than others in the general population. This “lower lifetime employment duration” was mainly due to their loss of life expectancy.
• More than 37 million Americans live with kidney diseases. • 800,000 Americans have kidney failure, a condition for which there is no cure. • Kidney diseases disproportionately affect communities of color. • COVID-19, especially deadly for people with kidney diseases, has highlighted the urgent need for change
• Among patients undergoing dialysis, the rate of COVID-19 hospitalizations peaked between March 22 and April 25, and it was 40-times higher than the rate in the general population. • Compared before the COVID-19 pandemic, the risks of dying from any cause were 17% and 30% higher during the second quarter of 2020 among patients receiving dialysis and patients with kidney transplants, respectively. • COVID-19 hospitalization and death rates both exhibited racial disparities.
• Most patients with kidney failure who were undergoing hemodialysis developed a positive antibody response after being vaccinated for COVID-19, but their response was lower than that of individuals without kidney disease.
Today, the American Society of Nephrology (ASN) announced seven winners in Round 2 of the KidneyX COVID-19 Kidney Care Challenge. From December to January, healthcare providers, dialysis centers, nonprofit health systems, and other entrants submitted solutions that could reduce the transmission of coronavirus among people with kidney disease and/or reduce the risk of kidney damage among people who contract the virus.
• A newly developed tool assesses patients' home dialysis experience. • The 26-item Home Dialysis Care Experience instrument will be a resource for future research use, clinical care, and quality improvement initiatives among home dialysis facilities and organizations.
• An analysis of published clinical trials suggests that aerobic exercise lessens several hemodialysis-related symptoms, including restless leg syndrome, symptoms of depression, muscle cramping, and fatigue. • More research, with more diverse patients, is needed to determine the extent of benefits from aerobic exercise for individuals with kidney failure who are undergoing dialysis.
• A one-year trial found that the eKidneyCare smartphone app helped patients with chronic kidney disease take their prescribed medications properly. • The app may help to prevent adverse drug reactions and other medication errors that can endanger patients.
A new perspective article published in CJASN examines how the use of race in calculating kidney function, as well as other aspects of health, can cause harm to patients.
• Adding measures of kidney function to traditional measures of cardiovascular health could help clinicians predict an individual’s risk of developing cardiovascular disease.
• Patients with kidney failure associated with sickle cell disease benefit from kidney transplants, but they’re less likely than other patients to receive them.
Washington, DC (February 25, 2021) —The American Society of Nephrology (ASN) is spearheading efforts to secure direct federal allocation of COVID-19 vaccines to dialysis patients and frontline dialysis workers. This allocation would improve access for a vulnerable patient population, more than half of whom are Black, Hispanic, Asian, Native American, and Native Hawaiian or other Pacific Islanders (NHPIs).
• Racial disparities in access to kidney transplantation persist in the United States. New research indicates that registering Black patients on the kidney transplant waitlist at a slightly higher level of kidney function compared with white patients might lessen racial inequality in patients’ wait time prior to kidney failure onset, and ultimately improve racial equity in access to kidney transplantation.
• Veterans who receive all of their post–kidney transplant care within the Veterans Health Administration (VA) have a lower risk of death than those who receive care outside the VA through Medicare coverage, according to a recent study.
• Despite wide recognition, policy reforms, and extensive research to address barriers in patients’ access to kidney transplantation, investigators found no improvement in rates of wait list placement and transplantation over 2 decades. • Moreover, rates among vulnerable populations are especially low.
— The American Society of Nephrology (ASN) re- affirms its support for the Organ Procurement Organizations (OPOs) Conditions for Coverage final rule issued on November 20, 2020. The society calls for the Biden-Harris administration to implement this final policy as expediently as possible. By bringing objective and verifiable standards to assess the performance of OPOs, this final rule will increase the number of organs available for transplant and reduce racial inequity in the U.S. transplant system.
• Race and social determinants of health were associated with the likelihood of undergoing kidney transplantation among US adults with kidney failure. • Interventions that target social determinants of health may improve access to kidney transplantation.
The American Society of Nephrology (ASN) welcomes Susan E. Quaggin, MD, FRCP(C), FASN, as ASN President, effective January 1, 2021. Dr. Quaggin succeeds Anupam Agarwal, MD, FASN.
• In a survey of adults with kidney failure who were receiving dialysis, most owned mobile devices and had intermediate or advanced mobile health proficiency. • The main reasons for using mobile health were for making appointments, communicating with healthcare personnel, and obtaining laboratory results.
• An estimated 375 adult kidney transplant recipients lose their transplant every year due to a lack of coverage of immunosuppressive medications after the prior 36-month Medicare coverage period. • Congress passes ASN priority legislation to extend immunosuppressive drug coverage for kidney transplant patients. • The bipartisan bill is expected to save Medicare $400,000,000 over 10 years by averting the return of transplant patients to dialysis.
• Exposure to higher amounts of fine particulate air pollution was associated with a greater likelihood of having chronic kidney disease. • This link was stronger in urban areas, males, younger adults, and adults without comorbid diseases.
A joint statement from the National Kidney Foundation and the American Society of Nephrology December 17, 2020
• When determining whether kidneys are suitable for transplantation in the United States, biopsy analyses don’t provide useful information beyond standard donor and recipient characteristics. • Many kidneys discarded based on biopsy findings would likely benefit U.S. patients who are waiting for a transplant.
• A recent analysis indicates that Accountable Care Organizations may reduce the cost of medical care for patients undergoing dialysis. • The cost savings were seen only for patients who regularly received care from primary care physicians.
• The diabetes drug canagliflozin slowed kidney function decline in patients with diabetes and advanced chronic kidney disease. • The drug also reduced the risk of developing kidney failure and cardiovascular problems in these patients.
• A recent analysis found limited research evaluating depression screening tools in patients with kidney failure. • Many studies were small in size and had other shortcomings.
• Acute kidney injury (AKI) is common during hospitalization with COVID-19 in the U.S. veterans, and it’s associated with a higher risk of death. This risk is especially high for Black veterans. • Nearly half of the veterans with AKI in this analysis did not fully recover their kidney function by the time of hospital discharge.
• In an analysis of information on patients with kidney failure, Black patients are less likely than white patients to be placed on transplant waiting lists. • For patients on such lists, Blacks are less likely to receive transplants than whites. • Results from the study will be presented online during ASN Kidney Week 2020 Reimagined October 19–October 25.
• Social determinants of health are associated with patient-reported outcomes in adults who are eligible to undergo kidney transplantation evaluations. • Results from the study will be presented online during ASN Kidney Week 2020 Reimagined October 19–October 25.
• A new model that incorporates a type of artificial intelligence can accurately predict which individuals with chronic kidney disease face a high risk of developing atrial fibrillation. • Results from the study will be presented online during ASN Kidney Week 2020 Reimagined October 19–October 25.
• Adults with glomerular diseases have a 2.5-times higher risk of developing cardiovascular disease than individuals in the general population. • Results from the study will be presented online during ASN Kidney Week 2020 Reimagined October 19–October 25.
• In a recent study, a new algorithm achieved good performance for predicting which hospitalized patients will develop acute kidney injury requiring dialysis. • Results from the study will be presented online during ASN Kidney Week 2020 Reimagined October 19–October 25.
• A new study indicates that Blacks and Hispanics have experienced higher rates of kidney failure compared with whites due to more rapid kidney function decline. • Results from the study will be presented online during ASN Kidney Week 2020 Reimagined October 19–October 25.
• New research examines the risk of acute kidney injury in people with sickle cell trait or disease, as well as the effect of acute kidney injury on kidney function decline in these individuals. • Results from the study will be presented online during ASN Kidney Week 2020 Reimagined October 19–October 25.
• In individuals with chronic kidney disease who received online peer mentoring, improved patient activation correlated with improvements in various aspects of quality of life. • Results from the study will be presented online during ASN Kidney Week 2020 Reimagined October 19–October 25.
• In a recent study, a new algorithm outperformed the standard method for predicting which hospitalized patients will develop acute kidney injury. • Results from the study will be presented online during ASN Kidney Week 2020 Reimagined October 19–October 25.
The results of numerous high-impact clinical trials that could affect kidney-related medical care will be presented online during ASN Kidney Week 2020 Reimagined October 19–October 25.
• A new patient-reported outcome measure assesses fatigue in patients receiving dialysis. The tool gauges tiredness, energy, and the impact of fatigue on life participation.
• Certain indicators may be used to monitor and improve the performance of transplant centers in how efficiently they evaluate individuals interested in becoming living kidney donors.
• Over the last decade, the Department of Veterans Affairs implemented payment changes to reduce spending on community dialysis treatments and to improve access to care for Veterans with kidney failure. • The changes led to reduced costs for dialysis sessions and less variation in payments for dialysis. • The changes led to improved access to dialysis care without change in the quality of that care.
In an analysis of patients hospitalized with COVID-19, kidney damage associated with the infectious disease was linked with a higher risk of dying during hospitalization.
• A recent analysis examines data from over the past 25 years concerning couples’ use of genetic testing for kidney diseases in embryos from in vitro fertilization. • The analysis provides the first report on the types of genetic kidney diseases tested in this way, how often these tests result in live births of unaffected children, and what reasons couples cite for not undergoing testing.
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