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Exam Code: CNN Practice exam 2022 by Killexams.com team
CNN Certified Nephrology Nurse

Exam ID : CNN
Exam Title : Certified Nephrology Nurse
Number of Questions : 150
Duration of exam : 3 hours
Passing Scores : 70%

The CNN exam consists of 150 questions and must be completed in three (3) hours. A correct response rate of no less than 70% is required to pass the exam.

Content Areas % of Test
Concepts of kidney disease 35%
Hemodialysis 30%
Peritoneal dialysis 20%
Transplant 10%
Acute therapies 5% (CRRT, SLEDD, apheresis, acute HD, acute PD)

1. Recognize pathologic processes and complications that occur with kidney disease and/or treatment modalities. (18%)
2. Select interventions appropriate to the pathologic processes and complications that occur with kidney disease and/or treatment modalities. (15%)
3. Apply physiologic and technical principles of renal replacement therapies. (10%)
4. Select appropriate teaching/learning strategies to educate client, family, other health professionals, and the public. (10%)
5. Select appropriate actions in administering medication(s) to the patient being treated for kidney disease. (12%)
6. Recognize the importance of an interdisciplinary approach to promote optimum functioning across the continuum of care. (7%)
7. Select interventions appropriate to the psychological and sociocultural effects of kidney disease. (6%)
8. Apply principles of infection control. (16%)
9. Recognize the importance of professional nursing practice in promoting patient outcomes (e.g., staff development, quality improvement, consultation, and research). (6%)

The applicant must hold a full and unrestricted license as a registered nurse in the United States, or its territories. The applicant must have completed a minimum of 3,000 hours of experience in multiple areas of nephrology nursing within the three (3) years prior to application. If the applicant is working in an outpatient hemodialysis facility, at least 750 hours (25%) of the 3,000 hours of experience must also include one or more of the following:
Home hemodialysis.
Home peritoneal dialysis.
Inpatient acute kidney injury on kidney replacement therapy.
Inpatient critical care on kidney replacement therapy.
CKD management NOT on kidney replacement therapy.
Kidney transplant.
Apheresis.
The applicant must possess a baccalaureate degree in nursing or a masters degree in nursing.
The applicant must have completed thirty (30) contact hours of approved continuing education credit in nephrology nursing within three (3) years prior to submitting the exam application.

Continuing education must be approved by one of the following:
Organizations accredited by the American Nurses Credentialing Center – Commission on Accreditation (ANCC-COA) the credentialing body of the American Nurses Association.
The American Association of Critical-Care Nurses (AACN).
The Council of Continuing Education.
California, Florida, Iowa, Kansas, or Ohio State Boards of Nursing.
Please be aware that although programs may meet requirements set forth by other state boards of nursing, they may not meet the Nephrology Nursing Certification Commission criteria.

Certified Nephrology Nurse
Medical Nephrology study help
Killexams : Medical Nephrology study help - BingNews https://killexams.com/pass4sure/exam-detail/CNN Search results Killexams : Medical Nephrology study help - BingNews https://killexams.com/pass4sure/exam-detail/CNN https://killexams.com/exam_list/Medical Killexams : Nephrology Fellowship Program In order to achieve the goals and objectives for the Nephrology Fellowship Training  Program, the following teaching experiences have been established:
UAB Nephrology Ward Service
The Nephrology Ward Service is an inpatient medicine ward designed to care for patients with end-stage kidney disease (ESRD) and chronic kidney disease (CKD) who require hospitalization for renal and non-renal reasons. The ward service houses patients on the 8th floor of the Spain-Wallace building, and also houses the inpatient dialysis unit. The nursing staff is specifically trained to care for patients with renal disease, including the routine management of peritoneal dialysis. The Nephrology ward team includes the Nephrology Attending, one or two Nephrology Fellows, two upper-level and two intern-level house staff each month.  Fourth-year medical students may also be included on the team.

Responsibilities of the renal Fellow on this rotation include, but are not limited to:

  • Evaluating the need for dialysis in patients on the ward service
  • Prescribing and adjusting hemodialysis and peritoneal dialysis prescriptions for patients with a wide range of medical problems
  • Evaluating patients presenting in the emergency room with renal issues
  • Performing renal biopsies in inpatients
  • Learning about dialysis access issues
  • Teaching the house staff the rudiments of the care of the patient with CKD and ESRD
  • Supervising the house staff and providing guidance on therapy related to ESRD management.
  • Essential in this role is the development and refinement of clinical skills in the evaluation, diagnosis, treatment, and follow-up of patients with renal disease. These skills include developing appropriate differential diagnoses, assessing the need for hospitalization, and implementing diagnostic strategies and treatment plans. Through this experience the Fellow will also develop a comprehensive understanding of the indications, contraindications, techniques, and complications of hemodialysis, peritoneal dialysis, vascular access placement, and renal biopsies. The Fellow will also acquire skill in educating patients about these procedures and in obtaining informed consent.
UAB Acute Consult Service
The Acute Consult Service engages in providing the services of renal consultation to UAB (including the Center of Psychiatry and Spain Rehabilitation Center), Cooper Green Hospital, and the Eye Foundation Hospital. The Acute Consult Fellows will be exposed to a wide range of renal pathology in patients admitted to other medical and surgical services. This is a busy service with the average number of patients followed by this service being 25 to 30, and the average number of new consults being 5 per day. UAB has 8 different intensive care units, providing a broad exposure to acute renal failure in several different clinical settings. Toward this end, UAB has 18 Prisma Continuous Renal Replacement Therapy (CRRT) machines available for use at UAB ICUs (not Cooper Green Hospital), and Fellows on this rotation will gain extensive renal replacement experience in diverse critical care settings.  Additionally, the Acute Consult Fellow will have an opportunity to see new presentations of glomerulonephritis, tubulointerstitial diseases, obstructive uropathy, toxic nephropathies, and a diverse array of challenging acid-base and electrolyte problems, as well as assessing the need for and performing renal biopsies.  A single Nephrology Attending Physician is assigned to this service for the entire month.  Three Fellows, in addition to two to four second and third-year internal medicine residents, are assigned to the Acute Consult Service in any given month.  During this month, it is customary that the residents and Fellows assigned to the acute consult service also attend the Cooper Green and/or VA Nephrology Clinic. The schedule is designed to ensure that when one Fellow is in clinic there is always another Fellow available to take consults. The Acute Consult Fellow will also be responsible for any biopsies deemed necessary by the consult service. There is a Renal Consult Template to be used for all new consults.
UAB Chronic Consult Service
The Chronic Consult Service is designed to provide care for patients with established ESRD on other services in the hospital, with the exception of ESRD patients in an ICU. The service is staffed by a Nephrology Attending Physician and a First Nephrology Fellow.  The First Year Fellow on the Chronic Consult Service provides renal replacement therapy for these patients, makes adjustments in their dialysis prescription as necessary, and learns about the challenges of dialysis access in patients with a wide range of co-morbid conditions.  Hemodialysis access responsibilities consist of placement of femoral hemodialysis catheters in the inpatient dialysis unit (IDU) and the removal of tunneled catheters in the Kirklin Clinic on the 4th floor Cardiovascular Suite. This Fellow is also responsible for any chronic dialysis issues involving outpatient ESRD patients in Interventional Radiology. Of note, Interventional Radiology does not use IMPACT. This Fellow will also have ample opportunity to learn the important art of cooperating with services to achieve the best outcome for the patient.  There are no residents on this service.
VA Consult Service
The Birmingham Veteran’s Hospital provides Nephrology services through an autonomous hemodialysis unit, a weekly Nephrology clinic and a Consultation service. The consult service is covered by Nephrology Fellows in the second year of training. However, some of first-year Fellows will have an opportunity to participate in the weekly Nephrology clinic throughout the year. The service is staffed by a VA Nephrology Attending Physician and typically a Second Year Nephrology Fellow. There are no residents on this service.  Second year Fellows are on call during the weekends from 7AM to 12PM Saturday and Sunday. Their responsibilities include rounding on patients seen by the consult service during the week. Patients will be discussed with the Acute Consult Attending on call at UAB.  The weekend rounding at the VA/Highlands will be divided among the Second Year Nephrology Fellows and assigned monthly along with the General Nephrology Call Schedule.
UAB Highlands Consult Service
In 2006, UAB Hospitals purchased Healthsouth Hospital and renamed it UAB Highlands. The hospital is designed to admit patients primarily with orthopedic and elective surgeries. A Hospitalist service will care for these patients. The Highland Consult Fellow is a Second Year Fellow who will be responsible for all consults, acute and chronic, at Highlands. All consults will be staffed with the Chronic/Access Attending. The Highlands Consult Fellow is also responsible for attending VA dialysis rounds, the VA Chronic Kidney Disease Clinic, and helping the VA Consult Fellow when he or she is in clinic.
UAB Nephrology Transplant Ward Service
UAB boasts one of the largest Nephrology transplantation programs in the country, with over 320 combined living-donor and cadaveric-donor transplants per year. The transplant ward service provides an opportunity to see transplant recipients at all stages of the process, including newly transplanted patients, patients with existing allografts with other medical problems requiring hospitalization, and patients with allograft dysfunction. The relationship between the transplant Nephrologists and surgeons is very good, and Fellows often benefit from the synergy of the interaction, as the Nephrology and surgical teams have made it a habit of rounding together. The transplant service is staffed by a Nephrology Transplant Attending, a Nephrology Fellow, and Nurse Practitioners.

The Fellow on the transplant ward service will have an opportunity to do a number of renal transplant biopsies (15-20/month is not unusual), learn the basics of immunosuppression, see a variety of post-transplant complications (medical and surgical), participate in their management, and if interested, view renal transplants in the operating room.  Exposure to current syllabus in transplantation will be provided through participation in weekly conferences dedicated to discussion of current research articles relating to transplantation.

UAB is one of the few programs in the country that offers a separate Nephrology transplant Fellowship to interested and motivated Nephrology Fellows. Successful completion of the general Nephrology Fellowship, along with completion of the transplant Fellowship is currently sufficient to become board-certified in transplant Nephrology by the American Society of Transplantation.
UAB Nephrology Transplant Consult Service
In 2007 the Transplant consult service was established for 2nd year Nephrology Fellows. This rotation will deliver the 2nd year Fellows continued exposure to Transplant topics. The Fellow will help other teams manage transplant patients not admitted to the medical Transplant floor. Consults will usually consist of transplant patients admitted to ICUs or surgical floors outside of S7s. The Consult Transplant Fellow will also aid in outpatient transplant biopsies performed on S7 in the mornings.
UAB Nephrology Transplant Evaluation Service
The Division of Transplant Nephrology is also responsible for the pre-operative evaluation of both potential transplant recipients and potential living donors. This service gives Fellows the opportunity to gain experience in the evaluation of patients with end stage renal disease (ESRD) for renal transplantation. The goals of this experience are to learn to evaluate ESRD patients to determine if they are potential and acceptable candidates, to learn the appropriate work-up of ESRD patients for either living donor transplantation or placement on the cadaver list, to learn the appropriate work-up of individuals as potential living related and living non-related donors, and learn the fundamentals of HLA matching and histocompatibility testing. The evaluation service is an outpatient clinic that coordinates a multidisciplinary group of consultants needed for transplant evaluation, including Nephrology, surgery, and social services. The transplant evaluation Fellow will see patients and write an evaluation, coordinating the results of an interview, medical, laboratory and radiologic information into a formal transplant evaluation. The Fellow will be responsible for presenting these patients at a weekly transplant evaluation conference, attended by representatives from transplant Nephrology, transplant surgery, blood bank and tissue typing, and social services. An experienced transplant Nephrology Attending staffs the evaluation clinic.

Also, the Transplant Evaluation Fellow will also be responsible for performing outpatient native renal biopsies in the outpatient vascular/heart center on the 6th floor of the North Pavilion.  Patients typically arrive at 6:30 AM. The Attending Physician should be contacted when the patient has been evaluated and is ready for biopsy. The biopsy will be performed and closely monitored in recovery in the same area.
The Outpatient Dialysis Experience
All outpatient hemodialysis activities are supervised by the specific outpatient dialysis unit’s Medical Director.  Each Second-Year Fellow will be assigned to an outpatient dialysis unit and is expected to round on an assigned shift of patients twice a month.  Fellow responsibilities include writing and updating hemodialysis orders, evaluation and management of patients’ hemodialysis accesses, dry weights, blood pressures and extracellular fluid balances, hemodialysis prescriptions, nutritional status, osteodystrophy status, anemia status; and reviewing monthly and other non-routine labs and cultures.  The Fellow will also address and triage patient medical complaints.  Rounds will be made with the Medical Director.  As a result of these patient evaluations, notes are made on each patient by the Fellow, which address the above issues.  The Fellow will also meet with the hemodialysis staff to review the water treatment facilities and the set-up and running of a dialysis machine and attend monthly patient-care conferences.  These are multidisciplinary conferences attended by the head nurse, the on-site social worker, and the Medical Director.  The purpose of the conference is to review all medical, social, and dietary issues that pertain to a patient on chronic hemodialysis and to address Quality Assurance and Quality Improvement.

Second year Fellows are required to attend UAB’s Peritoneal Dialysis Academy (PDA) in October. This is a three day all day conference in which Fellows will receive extensive training in peritoneal dialysis. The curriculum for PDA includes peritoneal dialysis lectures by expert guest lecturers, interactive problem sessions, and hands-on workshops.  Fellows will be excused from all clinical activities during this time.  Fellows from other training programs are invited to attend.  Following PDA, Dr. Zipporah Krishnasami, the Medical Director of the HTU, will assign to each Fellow at least three peritoneal dialysis patients to follow for the rest of the year.  Fellows will see and examine these patients in the HTU as needed and report to the patient’s Attending Physician.  Fellows will be involved in adjusting peritoneal dialysis prescriptions and addressing access issues, dry weights, blood pressure, extracellular fluid balance, nutritional status, dialysis adequacy, osteodystrophy status, and anemia status. The Fellow will also be responsible for reviewing treatment of a patient’s peritonitis or exit site infection if applicable.

Some First Year Fellows may also have a month long opportunity to send time in one of our outpatient dialysis units. This will serve as an introduction to the basics of hemodialysis, dialysis adequacy, calcium/phosphorus management, diet management, and other issues including water management.  This rotation will also allow the Fellows to see and examine grafts, fistulas, and permcaths. 
The Ambulatory Nephrology Experience
All Fellows will be required to maintain the equivalent of a half-day clinic per week at the Kirklin Clinic during each year of Fellowship to see patients with renal diseases and problems related to renal disease. This clinic sees new outpatient consultations and continued follow-up of established patients.  This experience will continue with progressive responsibility through the Fellowship and will be appropriately supervised by dedicated Attending faculty members. The goal of this experience will be for the Fellows to gain expertise in the outpatient evaluation and management of kidney problems. The experience provides an opportunity to develop an understanding of the natural history of these conditions over an extended period of time.  Each Fellow should, on average, be responsible for four to eight patients during each half day session.  After initially evaluating the patient, Fellows will present the patient to the Clinic Attending, discuss the patient, and then evaluate the patient with the Clinic Attending.  Fellows are responsible for dictating patient encounters through the UAB phone dictation system.  Dictations are electronically transcribed into the UAB CDA system and are available for editing by the Nephrology Attending within 1 to 2 days of dictation.  Dictations must be completed within 24 hours.  The notes are electronically signed by the Clinic Attending. Of note there are two different dictations systems used by the Clinic Attendings in our division. All Fellows will be responsible for contacting their specific Attending’s secretary to find out which system their attendings use.

All Fellows will also have the opportunity to participate in weekly half-day Nephrology clinics at the VA and Cooper Green Hospital. 

In addition, Second Year Fellows will spend a half-day clinic per week in Nephrology transplant clinic at the Kirklin Clinic. Through the transplant clinics, Fellows will obtain outpatient longitudinal follow-up renal transplant experience.  Fellows will follow no fewer than 20 patients as required by the ACGME. The goals of this experience are to learn about immunosuppressive drugs and regimens used in the management of renal transplants, to learn the side effects, complications and drug interactions of immunosuppressive drugs, to learn to evaluate and treat post-transplant complications including infection, hypertension, malignancy, de novo glomerular disease and recurrent glomerular disease, to learn to recognize and treat acute rejection, to learn to recognize and treat chronic rejection, and finally, to learn the fundamentals of HLA matching and histocompatibility testing.

Interdisciplinary Interactions
The Fellow also will be provided with opportunity to pursue experiences in other disciplines whose expertise is required in the care of patients with Nephrology diseases. These disciplines include: 1) intensive care medicine, 2) cardiology, 3) Nephrology transplantation surgery, 4) general and vascular surgery, 5) pediatric Nephrology 6) Nephrology imaging, and 7) urology. The goal of these experiences is for the Fellow to appreciate the approach to the specific conditions that relate to Nephrology disorders within these subspecialties. These interdisciplinary interactions can occur in the form of a clinical rotation, multidisciplinary conference, etc. Clinical experiences should be under the direction of Attending Physicians in the respective specialty or subspecialty who participate fully in the educational goals of the rotation.

In addition, the Plasmapheresis rotation is a four week elective supervised by Dr. Marisa Marques.  The goals of the rotation are for the Fellow to understand the fundamentals of plasmapheresis, including indications, technique, complications, and effectiveness. This rotation is offered to interested Second Year Fellows

Finally, Second Year Fellows can elect to train in Interventional Nephrology with Dr. Roman Shingarev. This rotation is typically 2-6 months of exposure depending on the Fellow’s goals.  Fellows will be exposed to permcath placement, vascath placement, permcath exchange, fistula and graft thrombectomies and angioplasties, PD catheter insertion, Ligations of grafts and fistulas, and stent placement in Grafts and Fistulas.

Didatic Conferences
Conferences will be held on a regularly scheduled basis with attendance required of all Fellows and divisional faculty. These conferences are usually multifaceted and because of the nature of syllabus under discussion, cover a combination of tasks and syllabus including but not limited to literature review, discussion of clinical cases, evaluation and presentation of research, and concepts of Nephrology basic science.  Weekly conferences include the Nephrology Research and Training Center conference, a research conference; Fellows’ Conference, a subspecialty conference given by the Fellows on clinically relevant topics; Fellows’ Journal Club, a clinically oriented forum for discussion of current articles in Nephrology and relevant internal medicine literature; and the Nephrology Histopathology (biopsy) conference. These conferences will occasionally include lectures from faculty in divisions outside of Nephrology or outside of the Department of Medicine and guest faculty who are visiting UAB.

BIRMINGHAM VETERANS AFFAIRS MEDICAL CENTER (BVAMC) NEPHROLOGY SERVICE

Paul W. Sanders, MD
Chief, VA Nephrology Section
This program is part of the Division of Nephrology of the University of Alabama at Birmingham Medical Center, and part of the Department of Medicine in that institution. The Nephrology Service is the only such service in a Veterans Hospital in the State of Alabama. Therefore, the Birmingham VA Hospital serves as a tertiary referral center for veterans with renal problems throughout Alabama. Other nearby VA Hospitals having dialysis facilities are located in Nashville, Tennessee to the north; Gainesville, Florida to the south and Atlanta, Georgia to the east.

VA chronic Dialysis Unit
The ten-station Chronic Dialysis Unit located in the VA Hospital is designed to provide in-center dialysis support for about 34 veterans and back-up dialysis support for about 40 patients contracted to private, nongovernmental dialysis throughout the state. The VA dialysis unit also provides acute dialytic support for inpatients throughout the VA Hospital with acute renal failure and other medical conditions requiring dialysis. The VA dialysis unit serves those veterans with end-stage renal disease admitted to the hospital with other problems. The small size of the unit allows the Nephrology Fellows to learn how to manage dialysis patients in the outpatient setting and develop the necessary skills to manage a dialysis unit.

The VA Consultation Service
The VA Consultation Service is staffed by a second-year fellow and lead by one of the VA attending physicians. This service provides the fellow a unique opportunity to interact with a faculty member in a one-on-one fashion.

The VA Transplant Service
Inpatient services are provided by the consult service. outpatient services are provided by the VA faculty led by Dr. Roslyn Mannon.

Wed, 16 Mar 2022 11:53:00 -0500 en-US text/html https://www.uab.edu/medicine/nephrology/education/fellowships/nephrology-fellowship-prog
Killexams : Nephrology News and Research

Using neuroimaging to investigate how petting dogs could help clinicians Strengthen animal-assisted therapy

In this interview, News Medical speaks to Rahel Marti, Ph.D. student in the faculty of Psychology at the University of Basel, about her new research, which shows that petting dogs engages the social brain, leading the way for new potentialities in animal-assisted clinical therapy.

Tue, 27 Sep 2022 12:00:00 -0500 en text/html https://www.news-medical.net/?tag=/Nephrology
Killexams : UpToDate has a racism problem. Its name is Dr. Stanley Goldfarb

The University of Pennsylvania’s Division of Renal-Electrolyte and Hypertension recently made a quiet update to its history web page: it removed all references to its former co-chief, Dr. Stanley Goldfarb.

For several years, Goldfarb has been a vocal critic of considering social determinants of health, racism, and anything else he considers too “woke” in medical education or health care at large. In 2019, he penned a Wall Street Journal editorial entitled, “Take Two Aspirin and Call Me by My Pronouns,” which gave rise to the social media hashtag #GoldfarbChallenge. It makes fun of his criticism that medical students are taught about social issues and don’t spend enough time concentrating on biochemistry and physiology. These tweets share stories of how physicians heroically procured therapies for their patients but, instead of celebrating their successes, sarcastically lament their inability to remember the biochemistry of those medications or the disease processes.

One can argue — up to a point — that physicians have unique skills and knowledge, and that their efforts are best spent on traditional “medical” concerns. One can also engage in civil debate about how social determinants of health affect people. But there’s a problem when hateful stereotyping and inflammatory rhetoric enter the conversation.

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This year, Goldfarb published a book by the same title as his Wall Street Journal piece and, for his virtual book tour, he twisted the findings of a study published in the journal Academic Medicine to argue on Twitter that medical residents from groups considered to be underrepresented in medicine might be “less good at being residents” compared with their non-underrepresented counterparts, a claim he echoed in similar terms in an essay for Newsweek. Michael Parmacek, the chair of Penn’s Department of Medicine, called his statements “racist.” The editor-in-chief of the journal Health Affairs later said essentially the same thing about Goldfarb’s organization, Do No Harm.

Now retired from Penn, Goldfarb retains a position of influence as a nephrology editor-in-chief for publisher Wolters Kluwer’s UpToDate, the leading point-of-care medical reference for millions of clinicians. That’s problematic for several reasons, including the importance of ensuring an appropriate discussion of race in nephrology (the branch of medicine that focuses on the kidneys), accurately and dispassionately interpreting scientific data, and promoting values of respect and collegiality in medicine.

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Goldfarb’s position at UpToDate is an impediment to all three.

Nephrology — which was the focus of my work as a medical fellow — has been a focal point in the debate over the use of race in medical decision-making because the equation that was used until recently to estimate kidney function included a controversial adjustment for Black race, potentially minimizing the perceived severity of kidney disease and need for treatment and perpetuating unfair stereotypes of Black people. There are also historical and ongoing concerns about fair access to donated kidneys and disparities in outcomes of therapies such as dialysis and kidney transplantation.

UpToDate also has a stated goal, in line with the policy of the American Medical Association, of ensuring that race is framed as a social construct and not as a biological variable.

Yet many nephrology articles in UpToDate continue to discuss race as a biological risk factor. In Goldfarb, UpToDate has an editor who derides efforts to advance health equity and is unlikely to help bring UpToDate’s content in line with its own policies and those of the AMA, or even to discuss these issues in a meaningful way.

Goldfarb’s inflammatory criticism of health equity is not only counterproductive but also inconsistent. While saying he opposes the use of race in any medical decision-making or to ensure equal access to care, he supports the use of the kidney function race multiplier and attacks institutions that eliminate it as giving in to the “woke crowd.” I question whether Goldfarb is pursuing a philosophy on the use of race, or is rather just demonstrating a reflexive opposition to any change made in the name of fairness or equity, or worse: objecting to changes that might deprioritize white people.

Since its founding in 1992, UpToDate has become a primary point-of-care resource for clinicians in the U.S. and around the world. It is essential that the company retains its reputation as a trustworthy and evidence-based source of clinical information. Goldfarb’s numerous public statements in the media and through his organization make it difficult to trust that the patient care recommendations he curates are objective and free of bias. This is not an academic exercise — the information in UpToDate affects patients’ lives.

It is especially concerning that, in accurate months, Goldfarb has provided misleading accounts of multiple studies to further his ideological goals. In the Academic Medicine article I mentioned earlier, he ignored the fact that the researchers controlled for exam rankings as a way to argue that lower evaluations were evidence of “less good” performance rather than bias on the part of evaluators. In a subsequent blog post, he inaccurately conflated people who were “non-underrepresented in medicine” with those who were white (in the study, non-underrepresented residents were both white and non-white) to argue for the superiority of white doctors.

Similarly, in his criticism of a 2019 study conducted by researchers at Brigham and Women’s Hospital in Boston showing that Black and Hispanic patients were less likely than white patients to be admitted to a cardiology service for heart failure, he ignored all control variables to cast doubt on the integrity of the analysis. The reasons these are problems for a medical reference editor require no further explanation, and the fact that he does this to advance a racist narrative is inexcusable.

Respect for others, which is a mainstay of the medical profession, is something else Goldfarb has cast aside. He repeatedly fails to treat other physicians with respect. For example, in a report his organization released attacking a specific medical school’s diversity, equity, and inclusion initiatives (I am not citing it here to protect the school’s participants), he gratuitously included an appendix with the names, email addresses, and salaries of the committee members, including medical residents, unnecessarily exposing them to risks of harassment.

In May 2022, his organization sent a mobile billboard to disrupt Harvard Medical School’s commencement. He and his organization have also used inflammatory language to deride institutions such as Boston Children’s Hospital, which subsequently became a target of unrelated violent threats over its transgender care. While the threats were not directly precipitated by Goldfarb’s rhetoric, his claim that one of the most renowned children’s hospitals in the world has given up on its mission of caring for children to become a radical political institution is eerily similar to claims made by those railing against Boston Children’s Hospital. Even if Goldfarb truly believes this, it should disqualify him from having influence over medical guidelines.

Simply stated, Goldfarb does not demonstrate the behavior expected of a physician, much less one in a position of influence. There are many nephrologists who are qualified to curate science and guidelines while also advancing health equity and treating others with respect. Goldfarb is not one of them, and he should not have a position at UpToDate.

Let’s make replacing him the next #GoldfarbChallenge.

Eric R. Gottlieb is an internal medicine physician in the Boston area and an instructor in medicine at Harvard Medical School. The views expressed here are his own and do not necessarily reflect those of the organizations he is affiliated with.

Sun, 16 Oct 2022 20:35:00 -0500 en-US text/html https://www.statnews.com/2022/10/17/uptodate-racism-problem-stanley-goldfarb/
Killexams : American Society of Nephrology

The American Society of Nephrology (ASN) is comprised of over 11,000 scientists and physicians dedicated to prevent or treat kidney disease. ASN supports the advancement of kidney research, publishes journals, provides newsletters and hosts symposiums on kidney-related issues. ASN's goal is to further the study of the kidneys and produce experts in the field of nephrology.

Address
1725 I Street, NW Suite 510 Washington, DC 20006
Website
http://www.asn-online.org/
Wikipedia
http://en.wikipedia.org/wiki/American_Society_of_Nephrology

Some content from Wikipedia, licensed under CC BY-SA

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Mon, 29 Aug 2022 12:00:00 -0500 en text/html https://medicalxpress.com/partners/american-society-of-nephrology/
Killexams : Peering into single cells reveals key processes in acute kidney injury

Acute kidney injury (AKI) is a frequent complication associated with various diseases and particularly affects patients on intensive care units. However, the mechanisms underlying AKI are incompletely understood. Just recently, an interdisciplinary research team has used single-cell sequencing techniques to uncover the molecular processes associated with AKI.

Reporting in Genome Medicine and Kidney International, they describe novel gene expression patterns of injured that may lead to new therapeutic approaches and strategies for biomarker discovery. The studies were conducted in close collaboration between Charité—Universitätsmedizin Berlin; the Berlin Institute for Medical Systems Biology (BIMSB) of the Max Delbrück Center; the German Rheumatism Research Center Berlin (DRFZ), a Leibniz Institute; and the Hannover Medical School.

The kidneys are among the most important organs in the . They filter waste products from the blood, control body fluid composition and blood pressure, influence energy metabolism, and produce vital hormones. If is impaired—as is the case in AKI—there can be severe consequences.

"AKI is a frequent and serious complication in , affecting about half of our intensive care unit patients," says Dr. Jan Klocke of Charité's Department of Nephrology and Medical Intensive Care. "The condition is often underestimated, despite the fact that AKI is associated with increased mortality and patients can suffer permanent damage, even complete loss of kidney function."

AKI can accompany a wide range of diseases. It often occurs in conjunction with cardiovascular diseases or severe infectious diseases such as COVID-19, but also after surgical interventions or in association with drug treatment. There are often no concrete treatment options.

"We try to stabilize affected patients, but so far it is usually not possible to reverse the destructive processes in the kidney with targeted treatments," says Dr. Hinze, who played a key role in supervising one of the studies at Charité and the Max Delbrück Center and now works at the Hannover Medical School.

"Up to now, little has been known about which mechanisms are at play in the kidney cells. The aim of our studies was to shed some light on this, with the long-term goal of improving the treatment provided to our patients in the clinic."

AKI is often triggered by an insufficient supply of blood to the kidneys, causing the cells there to no longer receive sufficient oxygen and nutrients—and to react with stress. The cells go into a kind of alarm mode and produce signal substances that can lead to inflammatory and remodeling processes (fibrosis) in the surrounding tissue.

It is known from animal model studies that —the cells that line the fine renal tubules—are involved in these inflammatory and fibrotic processes. This was demonstrated using a novel state-of the-art method called single-cell sequencing, which enables researchers to create a detailed profile of the molecular gene expression profiles of thousands of . But what happens on the in human AKI?

This is the question that research teams led by Dr. Hinze and Dr. Klocke set out to investigate. The two recently published studies are among the first to ever investigate the in AKI using single-cell technologies in human kidney cells. The scientists examined cells taken from tissue and urine samples of more than 40 patients and analyzed the molecular patterns of more than 140,000 cells using state-of-the-art bioinformatics approaches.

"Single-cell sequencing allows us to virtually zoom into each cell and see which genes are active in that cell at that point in time," explains Dr. Hinze. "From this, we can determine whether that particular kidney cell is currently functioning normally, is under stress, or is about to die. This cutting-edge technology gives us an understanding of AKI in unprecedented detail."

The team was also able to show that different cell types of the kidney react quite differently to AKI, with the strongest response observed in the epithelial cells of the renal tubules. These are the smallest functional units of the kidney and consist of several segments. It was known from animal models that epithelial cells of a specific early renal tubule segment were mainly affected by AKI.

However, the results of the latest studies on human kidney cells have revealed that the epithelial cells of almost all tubule segments are involved in the injury processes.

"This illustrates once again how important it is that we study human systems and learn to understand them better," says Dr. Hinze. "In the different types of epithelial cells, we were able to identify certain molecular patterns that occurred in all patients with AKI, but at individual abundances. In the future, these findings could help doctors to better assess the risk for severe disease progression."

In , physicians ideally need a fast, non-invasive, and precise testing method to clearly diagnose AKI at an early stage. In order to get closer to this vision for the future, Dr. Klocke started searching for epithelial cells in urine samples. Hardly any cells are found in the urine of healthy people.

But in those with AKI, epithelial cells detach from the renal tubule and are excreted into the urine. However, since cells do not survive in urine for long, there were initial doubts as to whether the cells would still be intact and whether their molecular state could even be measured using single-cell sequencing.

"We processed the urine samples within four to six hours, and it actually worked very well," says Dr. Klocke. The researchers were able to determine from which segment of the renal tubules the cells came from and which genetic programs they had activated in response to kidney damage.

"The information provided by the cells from the matched that of the corresponding cells from tissue samples," says Dr. Klocke. "Thus, urine provides us with an uncomplicated and patient-friendly method of obtaining demo material for further investigations—in order to identify biomarkers and, in the long term, perhaps reduce or even replace kidney biopsies."

With the two current studies, the research team has provided completely new insights into the cellular mechanisms in AKI using single cell sequencing as well as promising approaches for future diagnostic procedures and personalized therapies. In further studies, they plan to enroll a larger number of patients, investigate the cellular responses in different underlying diseases, and uncover other fundamental molecular mechanisms of AKI using cell cultures.



More information: Christian Hinze et al, Single-cell transcriptomics reveals common epithelial response patterns in human acute kidney injury, Genome Medicine (2022). DOI: 10.1186/s13073-022-01108-9

Jan Klocke et al, Urinary single-cell sequencing captures kidney injury and repair processes in human acute kidney injury, Kidney International (2022). DOI: 10.1016/j.kint.2022.07.032

Citation: Peering into single cells reveals key processes in acute kidney injury (2022, October 5) retrieved 17 October 2022 from https://medicalxpress.com/news/2022-10-peering-cells-reveals-key-acute.html

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Killexams : Evaluation of Risk Factor Management of Patients Treated on an Internal Nephrology Ward: A Pilot Study

Conclusion

Our pilot study identifies possibilities and needs for improvements in the management of hypertension, diabetes and hyperlipidemia, which are three major RFs for renal and/or CV disease. In the subgroup of TX patients, tight control of immunosuppressant blood levels according to the reference range could be optimised. Medication regimens are complex, and the frequency of pDDIs increased during in-hospital treatment. Detected pDDIs were frequently associated with a potential aggravation of already impaired kidney function. Clinical pharmacy services could positively influence RF management, TDM and the management of pDDIs. However, this hypothesis must be confirmed in future research. Based on our study findings, the impact of clinical pharmacy services on drug-therapy related problems and RF management should be addressed using a prospective study design in a nephrology patient population and a kidney transplant population, respectively.

Tue, 04 Oct 2022 12:00:00 -0500 en text/html https://www.medscape.com/viewarticle/713734_5
Killexams : Nephrology EMR Software Market Growth, Competitive Analysis and Forecast 2028 | Kareo, AdvancedMD, athenahealth

The MarketWatch News Department was not involved in the creation of this content.

Oct 03, 2022 (Heraldkeepers) -- The Global Nephrology EMR Software Market research includes an in-depth analysis of key geographical trends, market dynamics, and global size estimates for the market industry. Product description, product classification, industry structure, and numerous participants in the Global Nephrology EMR Software Market. For each segment and geographic market, the market research contains figures from the previous period, as well as the future term.

Download Free demo Nephrology EMR Software Market report
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The worldwide Nephrology EMR Software Market is expected to grow at a booming CAGR of 2022-2030, rising from USD billion in 2021 to USD billion in 2028. It also shows the importance of the Nephrology EMR Software Market main players in the sector, including their business overviews, financial summaries, and SWOT assessments.

The Key companies profiled in the Nephrology EMR Software Market:

The study examines the Nephrology EMR Software Market's competitive landscape and includes data on Kareo, AdvancedMD, athenahealth, PrognoCIS HER (Bizmatics), eClinicalWorks, Epic, Allscripts, Greenway Health, MEDITECH, NextGen Healthcare, DrChrono, WRS Health, CareCloud, Practice Fusion, Meditab, Advanced Data Systems (ADS), Acumen Physician Solutions, iSalus, Cerner, CompuGroup Medical & Others.

The study focuses on global companies that operate in the Global Nephrology EMR Software Market and includes information such as company profiles, product samples and descriptions, capacity, production, value, and income. This study includes crucial facts on the industry’s current situation and serves as a valuable source of guidance for businesses and individuals working in the market.

Global Nephrology EMR Software Market Split by Product Type and Applications

This report segments the Nephrology EMR Software Market on the basis of Types:
Cloud-Based, On-Premises

On the basis of Application, the Nephrology EMR Software Market is segmented into:
Hospitals, Clinics, Others

Comprehensive data on the product portfolios of the top players in the Nephrology EMR Software Market. Detailed information about upcoming technologies, R&D activities, and market product debuts. An in-depth analysis of the market’s top companies’ market strategies, as well as their geographic and business segments. Information on developing markets in its entirety. This study examines the market in several geographies for various segments. Extensive data on new goods, untapped geographies, accurate advancements, and investment opportunities in the Nephrology EMR Software Market.

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Global Nephrology EMR Software Market have increased the need for new infrastructure construction. This has prompted a rise in the use of bucket trucks. Additionally, massive amounts of money are being spent by governments and the private sector globally on Nephrology EMR Software Market, which is further boosting the market’s expansion. The amount that regional governments are investing to Strengthen the current infrastructure is increasing as part of their Nephrology EMR Software Market plans.

Nephrology EMR Software Market is split by Type and by Application. For the period 2017-2028, the growth among segments provide accurate calculations and forecasts for revenue by Type and by Application. This analysis can help you expand your business by targeting qualified niche markets.

The years examined in this study are the following to estimate the Nephrology EMR Software Market size:

History Year: 2015-2019
Base Year: 2021
Estimated Year: 2022
Forecast Year: 2022 to 2028

Reasons Why You Should Buy This Report:

1.To gain an in-depth understanding of Nephrology EMR Software Market
2.To obtain research-based business decisions and add weight to presentations and marketing strategies
3.To gain competitive knowledge of leading market players
4.It gives pin point investigation of changing rivalry elements and keeps you in front of contenders.
5.It helps in settling on educated business choices by having total bits of knowledge of market and by making inside and out investigation of market sections.

If you have any special requirements, please let us know and we will offer you the report as you want.

You can get some information about this research here
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The research illuminates many elements of the market and provides answers to the following questions::

1.What motivates them to make a purchase?
2.What are their fears and reservations about your brand?
3.How do they interact with your products and services?
4.What makes them choose your competitors over you?

Major Points from Table of Contents:

1 Nephrology EMR Software Market Overview
2 Company Profiles
3 Nephrology EMR Software Market Competition, by Players
4 Nephrology EMR Software Market Size Segment by Type
5 Nephrology EMR Software Market Size Segment by Application
6 North America by Country, by Type, and by Application
7 Europe by Country, by Type, and by Application
8 Asia-Pacific by Region, by Type, and by Application
9 South America by Country, by Type, and by Application
10 Middle East & Africa by Country, by Type, and by Application
11 Research Findings and Conclusion
12 Appendix…

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The post Nephrology EMR Software Market Growth, Competitive Analysis and Forecast 2028 | Kareo, AdvancedMD, athenahealth appeared first on Herald Keeper.

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Sun, 02 Oct 2022 17:32:00 -0500 en-US text/html https://www.marketwatch.com/press-release/nephrology-emr-software-market-growth-competitive-analysis-and-forecast-2028-kareo-advancedmd-athenahealth-2022-10-03
Killexams : Kidney & Hypertension—Nephrology

This clinic involves evaluation and treatment of patients with inflammation of the kidney. Untreated, glomerulonephritis can lead to complete kidney failure. This means that early and accurate diagnosis and management of the disease is crucial to preserve kidney function.

We work in collaboration with certified in rheumatology and provide comprehensive, multi-disciplinary care. We also conduct clinical trials that involve treatment of kidney diseases due to multiple inflammatory causes, including lupus, focal segmental glomerulonephritis, membranous glomerulonephritis, rapidly progressive glomerulonephritis, and others.

Phone: 801-585-6320

Wed, 28 Sep 2022 12:00:00 -0500 en text/html https://healthcare.utah.edu/kidney-hypertension-nephrology/
Killexams : XORTX Sponsored Study Selected For Presentation At The American Society Of Nephrology Kidney Week 2022

(MENAFN- GlobeNewsWire - Nasdaq)

CALGARY, Alberta, Sept. 01, 2022 (GLOBE NEWSWIRE) -- XORTX Therapeutics Inc. ('XORTX' or the“Company”) (NASDAQ: XRTX | TSXV: XRTX | Frankfurt: ANU), a late stage clinical pharmaceutical company focused on developing innovative therapies to treat progressive kidney disease is pleased to announce acceptance of a study abstract for presentation at the American Society of Nephrology (“ASN”) Kidney Week 2022 meeting to be held the week of November 4, 2022. The title of the poster presentation selected by the Kidney Week Education Committee and following peer review is “Raising Serum Uric Acid with a Uricase Inhibitor Worsens PKD in Rat and Mouse Models ” which will be presented during the ASN Session Title: Genetic Diseases of the Kidneys, by Dr. Charles Edelstein of the University of Colorado.

About this Study

Humans are predisposed to chronically high uric acid and gout because they lack uricase that converts uric acid to allantoin. In rodents uricase converts uric acid to allantoin and uricase inhibition raises serum uric acid. The aim of the study was to determine whether raising serum uric acid with the uricase inhibitor oxonic acid (OXO) was associated with worse PKD.

Dr. Allen Davidoff, CEO of XORTX, stated,“We are pleased to participating in the ASN annual meeting during Kidney Week 2022 with this poster presentation. Most importantly, results of this study show that increased serum uric acid can accelerate injury in two separate models of PKD in different species – a fundamental finding that we believe supports the XRx-008 program. These results and additional novel key discoveries from the study also provide XORTX with the opportunity to potentially further expand our patent portfolio, through a accurate continuation of our formulation patent and a new provisional patent application. We anticipate further updated information near the time that the abstract for the ASN becomes public.”

About the American Society of Nephrology – Kidney Week

ASN represents more than 21,000 kidney health professionals working to help people with kidney diseases and their families. Source:

The Kidney Week Conference, being held in Orlando, Florida, is attended by approximately 10,000 kidney professionals from across the globe. The world's premier nephrology meeting, Kidney Week provides participants exciting and challenging opportunities to exchange knowledge, learn the latest scientific and medical advances, and listen to engaging and provocative discussions with leading experts in the field. Source:

American Society of Nephrology - Program and Abstracts

The Kidney Week program is available on the ASN website . Abstracts will be available on the ASN website by October 14, 2022.

About ADPKD

ADPKD is a rare disease that affects more that 10 million individuals worldwide.1,2 ADPKD is typically diagnosed based upon expansion of fluid-filled cysts in the kidneys. Over time, the increasing number and size of cysts can contribute to structural and functional changes to kidneys and is frequently accompanied by chronic pain which is a common problem for patients with ADPKD.3 Expansion of cysts is thought to compress healthy functioning tissue surrounding the cysts and contribute to further loss of kidney function, fibrosis, impaired nutrient exchange and impaired kidney function, accompanied later by end-stage renal disease.1 Health consequences of high uric acid have been reported to be increased in ADPKD individuals, including increased incidence of kidney stones5 and gout.6,7 For individuals with progressing ADPKD, treatment recommendations include anti-hypertensive treatment, dietary restrictions, and, for a limited percentage of suitable patients, pharmacotherapy.4 New, more broadly applicable therapies to effectively slow decline of kidney function in ADPKD are needed.

About XORTX Therapeutics Inc.

XORTX is a pharmaceutical company with two clinically advanced products in development: 1) our lead, XRx-008 program for ADPKD; and 2) our secondary program in XRx-101 for acute kidney and other acute organ injury associated with Coronavirus / COVID-19 infection. In addition, XRx-225 is a pre-clinical stage program for Type 2 Diabetic Nephropathy. XORTX is working to advance its clinical development stage products that target aberrant purine metabolism and xanthine oxidase to decrease or inhibit production of uric acid. At XORTX, we are dedicated to developing medications to Strengthen the quality of life and future health of patients. Additional information on XORTX is available at .

For further information, please contact:
Allen Davidoff, CEO Nick Rigopulos, Director of Communications
or +1 403 455 7727 or +1 617 901 0785

The TSX Venture Exchange and Nasdaq have neither approved nor disapproved the contents of this news release. No stock exchange, securities commission or other regulatory authority has approved or disapproved the information contained herein.

References:

  • Wiley C., Kamat S., Stelhorn R., Blais J., Analysis of nationwide date to determine the incidence and diagnosis of autosomal dominant polycystic kidney disease in the USA, Kidney Disease, 5(2): 107-117, 2019
  • Bergmann C., Guay-Woodford L.M., Harris P.C., Horie S., Peters D.J., Torres V.E., Polycystic Kidney Disease, Nat Rev Dis Primers. 4(1): 50, 2018
  • Gimpel C., Bermann C., Bockenhauer D., et al., International consensus statement of the diagnosis and management of autosomal dominant polycystic kidney disease in children and young people, Nat Rev Nephrol 15(11):713-726, 2019
  • Torres VE, et al, The association of nephrolithiasis and autosomal dominant polycystic kidney disease, Am J Kidney Dis, 1988, vol 11, 318-325
  • Newcombe, DS. Letter Gouty Arthritis and polycystic kidney disease, Ann Intern Med, 1973 vol 79, pg 605
  • Rivera JV Martinez, et al, Association of hyperuricemia and polycystic kidney disease, Bol Asoc Med P R, 1965 vol 7 251-263
  • Forward Looking Statements

    This press release may contain express or implied forward-looking statements pursuant to applicable securities laws. These forward-looking statements and their implications are based on the current reasonable expectations of the management of XORTX only, and are subject to a number of factors and uncertainties that could cause genuine results to differ materially from those described in such forward-looking statements. The forward-looking statements in this press release include, but are not limited to, the results from the study supporting (i) the XRx-008 program and (ii) the potential expansion of XORTX's patent portfolio. Except as otherwise required by law, XORTX undertakes no obligation to publicly release any revisions or updates to these forward-looking statements to reflect events or circumstances after the date hereof or to reflect the occurrence of unanticipated events. The risks and uncertainties that could impact these forward-looking statements of XORTX generally are contained in the Company's most recently filed Annual Information Form and the Management Discussion and Analysis for its most accurate financial reporting period filed on the Company's SEDAR profile ( ) and under the heading“Risk Factors” in XORTX's annual report on Form F-20F filed with the United States Securities and Exchange Commission (“SEC”) available on the SEC's website, .




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Killexams : Maher Bishara, MD, Nephrologist

The MarketWatch News Department was not involved in the creation of this content.

Oct 14, 2022 (IssueWire via Comtex) -- New York City, New York Oct 14, 2022 (Issuewire.com) - Holding over four decades of experience, Dr. Bishara is a well-versed nephrologist who is based in the state of Texas. He holds privileges at the following hospitals: Houston Methodist Hospital, Houston Methodist West Hospital, Memorial Hermann Greater Heights Hospital, and Memorial Hermann Memorial City Medical Center.

Specializing in internal medicine and nephrology, his clinical interests include dialysis, hypertension, kidney-related disease, kidney stones, kidney transplants, and renal failure.

Educated in Syria, Dr. Bishara graduated with his medical degree from the Damascus University Faculty of Medicine. He then relocated to the United States, performing his internship and residency in internal medicine at Lutheran Medical Center, and his fellowship in nephrology at the University of Texas Health Science Center in Houston.

Licensed to practice medicine in Texas and Florida, he is board-certified in internal medicine and nephrology by the American Board of Internal Medicine (ABIM). The ABIM is a physician-led, non-profit, independent evaluation organization driven by doctors who want to achieve higher standards for better care in a rapidly changing world.

Nephrology is a specialty of medicine and pediatrics that concerns itself with the kidneys. It is the study of normal kidney function and kidney disease, the preservation of kidney health, and the treatment of kidney disease, from diet and medication to renal replacement therapy. Nephrologists have advanced training in treating kidney disease. They diagnose and treat kidney failure, as well as help patients by prescribing medications, offering special diet advice, and coordinating dialysis care or kidney transplantation when it becomes necessary.

On a more personal note, Dr. Bishara is fluent in both English and Arabic.

Learn More about Dr. Maher Bishara:
Through his findatopdoc profile, https://www.findatopdoc.com/doctor/3158186-Maher-Bishara-Nephrologist-Kidney-Specialist or through Memorial Hermann, https://www.memorialhermann.org/doctors/nephrologists/dr-maher-bishara-md-1689650970

About FindaTopDoc.com
FindaTopDoc is a digital health information company that helps connect patients with local physicians and certified who accept your insurance. Our goal is to help guide you on your journey toward optimal health by providing you with the know-how to make informed decisions for you and your family.

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Source :Maher Bishara, MD

This article was originally published by IssueWire. Read the original article here.

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Fri, 14 Oct 2022 04:37:00 -0500 en-US text/html https://www.marketwatch.com/press-release/maher-bishara-md-nephrologist-2022-10-14
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