From MedPage Today:

  1. Sudden Cardiac Death Robs Many Years of Life. The burden of sudden cardiac death in terms of years of potential life lost is high compared with other leading causes of death in the U.S.
  2. HTN Guidance Takes Center Stage at NKF. Guidelines on hypertension management, particularly the JNC8 recommendations released last December, will be a major talking point at this year's ...

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Given all the complaining I and my colleagues do about the problems with the EMR, I figured I’d take the opportunity to tell you about something good that came from having my practice online. A patient came to see me last week for a check up and requested a prescription for birth control pills.  She’d used them in the past without problems. I wrote the script and sent her on her ...

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NephMadness 2014: Lets reinvigorate nephrologyThe field of nephrology is in a workforce crisis. We as a subspecialty have witnessed a steady decline in the number of applicants perusing nephrology fellowship over the last several years. In fact, fewer than 100 US medical school applicants participated in the 2014 nephrology fellowship match. This is a sobering statistic as 403 nephrology slots were available in this year’s ...

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From MedPage Today:

  1. Can the Health App Wild West Be Tamed? Mobile health applications can have a big impact on people's health and lifestyle habits and gather vast amounts of personal data -- all without any oversight. Is this a problem?
  2. Hypertension, Obesity Tied to Kidney Cancer. Increases in blood pressure and body mass were associated with greater risks of kidney cancer in U.S. ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 59-year-old woman is evaluated during a routine follow-up visit. She was recently diagnosed with type 2 diabetes mellitus and hyperlipidemia. She feels well. Medications are metformin, atorvastatin, and aspirin. Physical examination findings and vital signs are normal. BMI is 27. Laboratory studies reveal a serum creatinine level of 0.9 mg/dL (79.6 µmol/L), an ...

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I have been doing admitting shifts at a large hospital, as hospitalist. It is flu season, so volumes are large. Even people without the flu are sick. It often happens that way. And they are so very sick! The thing about the very sick patients I see is that they are generally what might be called medical "train wrecks." They are very sick because they have had interventions over the years ...

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From MedPage Today:

  1. Primary Care Pay Bump Unlikely. The 10% pay raise select primary care services received under the Affordable Care Act likely won't be extended beyond 2015.
  2. New Guideline Lowers eGFR for Dialysis Start. New Canadian guidelines suggest that nephrologists can wait to start dialysis in some chronic kidney disease patients until their estimated glomerular filtration rate (eGFR) drops below the 10 to ...

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This post is a question, an invitation and a challenge. How can we bring technologies we take for granted back home to those in the developing world? Many before me have spoken with outrage about the reality of two worlds: one of abundance, and the other where people live like they have in centuries past. The situation is more complicated since even poor people may have some technologies like cellphones now, but vital lifesaving technologies ...

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Much has been made about the steady decrease in the number of U.S. medical school graduates choosing to pursue nephrology as a career.  Even among nephrologists, both those in private practice as well as academia, there has been substantial hand-wringing on this issue. My more pessimistic colleagues see a subspecialty in decline, which they attribute to a myriad of factors.  These include the encroachment on our “turf” by other sub-specialists (intensivists ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 74-year-old woman is evaluated for a 2-month history of fatigue, anorexia, and a 6-kg (13.2-lb) weight loss. She was treated with chemotherapy for ovarian cancer 6 months ago. She also has hypertension managed with hydrochlorothiazide. On physical examination, temperature is 36.2 °C (97.2 °F), blood pressure is 132/75 mm Hg without postural ...

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