But Why Weight: Understanding the Implications of Obesity in Kidney Transplant
Obesity is increasing in prevalence among candidates for kidney transplant. Understanding the influence of obesity on candidate evaluation, surgical risk, peritransplant management, and post-transplant outcomes is critical to ensuring equitable access to transplant for this growing population. (Source: Seminars in Nephrology)
Source: Seminars in Nephrology - July 1, 2021 Category: Urology & Nephrology Authors: Gayle Vranic, Matthew Cooper Source Type: research
Obesity Management and Chronic Kidney Disease
Summary: Obesity is one of the risk factors for the development and progression of chronic kidney disease (CKD). Several studies have shown the association between increased body mass index and kidney function decline. Obesity leads to CKD directly by acting as an independent risk factor and indirectly through increasing risks for diabetes, hypertension, and atherosclerosis, a group of well-established independent risk factors for CKD. Alterations in renal hemodynamics, inflammation, and in hormones and growth factors results in hyperfiltration injury and focal segmental glomerulosclerosis. (Source: Seminars in Nephrology)
Source: Seminars in Nephrology - July 1, 2021 Category: Urology & Nephrology Authors: Yang Chen, Walaa Dabbas, Antonio Gangemi, Enrico Benedetti, James Lash, Patricia W. Finn, David L. Perkins Source Type: research
Masthead
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Source: Seminars in Nephrology - July 1, 2021 Category: Urology & Nephrology Source Type: research
Editorial Board
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Source: Seminars in Nephrology - July 1, 2021 Category: Urology & Nephrology Source Type: research
Table of Contents
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Source: Seminars in Nephrology - July 1, 2021 Category: Urology & Nephrology Source Type: research
Social Justice as a Tool to Eliminate Inequities in Kidney Disease
Summary: Kidney disease has disparate effects on racial and ethnic minority groups, who have higher rates of chronic kidney disease and generally poorer outcomes. These disparate rates and outcomes have been attributed to social determinants of health; however, these social determinants of health are related to governmental and societal structural barriers that have created inequities not only in kidney disease, but also in other chronic diseases and in maternal/fetal health outcomes. The societal barriers to health equity include income inequality, inadequate education, environmental injustice, mass incarceration, and the...
Source: Seminars in Nephrology - May 1, 2021 Category: Urology & Nephrology Authors: J. Kevin Tucker Source Type: research
Ethical Challenges in Dialysis and Transplantation: Perspectives From the Developing World
Summary: Renal replacement therapies including dialysis and transplantation for patients with end-stage kidney failure are treatment options beyond the reach of a large segment of the population, particularly in resource-constrained settings. Health care professionals practicing within developing countries face unique ethical issues in the provision of these treatment options despite the existence of free treatment at different centers. Apart from issues of accessibility of dialysis services, initiation of treatment can have disastrous consequences for the entire family unit, which is magnified in collectivist societies. (...
Source: Seminars in Nephrology - May 1, 2021 Category: Urology & Nephrology Authors: Sualeha Siddiq Shekhani, Ali Asghar Lanewala Source Type: research
What Role Can the Right to Health Play in Advancing Equity in Kidney Care?
Summary: Kidney disease, whether acute or chronic, is an important health concern for more than 750 million people worldwide. Although its magnitude has been better studied within developed countries, evidence increasingly suggests similar scales of impact in developing and underdeveloped countries. On a shared planet where limited resources and high costs keep life-saving care out of reach for the poor and other structurally disadvantaged populations, addressing health concerns on such a large scale requires a governing basis in the recognition of the universal right to health. (Source: Seminars in Nephrology)
Source: Seminars in Nephrology - May 1, 2021 Category: Urology & Nephrology Authors: Diya Uberoi, Lisa Forman Source Type: research
Priority Setting as an Ethical Imperative in Managing Global Dialysis Access and Improving Kidney Care
Summary: Priority-setting dilemmas arise when trade-offs must be made regarding the kinds of services that should be provided and to whom, thereby withholding other services from individuals or groups that could benefit from them. Currently, it is practically impossible for lower-income countries to provide dialysis for all patients with kidney failure; however, the fundamental premise of the human right to health, while acknowledging the current resource constraints, is the progressive realization of access to care for all. (Source: Seminars in Nephrology)
Source: Seminars in Nephrology - May 1, 2021 Category: Urology & Nephrology Authors: Valerie A. Luyckx, M. Rafique Moosa Source Type: research
In Defense of Patient Autonomy in Kidney Failure Care When Treatment Choices Are Limited
Summary: Respect for patient autonomy is a primary ethical obligation of health care providers. In kidney health care, clinical practice recommendations commonly include strategies to promote shared decision making with patients and their families about treatment options to promote patient autonomy and improve patient outcomes. However, for many people with kidney failure, treatment options may be unavailable or inaccessible. In these circumstances some clinicians may act paternalistically and withhold information from patients because of a fear of causing harm or because clinicians believe that patient autonomy is not a r...
Source: Seminars in Nephrology - May 1, 2021 Category: Urology & Nephrology Authors: Dominique E. Martin, Elmi Muller Source Type: research
Moral Distress and Moral Injury in Nephrology During the COVID-19 Pandemic
Summary: Across the world, challenges for clinicians providing health care during the coronavirus disease 2019 (COVID-19) pandemic are highly prevalent and have been widely reported. Perspectives of provider groups have conveyed wide-ranging experiences of adversity, distress, and resilience. In understanding and responding to the emotional and psychological implications of the pandemic for renal clinicians, it is vital to recognize that many experiences also have been ethically challenging. The COVID-19 pandemic has prompted rapid and extensive transformation of health care systems and widely impacted care provision, heig...
Source: Seminars in Nephrology - May 1, 2021 Category: Urology & Nephrology Authors: Kathryn Ducharlet, Mayuri Trivedi, Samantha L. Gelfand, Hui Liew, Lawrence P. McMahon, Gloria Ashuntantang, Frank Brennan, Mark Brown, Dominique E. Martin Source Type: research
Ethical Duties of Nephrologists: When Patients Are Nonadherent to Treatment
Summary: When providing care, nephrologists are subject to various ethical duties. Beyond the Hippocratic notion of doing no harm, nephrologists also have duties to respect their patients ’ autonomy and dignity, to meet their patients’ care goals in the least invasive way, to act impartially, and, ultimately, to do what is (clinically) beneficial for their patients. Juggling these often-conflicting duties can be challenging at the best of times, but can prove especially difficult when patients are not fully adherent to treatment. (Source: Seminars in Nephrology)
Source: Seminars in Nephrology - May 1, 2021 Category: Urology & Nephrology Authors: Jordan A. Parsons, Dominic M. Taylor, Fergus J. Caskey, Jonathan Ives Source Type: research
Ethics in Research: Relevance for Nephrology
Summary: Research is crucial to progress in nephrology. It is important that studies are conducted rigorously from the scientific perspective, as well as in adherence to ethical standards. Traditional clinical research places a high value on individual research subject autonomy. Research questions often include the clinical effectiveness of new interventions studied under highly controlled conditions. Such research has brought the promise of new game-changers in nephrology, such as the sodium-glucose cotransporter 2 inhibitors. (Source: Seminars in Nephrology)
Source: Seminars in Nephrology - May 1, 2021 Category: Urology & Nephrology Authors: Ariadne A. Nichol, Erisa S. Mwaka, Valerie A. Luyckx Source Type: research
A Call for an Ethics and Governance Action Plan to Harness the Power of Artificial Intelligence and Digitalization in Nephrology
Summary: Digitalization in nephrology has progressed in a manner that is disparate and siloed, even though learning (under a broader Learning Health System initiative) has been manifested in all the main areas of clinical application. Most applications based on artificial intelligence/machine learning (AI/ML) are still in the initial developmental stages and are yet to be adequately validated and shown to contribute to positive patient outcomes. There is also no consistent or comprehensive digitalization plan, and insufficient data are a limiting factor across all of these areas. (Source: Seminars in Nephrology)
Source: Seminars in Nephrology - May 1, 2021 Category: Urology & Nephrology Authors: Calvin Wai-Loon Ho, Karel Caals Source Type: research
Introduction: Ethical Issues in Nephrology
The coronavirus disease 2019 pandemic has brought discussion of ethical issues in medicine to the front pages of newspapers and to kitchen tables. A patient may be denied access to intensive care treatment or dialysis if another patient is deemed more likely to benefit from the limited resource. Prioritization decisions around access to vaccination have been accepted by the general population, meaning some still do not know when their turn will come. It has become clear that individual choices we make affect the lives of others in our communities. (Source: Seminars in Nephrology)
Source: Seminars in Nephrology - May 1, 2021 Category: Urology & Nephrology Authors: Valerie A. Luyckx Source Type: research
