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ASN News

At its annual business meeting in conjunction with the 35^th Annual Meeting and Scientific Exposition in Philadelphia, results of the most recent ASN election were announced. Peter Aronson was selected from a slate of three candidates as the newest Councilor. Peter is currently the C.N.H. Long Professor of Internal Medicine and Professor of Cellular and Molecular Physiology and the Chief of Nephrology at Yale University School of Medicine. Peter has served as a member and chair of a number of ASN committees, was the recipient of the ASN Young Investigator Award in 1985, and has been very active in and received numerous honors from a broad range of other professional societies. His research interests include NaCl and acid-base homeostasis, molecular physiology of proximal tubule transport processes, and ion exchangers mediating renal tubular Na, Cl, and HCO₃ transport.

Alan Krensky was elected to the position of Secretary-Treasurer. Alan is the Shelagh Galligan Professor of Pediatrics at Stanford University, where he is also serves as the Associate Dean for Children’s Health and the Chief of Immunology and Transplantation Biology. Alan has also been very active in ASN committees and advisory groups, and he has served as an associate editor of JASN for five years. His research interests include transplantation biology, immune tolerance, and autoimmune diseases. Alan’s list of professional memberships and honors is long and impressive, and ASN is fortunate to have Alan in this important Council position.

Bill Mitch was elected to the position of President-Elect. Bill recently moved to Galveston to become the Edward Randall and Edward Randall Jr. Distinguished Professor of Medicine and Chair, Department of Medicine at the University of Texas Medical Branch. Bill received his medical degree from Harvard University and has been active in ASN and other professional association activities for many years. In addition to being honored many times and receiving numerous prestigious awards, Bill has also served on several editorial boards. His research interests include cellular and molecular mechanisms controlling protein turnover, regulatory mechanisms in kidney disease, and mechanisms that cause progression of renal disease.

Congratulations to Peter, Alan, and Bill!!!

UpToDate Releases Survey Data

UpToDate, an official educational program of the ASN, recently released the results of its current subscriber survey. The survey showed that the use of UpToDate in Nephrology has a significant impact on medical practice and overall patient care. Eighty-four percent of subscribers surveyed reported that the use of UpToDate led them to a change in diagnosis, and 96% to a change in diagnostic testing. Further, 98% of survey respondents reported that using UpToDate led them to a change in patient management; 67% said that using UpToDate had eliminated the need for a referral. Nephrologists also noted that UpToDate saves them time, reporting that (on average) using UpToDate saved them 2.8 hours per week.

The physicians surveyed indicated that UpToDate also helps them be more efficient. Ninety-three percent said they get to the answer faster with UpToDate than with other resources. Ninety-six percent said it saves them time in answering clinical questions, and 97% reported that it is easy to use. In fact, most of the physicians surveyed reported that they were able to find answers to their questions in UpToDate in less than five minutes, and nearly a third were able to find what they needed in less than two minutes.

The survey also found that 88% of nephrologists surveyed say UpToDate helps them be a better doctor. "UpToDate is the most reliable and well-written source of current knowledge in all medical specialties available anywhere in any format," said Dr. Gerald Karr, an UpToDate subscriber and nephrologist. "In guiding the clinical consultant, it strikes a perfect balance between basic science and clinical medicine, and between evidence and expert opinion."

These findings are backed by other independent research studies that show that UpToDate outperforms other similar resources and has a significant impact on patient care. If you are interested in more information on the survey results, visit UpToDate on the Web at www.uptodate.com/research.

Summit Conference on CKD Planned

The ASN has partnered with the National Kidney Foundation to sponsor a planned national conference on chronic kidney disease. The meeting is scheduled to take place in Washington, DC, during September 2003. Watch for upcoming notices and additional materials about this important conference!

The conference, entitled "Chronic Kidney Disease: Strategies for Success, A Call to Action," has been designed to raise awareness about early kidney disease. The decision to bring together a large variety of parties with a professional interest in the identification and treatment of CKD patients was based on the essential fact that the prevalence of CKD in the US population is greater than 20,000,000 . . . perhaps considerably more. Yet, there are unanswered questions about how to stratify these patients, about who will ultimately progress to renal failure, about how to best care for these patients, and about their potential cost to healthcare third-party payers.

In a meeting earlier this year, the Council on American Kidney Societies (CAKS) recognized that the progress to date in finding answers to the issues identified above was fragmented and without focused direction. It was therefore suggested that a meeting, comprehensive in nature and including all the components of the healthcare team, should be considered. Tom Parker, who has been involved in planning similar meetings in the past, was asked to act as Chair of a Steering Committee to develop this conference. Members of the Steering Committee include Roland Blantz, Jonathan Himmelfarb, Tom Hostetter, Alan Kliger, Michael Lazarus, Allen Nissenson, and Brian Pereira.

The purpose of the meeting is as follows:

• To fully understand the disease, the pathophysiology, and the comorbid conditions that lead to poor medical outcomes and high costs for patients with early kidney disease
  
• To accurately understand the magnitude of the problem. . .
  
• How many people are at "risk"?
  
• Who are they?
  
• Which ones require specific attention?
  
• To investigate the process by which clinical outcomes may be favorably altered, and to determine the cost of preferred treatment regimens
  
• To understand, if clinical-care models are altered, how various components of the delivery system are affected. . .
  
• Primary care physicians, nephrologists, nurses, physician extenders
  
• Payers (insurance companies, HMOs, DMOs, etc.)
  
• Pharmaceutical companies with renal-related products
  
• Providers of ESRD services
  
• To chart the future plan of action, including awareness initiatives and appropriate education
  

It is expected that participants in this conference (expected to draw more than 1,000 individuals) will appropriately represent a variety of interested constituencies, including primary care physicians, nephrologists, nurses, other related healthcare personnel, third-party payers, representatives from CMS and state agencies responsible for Medicaid administration, dialysis providers, and healthcare networks. In addition, pharmaceutical companies will be represented at the meeting, as will the NIH and NIDDK.

Tom Parker stated that, "It is the vision of the Steering Committee that the outcome and culmination of the meeting will provide a foundation on which each component of the renal healthcare delivery and payment system may then collectively build their strategies."

Government Relations

As of press time, Congress has left town with a roster of unfinished business at a level not seen for the last 50 years. Not scheduled to return for any substantive business until November 22, the government is currently operating under a "continuing resolution," a stop-gap spending measure designed to keep the government in business past October 1 in the absence of enacted appropriations measures. At present, only 2 of the 13 appropriations bills have been sent to the President for his review and signature. The Labor, Health and Human Services Appropriations bill, which controls funding for NIDDK for Fiscal Year 2003, has not passed either House, but the Senate Appropriations Committee has at least considered its version of a bill and sent it on for a vote by the full Senate, hopefully to take place this Fall.

Despite this somewhat grim outlook, ASN can take comfort in knowing that the Senate Appropriations report contains virtually all of the language we have been pushing this year in order to keep attention focused on the need for federal funding for kidney disease research. Even in the absence of a House-passed bill, this language has relevance to ASN, as it signifies to NIDDK the amount of congressional interest in a given issue. The exact verbiage follows:

1. Kidney disease clinical research: The Committee previously noted the current inherent problems in conducting kidney disease research due to the lack of a permanent infrastructure, such as a clinical trials cooperative group. The Committee commends the NIDDK for its leadership in moving forward in this area, by holding an initial workshop to develop strategies that will strengthen kidney research and enhance researchers’ abilities to translate research findings to the bedside, facilitate clinical trials, and recruit patients for studies. The Committee urges the NIDDK to continue with these efforts, and to make the necessary funds available in this fiscal year to launch a permanent kidney disease clinical research mechanism.
   
2. Kidney disease and end-stage renal disease: Diabetes is the leading cause of kidney failure and end-stage renal disease. The Committee urges the NIDDK to expand research into early prevention and therapeutic intervention of kidney disease to prevent end-stage renal failure. The Committee also encourages the NIDDK to consider launching a permanent kidney disease clinical research mechanism. Finally, the Institute is urged to address an anticipated workplace shortage in nephrology by launching new training initiatives and workshops to foster interest in the field.
   
3. Heart disease and kidney disease: There is a well-established and significant link between heart disease, hypertension, and kidney disease. The Committee encourages the NHLBI to increase its collaboration with the NIDDK to develop cooperative research initiatives in this area, and it urges the NHLBI to consider sponsoring a workshop on hypertension as it relates to heart and kidney disease.
   

During this fiscal year, NIDDK is preparing to launch the first phases of a kidney disease clinical trials group, which holds the promise of dramatically improving and streamlining the treatment of kidney clinical trials in the years to come. Additionally, the National Kidney Disease Education Program (NKDEP) officially kicks off in January 2003 with a four-city program of media outreach and education targeted specifically at African Americans. Both of these successes are due solely to ASN’s Government Relations advocacy efforts, including nephrologists who are active in grassroots efforts.

In looking toward next year, one issue of concern bears warning. While many facets within NIH have received special attention over the last 5 years, there is significant and well-grounded concern in the health community that Congress plans to scale back on the amount of increase afforded to research and would instead devote more time and resources to other areas. With the significant increases NIDDK has received in recent years, ASN will now face the challenge of ensuring that the momentum continues without interruption.

January 2003 will usher in a new 108^th Congress. All kidney-related legislation that ASN has been supporting, such as coverage of immunosuppressive drugs, expansion of Medicare to cover certain chronic kidney patients, and Graduate Medical Education (GME) relief, will have to be reintroduced next year if the issues have not been addressed before the 107^th Congress adjourns sine die. For these reasons, and given the lack of substantive progress of Congress in addressing a number of issues to date, 2003 promises to be a year in which ASN advocacy will need to be especially vocal in order to be heard above the fray of other health groups who are similarly situated.

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