Outgoing ASN president highlights progress in transplant, workforce, sustainability
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Key takeaways:
- The American Society of Nephrology president said the specialty has heroes who have improved kidney care.
- ASN has focused on transplantation, workforce and the impact of dialysis on the environment.
PHILADELPHIA — Improvements in access to transplant, workforce issues and the impact of dialysis treatments on the environment have been a focus for the American Society of Nephrology in the past year, the outgoing ASN president said here.
Making comparisons to the achievements of historic figures like Joan of Arc, Mahatma Gandhi and Harriet Tubman, Michelle A. Josephson, MD, FASN, said nephrologists throughout the history of kidney care have proven to be heroes, and the opportunity in the kidney care specialty exists today as well.
“It is clear that we need heroes today, more than ever. We are fortunate to have plenty of heroes in the medical field,” she told conference attendees.
Josephson, professor of medicine and surgery at the University of Chicago, director of education at the Transplant Institute, medical director of the Pancreas Transplant Program and program director of the Transplant Nephrology Fellowship, reviewed the success of 2023 Nobel Prize in Medicine winner Katalin Kariko, PhD, who came to Philadelphia from Hungary to conduct clinical research and reviewed the obstacles she faced.
“When her research program ran out of money, she and her family sold all their possessions and they moved from Hungary to Philadelphia, just a few miles from here to continue her career,” Josephson said.
“Today, I’d like to challenge you to consider whether you can write your own epic tale about your contributions to nephrology,” Josephson told attendees. “The journey you’re taking is that of innovation and discovery. All of us have contributed in a meaningful way, be it through patient care, research, teaching or administration.
“Our final destination is a world without diseases. Out there, we have battles to fight, dragons to slay and seas to cross. We are all part of these journeys.”
Josephson, who will step down as president in January and be replaced by incoming president Deidra C. Crews, MD, ScM, reviewed progress made by the ASN in the areas of transplant, workforce and training, and sustainability.
“ASN has served as a leading, trusted voice in advising the U.S. government on transplant policy and has helped to increase access to donor kidneys,” she said. “ASN has worked with the Obama, Trump and Biden administrations to affect positive change in transplant. We are advocating to expedite the government reforms necessary to maximize patient access to transplant, enable the use of more organs and establish transparency to improve access to transplant, and ensure that the access is equitable and reduce barriers in the kidney health ecosystem,” Josephson said. “The [Biden] administration is on the record that improving the organ transportation system is a priority.”
Workforce
Josephson said challenges remain with workforce issues in nephrology. “These challenges are not unique to nephrology. They affect every facet of health care today, and they were exacerbated by the COVID-19 pandemic,” she told attendees. “[W]e must reevaluate how we can best make a case for ‘Why nephrology?’ We need to expose students, residents and other trainees at every medical school and graduate school to the excitement, the joy and the fascination of our field.”
ASN initiatives have focused on advocating for more fellowship training in home modalities and partnered with Home Dialysis University earlier this year. “I understand all too well how our workforce is insufficient to meet the overwhelming demand,” she said.
Environment
Lastly, Josephson said the kidney community needs to be sensitive to the use of natural resources when performing dialysis. “We must reduce the environmental footprint we create to manage kidney failure and foster resilience among people living with or at risk of kidney diseases who are uniquely impacted by climate change,” Josephson said. The water dialysis requires globally is 265 billion liters every year, she said, “and that doesn't even account for the tremendous number of disposable plastics we consume and discard” during a treatment.
“ASN is collaborating to specifically address that huge impact,” she said, by joining the Medical Society Consortium on Climate and Health and the International Society of Nephrology, which is “advancing education, innovation and clinical pathways to address the impact of climate change on kidney health,” she said.
“As a clinician, your journey looks different than the researchers or the educators or the administrators,” Josephson said. “This is our quest together. We all have different strengths, different tools and different skills to make a difference.”
Reference:
Josephson M. Presidential address. Presented at: ASN Kidney Week; Nov. 1-5, 2023; Philadelphia.
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