ASN president opens ASN Kidney Week with call to redefine the standard of care
Click Here to Manage Email Alerts
Key takeaways:
- ASN has ramped up collaborations with federal agencies to increase funding and improve policy, Crews said.
- Partnerships with specialty groups have also helped enhance education and training.
SAN DIEGO — Health care providers and advocates must confront social disparities among patients with kidney disease to improve the standard of care, American Society of Nephrology President Deidra C. Crews, MD, ScM, FASN, said.
While advances have been made in technology and other specialties, inequities for certain patient groups remain, Crews said in her opening remarks at ASN Kidney Week, here. Black adults, for example, may face disproportionately higher kidney failure rates than white adults, especially among those with lower income or socioeconomic status.
Even in high-income countries, “injustice and social factors have an outsized influence on health — especially kidney health,” Crews said.
One method to tackle these issues is through clinical research, Crews said.
“We’re leading clinical trials of interventions addressing the effects of structural racism and other structural inequities and their impact on disparities in kidney health. We’re testing approaches to prevent patients from being referred late for nephrology care. We’re advancing health policies to incentivize transplant centers to address disparities,” she said. “[And] we’re moving closer to identify a treatment for a genetically mediated form of kidney disease that disproportionately affects a historically marginalized population.”
Kidney care initiatives
Recently, ASN initiatives to remove race from eGFR equations have informed new clinical algorithms and guided other medical disciplines to examine the role of race in health equity.
“The kidney community is having breakthroughs in our understanding of the basic mechanisms of kidney diseases,” Crews said, highlighting some specific achievements.
- Researchers have developed a new understanding of the cause of minimal change disease, idiopathic nephrotic syndrome and the use of immunosuppression for patients with glomerular diseases.
- Single-cell transcriptomics, proteomics and chromatin status have offered novel insights into kidney disease progression.
- Investigators are uncovering underlying causes and prevention techniques for AKI and chronic kidney disease and finding therapeutic advances for IgA nephropathy, focal segmental glomerulosclerosis, diabetic kidney disease and xenotransplantation.
In addition to a wave of key FDA approvals in kidney care, “we’ve gone big with our trials, leveraging electronic health records and pragmatic approaches to identify and randomize large numbers of patients in clinical settings to test our interventions at scale,” she said.
Redefining the standard of care
Partnerships with the American Society of Transplantation and the American Nephrology Nurses Association have also helped ASN to enhance nephology education and training.
“Redefining the standard for kidney care also means equipping nephrologists and other clinicians caring for people with kidney diseases with timely and practical information to guide them in the care of their patients,” according to Crews. “This responsibility is particularly important given the exciting pace at which new pharmacologic and non-pharmacologic therapies are being developed in kidney care.”
The newly launched ASN Kidney Health Guidance provides advice on screening, early detection, diagnosis and treatment, among other topics. The Partnership for Responsible AI in Kidney Health, meanwhile, offers guidance to navigate augmented intelligence, Crews said.
She noted that ASN has ramped up collaborations with federal agencies, such as the FDA and HHS, to increase funding and improve policy, as well as with global entities, like the European Renal Association and the International Society of Nephrology, to increase kidney care awareness.
More work is needed, Crews said: “One of every 10 people worldwide is still living with kidney diseases, in most cases while unaware of it. ... That’s one person enjoying their milestone birthday at a dinner party [for] a table for 10. And for families like mine [that are] disproportionately impacted, that could be as many as two or three people at that table.”
“Redefining the standard for kidney health research requires that we galvanize the kidney community to advocate for increased and coordinated funding for kidney research across the entire spectrum, starting with basic or fundamental research that improves our understanding of the kidney in health and disease and extending to implementation research that informs how we actually get effective therapies and treatment strategies to the people who need them and may benefit most from them,” Crews said. “As kidney professionals and advocates, we have the authority and the mandate to redefine the standard for kidney health — because, in fact, we are the standard-bearers.”
Collapse
Crews DC. Opening plenary: ASN president's address. Presented at: ASN Kidney Week; Oct. 24-27, 2024; San Diego.
Click Here to Manage Email Alerts