Kenar Jhaveri | Hofstra North Shore-LIJ School of Medicine (original) (raw)

Papers by Kenar Jhaveri

Research paper thumbnail of Acremonium skin and soft tissue infection in a kidney transplant recipient

Transplantation, Feb 27, 2013

Research paper thumbnail of BRAF inhibitors - do we need to worry about kidney injury?

Expert Opinion on Drug Safety, 2016

Research paper thumbnail of Nephrology education for medical students: a narrative review

Renal Failure, 2016

Strategies used to teach nephrology to medical students are not well studied. This study assesses... more Strategies used to teach nephrology to medical students are not well studied. This study assesses the published literature on medical student education in nephrology. A review of the published literature on nephrology education for medical students was conducted on two major online search engines (PubMed and ERIC). In addition, references of the manuscripts discovered in these searches were reviewed. The empirical studies were categorized by subject within nephrology and research design. We found 26 original studies in which a method of teaching nephrology to medical students was described. The studies dated from 1977 to 2015. The focus of these nephrology teaching experiences was as follows: anatomy (6.5%), physiology (22.6%), pathophysiology (29.0%), pathology (6.5%), treatment (25.8%), and general nephrology (9.7%). The studies were also categorized into various types of research design. 6.9% had either no assessment of the educational experience or had a description too vague to categorize it; 3.4% involved a survey about the existing educational approach before a curriculum change was implemented; 55.2% used surveys or tests after an educational course was carried out; 10.3% sought feedback from students before and after the educational experience; 13.8% were case studies; and 10.3% included a randomized controlled trial. The randomized controlled trials involved teaching techniques focused on the pathophysiology of renal disease. Rigor was lacking in most empirical studies on medical student education in nephrology. Well-designed randomized controlled studies are needed to accurately assess the effectiveness of the educational techniques introduced into medical school curricula.

Research paper thumbnail of 302: Hypomagnesemia Causing Rapid New Onset Type II Diabetes Post Transplant (NODAT)

Research paper thumbnail of Bone Parameters and Risk of Hip and Femur Fractures in Patients on Hemodialysis

Clinical journal of the American Society of Nephrology : CJASN, Jan 29, 2016

Patients on hemodialysis have a high rate of hip fractures. In this study, we performed a contemp... more Patients on hemodialysis have a high rate of hip fractures. In this study, we performed a contemporary analysis of mineral and bone parameters and their relationship to hip and femur fracture risk. Patients on hemodialysis treated between 2000 and 2013 in Fresenius Medical Care North America facilities were included. Predictors were on the basis of data as of December 31 of each baseline year and time-averaged values of selected laboratory parameters and medication doses throughout the year. Four period cohorts were constructed from baseline years: 2000, 2003, 2006, and 2009. Follow-up for each cohort was ≤3 years. The incidence of hip and femur fractures remained generally unchanged (P=0.40), except among patients who were white and >65 years of age, in whom the rate decreased significantly over the 14-year period (P<0.01). Results from combined multivariable models indicated that the lowest quartiles of time-averaged intact parathyroid hormone were independently associated w...

Research paper thumbnail of History of nephrology: Ukrainian aspects Reply

Kidney International, 2012

The Authors Reply: We appreciate the interest of Khadzhynov and Peters 1 in our recently publishe... more The Authors Reply: We appreciate the interest of Khadzhynov and Peters 1 in our recently published crossword puzzle on the history of nephrology. We apologize for perpetuating the error you mention, which unfortunately appears in numerous accounts in the medical literature. The medical literature has confusion over the place, date, and the difference between the dates and origins of the surgeon. 3-6

Research paper thumbnail of Crossword: Acute Kidney Injury—Basics

Journal of Clinical Pediatric Nephrology, Dec 31, 2012

Research paper thumbnail of Harvoni (Ledipasvir With Sofosbuvir)-Induced Renal Injury

The American Journal of Gastroenterology, 2016

Research paper thumbnail of Nephrology Crosswords: Diabetic nephropathy

Kidney International, 2015

Research paper thumbnail of Carfilzomib-induced nephrotoxcity

Kidney International, 2015

Research paper thumbnail of Carfilzomib-related acute kidney injury

Clinical Advances in Hematology Oncology H O, Sep 1, 2013

Research paper thumbnail of Onconephrology abstracts and publication trends: time to collaborate

Clinical Kidney Journal, 2015

Onconephrology is an emerging subspecialty of nephrology. The American Society of Nephrology(ASN)... more Onconephrology is an emerging subspecialty of nephrology. The American Society of Nephrology(ASN) created a forum dedicated to the field of onconephrology in 2011 to improve collaborative care for cancer patients with kidney disease. In this article, we review the ASN Kidney Week abstracts that were related to onconephrology. There has been an increase in the number of onconephrology-related abstracts at ASN over last 3 years. But only one-fifth of abstracts that were onconephrology related in ASN were published in peer review journals. Clinical Kidney Journal (CKJ) has seen an increase in onconephrology publications in the last 3 years. Most were case reports or review articles. The more widespread use of the keyword &amp;amp;amp;amp;#39;onconephrology&amp;amp;amp;amp;#39; in all such manuscripts may facilitate the search for onconephrology research papers. To advance the field, CKJ has now created an onconephrology subheading for manuscript categorization. We also propose that conference organizers of ASN and other kidney-related society meeting such as International Society of Nephrology, National Kidney Foundation and European Dialysis and Transplantation Association have a separate onconephrology abstract category. Randomized controlled trials in a subspecialty like onconephrology can only be possible when there is collaboration amongst nephrologists and cancer physicians from cancer centers around the world that interact and share research ideas at international meetings.

Research paper thumbnail of Outcomes following Kidney Transplantation in IgA Nephropathy: A UNOS/OPTN analysis

Clinical Transplantation, 2015

This study updates assessment of post-transplant outcomes in IgAN patients in the modern era of i... more This study updates assessment of post-transplant outcomes in IgAN patients in the modern era of immunosuppression. Using UNOS/OPTN data, patients ≥18 yr of age with first kidney transplant (1/1/1999 to 12/31/2008) were analyzed. Multivariable Cox regression models and propensity score-based matching techniques were used to estimate hazard ratios (HRs) for death-censored allograft survival (DCGS) and patient survival in IgAN compared to non-IgAN. Results of multivariable regression were stratified by donor type (living vs. deceased). A total of 107, 747 recipients were included (4589 with IgAN and 103 158 with non-IgAN). Adjusted HR for DCGS showed no significant difference between IgAN and non-IgAN. IgAN had higher patient survival compared to non-IgAN (HR 0.54, 95% CI 0.47-0.62, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001 for deceased donors; HR 0.42, 95% CI 0.33-0.54, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001 for living donors). Propensity score-matched analysis was similar, with no significant difference in DCGS between matched groups and higher patient survival in IgAN patients compared to non-IgAN group (HR 0.54, 95% CI 0.47, 0.63; p-value &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.0001). IgAN patients with first kidney transplant have superior patient survival and similar graft survival compared to non-IgAN recipients. Results can be used in prognostication and informed decision-making about kidney transplantation in patients with IgAN.

Research paper thumbnail of Nephrotoxicity of the BRAF Inhibitors Vemurafenib and Dabrafenib

JAMA Oncology, 2015

The selective BRAF inhibitors vemurafenib and dabrafenib have shown significant improvement in pa... more The selective BRAF inhibitors vemurafenib and dabrafenib have shown significant improvement in patient survival compared with standard therapy in BRAF V600-mutant metastatic melanoma. We reviewed Food and Drug Administration Adverse Event Reporting System (FAERS) data for both agents for renal toxic effects. From July 2011 through June 2014, 132 cases of acute kidney injury in patients receiving vemurafenib therapy were reported. Renal injury was more common in men (85 men vs 47 women; P &amp;amp;amp;amp;amp;amp;amp;amp;lt; .001). From April 2013 through June 2014, 13 cases of renal injury in patients receiving dabrafenib therapy were reported (12 men and 1 woman). Hypokalemia (6 cases in patients receiving vemurafenib and 2 cases in patients receiving dabrafenib) and hyponatremia (8 and 6 cases, respectively) were also reported. Vemurafenib seems to be more nephrotoxic than dabrafenib. This renal toxicity seems to be more prevalent among male patients with melanoma. On the basis of the few published case reports, the mode of injury seems to be tubular interstitial injury. Our findings suggest a need to monitor renal function and electrolyte levels in all patients who receive these drugs. Dermatologists, oncologists, and nephrologists need to be aware of this potential hazard.

Research paper thumbnail of Nephrology elective experience during medical residency: a national survey of US nephrology fellowship training program directors

Renal Failure, 2015

Interest in nephrology careers continues to decline in the United States. The reasons for this de... more Interest in nephrology careers continues to decline in the United States. The reasons for this declining interest are not fully understood but it is plausible that inadequate exposure to the full spectrum of what a career in nephrology encompasses may be part of the explanation. Inpatient-based nephrology electives have been a common venue for residents to gain exposure to nephrology but little is known regarding the details of such electives and how often they include outpatient experiences. We carried out a national survey of nephrology fellowship training program directors to obtain data on the content of nephrology elective experiences as well as their ideas on how to promote interest in the field. The survey revealed the majority of elective experiences to be either exclusively or heavily inpatient based, with only a small percentage having a substantial outpatient component, particularly in outpatient dialysis or transplantation. Training program directors felt that providing greater outpatient experiences to residents during elective rotations would be an effective means to promote interest in nephrology, along with structured faculty mentoring. Our findings suggest that current approaches to the nephrology elective experience are heavily inpatient-based and might benefit from incorporating much more of the rich spectrum of activities a career in nephrology entails. Hopefully such efforts can create and enhance interest in careers in nephrology and potentially begin a sustained reversal of an unfortunate and serious decline in interest.

Research paper thumbnail of Carfilzomib-related acute kidney injury

Clinical advances in hematology & oncology : H&O, 2013

Research paper thumbnail of NephMadness 2015: Nephrology as a Cornerstone of Medicine

American Journal of Kidney Diseases, 2015

Research paper thumbnail of Wanted: pediatric nephrologists! — why trainees are not choosing pediatric nephrology

Renal Failure, 2014

A workforce crisis for many pediatric specialties, particularly nephrology, is due to growing ret... more A workforce crisis for many pediatric specialties, particularly nephrology, is due to growing retirement rates, attrition during training, and retention difficulties. To obtain specific information regarding pediatric nephrology trainee shortages, we administered two cross-sectional surveys to non-renal pediatric subspecialty fellows and pediatric nephrology program directors. We characterized the fellows&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; experiences with nephrology and the program directors&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; experiences with their fellows as well as their outcomes in the last 10 years. We analyzed responses from 531 non-renal fellows (14.4% response rate). Overall, 317 (60%) fellows rated nephrology as difficult, particularly women (65.4% vs. 49.5%, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), with American women medical graduates rating nephrology as more difficult compared to all others (p = 0.001). More men than women (24% vs. 8%, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) considered the monetary benefit as not adequate. Program directors (25; 64% response rate) represented 57% of all USA fellows in training, and 15 (60%) found it difficult to recruit qualified applicants. Of the 183 graduates in the past 10 years, 35 (19%) were reported as not in the USA pediatric nephrology workforce. These findings support our belief that a strong effort needs to be made by the academic community to teach nephrology in more interesting and understandable formats. While these are national samples, we were unable to contact non-nephrology fellows directly and program directors from larger programs were underrepresented. Difficulties in attracting/retaining trainees (particularly women) to nephrology must be addressed systematically, identifying incentives to practice in this field. Bold concerted efforts are required and we propose seven steps to achieve this goal.

Research paper thumbnail of The Need for Enhanced Training in Nephrology Medical Education Research

American Journal of Kidney Diseases, 2015

tion and whether these studies ultimately are published by peerreviewed journals have not been an... more tion and whether these studies ultimately are published by peerreviewed journals have not been analyzed. We reviewed all accepted educational research abstracts from 2008 to 2013 and categorized them as related to 1 of 4 subcategories: medical trainee education (MTE), patient education (PE), social media (SoM), and faculty development (FD). To determine the journal publication rate of these abstracts, we performed a PubMed literature search.

Research paper thumbnail of Partial Closure of Skin Wounds after Kidney Transplantation Decreases the Incidence of Postoperative Wound Infections

International Journal of Angiology, 2012

Wound infections are a major cause of postoperative morbidity in patients undergoing kidney trans... more Wound infections are a major cause of postoperative morbidity in patients undergoing kidney transplantation. These patients can then be at risk for graft loss and mortality as well. 1 Beyond the routine risk of surgical site infections for standard procedures, kidney transplantation bears the added risk caused by its obligate medication regimented immunosuppression. Immunosuppressive agents inhibit the inflammatory cytokines that are responsible for transplant rejection. These cytokines are also responsible for the initial inflammatory phase of wound healing. 2 Furthermore, many patients with end-stage renal disease have concomitant diabetes or obesity which are additional independent risk factors for surgical site infection.

Research paper thumbnail of Acremonium skin and soft tissue infection in a kidney transplant recipient

Transplantation, Feb 27, 2013

Research paper thumbnail of BRAF inhibitors - do we need to worry about kidney injury?

Expert Opinion on Drug Safety, 2016

Research paper thumbnail of Nephrology education for medical students: a narrative review

Renal Failure, 2016

Strategies used to teach nephrology to medical students are not well studied. This study assesses... more Strategies used to teach nephrology to medical students are not well studied. This study assesses the published literature on medical student education in nephrology. A review of the published literature on nephrology education for medical students was conducted on two major online search engines (PubMed and ERIC). In addition, references of the manuscripts discovered in these searches were reviewed. The empirical studies were categorized by subject within nephrology and research design. We found 26 original studies in which a method of teaching nephrology to medical students was described. The studies dated from 1977 to 2015. The focus of these nephrology teaching experiences was as follows: anatomy (6.5%), physiology (22.6%), pathophysiology (29.0%), pathology (6.5%), treatment (25.8%), and general nephrology (9.7%). The studies were also categorized into various types of research design. 6.9% had either no assessment of the educational experience or had a description too vague to categorize it; 3.4% involved a survey about the existing educational approach before a curriculum change was implemented; 55.2% used surveys or tests after an educational course was carried out; 10.3% sought feedback from students before and after the educational experience; 13.8% were case studies; and 10.3% included a randomized controlled trial. The randomized controlled trials involved teaching techniques focused on the pathophysiology of renal disease. Rigor was lacking in most empirical studies on medical student education in nephrology. Well-designed randomized controlled studies are needed to accurately assess the effectiveness of the educational techniques introduced into medical school curricula.

Research paper thumbnail of 302: Hypomagnesemia Causing Rapid New Onset Type II Diabetes Post Transplant (NODAT)

Research paper thumbnail of Bone Parameters and Risk of Hip and Femur Fractures in Patients on Hemodialysis

Clinical journal of the American Society of Nephrology : CJASN, Jan 29, 2016

Patients on hemodialysis have a high rate of hip fractures. In this study, we performed a contemp... more Patients on hemodialysis have a high rate of hip fractures. In this study, we performed a contemporary analysis of mineral and bone parameters and their relationship to hip and femur fracture risk. Patients on hemodialysis treated between 2000 and 2013 in Fresenius Medical Care North America facilities were included. Predictors were on the basis of data as of December 31 of each baseline year and time-averaged values of selected laboratory parameters and medication doses throughout the year. Four period cohorts were constructed from baseline years: 2000, 2003, 2006, and 2009. Follow-up for each cohort was ≤3 years. The incidence of hip and femur fractures remained generally unchanged (P=0.40), except among patients who were white and >65 years of age, in whom the rate decreased significantly over the 14-year period (P<0.01). Results from combined multivariable models indicated that the lowest quartiles of time-averaged intact parathyroid hormone were independently associated w...

Research paper thumbnail of History of nephrology: Ukrainian aspects Reply

Kidney International, 2012

The Authors Reply: We appreciate the interest of Khadzhynov and Peters 1 in our recently publishe... more The Authors Reply: We appreciate the interest of Khadzhynov and Peters 1 in our recently published crossword puzzle on the history of nephrology. We apologize for perpetuating the error you mention, which unfortunately appears in numerous accounts in the medical literature. The medical literature has confusion over the place, date, and the difference between the dates and origins of the surgeon. 3-6

Research paper thumbnail of Crossword: Acute Kidney Injury—Basics

Journal of Clinical Pediatric Nephrology, Dec 31, 2012

Research paper thumbnail of Harvoni (Ledipasvir With Sofosbuvir)-Induced Renal Injury

The American Journal of Gastroenterology, 2016

Research paper thumbnail of Nephrology Crosswords: Diabetic nephropathy

Kidney International, 2015

Research paper thumbnail of Carfilzomib-induced nephrotoxcity

Kidney International, 2015

Research paper thumbnail of Carfilzomib-related acute kidney injury

Clinical Advances in Hematology Oncology H O, Sep 1, 2013

Research paper thumbnail of Onconephrology abstracts and publication trends: time to collaborate

Clinical Kidney Journal, 2015

Onconephrology is an emerging subspecialty of nephrology. The American Society of Nephrology(ASN)... more Onconephrology is an emerging subspecialty of nephrology. The American Society of Nephrology(ASN) created a forum dedicated to the field of onconephrology in 2011 to improve collaborative care for cancer patients with kidney disease. In this article, we review the ASN Kidney Week abstracts that were related to onconephrology. There has been an increase in the number of onconephrology-related abstracts at ASN over last 3 years. But only one-fifth of abstracts that were onconephrology related in ASN were published in peer review journals. Clinical Kidney Journal (CKJ) has seen an increase in onconephrology publications in the last 3 years. Most were case reports or review articles. The more widespread use of the keyword &amp;amp;amp;amp;#39;onconephrology&amp;amp;amp;amp;#39; in all such manuscripts may facilitate the search for onconephrology research papers. To advance the field, CKJ has now created an onconephrology subheading for manuscript categorization. We also propose that conference organizers of ASN and other kidney-related society meeting such as International Society of Nephrology, National Kidney Foundation and European Dialysis and Transplantation Association have a separate onconephrology abstract category. Randomized controlled trials in a subspecialty like onconephrology can only be possible when there is collaboration amongst nephrologists and cancer physicians from cancer centers around the world that interact and share research ideas at international meetings.

Research paper thumbnail of Outcomes following Kidney Transplantation in IgA Nephropathy: A UNOS/OPTN analysis

Clinical Transplantation, 2015

This study updates assessment of post-transplant outcomes in IgAN patients in the modern era of i... more This study updates assessment of post-transplant outcomes in IgAN patients in the modern era of immunosuppression. Using UNOS/OPTN data, patients ≥18 yr of age with first kidney transplant (1/1/1999 to 12/31/2008) were analyzed. Multivariable Cox regression models and propensity score-based matching techniques were used to estimate hazard ratios (HRs) for death-censored allograft survival (DCGS) and patient survival in IgAN compared to non-IgAN. Results of multivariable regression were stratified by donor type (living vs. deceased). A total of 107, 747 recipients were included (4589 with IgAN and 103 158 with non-IgAN). Adjusted HR for DCGS showed no significant difference between IgAN and non-IgAN. IgAN had higher patient survival compared to non-IgAN (HR 0.54, 95% CI 0.47-0.62, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001 for deceased donors; HR 0.42, 95% CI 0.33-0.54, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001 for living donors). Propensity score-matched analysis was similar, with no significant difference in DCGS between matched groups and higher patient survival in IgAN patients compared to non-IgAN group (HR 0.54, 95% CI 0.47, 0.63; p-value &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.0001). IgAN patients with first kidney transplant have superior patient survival and similar graft survival compared to non-IgAN recipients. Results can be used in prognostication and informed decision-making about kidney transplantation in patients with IgAN.

Research paper thumbnail of Nephrotoxicity of the BRAF Inhibitors Vemurafenib and Dabrafenib

JAMA Oncology, 2015

The selective BRAF inhibitors vemurafenib and dabrafenib have shown significant improvement in pa... more The selective BRAF inhibitors vemurafenib and dabrafenib have shown significant improvement in patient survival compared with standard therapy in BRAF V600-mutant metastatic melanoma. We reviewed Food and Drug Administration Adverse Event Reporting System (FAERS) data for both agents for renal toxic effects. From July 2011 through June 2014, 132 cases of acute kidney injury in patients receiving vemurafenib therapy were reported. Renal injury was more common in men (85 men vs 47 women; P &amp;amp;amp;amp;amp;amp;amp;amp;lt; .001). From April 2013 through June 2014, 13 cases of renal injury in patients receiving dabrafenib therapy were reported (12 men and 1 woman). Hypokalemia (6 cases in patients receiving vemurafenib and 2 cases in patients receiving dabrafenib) and hyponatremia (8 and 6 cases, respectively) were also reported. Vemurafenib seems to be more nephrotoxic than dabrafenib. This renal toxicity seems to be more prevalent among male patients with melanoma. On the basis of the few published case reports, the mode of injury seems to be tubular interstitial injury. Our findings suggest a need to monitor renal function and electrolyte levels in all patients who receive these drugs. Dermatologists, oncologists, and nephrologists need to be aware of this potential hazard.

Research paper thumbnail of Nephrology elective experience during medical residency: a national survey of US nephrology fellowship training program directors

Renal Failure, 2015

Interest in nephrology careers continues to decline in the United States. The reasons for this de... more Interest in nephrology careers continues to decline in the United States. The reasons for this declining interest are not fully understood but it is plausible that inadequate exposure to the full spectrum of what a career in nephrology encompasses may be part of the explanation. Inpatient-based nephrology electives have been a common venue for residents to gain exposure to nephrology but little is known regarding the details of such electives and how often they include outpatient experiences. We carried out a national survey of nephrology fellowship training program directors to obtain data on the content of nephrology elective experiences as well as their ideas on how to promote interest in the field. The survey revealed the majority of elective experiences to be either exclusively or heavily inpatient based, with only a small percentage having a substantial outpatient component, particularly in outpatient dialysis or transplantation. Training program directors felt that providing greater outpatient experiences to residents during elective rotations would be an effective means to promote interest in nephrology, along with structured faculty mentoring. Our findings suggest that current approaches to the nephrology elective experience are heavily inpatient-based and might benefit from incorporating much more of the rich spectrum of activities a career in nephrology entails. Hopefully such efforts can create and enhance interest in careers in nephrology and potentially begin a sustained reversal of an unfortunate and serious decline in interest.

Research paper thumbnail of Carfilzomib-related acute kidney injury

Clinical advances in hematology & oncology : H&O, 2013

Research paper thumbnail of NephMadness 2015: Nephrology as a Cornerstone of Medicine

American Journal of Kidney Diseases, 2015

Research paper thumbnail of Wanted: pediatric nephrologists! — why trainees are not choosing pediatric nephrology

Renal Failure, 2014

A workforce crisis for many pediatric specialties, particularly nephrology, is due to growing ret... more A workforce crisis for many pediatric specialties, particularly nephrology, is due to growing retirement rates, attrition during training, and retention difficulties. To obtain specific information regarding pediatric nephrology trainee shortages, we administered two cross-sectional surveys to non-renal pediatric subspecialty fellows and pediatric nephrology program directors. We characterized the fellows&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; experiences with nephrology and the program directors&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; experiences with their fellows as well as their outcomes in the last 10 years. We analyzed responses from 531 non-renal fellows (14.4% response rate). Overall, 317 (60%) fellows rated nephrology as difficult, particularly women (65.4% vs. 49.5%, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), with American women medical graduates rating nephrology as more difficult compared to all others (p = 0.001). More men than women (24% vs. 8%, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) considered the monetary benefit as not adequate. Program directors (25; 64% response rate) represented 57% of all USA fellows in training, and 15 (60%) found it difficult to recruit qualified applicants. Of the 183 graduates in the past 10 years, 35 (19%) were reported as not in the USA pediatric nephrology workforce. These findings support our belief that a strong effort needs to be made by the academic community to teach nephrology in more interesting and understandable formats. While these are national samples, we were unable to contact non-nephrology fellows directly and program directors from larger programs were underrepresented. Difficulties in attracting/retaining trainees (particularly women) to nephrology must be addressed systematically, identifying incentives to practice in this field. Bold concerted efforts are required and we propose seven steps to achieve this goal.

Research paper thumbnail of The Need for Enhanced Training in Nephrology Medical Education Research

American Journal of Kidney Diseases, 2015

tion and whether these studies ultimately are published by peerreviewed journals have not been an... more tion and whether these studies ultimately are published by peerreviewed journals have not been analyzed. We reviewed all accepted educational research abstracts from 2008 to 2013 and categorized them as related to 1 of 4 subcategories: medical trainee education (MTE), patient education (PE), social media (SoM), and faculty development (FD). To determine the journal publication rate of these abstracts, we performed a PubMed literature search.

Research paper thumbnail of Partial Closure of Skin Wounds after Kidney Transplantation Decreases the Incidence of Postoperative Wound Infections

International Journal of Angiology, 2012

Wound infections are a major cause of postoperative morbidity in patients undergoing kidney trans... more Wound infections are a major cause of postoperative morbidity in patients undergoing kidney transplantation. These patients can then be at risk for graft loss and mortality as well. 1 Beyond the routine risk of surgical site infections for standard procedures, kidney transplantation bears the added risk caused by its obligate medication regimented immunosuppression. Immunosuppressive agents inhibit the inflammatory cytokines that are responsible for transplant rejection. These cytokines are also responsible for the initial inflammatory phase of wound healing. 2 Furthermore, many patients with end-stage renal disease have concomitant diabetes or obesity which are additional independent risk factors for surgical site infection.