key Try Dr. Mendelssohn's poll: INITIAL CHOICE OF ESRD THERAPY. This poll, which has no right or wrong answers, is meant to query renal health providers about their approach to patients approaching dialysis, especially in terms of which potential options for therapy are presented to such patients.
Note: Use Internet Explorer only; feedback section does not work with some other browsers.



  New Insights, Treatments, and Management Strategies for ADPKD
Arlene B. Chapman, MD, and James P. Calvet, PhD
(ASN Renal Week Clinical Nephrology Conference, November, 2007.)
Chapman: What was the design of the CRISP study in ADPKD patients? How was progression measured? What factors are known to be associated with progression? How was cyst size measured? How did the investigators get by without gadolinium? What were factors predicting increase in cyst volume? What was found regarding liver cysts? PKD-1 vs. PKD-2? How is the renin-angiontensin system involved in ADPKD? What was the design of the HALT PKD study? What was the rationale for dual blockade? Is concomitant aldosterone blockade indicated? Calvet: What are the strategies to inhibit cyst formation in ADPKD? What are potential methods of inhibiting cell proliferation? Cyst secretion? How are CFTR and NKCC-1 involved? Is cyclic AMP good or bad for PKD? What about bumetanide? How does intracellular calcium act to affect cell proliferation? What are potential implications regarding calcium channel blockers? What are the data about manipulating B-Raf, MEK, and ERK? Note: The other 2 talks from this CNC are avaiable as audiofiles at this link.



Nephrolithiasis: Physicochemical Factors in the Pathogenesis of Urinary Calculi (Worcester); Nephrolithiasis: A Bacterial Disease? Evidence Supporting and Against a Role of Nanobacteria in Calcium Stone Formation (Lieske)

Elaine M. Worcester, MD, FASN; John C. Lieske, MD, FASN
(ASN Renal Week Clinical Nephrology Conference, November, 2007.)
Worcester: What are the conditions for stone formation? How is supersaturation of urine for calcium phosphate and calcium oxalate involved? What is the optimum pH? Is urine alkalinization dangerous? Do meals affect calcification risk? How is calcium apatite plaque involved and which types of stones start in this way? What are present models of hypercalciuria? Is separation into hyperabsorbers and hyperexcretors useful? How can stone formation best be prevented? Lieske: What are nanobacteria? How small are they? What species are they related to? What types of calcification are they possibly linked to in the human body? In what types of biologic specimens can they be found? Is there any way that we can inhibit their growth? Which antibiotics seem to work? What to we know about their DNA? How can they be grown in culture?




Challenges and Opportunities in the Treatment of Hyperuricemia and Gout

Richard Johnson, MD (moderator); Robert Terkeltaub, MD; Michael W. Rich, MD; Daniel Feig, MD, PhD, MS
(ASN Renal Week Official Symposium, 2007).
Terkeltaub: What are the available treatments for gout? What is the mechanism of action of allopurinol? What are the cautions associated with its use? How is febuxostat different and possibly better? How do uricosurics work? Which ones are available? What are the pros and cons of uricases? Rich: Elevated uric acid is associated with poor cardiovascular outcomes. What evidence suggests that this may be causal? What were the findings regarding serum uric acid in the SHEP study? How does uric acid figure in studies of congestive heart failure or coronary artery disease? What do interventional studies using allopurinol tell us? Did the uricosuric effect of losartan affect outcomes in the LIFE study? Feig: What does a rat model of uricase inhibition show in terms of blood pressure and salt sensitivity? What does raising uric acid do to glomerular pathology? What is true of serum uric acid in essential hypertension in adolescents? What happens when you give half of them allopurinol?



The Aging Kidney

Danilo Fliser, MD; George R. Aronoff, MD.
(ASN Renal Week Clinical Nephrology Conference, November, 2007.)
Fliser: How fast does GFR fall as we age? If GFR the best measure of renal function in the elderly? What other changes occur in the kidneys as we age? How is the fall in GFR related to comorbidity? To what extent is cystatin a better measure of GFR in the elderly? Aronoff: How do we approach drug dosing in the elderly? What happens to body composition and how does this affect dose? Is liver metabolism of drugs affected? If so, how? What about pharmacodynamics? What is the Beers list of drugs? Which drugs are best avoided in the elderly? What are practical ways of reducing drug exposure in this population?

Updated: July 09, 2019 (Jul09)
Jul09 Predicing serum K from the EKG trace measured by an Apple watch.
Feb28 Ringer's lactate causes less kidney injury than saline.
Apr18 High salt diet makes subjects drink less and eat more !?
Jul12 Dr. Fred Coe videos on urine calcium supersaturation in stone disease.
May29 Smoking increases risk of CKD progression in African Americans
May24 CRIC study shows a high urinary sodium excretion in CKD linked to higher CV risk.
Mar17 Updated CKD booklet for professionals released
Dec14 Even more news on the new HDCN Facebook page!
Jul31 Paid kidney donation and the Iranian model in the New York Times
May12 Controversy over ACP guidelines for kidney stone management
May08 Putting the brakes on bacterial resistance to antibiotics with targeted antibiotic scheduling.
Nov17 JAMA: New hyperkalemia sorbent effective in reducing hyperkalemia
Jul23 University of Chicago's Dr. Fred Coe's kidney stone website and blog.
Jul14 Bacteria found in healthy bladders differ from those in women with incontinence.
Jul14 Phase 1 trial launched of antibiotic that targets C. difficile.
Industry Advances Emphasis
Care of the Chronic Kidney Disease Patient (Campbell, Berns) ASN Renal Week 2008
Epidemiology of CKD: Who Are the Populations at Risk? (Saran) ASN Renal Week 2008
Prognostic Indicators to Guide Therapy: Options and Utility (Troyanov) ASN Renal Week 2008
CKD in the Elderly: Lessons from NHANES (C. Astor) ASN Renal Week 2008
GFR Estimates in the Elderly: What Do They Mean? (Vanita Jassal) ASN Renal Week 2008
Anatomic-Physiologic Considerations (Breborowicz) ASN Renal Week 2008
End Stage Renal Disease in the Elderly: Does the Type of Dialysis Make a Difference? (G. Oreopoulos) ASN Renal Week 2008
The Aging Pandemic: Demographic Changes of the General Population and ESRD Patients (W. Eggers) ASN Renal Week 2008
Does CKD Management Reduce Cost of Care? (D. Mattern) ASN Renal Week 2008
Renal Senescence: Mechanisms and Implications (F. Halloran) ASN Renal Week 2008
Basic: VEGF and Proteinuria (E. Quaggin) ASN Renal Week 2008
Can We Personalize Therapy for Kidney Disease? (H. Rovin) ASN Renal Week 2008
Glomerular Disease in the Elderly: Should We Be Doing More Renal Biopsies? (B. Appel) ASN Renal Week 2008
Ovarian Failure and Premature Menopause (L. Breen) ASN Renal Week 2008
Mechanisms Underlying Sex Differences in Disease Susceptibility, Severity, and Rate of Progression in Hypertension, Renal, and Vascular Disease (Sandberg) ASN Renal Week 2008
Menopause and the Decline of the Ovary and Hormone Replacement Therapy (Kurella-Tamura) ASN Renal Week 2008
Geriatric Assessment: An Approach to the Geriatric Patient (R. Gambert) ASN Renal Week 2008
Oxidative Stress and Prevention of CKD in Normal Aging Adults (E. Striker) ASN Renal Week 2008
Urinary Infections in the Elderly: When Does It Matter? (E. Nicolle) ASN Renal Week 2008
Pharmacokinetics and the Aging Kidney (M. Bennett) ASN Renal Week 2008
Sexual Dimorphism and the Aging Kidney: Changes in Nitric Oxide Metabolism (Baylis) ASN Renal Week 2008
Pregnancy and Fertility in the Renal Disease Patient (CKD/ESRD) (H. Hou) ASN Renal Week 2008
Urinary Concentration and Dilution in the Aging Kidney (M. Sands) ASN Renal Week 2008
Development and Issues of Adolescence (P. Yao) ASN Renal Week 2008
Podocytes and Glomerular Function in Aging (Wiggins) ASN Renal Week 2008
Obstructive Uropathy Related to Lower Urinary Tract Dysfunction in Geriatric Patients (P. Weiss) ASN Renal Week 2008
Clinical: Treatment of Proteinuria (L. Bakris) ASN Renal Week 2008
The Cost of CKD: Implementation of the UK Guidelines (K.T. Farmer) ASN Renal Week 2008
Shades of Grey: Key Questions in the Future of Treatment for CKD-Related Anemia (Toto, Schmidt) ASN Renal Week 2008
Preserving Residual Renal Function: Does It Matter? (Burrows) ADC 2008
Control the Inflammation? (Mehrotra) ADC 2008
The Elderly with ESRD: The Burden of Disease and the Need for Evidence (Misra) ADC 2008
Treatment Options: One-Year’s Experience with a Large Scale Pre-ESRD Education Initiative (Billadeau) ADC 2008
Metabolic Syndrome and CKD: Extent of the Problem and Correlations (Muntner) ASN Renal Week 2007
How Do PPAR-Gamma Agonists Protect Endothelial Dysfunction in CKD? (M. Mortensen) ASN Renal Week 2007
The Aging Kidney (Fliser, Aronoff) ASN Renal Week 2007
How Do Angiotensin Antagonists Protect Endothelial Function in CKD? (S. Wilcox) ASN Renal Week 2007
ESRD/CKD (Greenberg) ASN Renal Week 2007
Primary Care Issues in Nephrology: Peripheral Vascular Disease: Assessments and Approaches to Care (Froehlich); Rheumatology for Nephrologists (Kay) (Froehlich, Kay) ASN Renal Week 2007
Malignancy: The Current Immunosuppressive Impact (L. Kasiske) ASN Renal Week 2007
Do Calcimimetics Have a Role in Early Stage CKD? (A. Portale) ASN Renal Week 2007
Decreased GFR and Albuminuria: The Individual and Combined Risk with Incident CVD (C. Astor) ASN Renal Week 2007
ADPKD - 1 and 2 (P. Pei) ASN Renal Week 2007
The Impact of Declining GFR on Bone Metabolism (M. Moe) ASN Renal Week 2007
The Molecular Basis of Cystinuria (R. Goodyer) ASN Renal Week 2007
Metformin Revisited: Mechanisms of Endothelial Destruction (J. Mather) ASN Renal Week 2007
Determining GFR in the Clinical Setting: Should We Use Estimating Equations at All? (G. Cosio) ASN Renal Week 2007
ARPKD (M. Guay-Woodford) ASN Renal Week 2007
Shifting from ESRD to CKD: The (R)evolution in Nephrology Practice (R. Nissenson) ASN Renal Week 2007
John P. Peters Award (Remuzzi) ASN Renal Week 2007
New Insights, Treatments, and Management Strategies for ADPKD (Chapman, Calvet) ASN Renal Week 2007
Tuberous Sclerosis and Von Hippel Lindau (J. Bissler) ASN Renal Week 2007
CVD Risk in CKD: Serum Creatinine, Cystatin, and Albuminuria (Coresh) ASN Renal Week 2007
Rheumatology for Nephrologists (Kay) ASN Renal Week 2007
Estimating Equations and Direct Measurements of GFR: Assessing CKD Progression (I. Feldman) ASN Renal Week 2007
Vascular Calcification in Pre-ESRD (B. Langman) ASN Renal Week 2007
Primary Hyperoxaluria (S. Milliner) ASN Renal Week 2007
How Do Statins Protect Endothelial Dysfunction in CKD? (Levi) ASN Renal Week 2007
Vitamin D and Progression of Renal Disease: What are the Mechanisms? (J. Martin) ASN Renal Week 2007
Obesity, Metabolic Syndrome and CKD (J. Kramer) ASN Renal Week 2007
ESRD/CKD (Greenberg) ASN Renal Week 2007
What to Advise Patients and Families with PKD (D. Perrone) ASN Renal Week 2007
Physicochemical Factors in the Pathogenesis of Urinary Calculi (Worcester); Nephrolithiasis: A Bacterial Disease? Evidence Supporting and Against a Role of Nanobacteria in Calcium Stone Formation (Lieske) (Worcester, Lieske) ASN Renal Week 2007
Endothelial Dysfunction in CKD and Proteinuria (R. Sowers) ASN Renal Week 2007
Challenges and Opportunities in the Treatment of Hyperuricemia and Gout (Rich, Feig) ASN Renal Week 2007
Critical Review: Statins and CKD (F. Fried) ASN Renal Week 2007
The Cystic Diseases (Bennett) ASN Board Review 2007
Liver Disease, How It Impacts the Kidney (Isom) ADC 2007
Secondary Hypertension, including Chronic Kidney Disease ASN Board Review 2006
Pathogenesis and Management of Cardiovascular Disease (CVD) in Chronic Kidney Disease ASN Renal Week 2006
Anemia Management in CKD: Improving Iron Management (Reed, Copeland) ANNA 2006
CKD Outcomes (Somermeyer) RPA 2006, General Session 4
Implementation of the RPA CKD Toolkit and its Potential Impact on P4R and P4P (Haley) RPA 2006, General Session 1
CKD Management: What Can We Learn from South African and Australasian Efforts? (Katz) RRI 2006, Part 3 (handouts)
The Pathophysiology of Progressive Renal Disease and Hypertension: Importance of Gender and Ethnicity (August, Maric, Thomas, Lewis) ASN Renal Week 2005 (audiofiles)
Evidence for a New Treatment Paradigm in the Management of Secondary Hyperparathyroidism in CKD Stages 3 and 4 (Andress, Coyne) ASN Renal Week 2005 (audiofiles)
Redefining Outcomes in CKD (London, Block) ASN Renal Week 2005 (audiofiles)
Developing Therapeutics for Progressive Renal Disease (Martin, Mauer, Klein, Throckmorton, Hostetter, Kopp) ASN Renal Week 2005 (audiofiles)
Emerging New Agents in Diabetic Kidney Disease (Lewis) ASN 2005 Renal Week
Medical Crossfire: An Expert Panel Debates Key Clinical Issues in Mineral Metabolism and Mortality in CKD (Coyne, Moe, Martin) ASN Renal Week 2005
RPA’s Advanced CKD Patient Management Tool Kit: How to improve care (Goldman) RPA 2005
Information Systems to Monitor CKD Patient Management (Fadem) RPA 2005
Complications of Anemia and the CKD Patient (Petroff) ANNA 2005
Caring Through the End: Palliative Care Along the Continuum of CKD. (Various) MARC 2004

The Management of Older Adults With a Low eGFR: Moving Toward an Individualized Approach Am J Kidney Dis (Jun 2009)
Definition and Classification of CKD: The Debate Should Be About Patient Prognosis—A Position Statement From KDOQI and KDIGO Am J Kidney Dis (Jun 09)
Prediction, Progression, and Outcomes of Chronic Kidney Disease in Older Adults (Workshop Summary) JASN (Jun 2009)
Primum non nocere: is chronic kidney disease staging appropriate in living kidney transplant donors? Am J Transplant (Apr 2009)
The genetic basis of kidney disease risk in African Americans: MYH9 as a new candidate gene Am J Kidney Dis (Apr 2009)
Skin problems in chronic kidney disease Nature Clin Pract Nephrol (Mar 2009)
Aldosterone antagonists for preventing the progression of chronic kidney disease: a systematic review and meta-analysis Clin J Am Soc Nephrol (Mar 2009)
Is angiotensin-converting enzyme inhibitor and angiotensin receptor blocker combination therapy better than monotherapy and safe in patients with CKD? Am J Kidney Dis (Feb 2009)
A randomized, double-blind, placebo-controlled study to assess the efficacy and safety of cinacalcet HCl in participants with CKD not receiving dialysis Am J Kidney Dis (Feb 2009)
Effect of a very low-protein diet on outcomes: long-term follow-up of the Modification of Diet in Renal Disease (MDRD) Study Am J Kidney Dis (Feb 2009)
Pregnancy and the kidney J Am Soc Nephrol (Jan 2009)
Chronic kidney disease at high altitude J Am Soc Nephrol (Dec 2008)
Dual inhibition with losartan and aliskiren: a promising therapeutic option for type 2 diabetic nephropathy? Nature Clin Pract Nephrol (Dec 2008)
Is bowel preparation before colonoscopy a risky business for the kidney? Nature Clin Pract Nephrol (Nov 2008)
Are oral sodium phosphate products for bowel cleansing safe for the general population? Am J Med (Nov 2008)
Acid-base disturbances in gastrointestinal disease Clin J Am Soc Nephrol (Nov 2008)
Managing cancer risk and decision making after kidney transplantation Am J Transplant (Nov 2008)
Adverse effects of gadolinium administration in hemodialysis patients: a role for chromium supplementation? Am J Kidney Dis (Nov 2008)
The impact of automated eGFR reporting and education on nephrology service referrals Nephrol Dial Transplant (Nov 2008)
Reporting estimated GFR: A laboratory perspective Am J Kidney Dis (Oct 2008)
Passive smoking and risk of peripheral arterial disease and ischemic stroke in chinese women who never smoked Circulation (Oct 2008)
Coming clean: waterless hand cleaners -- which to choose? Am J Med (Oct 2008)
Balkan Nephropathy: Evolution of Our Knowledge (Bamias and Boletis) Am J Kidney Dis (Sep 2008)
Remission of aseptic inflammatory ascites after nephrectomy of a failed allograft Am J Kidney Dis (Sep 2008)
Adverse renal and metabolic effects associated with oral sodium phosphate bowel preparation Clin J Am Soc Nephrol (Sep 2008)
Balkan nephropathy: evolution of our knowledge Am J Kidney Dis (Sep 2008)
Routine reporting of estimated glomerular filtration rate: not ready for prime time (Glassock and Winearls) Nature Clin Pract Nephrol (Aug 2008)
Routine reporting of estimated glomerular filtration rate: not ready for prime time Nature Clin Pract Nephrol (Aug 2008)
Screening for prostate cancer: U.S. Preventive Services Task ForceRecommendation Statement Ann Intern Med (Aug 2008)
The aggravating mechanisms of aldosterone on kidney fibrosis J Am Soc Nephrol (Aug 2008)
Oral estrogen therapy in postmenopausal women is associated with loss of kidney function Kidney Int (Aug 2008)
Treating elderly people with diabetes and stages 3 and 4 chronic kidney disease Clin J Am Soc Nephrol (Jul 2008)
Formula-Based Estimates of the GFR: Equations Variable and Uncertain (Delanaye and Cohen) Nephron-Clin-Practice (Jul 2008)
Dyslipidemia in CKD: An approach to pathogenesis and treatment. (Tsimihodimos) (Am J Nephrol Jul 2008)
Treating elderly people with diabetes and stages 3 and 4 chronic kidney disease CJASN (Jul 2008)
Emergence of the concept of acute kidney injury Adv Chronic Kidney Dis (Jul 2008)
Reimbursement and economic factors influencing dialysis modality choice around the world Nephrol Dial Transplant (Jul 2008)
Oxalate in renal stone disease: the terminal metabolite that just won't go away Nature Clin Pract Nephrol (Jul 2008)
Lipid abnormalities and cardiovascular risk in renal disease J Am Soc Nephrol (Jun 2008)
Urinalysis: core curriculum 2008 Am J Kidney Dis (Jun 2008)
Should patients with venous thromboembolism be screened for thrombophilia? Am J Med (Jun 2008)
Role of remission clinics in the longitudinal treatment of CKD J Am Soc Nephrol (Jun 2008)
Adynamic bone in patients with chronic kidney disease Kidney Int (Jun 2008)
Staging of chronic kidney disease: time for a course correction J Am Soc Nephrol (May 2008)
Efficacy and safety of fondaparinux and enoxaparin for acute coronary syndromes in CKD Am J Kidney Dis (May 2008)
Atherosclerotic renal artery stenosis: overtreated but underrated? J Am Soc Nephrol (Apr 2008)
Targeting proteinuria as a valid surrogate for individualized kidney protective therapy Am J Kidney Dis (May 2008)
Nephrogenic systemic fibrosis: early recognition and treatment Semin Dial (Apr 2008)
The utility of the transtubular potassium gradient in the evaluation of hyperkalemia J Am Soc Nephrol (Mar 2008)
The Janus faces of allopurinol -- allopurinol hypersensitivity syndrome Am J Med (Mar 2008)
Systematic Review: Randomized, controlled trials of nonsurgical treatments for urinary incontinence in women Ann Intern Med (Mar 2008)
Supratherapeutic doses of angiotensin receptor blockers to decrease proteinuria in patients with chronic kidney disease Am J Nephrol (Mar 2008)
National Institutes of Health State-of-the-Science Conference Statement: Prevention of fecal and urinary incontinence in adults Ann Intern Med (Mar 2008)
Protein restriction and body composition in renal disease J Ren Nutr (Mar 2008)
Rationale for combination angiotensin receptor blocker and angiotensin-converting enzyme inhibitor treatment and end-organ protection in patients with chronic kidney disease Am J Nephrol (Mar 2008)
Soft drinks, fructose consumption, and the risk of gout in men: prospective cohort study Brit Med J (Feb 2008)
Low birth weight is associated with chronic kidney disease only in men Kidney Int (Feb 2008)
Primary care-based disease management of chronic kidney disease (CKD), based on estimated glomerular filtration rate (eGFR) reporting, improves patient outcomes Nephrol Dial Transplant (Feb 2008)
Beta-blockade in chronic dialysis patients Semin Dial (Feb 2008)
Association between obesity and kidney disease: A systematic review and meta-analysis Kidney Int (Jan 2008)
Dermatological disease in patients with CKD Am J Kidney Dis (Feb 2008)
Renal and cardiac effects of antihypertensive treatment with ramipril vs metoprolol in autosomal dominant polycystic kidney disease Nephrol Dial Transplant (Feb 2008)
The impact of population-based identification of chronic kidney disease using estimated glomerular filtration rate (eGFR) reporting Nephrol Dial Transplant (Feb 2008)
Mechanisms of vascular calcification in chronic kidney disease J Am Soc Nephrol (Feb 2008)
Poor correlation between coronary artery calcification and obstructive coronary artery disease in an end-stage renal disease patient Hemodial Int (Jan 2008)
Meta-analysis: Effect of monotherapy and combination therapy with inhibitors of the renin-angiotensin system on proteinuria in renal disease Ann Intern Med (Jan 2008)
Outcomes in patients with chronic kidney disease referred late to nephrologists: a meta-analysis (Chan et al) Am J Med (Dec 2007)
Treatment of microalbuminuria in hypertensive subjects with elevated cardiovascular risk: Results of the IMPROVE trial (Bakris et al) Kidney Int (Oct 2007)
Twenty years of PSA: From prostate antigen to tumor marker (De Angelis et al) Rev Urol (Sep 2007)
Association of antihypertensive therapy and diastolic hypotension in chronic kidney disease (Peralta et al) Hypertens (Sep 2007)
Antibiotic treatment for pyelonephritis in children: multicentre randomised controlled non-inferiority trial (Montini et al) Brit Med J (Aug 2007)
The role of magnesium binders in chronic kidney disease (Spiegel) Semin Dial (Aug 2007)
Methodology of screening for albuminuria (Gansevoort et al) Nephrol Dial Transplant (Aug 2007)
Gadolinium-induced nephrogenic systemic fibrosis in patients with kidney disease (Perazella et al) Am J Med (Jul 2007)
Early Start Peritoneal Dialysis Adv Chronic Kidney Dis (Jul 07)
Intensive versus moderate blood-pressure control in normotensive patients with type 2 diabetes (Briggs J) NCPN Jun 07
Kidney disease, Framingham risk scores, and cardiac and mortality outcomes (Weiner et al) Am J Med (Jun 2007)
Gadolinium use in patients with kidney disease: A cause for concern (Perazella et al) Semin Dial (Jun 2007)
Proteinuria as a therapeutic target in patients with chronic kidney disease (Palmer) Am J Nephrol (May 2007)
Autosomal dominant polycystic kidney disease: time for a change? (Chapman) J Am Soc Nephrol (May 2007)
The ESRD uninsured matter (Williams) Adv CKD (02-2007)
KDOQI Clinical Practice Guidelines and CPRs (2006 update) for Treatment of Diabetes and CKD AJKD (Feb 07)
Prevalence of abnormal serum vitamin D, PTH, calcium, and phosphorus in patients with chronic kidney disease: Results of the study to evaluate early kidney disease. (A. Levin et al) Kidney Int 01-07
Core Curriculum: Chronic Kidney Disease (Lederer, Ouseph) Am-J-Kidney-Dis 01-2007
Aldosterone and Cardiovascular Disease. Smoke and Fire (Calhoun). Circulation 12-06
Obesity: Growing Impact on CKD (McGill, Furth, Kaskel) Adv Chronic Kidney Dis 10-06
Management of dyslipidemias in patients with diabetes and chronic kidney disease (Molitch). CJASN 09-06
When to initiate dialysis (1-2) CKD-Diabetes, 2006
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David Mendelssohn, M.D.
Head, Division of Nephrology; Medical Director of Dialysis, Humber River Regional Hospital; Associate Professor of Medicine University of Toronto, CANADA.