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The Kidney Health Score: A Practical Guide to Early Detection of Kidney Disease Risk for Optimal Kidney Health.

Nephrol Nurs J

January 2025

Professor of Medicine, Department of Internal Medicine, Division of Nephrology, School of Medicine, Virginia Commonwealth University.

Chronic kidney disease (CKD) affects 10% of the global population, with increasing prevalence driven by diabetes, hypertension, and aging populations. CKD often progresses asymptomatically, frequently undetected until advanced stages, and may require costly treatments, such as dialysis or transplantation. CKD imposes a substantial financial burden on health care systems, with management costs rising sharply as the disease progresses, underscoring the need for early, cost-effective interventions.

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In 2023, a breast cancer risk assessment and a subsequent positive test for the BRCA-2 genetic mutation brought me to the uncomfortable intersection of a longstanding career as an advocate for high-quality medical evidence to support shared patient-provider decision making and a new role as a high-risk patient. My search for studies of available risk-management options revealed that the most commonly recommended approach for women with a ⩾20% lifetime breast cancer risk, intensive screening including annual mammography and/or magnetic resonance imaging beginning at age 25-40 years, was supported only by cancer-detection statistics, with almost no evidence on patient-centered outcomes-mortality, physical and psychological morbidity, or quality of life-compared with standard screening or a surgical alternative, bilateral risk-reducing mastectomy. In this commentary, I explore parallels between the use of the intensive screening protocol and another longstanding women's health recommendation based on limited evidence, the use of hormone therapy (HT) for postmenopausal chronic disease prevention, which was sharply curtailed after the publication of the groundbreaking Women's Health Initiative trial in 2002.

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Background: Results of the National Lung Screening Trial create the potential to reduce lung cancer mortality, but community translation of lung cancer screening (LCS) has been challenging. Subsequent policies have endorsed informed and shared decision-making and using decision support tools to support person-centered choices about screening to facilitate implementation. This study evaluated the feasibility and acceptability of LuCaS CHOICES, a web-based decision aid to support delivery of accurate information, facilitate communication skill development, and clarify personal preferences regarding LCS-a key component of high-quality LCS implementation.

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Retinal artery occlusion (RAO) is a critical ophthalmic emergency with a high risk of significant visual impairment. While traditional treatment aims to promptly restore blood flow to the retina, recent research has investigated the potential benefits of anticoagulation therapy for managing this condition. This paper reviews current literature and clinical trials investigating the efficacy and safety of anticoagulant and antiplatelet therapies, such as systemic heparinization and direct oral anticoagulants and aspirin, in treating RAO.

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Healthcare practitioners must be trained to collaborate in a dynamic environment where patients are complex and teams can change from day-to-day, but choosing the right measures to assess the effectiveness of interprofessional teamwork among learners is challenging. This study used measures representing four different perspectives to assess student teams in a practice setting where team composition varied each day. We tested the strength of the relationships between these measures, and we examined the impact of additional variables on each measure.

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