DR. ROBERT NEE, M.D.

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This study is looking at how gamification—using game-like features—can enhance rehabilitation mobile apps used in physical therapy. Researchers found over 2,148 publications on this topic and will analyze them to see how these apps help patients with various physical therapy needs. The goal is to find out which game elements work best for keeping patients engaged and improving their recovery outcomes, helping therapists make better decisions for remote care. Who this helps: This helps patients undergoing rehabilitation and their therapists.

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This study created and tested a new exam to help train nephrology fellows (doctors specializing in kidney care) on home hemodialysis (HHD), a treatment that allows patients to do dialysis at home. Out of 38 fellows who took the exam, 71% passed, with an average score of 21.5 out of 31 points, which was lower than the expert validators' average score of 27.5. The results highlight a gap in practice and knowledge since many fellows answered fewer questions correctly than experienced professionals, showing a need for better training in HHD. Who this helps: This benefits nephrology fellows, improving their training and ensuring better care for patients needing home-based dialysis.

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This research focused on kidney disease in the United States, using data from a comprehensive system that tracks the condition over time. It found that about 13-14% of U.S. adults have chronic kidney disease (CKD), with rates higher among older, non-Hispanic Black individuals, and those with diabetes or high blood pressure. Awareness of CKD has increased from under 10% to around 25% since 2013, while the incidence of acute kidney injury (AKI) among veterans rose significantly from 2008 to 2022, indicating a need for better management and awareness of kidney health. Who this helps: This research benefits patients with kidney disease and healthcare providers by highlighting the importance of tracking and improving kidney health.

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This study examined why Black adults in the U.S. are more likely to develop kidney failure compared to White adults. Researchers found that Black veterans had a 2.5 times higher rate of kidney failure than their White counterparts, mainly because they tend to develop chronic kidney disease (CKD) at a younger age and have a lower chance of dying from other causes before reaching kidney failure. Addressing the early onset of CKD in younger Black adults is crucial to reducing this disparity. Who this helps: This benefits patients, particularly younger Black adults with chronic kidney disease.

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The study looked at how surgery impacts kidney health in young adults with a condition called congenital ureteropelvic junction obstruction (UPJO). Among 108 patients followed for about 7 years, surgery did not significantly change overall kidney function or high blood pressure rates, but it did improve kidney drainage in many patients, with 54% showing delayed excretion before surgery compared to only 35% after. This matters because while general kidney health remained stable, surgical treatment can help with specific kidney function improvements. Who this helps: This helps young adults with UPJO and their doctors in making informed treatment decisions.

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This study looked at how removing race as a factor in kidney function calculations affects the recognition of chronic kidney disease (CKD) among adults in the US Military Health System. The results showed that using the new method led to a 58.1% increase in the number of Black adults identified as having advanced CKD (from 4,147 to 6,556), while the number of non-Black adults recognized with advanced CKD dropped by 30.4% (from 27,596 to 19,213). This change is important because it may influence how patients are diagnosed and treated for kidney disease, impacting health outcomes. Who this helps: This helps patients, particularly Black adults at risk for advanced kidney disease, and healthcare providers in the military system.

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This study looked at how homelessness affects the health of veterans with chronic kidney disease (CKD), particularly their risk of developing end-stage kidney disease (ESKD) and death. Among over 836,000 veterans, 3.1% developed ESKD and 43% died during the study. Veterans with a history of homelessness were found to have a 15% higher risk of developing ESKD and a 48% higher chance of dying compared to those without a history of homelessness. This highlights the critical impact of stable housing on health outcomes. Who this helps: This helps veterans and healthcare providers understand the importance of housing stability in managing chronic health issues.

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This study looked at how to make climate resilience planning fairer by involving community members, especially in smaller cities and rural areas. Researchers found that people discussed both environmental and social issues, recognizing the challenges related to social inequality and trauma. The findings highlight the need for dedicated resources to keep communities engaged in these important conversations and create effective resilience plans. Who this helps: This research benefits community members and local planners working on climate resilience.

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This study looked at kidney diseases in active military members who underwent a procedure called a kidney biopsy from 2005 to 2020. Out of 169 patients, 11% developed end-stage kidney disease, with 87% of those needing a kidney transplant, and 5% died during the follow-up period of about 7 years. This is significant because it shows that even young service members can face serious kidney health issues that can end their military careers. Who this helps: This research benefits patients and military doctors by providing important insights into kidney disease outcomes in active duty service members.

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This study looked at the risk of a serious kidney problem called scleroderma renal crisis (SRC) in patients diagnosed with systemic sclerosis (SSc), focusing on the differences between Black and non-Black patients. Researchers found that 16.5% of Black patients developed SRC compared to only 7.4% of non-Black patients, making Black patients 6.4 times more likely to have this issue. This is important because it highlights a significant racial disparity in health outcomes for patients with SSc, suggesting that Black patients may need more monitoring and preventive care. Who this helps: This helps patients with systemic sclerosis, particularly those who are Black, by raising awareness of their increased risk for kidney complications.

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This study looked at new medical treatments for people with chronic kidney disease (CKD) and type 2 diabetes. Researchers found that, although new drugs can significantly improve heart and kidney health and help patients live longer, they aren't being widely used, often due to barriers like a lack of awareness and education about CKD. To improve the situation, the study recommends better education for both patients and doctors, using technology to support decision-making, and engaging in collaborative care. Who this helps: This benefits patients with chronic kidney disease and their healthcare providers.

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This study looked at how point-of-care ultrasound (POCUS) is being used in nephrology, which is the field that deals with kidney health. The researchers found that only 46% of program directors offered training in POCUS, and many fellows felt they weren't adequately trained in using ultrasound for kidney assessments. Significant barriers to effective training included a lack of qualified instructors and the high cost of equipment, which means that many healthcare professionals aren't confident using POCUS even though the majority agree it should be part of their training. Who this helps: This helps nephrology fellows and their patients by improving the training that leads to better kidney care.

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This study looked at how anemia affects the risk of dementia in veterans with chronic kidney disease (CKD). Researchers found that among over 620,000 veterans, those with mild anemia had a 16% higher chance of developing dementia, while those with moderate to severe anemia had a 27% higher risk. Additionally, veterans with mild anemia were 39% more likely to experience kidney failure or death, and those with moderate/severe anemia faced a 115% higher risk. Who this helps: This research benefits veterans with CKD, their doctors, and caregivers by highlighting the importance of monitoring and managing anemia to potentially reduce dementia risk.

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This study looks at how social factors, like income and access to healthcare, affect the risk and severity of diabetic kidney disease (DKD) among different racial and ethnic groups. It highlights that people facing structural racism often struggle more with DKD, leading to worse health outcomes. The research suggests that by addressing these social inequities through community support and health system changes, we can improve health for everyone. Who this helps: This helps patients with diabetic kidney disease and their healthcare providers by promoting fair access to treatment.

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The study looked at how common chronic kidney disease (CKD) is within the US Military Health System between 2006 and 2015. They found that 2.9% of the population had CKD, but that number rose to 4.9% when adjusting for age. Certain factors increased CKD risk, such as being over 40 years old (63% more likely) and being Black (16% more likely), while being a woman and actively serving in the military lowered the risk. Who this helps: This research benefits patients in the military health system, especially those at higher risk for CKD.

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This study looked at how having multiple health problems affects the risk of death in US veterans who recently developed chronic kidney disease (CKD). It followed 892,005 veterans for an average of 4.5 years and found that younger veterans (ages 18-44) with five or more additional health issues had over seven times the risk of dying compared to those with none or only one. Older veterans (ages 85-100) also had a higher risk of death with multiple health problems, but it was not as extreme, being more than twice the risk. This is significant because it highlights that younger veterans with CKD and additional health conditions, especially heart disease, are at a much greater risk of dying prematurely. Who this helps: This helps patients, especially younger veterans with multiple health conditions.

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This study looked at a kidney disease called Focal Segmental Glomerulosclerosis (FSGS) and identified risk factors for serious kidney failure (end-stage kidney disease, or ESKD) in a diverse group of 338 adults. Researchers found that high levels of protein in urine, low kidney function, and specific kidney damage at diagnosis were linked to a higher risk of long-term kidney problems. While a type of treatment called immunosuppression did not seem to help everyone, it showed better effects on kidney health specifically in patients with both high protein levels in their urine and low albumin levels. Who this helps: This helps patients with FSGS, especially those experiencing symptoms of nephrotic syndrome.

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Researchers studied the health effects of cocooning—staying home and limiting social contact—on older adults during the COVID-19 pandemic. They found that nearly 40% of the 150 participants reported worsening mental health, over 40% experienced a decline in physical health, and more than half felt lonely. This is important because it highlights the negative impact of isolation on older adults, emphasizing the need for better support and resources to help them stay active and connected. Who this helps: This information benefits older patients and healthcare providers seeking to improve their well-being.

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Researchers studied how well nephrology fellows communicate difficult news about kidney treatments and biopsies to patients. They found that, overall, fellows scored high on their communication skills, but only 17% struggled in the kidney failure scenario, while more had difficulties with acute kidney injury (37%) and kidney biopsy scenarios (53%). This means that while fellows are generally good at these conversations, there is room for improvement in specific areas, which could lead to better patient experiences. Who this helps: This helps patients facing kidney treatments and their families.

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This study looked at end-stage kidney disease (ESKD) around the world, focusing on how many people have the disease and how many are getting treatment, such as dialysis. It found that while the number of people getting treatment has grown globally, especially in wealthier areas, many people in lower-income countries still lack access to necessary care, with treatment access being three times lower than the demand. In the U.S., about 41% of patients on treatment survive for five years, compared to 60% in Japan, highlighting significant differences in health care systems. Who this helps: This information helps patients suffering from kidney disease, especially in low- and middle-income countries, by showing the urgent need for better access to life-saving treatments.

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This research looked at how well nephrology fellows can manage bacterial infections related to peritoneal dialysis, which is an important skill as more people are treated at home. The study involved a practical exam where 87 fellows were tested, and only 67% passed, scoring significantly lower than experienced doctors, who had an average score of 19 compared to the fellows' average of 17. This matters because it shows that many training nephrologists may not be fully prepared to handle complications from peritoneal dialysis, which could impact patient care. Who this helps: This helps nephrology fellows and their instructors by identifying areas where training can improve.

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This study looked at kidney transplant patients with end-stage kidney disease caused by a condition called atypical hemolytic uremic syndrome (aHUS) to see if an early use of a drug called eculizumab would help them keep their new kidneys. Out of 335 patients studied, those who received eculizumab were significantly less likely to lose their kidney transplant—0% experienced graft loss compared to 20% who did not receive the drug. This is important because preventing kidney loss is crucial for patient health and can lead to better long-term outcomes. Who this helps: Kidney transplant patients with atypical hemolytic uremic syndrome.

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This study looked at death rates among patients on dialysis in U.S. territories compared to those in the 50 states, focusing on different racial and ethnic groups. It found that white patients in the territories had a lower death rate (14 deaths per 100 patient-years) than those in the states (29), but Hispanic patients in the territories had a higher death rate (27) than those in the states (16). Hispanic patients had a 65% higher risk of death, and Asian patients had double the risk (HR of 2.01), while death rates for white and black patients were similar across both groups. Who this helps: This research benefits patients on dialysis, particularly Hispanics and Asians living in U.S. territories.

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This study looked at how aliskiren, a medication that inhibits a specific kidney function, works for a 20-year-old man suffering from atypical hemolytic uremic syndrome (aHUS) and severe high blood pressure that didn't respond to regular treatments. The researchers found that increasing the dose of aliskiren helped lower blood pressure, increased platelet counts, and reduced the need for another medication to boost red blood cell production. This is important because it shows that aliskiren could be a useful addition to treatment for patients with difficult-to-manage high blood pressure related to aHUS. Who this helps: Patients with atypical hemolytic uremic syndrome and resistant hypertension.

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This study looked at whether the movement of the middle part of the foot affects the success of two treatments—foot orthotics (shoe inserts) and hip exercises—in managing knee pain caused by patellofemoral pain syndrome. Researchers found that after 12 weeks, the success rates for both treatments were similar: 48% of patients using foot orthotics felt better compared to 50% of those doing hip exercises, and foot mobility didn’t play a role in how well either treatment worked. This is important because it means doctors can choose either treatment without worrying about the patient's midfoot mobility. Who this helps: This helps patients dealing with knee pain and their doctors by providing flexible treatment options.

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This study looked at how electronic medical records (EMRs) affect the training of nephrology fellows in the United States. Researchers surveyed nephrology program directors, faculty, and fellows, finding that while 51% of fellows felt EMRs helped their education, over 40% reported issues like slow system performance and excessive documentation demands. These problems led many fellows to spend more time on paperwork, which interfered with learning opportunities, with 65% saying they often worked more hours than allowed due to these demands. Who this helps: This benefits nephrology fellows and their educators.

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This study looked at how biotin, a common vitamin supplement, affects hormone tests in a woman with severe kidney disease who was undergoing regular dialysis. While she was taking 10 mg of biotin daily, her vitamin D levels shot up from 25 to over 100 ng/mL, and her parathyroid hormone levels dropped from 966 to 63 pg/mL. Once she stopped taking biotin, her hormone levels returned to normal, showing that biotin can cause misleading test results in patients with kidney disease, potentially leading to inappropriate treatment decisions. Who this helps: This research helps doctors treating patients with kidney disease.

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This study looked at whether certain liver enzymes in the blood could help doctors predict problems with kidney transplants before they need to do a more invasive biopsy. Researchers tested blood samples from four groups: kidney transplant patients with issues, those doing well, patients with chronic kidney disease, and healthy individuals. They found that the enzyme alkaline phosphatase (ALP) was linked to kidney transplant health, with higher levels suggesting a higher risk of transplant rejection. This means measuring ALP could help doctors catch kidney transplant problems earlier, potentially improving patient outcomes. Who this helps: This helps kidney transplant patients and their doctors.

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Researchers studied patients with systemic sclerosis (SSc) to identify risk factors that might lead to a serious complication called scleroderma renal crisis (SRC). They found that certain conditions, such as high protein levels in urine (proteinuria), anemia, high blood pressure, and chronic kidney disease, significantly increase the likelihood of developing SRC. For example, having proteinuria at diagnosis raised the risk of future SRC by 183 times compared to those without it. Who this helps: This information helps doctors identify and closely monitor SSc patients who are at a higher risk for kidney issues, allowing for earlier interventions.

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This study looked at how doctors are trained to place temporary hemodialysis catheters, which are used in emergency situations. The researchers found that while 93% of nephrologists felt adequately trained, only 58% actually place these catheters and many refer patients to others for the procedure. Importantly, 92% agreed that knowing how to do this is crucial, but time constraints were a major hurdle for both training and performing the procedure. Who this helps: This benefits patients who may require emergency dialysis, as well as doctors needing to ensure they have the necessary skills.

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This research paper looks at dual kidney transplantation (DKT), which involves using kidneys from two donors instead of one to help more people receive kidney transplants. The findings indicate that DKT has similar success rates in terms of how long the transplanted kidneys last compared to single kidney transplants, with comparable outcomes for patients. This is important because it shows that DKT can be a successful way to increase the number of available kidneys for transplant without compromising patient safety. Who this helps: This helps patients in need of kidney transplants.

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This study looked at how race, ethnicity, and poverty levels affect the survival of nursing home residents on dialysis for kidney failure. Researchers analyzed data from over 56,000 residents and found that Black and Hispanic patients had lower death rates compared to their non-Black counterparts. Specifically, those who were eligible for both Medicare and Medicaid had a 20% lower risk of death, while residents in poorer neighborhoods faced a higher risk of death. Who this helps: This information helps healthcare providers and policymakers understand the factors that influence survival, potentially improving care for nursing home residents on dialysis.

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This study looked at the use of a heart procedure called percutaneous coronary intervention (PCI) in black and white patients with end-stage kidney disease who are on dialysis. Researchers found that white patients received PCI at a rate of 25.8 per 1,000 patient-years, while black patients had a lower rate of 15.5 per 1,000 patient-years. Even after considering various factors, it was determined that black patients were about 36% less likely to receive PCI than white patients, highlighting an ongoing racial disparity in access to this medical treatment. Who this helps: This information helps patients, healthcare providers, and policymakers address inequities in medical treatment access.

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This study looked at how certain medications for systemic sclerosis (a serious autoimmune disease) might affect the risk of developing a severe kidney condition called scleroderma renal crisis (SRC). The researchers found that using ACE inhibitors (ACEi) significantly increased the risk of SRC, with those taking higher doses being particularly at risk; specifically, the odds of developing SRC were more than four times greater for patients on ACEi compared to those who weren't. This matters because it highlights the need for careful monitoring of systemic sclerosis patients who are prescribed ACE inhibitors. Who this helps: This can help doctors better manage treatment for patients with systemic sclerosis.

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This study focused on evaluating the abilities of nephrology fellows in prescribing emergency kidney treatments, which are essential skills for kidney doctors. Out of 117 fellows tested, only 32% passed the overall assessment, with only 6% succeeding in the most difficult scenario related to severe potassium levels. These results highlight a significant need for improved training in this area, as proper understanding and application of kidney treatment protocols are crucial for patient care. Who this helps: This helps nephrology fellows and ultimately improves patient care for those needing kidney treatments.

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This study focused on creating and testing a new exam to evaluate how well nephrology fellows (doctors in training to specialize in kidney care) can order dialysis treatments. The test included three real-life scenarios related to dialysis and had a maximum score of 58 points, with a passing score set at 46. When initially tested on 25 fellows, only 36% passed, and they scored lower than a group of experienced doctors, indicating a need for better training in this area. Who this helps: This helps nephrology fellows and ultimately improves patient care by ensuring that doctors are well-prepared to handle dialysis treatments.

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This study looked at how kidney biopsies are performed and taught in the U.S. It found that many practicing nephrologists are doing fewer biopsies, with only 35% continuing to perform them regularly. Additionally, 51% of nephrology program directors believe that doctors in training should not be required to show they can do these procedures, even though most agree they should understand when to use them and the associated risks. Who this helps: This helps nephrologists and medical trainees who are involved in kidney care.

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This study looked at the survival rates of people who donated a kidney and later developed end-stage renal disease (ESRD) compared to similar patients who did not donate. The researchers found that living kidney donors on dialysis had a much lower mortality rate of 19%, compared to 49% for non-donors. This matters because it shows that kidney donors can expect better outcomes if they ever need dialysis, which should help doctors provide better advice to potential donors. Who this helps: Patients considering kidney donation.

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This study looked at what happens to patients who lose their kidney transplant and have to go back on dialysis. Researchers found that 5,077 patients who returned to dialysis had a higher chance of dying if they didn't have a certain type of access for dialysis, had low protein levels, or were underweight. Specifically, those without an arteriovenous fistula had a 22% higher risk of dying, and those with low albumin levels had a 33% higher risk. These findings highlight the importance of proper preparation and management for patients transitioning back to dialysis after kidney transplant failure. Who this helps: Patients who are returning to dialysis after losing a kidney transplant.

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This study is looking at two treatments for knee pain called patellofemoral pain (PFP): foot orthoses (arch supports) and hip exercises. Researchers will test which treatment works better by comparing the two in 220 participants aged 18-40 and checking if those with more flexible midfoot widths (11 mm or more difference between standing and sitting) benefit more from foot orthoses. The goal is to help doctors decide on the best treatment for patients based on their specific foot characteristics. Who this helps: This helps patients suffering from patellofemoral pain.

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This study looked at patients with end-stage kidney disease (ESRD) caused by diabetic nephropathy (DN) to see how often this diagnosis was accurate. Out of 299 patients, 18.7% had ESRD linked to Type 2 diabetes, but 21.4% of those diagnosed did not meet the established criteria for DN, meaning their diagnosis might have been wrong. This matters because if many patients are misclassified, it could change our understanding of how diabetes affects kidney disease in the U.S. Who this helps: This helps patients and doctors by providing clearer guidelines for diagnosing kidney disease caused by diabetes.

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This study looked at patients with severe kidney disease who needed dialysis, comparing those in the US Military Health System (MHS) to those outside it. Researchers found that MHS patients were significantly more likely to receive specialized kidney care before starting dialysis and had better access to types of blood vessels for treatment. As a result, these patients had lower death rates within the first year of treatment—about 30% less likely to die in the first six months compared to non-MHS patients—making their outcomes noticeably better. Who this helps: This benefits patients with end-stage renal disease, especially those in the Military Health System.

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This study looked at how poverty and race affect the care of patients with kidney issues before they reach the need for dialysis, which is called end-stage renal disease (ESRD). Researchers found that only 61% of patients in the poorest areas received the necessary kidney specialist care before starting dialysis, compared to nearly 68% in wealthier areas. It also showed that African American and Hispanic patients were less likely to receive this care, with odds ratios of 0.85 and 0.72, respectively. This matters because better access to care could lead to healthier outcomes for kidney patients and potentially save lives. Who this helps: This helps patients, especially those from low-income and minority backgrounds.