Clinical Topics


Nephrology

VA Study Resolves Debate Over Renal Protective Agents Used in Angiography

Is it better to use sodium bicarbonate or -N-acetylcysteine to prevent acute kidney failure related to common angiography procedures?

Nephrology

Inferior VA End-of-Life Care Reported for Some Noncancer Conditions

Although most patients in the United States die of another condition, cancer is the focus of most end-of-life care studies.

Nephrology

How Obesity Affects Kidney Function, Mortality in Veterans

MEMPHIS, TN — A new study investigated the association of body mass index with progressive loss of kidney function and all-cause mortality in U.S. veterans, finding that those who were overweight but not obese had... View Article

Nephrology

Dialysis Timing Tends to Be Different for VA Patients

SEATTLE — The estimated glomerular filtration rate (eGFR) tends to be lower at the VA when dialysis is initiated compared with other healthcare systems, according to a new study.The report, published recently in the Clinical... View Article

Nephrology

Secretary Proposes ‘Rightsizing’ VA by Closing Underused Facilities

Political Battles Expected WASHINGTON – The VA needs to “right-size” by shifting resources to areas of the country where the veteran population is growing and by disposing of more than 10 million square feet of... View Article

Nephrology

December 2014 Focus

In this Issue: Focus on HIV-HCV New Treatments Offer More Options, Fewer Side Effects for HIV-Infected Veterans Despite High Costs, VA Makes Sure Veterans Have Access to Newest HCV Drugs Pharmacy Update Partnerships, Drive-Throughs Seek... View Article

Nephrology

Senate Committee Chairman Decries High Costs for Potential HCV Cure

VA Suggests High Price Could Be Offset Future Savings

Nephrology

VA Fails to Follow Guidelines on Hepatitis B Follow-Up Testing Rates, Treatment

By Brenda L. Mooney BOSTON – Rates of serologic testing for hepatitis B (HBV) at the VA fail to meet levels recommended by the American Association for the Study of Liver Diseases (AASLD) practice guideline,... View Article

Nephrology

Despite High Costs, VA Makes Sure Veterans Have Access to Newest HCV Drugs

By Annette M. Boyle WASHINGTON – While commercial insurers responded to the approval of the breakthrough drug sofosbuvir for hepatitis C (HCV) by implementing prescribing restrictions, limiting use to the sickest patients and charging higher... View Article

Nephrology

Federal Healthcare Timeline

  1964 S. Medicine publishes its first issue. The new Naval Station Hospital Saigon receives the first American combat casualties directly from the Vietnam War. 1965 A U.S. Marine Corps Hawk air defense missile battalion... View Article

Nephrology

Evolution of Pioneer DCVAMC Clinic Tracks AIDS/HIV Treatment Through the Years

By Stephen Spotswood WASHINGTON – When the first Infectious Disease Clinic took place at the Washington, DC, VAMC in 1985, only a handful of HIV-infected patients took advantage. In fact, the disease hadn’t even been... View Article

Nephrology

Computer Model: HCV, Associated Cancer Will Be Rare by 2036

By Brenda L. Mooney PITTSBURGH – Will hepatitis C become a rare disease over the next two decades or so? The answer is yes, according to a computer simulation conducted by the University of Pittsburgh... View Article

Nephrology

VA Proposes Physician Pay Increases, Begins Major Recruiting Campaign

By Sandra Basu WASHINGTON – The maximum rates of annual pay for incoming VHA physicians and dentists would be increased as much as $35,000, under a VA proposal announced last month. The updated pay tables... View Article

Nephrology

What Is The Best Predictor of Heart Disease in CKD Patients?

BALTIMORE – The best indicator of the risk of heart disease in kidney disease patients appears to be calcium buildup in the coronary arteries as opposed to other risk factors, according to a new study.... View Article

Nephrology

New Guidelines Published for Renal Artery Stenting

CLEVELAND – Patients traditionally excluded from modern clinical trials could benefit from renal artery stenting to open blockages in the renal arteries, according to new recommendations. The report, published online by the journal Catheterization and... View Article

Nephrology

Too Low Systolic BP Dangerous for CKD Patients

MEMPHIS, TN – Lower is not better when it comes to systolic blood pressure in veterans with chronic kidney disease (CKD). That’s according to a new study published ahead of print recently in JAMA Internal... View Article

Nephrology

August 2014 Focus

In this Issue: Focus on Infectious Diseases HIV/HCV Co-Infected Patients Have No Safe Level of Alcohol Use VA’s Resistant Infection ‘Bundle’ Drives Down MRSA in Community Living Centers Pharmacy Update Milwaukee VA Develops Reversal Protocol... View Article

Nephrology

Should Digoxin Be Prescribed for Atrial Fibrillation?

VA Study Latest in Debate about Old Drug’s Safety By Brenda L. Mooney PALO ALTO, CA – A new study is calling into question the practice of treating atrial fibrillation with digoxin, finding that patients... View Article

Nephrology

HIV/HCV Co-Infected Patients Have No Safe Level of Alcohol Use

By Annette M. Boyle PHILADELPHIA – Otherwise “non-hazardous” levels of drinking pose a real danger for patients co-infected with human immunodeficiency virus (HIV) and hepatitis C virus. Drinking, even moderately, dramatically increases the risk of... View Article

Nephrology

2014 Compendium of Federal Medicine Introduction

Until my father enlisted in the U.S. Army in 1942, he lived in Brooklyn, NY. That changed after serving honorably in Europe during World War II. As soon as he disembarked from the troop ship, he telephoned a woman he met while in training at Camp (now Fort) Stewart, GA. Within hours, he was hitchhiking to Vidalia, GA, to propose marriage to the woman, who became his wife and the mother of my two sisters and me.

Nephrology

New Therapies Bring Rapid Changes to HCV Treatment

More than 6,000 veterans with HCV have been treated at the VA in the past two years with the triple therapy of boceprevir or telaprevir plus ribavirin and interferon. In addition, hundreds of veterans have... View Article

Nephrology

Military Medicine Also Benefits Civilians

By Jonathan Woodson, MD, Assistant Secretary of Defense for Health Affairs Throughout every war, the Military Health System (www.health.mil) has made significant medical advancements to help protect our troops. Our innovations not only save the... View Article

Nephrology

VHA Seeks to Expand Telepharmacy’s Reach in 2014

By Sandra Calenda, PharmD, CACP; Chasitie Levesque, PharmD; Julie Groppi PharmD, CDE; Helen Kasimatis, PharmD; Donna Leslie, PharmD History of Telepharmacy The Veterans Health Administration (VHA), the largest integrated healthcare system in the United States,... View Article

Nephrology

Building on Our Past to Create a Better Future

The size and composition of our military is expected to change as war efforts wind down and budget constraints take effect. However, our commitment to improving and maintaining the health and well-being of our troops, retirees and their families will remain unwavering. After 12 years of combat, we have achieved remarkable military medical advancements that we hope to take beyond the battlefield in the coming years.

Nephrology

For Veterans, Acute Kidney Injuries Are More Lethal than Heart Attacks

WASHINGTON — Veterans discharged with a diagnosis of acute kidney injury (AKI) have twice the mortality rate of those diagnosed with myocardial infarction (AMI), yet a lack of awareness and treatment options limit physicians’ ability to manage the condition.

Nephrology

Few HIV Patients at VA Reduce Risks by Achieving Undetectable Viral Loads

By Annette M. Boyle Jeffery McCombs, PhD LOS ANGELES — While achieving undetectable viral loads reduces the risk of death associated with hepatitis C by 45% and other adverse liver-related complications by 27%, only 4%... View Article

Nephrology

VA Clinicians Optimistic about Effectiveness of New HCV Drugs

By Annette M. Boyle David Ross, MD, PhD WASHINGTON — New therapies for hepatitis C (HCV) are pouring out of the pharmaceutical pipeline and promising effective treatment with fewer side effects for many of the... View Article

Nephrology

With HIV Treated as Chronic Disease, Adherence Challenges Develop

By Annette M. Boyle Amy Justice, MD, Ph.D NEW HAVEN, CT — With human immunodeficiency virus (HIV) now being treated more like diabetes, hypertension and other chronic diseases, HIV patients face some of the same... View Article

Nephrology

‘Ideal’ Blood Pressure Not Always Best for CKD Patients

MEMPHIS, TN — What’s considered ideal blood pressure measurement in most situations actually was linked with higher mortality rates in chronic kidney disease compared with patients with moderately elevated BP. A study led by Csaba... View Article

Nephrology

Fast-Tracking VA Liver Cancer Patients: Interarterial Therapy Up Tenfold in Chicago

Ramona Gupta, MD By Annette M. Boyle CHICAGO — At the Jesse Brown VAMC in Chicago, a multidisciplinary team approach to evaluating and treating veterans with hepatocellular carcinoma (HCC) has reduced wait times for treatment... View Article

Nephrology

Simponi Also Approved for Treatment of Ulcerative Colitis

HORSHAM, PA – A new treatment is available for adults with moderate to severe ulcerative colitis. The U.S. Food and Drug Administration today approved a new use for Simponi (golimumab) injection, which works by blocking... View Article

Nephrology

New Therapies, Programs Affect Hepatitis C Treatment within VA

By David Ross, MD, PhD, MBI, director, HIV, HCV and Public Health Pathogens Programs, Office of Public Health/Clinical Public Health Lorenzo L. McFarland, DHA, MSW, PMP, senior manager, Public Health Program, HIV, Hepatitis and Public... View Article

Nephrology

The PhARMD Program: Documenting Pharmacist Impact on VA Patient Outcomes

By Annette M. Boyle WEST PALM BEACH, FL – How much of a role are clinical pharmacists playing in patient care at VA? Since December 2011, the Pharmacists Achieve Results with Medications Demonstration (PhARMD) program... View Article

Nephrology

Public Health Service Pharmacy: Accelerating Transformation

By Rear Adm. Scott F. Giberson, RPh, MPh, assistant Surgeon General and chief pharmacy officer, U.S. Public Health Service Rear Adm. Scott F. Giberson, RPh, MPh Pharmacists are the third-largest category (and second-largest professional discipline)... View Article

Nephrology

The Clinical Pharmacy Specialist’s Growing Provider Role in VA

By Anthony P. Morreale, PharmD, MBA, BCPS; Heather Ourth, PharmD, BCPS, CGP; and Julie A. Groppi, PharmD, CDE  VA Pharmacy Benefits Management Services for Clinical Pharmacy Services and Healthcare Anthony P. Morreale, PharmD, MBA, BCPS... View Article

Nephrology

Military Pain Management’s Future: Less Invasive, More Data-Driven Techniques

By Col. Chester “Trip” Buckenmaier III, MD, program director, Defense and Veterans Center for Integrative Pain Management Col. Chester “Trip” Buckenmaier III, MD In August 2009, the Pain Management Task Force (PMTF) was chartered by... View Article

Nephrology

No Elevated Liver Damage in Buprenorphine/Naloxone Trial

SEATTLE — Buprenorphine/naloxone (BUP) and methadone (MET) are effective in treatment of opioid dependence, but some concerns have been raised about a link between the use of BUP and drug-induced hepatitis. A new study from... View Article

Nephrology

Drug Approved to Boost Platelet Counts Could Increase VA HCV Treatment Rates

“The approval of eltrombopag allows us to pharmacologically increase platelet counts so that we can initiate and maintain treatment in patients who could not otherwise be treated and achieve a sustained virologic response.” — Mitchell... View Article

Nephrology

VA Seeks to Increase Low Hepatitis C Treatment Rate for HIV Positive Patients

By Annette M. Boyle LOS ANGELES – Nearly 40% of veterans receiving antiretroviral therapy for human immunodeficiency virus (HIV) infection also have hepatitis C virus (HCV), yet many of them never are treated for the... View Article

Nephrology

Triple Therapy for Hepatitis C: High Cure Rate, Greater Risks

Annette M. Boyle LOS ANGELES — The approval last year of the first new drugs for treatment of hepatitis C (HCV) in 20 years substantially increased the rate of virologic cure for patients with the... View Article

Nephrology

What Is the Role of Immune Dysfunction in Schizophrenia? VA Researchers Seek to Find Out

By Annette M. Boyle SAN ANTONIO — Can cytokines, the signaling proteins secreted by immune system cells, offer a way to prevent development of schizophrenia in susceptible individuals or keep psychosis from occurring in veterans... View Article

Nephrology

Telemedicine Program Improving HCV Care for Rural Veterans

By Sandra Basu WEST HAVEN, CT — Twice-a-month online sessions hosted by the VA Connecticut Healthcare System are not typical telemedicine initiatives in which clinicians provide care to individual patients over electronic media. Instead, hepatitis... View Article

Nephrology

VA Attacks HIV Transmission with Aggressive Treatment – Prophylaxis

By Annette M. Boyle WASHINGTON–In 2009, only 9.2% of veterans in care had ever been tested for HIV. As of March 2012, 1.2 million veterans — 20% of the VA population — knew their serostatus.... View Article

Nephrology

Infection Problems Solved At Dayton VA Dental Clinic

DAYTON, OHIO—According to a VA Office of Inspector General (OIG) review, infection control deficiencies discovered last year at the Dayton VA Medical Center’s dental clinic have been brought under control. In 2010, an OIG investigation... View Article

Nephrology

Veterans in Cities More Likely to Use New HIV Drugs

Veterans in Cities More Likely to Use New HIV Drugs Urban veterans with HIV may be more likely than their rural counterparts to be early adopters of new HIV therapies, a recent study suggests.1 For... View Article

Nephrology

Improving Health and Preventing Illness Public Health at the VA

Victoria J. Davey, PhD, MPH VA Chief of Public Health The Office of Public Health within the Veterans Health Administration serves as the authority on public-health issues for the Department of Veterans Affairs. We think... View Article

Nephrology

Kidney Injuries Sharply Increase Wounded Death Rates

SAN ANTONIO, TX–Kidney injuries have dramatically increased death rates in military personnel evacuated to burn units in Iraq and Afghanistan. Up to 30% of those wounded troops suffer acute kidney injury (AKI) and, with the... View Article

Nephrology

HIV Drug Helps Block Herpes Virus

HIV Drug Helps Block Herpes Virus A recent discovery by NIH researchers has shown the mechanism by which an anti-HIV drug can stop the spread of the virus that causes genital herpes. Tenofovir, when applied... View Article

Nephrology

Hepatitis E Threatens Military Forces but U.S. Has Kept It Well-Controlled

Since its discovery in the early 1980s, hepatitis E has been a potent threat to military forces around the world. At one point, the U.S. military was concerned enough to fund intensive research on a... View Article

Nephrology

VA Looks to New Treatment Programs to Combat Alarming Rise in HCV-Related Cancer

Alarmed by a near tripling of the number of veterans developing hepatocellular carcinoma (HCC) during the past five years, VA has strengthened its programs for the prevention, screening and treatment of veterans with hepatitis C... View Article

               
           

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