Latest ISN News

ISN News is brought to you by category and is updated regularly. Please select a news category from the list below, then select a news article to read.

Reena Rachel George, RN, MSN

Professor, College of Nursing, and Nurse Manager, Dialysis Unit and Renal Transplant Unit, Christian Medical College, Vellore, India. Member of the ISN Kidney Health Professionals Working Group

The incidence and prevalence of chronic kidney disease is increasing nationally and globally owing to the growing percentage of population living with diabetes and hypertension. 20-30% of patients with kidney failure in India are not initiated in any form of kidney replacement therapy (KRT) due to inaccessibility to healthcare facilities or financial constraints. Popularity for peritoneal dialysis (PD) is gaining momentum in India since its conception in the year 1991. The fact that PD therapy does not require vascular access or a healthcare facility and that it can be learned and performed by patients or their family members in their own homes makes it a viable and attractive option of KRT for many. The scope of PD nurses is immense as they can demonstrate autonomy in their roles as educators, counsellors, facilitators, patient advocates, and researchers. Nurses adequately trained in PD will be able to efficiently run PD programs in their setting in coordination with the nephrology team, incorporating evidence-based scientific knowledge.

The College of Nursing and Department of Nephrology at the Christian Medical College in Vellore, India, designed a short course on peritoneal dialysis nursing to give registered nurses (GNM and BSC) the specialized knowledge, skills, and competence to provide PD to patients with kidney failure. The course would also equip nurses to educate, train, and counsel patients and caregivers on various aspects of PD therapy. The 4-week course consists of 27 hours of structured theory, 153 hours of clinical practice, and would be offered multiple times throughout 2020.

Professor Reena George, course Coordinator, states: “Christian Medical College in Vellore, South India is a 2900-bed tertiary care teaching hospital with a well-established Dialysis unit. We have 70-80 patients initiated on Peritoneal Dialysis each year, having about 180 patients for training and follow up. The facility adheres to the international standards and protocols of care and has a nursing and medical faculty who are adept at teaching/training in PD. Our department provides an excellent opportunity for kidney health professionals from elsewhere to come and learn and hence this endeavour. A similar training program in hemodialysis training is also being planned.”

How do patients in the Nephrology Unit in Assiut, Egypt, feel about the impact dialysis has had on their lives?

How does a low-resource community in Kenya help a member who needs a kidney transplant?

How does a mother in Malaysia cope when her daughter develops kidney failure?

Discover these and other accounts in the shortlisted ISN Community Films and vote for an overall winner here.

The winner will be announced on June 26.

In 2019, ISN welcomed 40 Fellows from around the world. ISN congratulates all graduated fellows and presents here a sample of experiences to highlight the capacity building and impact to kidney care made possible through the ISN Fellowship Program.

Xu Chen, from the Affiliated Hospital of Nantong University, Nantong, China, trained for 12 months in Glomerular Disease, AKI, and CKD under mentorship from Jonathan Barratt at the John Walls Renal Unit in Leicester General Hospital in the UK with support from the ISN Fellowship Program and Kidney Research UK.

Xu Chen developed basic science and clinical research skills in the study of glomerular disease. She developed an in-depth knowledge of laboratory and clinical research in IgA nephropathy. In particular, she focused on comparing Caucasian and Chinese IgAN populations concerning biomarkers of disease.

According to Xu Chen, both the incidence and prevalence of kidney disease in her home region are on the increase, but effective therapeutic strategies for CKD are limited. Patients rely on dialysis and renal transplantation, which cannot prevent all the complications of CKD. An improved understanding of the nature of CKD progression is needed, as well as effective therapeutic methods.

Xu Chen received training in a range of laboratory and analytical methods in anticipation of leading a laboratory-based research program on her return to China. Xu comments: “I believe Nantong will benefit greatly by the increased exposure to research and clinical training offered by Leicester.”

The Affiliated Hospital of Nantong University collaborates on several initiatives with Leicester General Hospital through the ISN SRC Program.


Judith Aujo from the Mulago National Referral Hospital in Kampala, Uganda, spent two years training at the Red Cross War Memorial Children’s Hospital in Cape Town, South Africa, under mentorship from Professor Mignon McCulloch and Dr. Peter Nourse, supported by ISN and the Salmasi Family.

Judith’s training focused on general pediatric nephrology, dialysis, and transplant. Her training highlighted the need to produce data to lobby governments for improved pediatric renal services and patient care.

According to Judith, kidney care in Uganda is generally poor. The prevalence of CKD is over 20%. There are around 11 nephrologists in Uganda for an estimated population of 39 million and no trained pediatric renal nurses. Most of the doctors and services are in the capital city; so, Judith’s home institution in Mulago receives referrals from across the country even though they have no designated area for pediatric dialysis, but access the service from the adult dialysis unit.

Judith plans to train others in her home institution, commenting: “It was a great opportunity for me to have this training. I have learned a lot, appreciated the many gaps in our healthcare systems back home, but also realize that things can be improved. I look forward to having other colleagues get this training opportunity so as to build bigger teams.”

Judith is currently at the forefront of running the pediatric renal services in Mulago and is working to establish a functional (acute) PD program. She will be involved in transplant activities when Mulago Hospital starts this service.

Professor McCullogh adds: “This is such an excellent program for training fellows in Africa. Judith benefitted from two years and really secured her knowledge and became confident.”

The Mulago National Referral Hospital has an SRC link with the Baylor College of Medicine in the Texas Children’s Hospital in the US.


Maisarah Jalalonmuhali, from the University of Malaya in Kula Lumpur, Malaysia, trained under mentorship from Patrick Coates in kidney transplantation at the Royal Adelaide Hospital in Adelaide, Australia, with support from the ISN and CREED.

Maisarah was involved in several clinical research projects as part of her training objectives. Her paper: Serum Free Light Chain as Surrogate Marker For Renal Activity In Lupus Nephritis won third place in the Fellowship Program Awards at WCN 2019.

Maisarah was able to conduct hands-on laboratory immunology tests and became confident in managing pre and post-transplant care, immunology interpretation, and long-term complications following transplantation.

According to Maisarah Jalalonmuhali, there is good dialysis support in Malaysia, but kidney transplantation knowledge needs developing. She says her training will help improve transplant care and believes the number of transplants in Malaysia will increase. She comments: “It was a great fellowship program with many opportunities and exposure regarding kidney transplants.”


Nirajan Mainali, from the Nobel Medical College Teaching Hospital in Biratnagar, Nepal, trained in renal and transplantation pathology under mentorship from Dr. Kim Solez from the University of Alberta in Edmonton, Canada.

Nirajan gained extensive experience in native kidney and transplant kidney pathology as well as in composing kidney biopsy reports. According to Dr. Solez, Nirajan “became an excellent renal pathologist” during his time at the University.

Nirajan submitted two case studies from his training as abstracts for WCN20 that were accepted for presentation as posters.

According to Nirajan, renal pathology services in Nepal are limited. He aims to establish a renal lab there and believes his training will help make a noticeable difference in the region. He comments: “It was a great program.”


Francisco Vargas, from Hospital Doctor Arnulfo Arias Madrid in Panama City, Panama, trained in clinical nephrology and renal transplantation and dialysis under mentorship from Dr. Manuel Praga at the Hospital Universitario 12 de Octubre, in Madrid, Spain, with support from the ISN and SLANH.

As part of his training, Francisco spent two months in transplant consultation following up on post-operative kidney transplant patients and assisting in the treatment of patients with other organ transplants referred to the nephrology department. Francisco was impressed by the collaboration between the nephropathology group and nephrologists as well as with other surgical teams to obtain the best results for patients. He comments: “From the moment I arrived in Madrid, the treatment offered by Dr. Prague and his team of nephrologists and residents was excellent. I was quickly integrated into daily work and teaching. I will be eternally grateful to the Nephrology service of the 12 de Octubre Hospital.”

According to Francisco, there is an epidemic of patients with CKD in Panama and an increasing number of patients who have difficulty accessing the dialysis they need. Panama City requires three or four additional hemodialysis rooms, and the number of transplants has fallen dramatically over the past five years.

Francisco plans to advocate for the development of nephropathology services in Panama and the need to update treatment and care protocols in clinical nephrology and renal transplantation. He wants to encourage new professionals to specialize in nephrology and is currently teaching Nurses and Postgraduates in his home institution.

Young ISN members continue to work on the frontline of the COVID-19 pandemic. Rhys Evans, a member of the ISN Young Nephrologists Committee, asked young ISN members from India, Ecuador, and Nigeria, to reflect on their experiences.

Read reflections from other young ISN members here.

Find resources relating to the COVID-19 infection here.

Reflections from Chandigarh, India

Joyita Bharati, Assistant Professor, Chandigarh, India

Health care systems across the world are bearing the brunt of COVID-19. Cases continue to increase in India despite the country being in an extended lockdown of all non-essential services since March 24, 2020.

The fear of transmission of COVID-19 led to the closure of many private dialysis units across the country and, hence, many patients were under-dialyzed or not dialyzed at all. We get referrals from various states and the number of patients who present with symptoms due to inadequate dialysis has increased remarkably. Most of them are patients on chronic dialysis and present with increasing shortness of breath, with or without fever. Once tested for COVID-19, these patients are shifted to a designated COVID-19 wing of the hospital. While waiting for the COVID-19 report, which takes a few hours, most of them need urgent dialysis.

There is a significant overlap between pulmonary edema-related bilateral lung shadows and COVID-19 pneumonia-related bilateral lung shadows. Most often, patients with fluid overload do not manifest characteristic lung shadows with peripheral sparing, and lung ultrasound B-lines used to monitor patients, along with bilateral involvement, are present in both conditions. Moreover, septal thickening and pleural effusion are also seen in severe COVID-19 pneumonia. Unless the patient has multi-organ dysfunction with hematological involvement, excluding COVID-19 pneumonia in a chronic dialysis patient, especially if previously inadequately dialyzed, is difficult.

In the absence of universal and standard testing policies, appropriate allocation and adherence of personal protection equipment are likely to help prevent transmission of COVID-19 in dialysis units and allay fear amongst private centers catering to large patient populations.

Reflections from Cuenca, Ecuador

Diego Coronel Aguilar, Nephrologist, Cuenca, Ecuador

I am a Nephrologist in Cuenca, Ecuador. Cuenca is the third biggest city in Ecuador. Currently, we have 43120 cases in Ecuador, and about 3621 deaths with PCR tests confirmed mostly in Guayaquil. The situation is getting worse every day because the number of cases is increasing around the country. The number of cases in Cuenca is 884.

We have two main hospitals in the city. I work in one of them, Hospital Jose Carrasco Arteaga (Figure 1), which is a public hospital. Unfortunately, at the moment, the situation does not seem under control because the hospital has a lot of COVID-19 patients and the number of cases is changing every week. The number of patients in ICU is variable: the unit has a total of 12 beds, but at this time, no beds are available.

Nephrologists here are currently part of a back-up team in case the situation becomes critical. We received training courses on the clinical management of COVID-19 and the orotracheal technique. At the same time, we are doing night shifts to support the main COVID-19 team in general patient care.

Within the nephrology department, we have not had many cases yet: one kidney transplant patient, one chronic dialysis patient, and two with acute kidney injury, out of approximately 25 patients in total. I think, in the beginning, we had the situation under control because the population was strictly following the government recommendations to quarantine and practice social distancing and good hygiene. But these measures are being progressively lifted.

I also work in a dialysis unit where we carry out triage and isolate patients with respiratory symptoms until the test for COVID-19 can be done. If the test is positive, the patient has to be isolated in the unit or a specific area within the unit. We’ll see how the situation goes, but to be honest, I am not very optimistic!

Hospital Jose Carrasco Arteaga, Cuenca, Ecuador

Reflections from Ife, Nigeria

Oguntade Hameed, Senior Registrar, Nephrology Unit, Obafemi Amolowo University Teaching Hospital, Ife, Nigeria

The COVID-19 pandemic is, without a doubt, the most challenging health issue at the moment. This disease has disproportionately affected developed countries with more robust health systems.

Nigeria is a country with an estimated population of around 180 million. The country recorded its first case on February 27, 2020, and has since confirmed 12, 486 cases with 354 deaths.

I work in the Renal Unit at Obafemi Awolowo University Teaching Hospital as a Senior Nephrology Registrar. The dialysis unit is the biggest in the state, carrying out around 90 dialysis sessions per month.

Since the outbreak of COVID-19, the unit has developed a protocol with timely updates. Firstly, the unit organized a sensitization and awareness lecture for its members: doctors, nurses, health attendants, and biomedical engineers working in the unit. After that, a protocol was developed that make the use of face masks mandatory for staff and patients in and around the dialysis room. Regular hand washing is emphasized, and patients and visitors must wash their hands before gaining access to the dialysis room and the renal wards. The unit procured PPE that includes disposable surgical gowns, goggles, and face shields to be used by all staff working in the dialysis room.

The unit has tested five suspected cases based on symptomatology and travel history. All five samples returned negative. The unit continues to promote behavior to prevent COVID-19 while making PPEs available to all health workers and, where any case is suspected, prompt testing is carried out.



ISN BetterTogether COVIDAs COVID-19 continues to have a global impact, the ISN reached out to its members around the world to hear about the crisis in their own words. Below are some first-hand accounts.

What has your experience been so far? ISN members are encouraged to tell us on Twitter or Facebook using #ThisIsISN and have your testimonial added here.

“During the quarantine period, my life has been frantic: taking care of children and homeschooling, increased workload, and living closely with the suffering of patients with COVID and their families; also participating in organizing the conversion of our Brazilian Congress of Nephrology into virtual form ... quarantine for health professionals without time to look back...let's keep going ...” D. Machado (Brazil)

“While people were locked down at home, my hospital became busier. I had to balance working from home in virtual clinics at night with seeing patients in the hospital in the morning. I enjoyed my rest time with my wife and kids at home.” Ahmed Akl (Egypt)

“During this time, I realized that nature is more powerful than us and can easily get rid of humankind if it wants to.” S. Bek (Turkey)

“In this pandemic time, I work mostly from home completing my last month in nephrology training, spiritedly finalizing my Advanced CNC from ISN-ANIO, and excitedly retraining my rusty cooking skills.” R. Duarsa (Indonesia)

“Lockdown made me rediscover a) my neurosurgeon husband's cooking and b) music and movies in my mother tongue.” U. Anandh (India)

“In these chaotic days, when you are overwhelmed by the context and the day-to-day exhausting work... there is nothing like getting home and feeling the love of your family, they heal everything.” A. Pastor (Peru)

“I was an intern when all hell broke loose with AIDS in 1982. Now, I’m a senior nephrologist on a COVID-19 service. Many lessons to be learned and relearned… don’t fear the virus, respect it. Move forward in a mission of service with humility, grace, and dignity for all.” K. Tuttle (USA)

Due to the critical COVID-19 situation, we were obliged to reshape our planned activities changing from face-to-face interactions to virtual ones. After brainstorming ideas between the teams, we decided to organize a set of webinars with useful information and exchange of personal experiences facing colleagues in our respective hospitals. Given the situation where Spain has passed the crisis, but the Philippines are in the middle of it, we believe that these webinars will give ideas and support to our Filipino colleagues in dealing with this situation.” E. Kondi (Spain)

Among my lasting memories of this strange time will be carefully passing food to my wife in the bedroom through a barely opened door while she was isolated pending swab results. She has been ‘query COVID’ three times now, but fortunately, she has never tested positive. The dog had a great time running between us (via the cat flap) as we competed for the affection of this furry fomite.” Brendan Smyth (Australia)

These days, finding the right balance between hospital assistance and home studies has become a hard task. I joined my children’s violin lessons to better cope with the uncertainty and anxiety. Additionally, I have strengthened ties with the ISN Education group to keep focused on a scientific view of the pandemic.” Augusto Cesar S. Santos Jr. (Brazil)

During this pandemic, I have realized that there is always a way to improve our health system. COVID-19 does not discriminate and does not look at race, sex, age, skin color, socioeconomic status, or educational level.  It continues to teach us that we are just humans and that in order to achieve change, it is necessary to teamwork.” Angie Aguilar Gonzales Lizet (Guatemala)

I am a nephrologist and involved in the care of COVID-19 cases too. Patients are developing oliguric AKI and proteinuria. Dialysis is affected as we are using alternate machines to keep a safe distance. I think the biggest challenge is that we don’t have treatment. My personal opinion is that we should do an autopsy on every mortality, which will help understand the disease’s pathophysiology in a better way.” Sourabh Sharma (India)

Biggest fear is the increased risk of transmitting the infection to loved ones.” Priti Meena (India)

I review most patients admitted to the isolation ward with my medical officers. The majority are asymptomatic, a few have mild symptoms, and I’ve had two with pneumonia, none with renal involvement. I am the only nephrologist working in the center. Three of my patients are diabetic and faced with the challenge of detailed investigations due to limited resources, for example, renal ultrasonography, urinary albumin creatinine ratio, shortage of manpower, including lab staff.” Osariemen Osunbor (Nigeria)

I am working as Head of Nephrology Unit in Makassed Hospital. Our hospital has a capacity of 300 beds as well as its tertiary hospital in Palestine. We prepared an independent department for COVID-19, but up till now, we do not have COVID-19 inpatients in our hospital. We prepared and trained the team well to deal with them.” Mohammad Bourini (Palestine)

Dialysis patients, as well as Nephrologists, are being affected in the dialysis unit.” Dr. Abu Zafor Md. Salahuddin (Bangladesh)

The COVID-19 pandemic compelled me to change my daily routine. I have started learning new skills from the internet. Reading non-COVID-related articles as much as possible!” Shubbarthi Kar (Bangladesh)

Being a nurse manager in a dialysis unit, having to plan dialysis sessions separately for positive, suspected, and regular patients, and planning optimal staffing, was challenging. This was also a period when, as teachers, we had to explore and experiment with various online modes of teaching for students. However, this season also allowed experiments in cooking, gardening, and quality time with family members!” R. George (India)

As a solo nephrologist in my hospital, which turned out to be a COVID-19 hospital, my working hours increased from 8 hours to 10-12 hours daily, 24/7 on-call, working every day including weekends, for more than two months. Even though I'm physically and mentally exhausted, once I'm back home, I have the full support of my family, and I thank GOD we're all well and safe.” B. Bernieh Al Ain (UAE)

"During this period, though we had a hard time at the hospital taking care of COVID-19 patients, I had a lesser number of regular patients to visit, less travel for work, no social meetings to take part in, and more time to spend with my family, cook, read, and rest. It felt like being on a dangerous vacation!" S. Ossareh (Iran)

Having teleconferences with my colleagues working from home has provided a ‘window’ into their personal lives, and I have enjoyed seeing their home surroundings and occasionally their children and pets.” J. Donner (Canada)

The ISN is proud to provide a platform for the international community to share resources, guidance and experiences in times of crisis. 

Become an ISN member today and support our work.

#Bettertogether #ISNFamily

ISN is pleased to invite you to the KDIGO Diabetes in CKD Guideline Webinar: Looking at the Latest Evidence and Beyond, to be held on Monday, June 22, 2020 at 06:00 PM CEST.

Join the webinar to learn more about the new KDIGO Guideline on Diabetes Management in CKD, focusing on topics such as glycemic monitoring and targets, lifestyle and anti-hyperglycemic interventions, and approaches to self-management and optimal models of care.

  Date: June 22, 2020
  Time: 6:00 PM CEST
Register Now

To learn more, watch the video introduction to the new KDIGO Diabetes Guideline below.



Ian de Boer

Ian de Boer, MD, MS
(Work Group Co-Chair)

Ian H. de Boer is Professor of Medicine and adjunct professor of epidemiology at the University of Washington in Seattle, WA, USA. Dr. de Boer received his medical degree from Oregon Health Sciences University. He trained in internal medicine at the University of California, San Francisco, and in nephrology at the University of Washington, where he also earned a master’s degree in epidemiology. Dr. de Boer practices nephrology at the Puget Sound Veterans Affairs Healthcare System and is an associate director of the Kidney Research Institute at the University of Washington.

Dr. de Boer’s research focuses on the prevention, diagnosis, and treatment of diabetic kidney disease (DKD) and its complications. His epidemiology work has helped define the clinical course of kidney disease in types 1 and 2 diabetes, including prevalence, incidence, risk factors, outcomes, relationships with cardiovascular disease, and the impact of diabetes treatments; his additional work also employs patient-oriented physiology research and clinical trials. Dr. de Boer has published more than 300 manuscripts in the field and was elected to the American Society for Clinical Investigation for these research contributions. He served on the American Diabetes Association Professional Practice Committee from 2016-2019, chairing the complications subgroup which oversaw development of the Standards of Medical Care in Diabetes, and is currently deputy editor of the Clinical Journal of the American Society of Nephrology.

Living with Diabetes and CKD

Tami Sadusky

Tami Sadusky, MBA
(Work Group Member)

Tami Sadusky received a pancreas and kidney transplant in 1993 and a second kidney transplant in 2011. She was diagnosed with type 1 diabetes at the age of 13 and, within 20 years, had developed complications from the disease, including kidney failure. The transplants brought her a new life.

Tami received her BS and MBA degrees prior to moving to Washington, where she worked at the University of Washington (UW) for 22 years as executive director of Research Finance and Operations. She is now an active volunteer in the areas of organ donation and transplantation and has been invited to speak about her patient experience both pre- and post-transplant. She is on the board of directors for Transplant House, a non-profit organization that provides housing for transplant patients. She is an active member of the UW Transplant Advisory Council, the UW Kidney Education and Support Group, the UW Team Transplant Strategic Planning and Finance Committee, the Kidney Research Institute Advisory Council, and works closely with the Northwest Kidney Centers. Three years ago, Tami established a UW gift fund, the Sadusky Diabetes Kidney Research Fund, which supports diabetes and kidney research.

Tami has been involved with KDIGO for the past two years developing the KDIGO Clinical Practice Guideline for Management of Diabetes and Chronic Kidney Disease.

Management of Diabetes in CKD

Peter Rossing

Peter Rossing, MD, DMSc
(Work Group Co-Chair)

Peter Rossing is a clinician researcher devoted to complications in diabetes with a focus on renal and cardiovascular complications. He obtained a specialist degree in internal medicine and endocrinology in 2004. Since 2007, he has been a chief physician and manager of the Steno Diabetes Center research team dedicated to the research of micro and macrovascular complications of diabetes.

As a professor in diabetic angiopathy at the University of Copenhagen since 2012, Dr. Rossing has conducted epidemiological studies investigating key features of the pathophysiology of the diabetic kidney at different stages. He has identified several markers for the development of diabetic nephropathy, making it possible to predict individual risk. Dr. Rossing has been involved in several intervention studies in patients with overt diabetic nephropathy aiming at improving the prognosis.

He is the coordinator of the EU FP7 project, PRIORITY, demonstrating that urinary proteomics can be used to stratify the prevention of renal complications in type 2 diabetes, and the Novo

Nordisk Foundation grant, PROTON, aiming at personalizing prevention of diabetic nephropathy.

He has co-authored over 420 papers, and his h-index is 69. He received the Minkowski prize in 2005, the Golgi prize in 2016 (both from the European Association for the Study of Diabetes [EASD]), and the E. Bierman award from the American Diabetes Association (ADA). Dr. Rossing has also served as president of the Danish Endocrine Society and the European Diabetic Nephropathy Study group, and as chairman of the Danish National Diabetes Registry.

Management of CKD in Diabetes

Katherine R. Tuttle

Katherine R. Tuttle, MD, FASN, FACP, FNKF
(Work Group Member)

Katherine R. Tuttle is the executive director for research at Providence Health Care, co-principal investigator of the Institute of Translational Health Sciences, and professor of medicine at the University of Washington, USA. Dr. Tuttle earned her medical degree and completed her residency in Internal Medicine at Northwestern University School of Medicine in Chicago, Illinois. She was a fellow in Metabolism and Endocrinology at Washington University in St. Louis, Missouri. Her Nephrology fellowship training was performed at the University of Texas Health Science Center in San Antonio, Texas.

Dr. Tuttle’s major research interests are in clinical and translational science for diabetes and CKD. She has published over 200 original research contributions and served two terms as Associate Editor for the Clinical Journal of the American Society of Nephrology and the American Journal of Kidney Disease. Dr. Tuttle has received many honors and awards, including the Medal of Excellence from the American Association of Kidney Patients, Garabed Eknoyan Award from the NKF, the YWCA Woman of Achievement Award in Science, and two Outstanding Clinical Faculty Awards at the University of Washington. Dr. Tuttle served on the Board of Directors for the Kidney Health Initiative and has chaired numerous kidney and diabetes-related working groups and committees for organizations including the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)/NIH, the NKF, the American Society of Nephrology, the ISN, and the ADA.

Join the KDIGO Webinar

Register Now
Tuesday, 02 June 2020 08:00

Honoring the Past, Welcoming the Future

Honoring the Past, Welcoming the Future:
Experience the ISN Timeline

As part of the ISN’s 60th year celebrations, I am pleased to share with you a short video highlighting some of the Society’s recent achievements. These have been made possible by the passion and commitment of ISN members, steady supporters, and visionary leaders.

A unique role in global nephrology:
The International Society of Nephrology 2011-2020 

ISN Past-President John Feehally traces the evolution of the ISN's vision for meeting the challenges of the 21st century in his narration of history of the Society in “A unique role in global nephrology: The International Society of Nephrology 2011-2020”, published in the Kidney International.

The ISN continues to fulfil its role in addressing the most pressing global challenges in delivery of kidney care through its capacity building programs, continued education of all kidney health professionals, supporting research, advocating for optimal kidney health through initiatives such as 0by25, and partnering with other organizations including the WHO.

The Kenya Renal Association (KRA) and the Guatemalan Association of Nephrology (AGN) have joined the ISN as Collective Societies further strengthening a mutual commitment to the advancement of kidney care.

Collective Society status increases global activity and visibility through ISN endorsement, priority consideration for managing joint events, and complimentary participation in the Global Village at the World Congress of Nephrology (WCN).

In addition, for a tailored fee, individual members of these societies enjoy full membership benefits including Kidney International journals, special event rates, and education at the ISN Academy.

ISN looks forward to working closely with KRA and AGN to advance kidney health worldwide – together.

If you would like more information about the benefits of collective membership, please send an email to

On May 18, 2020, the ISN represented the global kidney health community at the 73rd session of the WHO’s World Health Assembly (WHA) in Geneva.

At this historic WHA, which took place virtually due to COVID-19-related restrictions, delegates adopted a landmark resolution to press for solidarity in addressing the pandemic.

The resolution calls for a joint and intensified effort to control the spread of the virus and to ensure access to COVID-19 treatments and future vaccines.

Working alongside the NCD Alliance and larger advocacy network, the ISN contributed to the WHA 73 discussions and achieved the important goal of including the NCD’s perspective within the resolution by issuing a joint statement, as well as the official ISN statement.

The ISN holds a long-standing relationship with the WHO and reiterates the need for a global health agency. The WHA provides an excellent platform for all stakeholders, including civil society organizations such as the ISN, to deliver statements and advocate for an inclusive approach to health, especially during pandemics such as the current COVID-19 crisis.

ISN Statement

Global Coalition for Circulatory Health Statement

Friday, 29 May 2020 12:32

KDIGO Report to be published in Kidney International and Kidney International Reports

KDIGO’s Nomenclature for Kidney Function and Disease Conference Report and Glossary will be released in the June issue of Kidney International. An executive summary and glossary will be published in KI Reports.

The KDIGO consensus conference took place in June 2019 providing a platform to discuss standardizing and refining kidney-related terminology to be more patient-centered and precise and to align communication in clinical practice, research, and public health.

Friday, 29 May 2020 12:26

WCN’21 Abstract Submission Is Open

Stand out in your field – submit an abstract for WCN’21

Submission deadline: November 18, 2020 Find out more and submit your abstract here.

Nominate a Candidate for the ISN 2021 Awards

Do you know someone who has made an outstanding contribution to nephrology? Nominate them for an ISN Award before August 27, 2020:

Send your nominations, supporting materials, and questions to the ISN Awards Coordinator.

Read about the 2019 ISN Award winners here.

In 2017, the ISN and the Australian and New Zealand Society of Nephrology (ANZSN) signed a memorandum of Understanding (MOU) to develop a partnership to advance kidney care in the Asia Pacific region.

Since then, the ISN and ANZSN have successfully co-funded ISN Programs, including Sister Renal Centers, Clinical Research, and Educational Ambassadors Program, as well as Fellowships and CME meetings.

The ISN-ANZSN collaboration within the SRC program achieved notable success in Fiji. A paper produced by the emerging hospital in the program, demonstrating that Fiji has one of the highest rates of end-stage kidney disease worldwide, was pivotal in obtaining government funding to set up a National Kidney Research and Treatment Centre to improve access to kidney care in the region.

In 2018, an ISN CME meeting was held in collaboration with the ANZSN and the APSN in Samoa highlighting the importance of early detection of AKI and screening for and managing patients with CKD in a region where kidney disease is a growing burden.

In 2019, the ISN World Congress of Nephrology was co-hosted by the ANZSN and the APSN. The ANZSN provided substantial support toward travel grants for delegates from low and middle-income countries to attend the event.

In 2020, the ISN endorsed the ANZSN 2020 Home Dialysis Conference, which brought together health care professionals, carers, and patients from Australia, New Zealand, and the Pacific to focus on building and developing home-based dialysis therapies.

ISN President, Vivek Jha, states: “This partnership reinforces the ongoing cooperation between the two societies to support the growth of nephrology in the Asia Pacific region. The successful organization of WCN19, which drew the attention of the global nephrology community to kidney health issues in the region, is an example.”

Thursday, 28 May 2020 10:50

ISN Welcomes New Chairs for the:

 Kidney Health Professionals Working Group


Sister Renal Centers Committee


ISN Advancing Clinical Trials (ACT) Committee


Outgoing Chair

Paul Bennett

“Nephrology nurses and allied health professionals are the largest professional nephrology group, and the development of the ISN Kidney Health Professionals Working Group has been an important ISN initiative recognizing this group’s vital role. It has been an honor to serve as the working group’s Chair from 2018 to 2020. The commitment of the working group’s members in these foundation years has produced a momentum that will no doubt be enhanced under the leadership of Michele Trask.”

Incoming Chair

Michele-Anne Trask

“I am excited for the future of the Kidney Health Professionals Working Group. We have an amazing team and I know we are going to make incredible things happen. It is truly an honor to have been elected Chair of this group.”


David Harris, Chair of ISN Programs, offers thanks to Peter Kerr and welcomes Marcelo Orias: 



“On behalf of the ISN and the ISN Programs Committee, I would like to thank Peter Kerr for his outstanding leadership of, and commitment to, the Sister Renal Center Program over the last three years. With Peter at the helm, the SRC program has gone from strength to strength. We are very grateful for the generous personal time commitment he has made to ensure the success of the SRC program.”
Outgoing Chair
Peter Kerr
“Marcelo Orias will be replacing Peter as Committee Chair, with Chih-Wei Yang, as Deputy Chair. Together with the SRC Committee Members, they will guide implementation and provide advice related to the SRC Program, which is a key component of the overall capacity building effort of the ISN and strives to bring essential teaching and training to doctors and healthcare practitioners in low resource countries. We congratulate them on their appointment and look forward to working with them.”
Incoming Chair
Marcelo Orias


Adeera Levin, Chair of the ISN Research Working Group, offers thanks to Vlado Perkovic, outgoing Chair of the ISN-ACT Committee and Louise Moist, Outgoing Chair of the ISN-H4KH Initiative, and welcomes Thomas Hiemstra as Incoming Chair of the ISN-ACT Committee:


“ISN and the Research Working Group extend heartfelt thanks to Vlado Perkovic. His renowned expertise in clinical trials and leadership role have been critical over the last five years in the setting-up and development of the Committee aimed at facilitating high-quality clinical trials and studies in nephrology. During his leadership, great initiatives such as the Global Focus List and the ISN-ACT Toolkit have emerged. He has made an outstanding contribution in his support of the ISN.”
Outgoing Chair
Vlado Perkovic
“I welcome Thomas Hiemstra as the new Chair of the ISN-ACT Committee, taking over from Vlado Perkovic. Thomas Hiemstra was the Deputy Chair of the ISN-ACT Committee. Based at the University of Cambridge in the United Kingdom, Thomas has co-led the development of the ISN-ACT Toolkit. A clinical trialist, with expertise in trial design, conduct, analysis, and reporting, he co-leads the UK Renal Trials Network (UKRTN). Alongside the ISN-ACT Committee members, he will continue to improve global nephrology community participation in clinical trial research through a series of activities and initiatives.”
Incoming Chair
Thomas Hiemstra
(United Kingdom)

“The ISN thanks Louise Moist as the outgoing chair of the ISN-H4KH (Hydration for Kidney Health) Initiative. Her leadership has been essential in implementing this initiative aimed at stimulating the interest of established and new researchers to explore the role of hydration in kidney health. With the support of the ISN-H4KH Committee members and her precious guidance, all selected ISN-H4KH grant awardees successfully carried out their projects. Her commitment and energy have been greatly appreciated.”
Outgoing Chair
Louise Moist
ISN-H4KH initiative Chair

The ISN Global Kidney Care Podcast (GKCP) , to be launched this month, will initially focus on the COVID-19 pandemic.

Over time, the GKCP will provide content on science, research, and clinical aspects of nephrology, including:

  • Case-Based Discussions
  • Paradox Nephrology
  • Everyday Nephrologists
  • Latest Kidney International and Kidney International Reports Papers

The GKCP will be available via numerous podcast platforms and apps, including Apple, Stitcher, Spotify, and Google Podcast. All episodes will be free and open access.

Listen to ISN Podcast

On May 17th 2020, the ISN was proud to attend the 73rd World Health Organization General Assembly as the global leading society representing nephrology and renal healthcare. Due to the current COVID-19 pandemic, the Health Assembly is taking place as a de minimis meeting,

At the Assembly, ISN joined discussions on the adoption of the COVID-19 Resolution. As part of our dedicated advocacy campaign to advance kidney health worldwide, ISN participation is crucial in calling for a timely treatment of acute and chronic kidney disease: due to the current pandemic, renal patients are likely to face interruption or unavailability of life-saving treatments such as dialysis and transplant.

To download our statement, please click here.

Has someone you know made a true difference to kidney care or research? Are they especially dedicated to the patient cause in their country or region? Show your appreciation by nominating them for an ISN award.

As an ISN member, you can nominate candidates for the following awards:

Award winners will be recognized at The ISN World Congress of Nephrology 2021 taking place from April 15-18 in Montreal, Canada. ISN Pioneer Awards are handed out during regional events throughout the year.

Nominations are open until August 27, 2020.

  • Review the links above for each award’s nomination requirements
  • Send all nominations, supporting materials, and questions to the Awards Coordinator
  • Candidates do not need to be ISN members
  • You must be an ISN member to nominate a colleague. If you are not yet a member, learn about our membership packages and join the ISN community today!

We look forward to receiving your nominations!

The majority of patients with kidney disease in low- and middle-income countries (LMICs) are thought to present to sub-tertiary hospitals. Therefore, the capacity of these healthcare facilities to manage kidney disease is an important consideration.

Young ISN Member, Dr. Grace Igiraneza (Rwanda), who undertook an ISN Fellowship at Yale University, recently investigated the capacity of sub-tertiary hospitals to manage kidney disease in Rwanda. Her research findings, published in Kidney International Reports, can be read here.

Two other Young ISN Members, Dr. Rhys Evans (United Kingdom), ISN Young Nephrologist Committee Member, and Dr. Chimota Phiri (Malawi), ISN African Regional Board Member, comment on the importance of this work in this associated article.

Dr. Igiraneza outlines the key findings from her research in response to the questions below:

Why did you undertake this research?

While pursuing my nephrology fellowship, the more I learned about the complexity of kidney diseases and the economic burden related to its management or lack thereof, I realized how quality kidney care is an important health need especially in developing countries that are already struggling with limited resources.

 Acute kidney injury, if diagnosed and treated on time, can be reversed. As a nephrologist working in LMIC, I like to think that if we focus on optimizing the prevention and management of AKI, we will save many lives despite limited resources. There are international and national guidelines to diagnose and treat AKI, but are hospitals in LMIC equipped to follow those guidelines?

 Therefore, my study tried to address important questions such as: “What is the existing capacity for and what challenges do health facilities and providers face in managing AKI patients?” These questions inspired me to undertake the study to understand the current state of AKI care in sub-tertiary hospitals

What did you do?

The study was designed to assess ten sub-tertiary hospitals across the country, including at least 2 hospitals in each of the 4 provinces of the country. Using a pre-designed checklist, partly inspired by KDIGO AKI guidelines, we evaluated the capacity of the hospitals to provide accurate and appropriate diagnosis and management of AKI. Simultaneously, we conducted a knowledge assessment survey on AKI prevention, diagnosis, and treatment of providers using clinical vignettes.

What did you find?

The findings show that sub-tertiary hospitals have limited capacity in terms of diagnosis and treatment of AKI, especially in dialytic treatment. The providers at these facilities demonstrated substantial knowledge gaps in both the recognition and management of AKI.

How do you hope the findings of your work will impact kidney care in Rwanda and other LMICs in the region?

Understanding the challenges and gaps in health systems in LMIC is key in guiding interventions needed to improve kidney care. The study highlighted the urgent need to train healthcare providers. This is likely to be the next project for the Rwanda Renal Society and other stakeholders.

When a country identifies an urgent need, it is up to them to determine how best to address it and how quickly to do so. The findings of this study can guide policymakers and nephrologists in LMICs to develop sustainable and achievable strategies to improve AKI care at a sub-tertiary level.

How did your ISN Fellowship facilitate this work?

The ISN offered me the opportunity to train at Yale University, a renowned and outstanding training program. Training under dedicated and knowledgeable mentors has not only allowed me to learn clinical nephrology but also to look at kidney care from a global health standpoint and appreciate the disparities in health care access. The initial one-year training program was extended to 18 months which allowed me to incorporate research into my training. I am grateful to the ISN for believing and investing in me!

Join an informational webinar presented by ISN President, Vivek Jha on the ELP program on May 20:

Webinar May 20 at 5 pm CEST Register here.

Find out more about the ISN Emerging Leaders Program and apply here.

The application session is open until June 15, 2020.

The ISN welcomes early-career professionals interested in shaping the direction of kidney health to work alongside a network of international healthcare experts to develop leadership skills.

The ISN Emerging Leaders Programs (ELP) is supported by unrestricted educational grants by Janssen, The Boehringer Ingelheim and Lilly Alliance.

The call for nominations to receive ISN Awards in 2021 is open until August 27, 2020.

All ISN Members can nominate candidates for:

Discover more on ISN Awards and the requirements for nominations HERE.

Award winners will be recognized at The ISN World Congress of Nephrology 2021 taking place from April 15-18 in Montreal, Canada. ISN Pioneer Awards are handed out during regional events throughout the year.

Support and honor your peers: Send your nominations, supporting materials, and questions to the ISN Awards Coordinator.

As part of the ISN-TTS Sister Transplant Centers and the Continuing Medical Education (CME) Programs, the ISN supported the 1st Primer on Pediatric Renal Transplant and Immunology Workshop alongside the International Society of Pediatric Nephrology (IPNA).

The workshop was held from March 5-7, 2020 at the Christian Medical College and Hospital (CMCH) in Vellore, India.

This three-day meeting, the first of its kind, focused on:

  • transplants in special situations,
  • ABO-incompatible and paired donor transplants,
  • surgical techniques and perioperative care,
  • post-transplant immunosuppression and infection management,
  • ethical issues in renal transplant and donor selection and long term outcomes in donors.

A total of 120 delegates attended the course, including residents, Fellows, and practicing pediatric and adult nephrologists from remote parts of India, as well as from Sri Lanka and Nepal. In addition to faculty from India, teaching was provided by international faculty from the US and Australia.

Due to the travel restrictions imposed as a result of the COVID-19 pandemic, ISN sponsored speaker Dr. Basu Gopal, a transplant nephrologist at the Alfred Hospital and Associate Professor at the Monash University in Melbourne Australia, recorded his talk for broadcast at the course and answered questions via video conference.

One of the highlights of the course was a session on deceased donor transplant: a talk on its status in India, as a model for the developing world, was delivered by Dr. Georgi Abraham, Chief of Nephrology at the Madras Medical Mission hospital.

A teaching coursebook was released by Dr. V. Tamilarasi, former Head of the Nephrology Department at CMCH. The Tamil Nadu Dr. MGR Medical University awarded 30 CME credit points for the program.


The ISN is pleased to support innovative events through a range of programs that promote kidney care in emerging regions.

By Rachael C Walker, Ph.D., NP, MN, RN

Eastern Institute of Technology, Hawke’s Bay, New Zealand. Member of the ISN Kidney Health Professionals Working Group

For a variety of reasons, many countries are unable to accommodate those with end-stage kidney disease on hemodialysis in hospitals or in-centre dialysis units.1 Home dialysis offers an alternative to this with several advantages to both patients and the health systems, particularly regarding access to treatment and extended-hour dialysis.2-7 However, countries that have active home dialysis programs have noted that the uptake of home dialysis is often lower in Indigenous, ethnic minority, and more socio-economically disadvantaged groups.8,9,10 This is despite home dialysis being acknowledged as a kidney replacement therapy option that helps to maintain a sense of individual and cultural identity and involvement.11

In New Zealand, a country with high rates of home dialysis, the first community hemodialysis houses were set up to support patients from both urban and remote areas whose housing and/or utilities were barriers to home hemodialysis.12 Community house hemodialysis is a sub-modality of home hemodialysis that enables patients to perform hemodialysis independent of nursing or medical supervision in a shared house somewhere within their local community.

When researching patients who have chosen to use community house hemodialysis, we found that this alternative treatment option often better aligns with the treatment preferences of a group of patients who otherwise may not utilize home hemodialysis.13 In this study, this sub-modality was more acceptable for Indigenous and minority groups, who typically have lower uptake of home dialysis. The community houses supported patients to achieve hemodialysis best practice by providing them with the ability to extend their treatment hours as they could access the houses when it suited them and provided them with a safe and comfortable environment to do so. The community houses also provided many other benefits over both home and facility dialysis, including reduced burden on family, flexibility, and freedom (particularly in respect to the ability to maintain employment); this sub-modality also encouraged personal health, sense of community, and peer support.

For countries who want to promote the use of home dialysis and encourage equitable access to home dialysis, community house hemodialysis should be explored. This sub-modality may also support extended-hour hemodialysis and therefore be more ideal for some subgroups such as younger patients or those awaiting transplantation.

Benefits of Community House Hemodialysis:

 Benefits of Community House Hemodialysis


  1. Liyanage T, Ninomiya T, Jha V. Worldwide access to treatment for end-stage kidney disease: a systematic review. Lancet. 2015;385:1975–1982.
  2. Marshall MR, Hawley CM, Kerr PG, Polkinghorne KR, Marshall RJ, Agar JW, et al. Home hemodialysis and mortality risk in Australian and New Zealand populations. Am J Kidney Dis. 2011;58(5):782-93.
  3. Kooistra MP, Vos J, Koomans HA, Vos PF. Daily home haemodialysis in The Netherlands: effects on metabolic control, haemodynamics, and quality of life. Nephrol Dial Transplant. 1998;13(11):2853-60.
  4. McFarlane PA, Pierratos A, Bayoumi AM, Redelmeier DA. Estimating preference scores in conventional and home nocturnal hemodialysis patients. Clin J Am Soc Nephrol. 2007;2(3):477-83.
  5. Vos PF, Zilch O, Jennekens-Schinkel A, Salden M, Nuyen J, Kooistra M MP, et al. Effect of short daily home haemodialysis on quality of life, cognitive functioning and the electroencephalogram. Nephrol Dial Transplant. 2006;21(9):2529-35.
  6. Wyld M, Morton RL, Hayen A, Howard K, Webster AC. A systematic review and meta-analysis of utility-based quality of life in chronic kidney disease treatments. PLoS Med. 2012;9(9):e1001307.
  7. Johansen KL, Zhang R, Huang Y, Chen SC, Blagg CR, Goldfarb-Rumyantzev AS, et al. Survival and hospitalization among patients using nocturnal and short daily compared to conventional hemodialysis: a USRDS study. Kidney Int. 2009;76(9):984-90.
  8. New Zealand National Renal Advisory Board. New Zealand Nephrology Activity Report 2016. Publisher Ministry of Health, Wellington, New Zealand. 2018.
  9. McKercher C, Jose MD, Grace B, Clayton PA, Walter M. Gender differences in the dialysis treatment of Indigenous and non‐Indigenous Australians. Australian and New Zealand Journal of Public Health. 2017;41(1):15-20.
  10. Mehrotra R, Soohoo M, Rivara MB, Himmelfarb J, Cheung AK, Arah OA, et al. Racial and Ethnic Disparities in Use of and Outcomes with Home Dialysis in the United States. J Am Soc Nephrol. 2016;27(7):2123-34.
  11. Walker RC, Howard K, Morton RL, Palmer SC, Marshall MR, Tong A. Patient and caregiver values, beliefs and experiences when considering home dialysis as a treatment option: a semi-structured interview study. Nephrol Dial Transplant. 2016;31(1):133-41.
  12. Marshall MR, Supershad S. Health Related Quality of Life (HRQoL) in Community House Hemodialysis (CHHD) versus Home Hemodialysis (Home HD). J Am Soc Nephrol. 2013;24 (Suppl):4 41A.
  13. Walker RC, Tipene-Leach D, Graham A, Palmer SC. Patients’ Experiences of Community House Hemodialysis: A Qualitative Study. Kidney Med. 2019;1(6):338-346.

Over 5,000 people worldwide have already visited ISN's recently launched, open-access, online resource to assist you in trial design, study conduct, data management, data analysis, and publication.

More than ever, clinical trials in nephrology are needed to generate high-quality evidence to inform all aspects of care for patients with or at risk of kidney disease, including with COVID-19.

Access the ISN-ACT Toolkit to help carry out meaningful and robust clinical trials, or to become involved as a trial site.

Find key results from your region through scorecards.

Available here

Share the results from your region via social media or other media and press channels to support discussions on and advocate for kidney health care.

In collaboration with the World Health Organization (WHO), the ISN i3C (International Consortium CKDu Collaborators) group has developed the ISN Observatory of CKDu to facilitate the exchange of information and knowledge to raise awareness of the urgent issue of Chronic Kidney Disease of unknown etiology.

The input of experts in the field of CKDu provides both the ISN and the WHO with an understanding of the global burden of kidney disease, addressing kidney disease in the context of global, regional, and national NCD (Noncommunicable disease) strategies.

Access the ISN Observatory of CKDu and share your data on CKDu.

Dear colleagues,

On behalf of the ISN membership, it is my very great pleasure to announce this year’s recipients of the Jean Hamburger Award, the Bywaters Award, and the Lillian Jean Kaplan International Prize for Advancement in the Understanding of Polycystic Kidney Disease. The winners have made outstanding contributions to nephrology and patient care as scientists, educators, clinicians, and leaders, and we extend our gratitude and appreciation for their efforts.

Nominated by the ISN membership and selected by the ISN Awards Committee and Lillian Jean Kaplan Prize Advisory Committee, the 2020 winners are proudly honoured for their commitment to nephrology. They will be officially presented with their awards at WCN’21 in Montreal, QC, Canada in April 2021.


The Jean Hamburger Award recognizes outstanding research in nephrology with a clinical emphasis. This year’s winner is Prof. William Couser.

This award is the greatest honor of my professional career and highlights the exceptional work done by the many fellows from nine countries who worked with me over the years to better understand and treat immunologic renal diseases."
    Dr. Couser is Affiliate Professor of Medicine at the University of Washington in Seattle, Washington, USA. He is a past president of both the American Society of Nephrology (ASN) and the International Society of Nephrology (ISN) and served on the Executive Committee of the ISN from 2001-2013 as Head of its Global Outreach Programs and as Chairperson of the World Kidney Day Steering Committee. He also served as Editor-in-Chief of the Journal of the American Society of Nephrology (JASN).

He is a recipient of the David Hume Award from the US National Kidney Foundation, the Joel Kopple Award from the International Federation of Kidney Foundations, and the John Peters Award from the ASN.

Dr. Couser’s area of expertise is pathogenic mechanisms and clinical management of glomerulonephritis (GN). His research showed that most forms of GN were autoimmune and resulted from in situ formation of immune complexes involving self-antigens rather than circulating immune complex trapping involving foreign antigens, and that the complement membrane attack complex (C5b-9) was a critical mediator in several forms of GN and interstitial diseases. He has lectured in over 60 countries and published over 360 papers including multiple reviews, editorials, and book chapters on these topics.



The Bywaters Award is a life-time achievement award recognizing outstanding contributions to the understanding of Acute Kidney Injury. This year’s winner is Prof. Karl Nath.

This is the greatest honor I have ever been privileged to receive in my entire career! Eric Bywaters has been a tremendous inspiration to me in multitudinous ways throughout my career, and to be the recipient of this award is a dream come true!"
    Dr. Nath was born and raised in Trinidad, West Indies. He attended the University of Edinburgh, Scotland, where he was the most distinguished graduate in medical school (1978). He completed training in Internal Medicine (1982) and Nephrology (1985) at the University of Minnesota (MN), Minneapolis, MN, USA. He has served at Mayo Clinic, Rochester, MN, USA since 1996 where he is a Professor of Medicine, Consultant in Nephrology, and the Robert Joseph Patnode Professor in Nephrology (appointed 2018).

Dr. Nath is the recipient of an NIH Merit Award for his research on heme oxygenase and the nephrotoxicity of heme proteins, and has been NIH-research funded continuously since 1988. He is the recipient of the Karis Award for outstanding patient care, Mayo Clinic (2005); the Distinguished Alumnus Career Achievement Award, University of Minnesota (2006); the Research Career Achievement Award, Department of Medicine, Mayo Clinic (2016); and Mayo Clinic’s Distinguished Investigator Award (2016).

Dr. Nath served as the Program Director of the Clinician Investigator Training Program, Mayo Clinic (1998-2018). He is the Editor-in-Chief of Mayo Clinic Proceedings, prior to which Dr. Nath served as Editor-in-Chief of Journal of the American Society of Nephrology (JASN).



The Lillian Jean Kaplan International Prize recognizes individuals for excellence and leadership in Polycystic Kidney Disease (PKD) clinical or basic research whose seminal scientific work has advanced knowledge and treatment of PKD. This year’s winner is Prof. Arlene Chapman.

The Lillian Jean Kaplan Prize is the most prestigious award for a clinician or clinician scientist working in the area of autosomal dominant polycystic kidney disease. This is a beautiful honor and the most cherished of my career. The encouragement this recognition gives extends beyond expectations and gives further support to find a cure for this life threatening disorder. I am humbled and extremely appreciative."
    Dr. Chapman is the Chief Section of Nephrology at the University of Chicago and a physician scientist who has worked in the field of autosomal dominant polycystic kidney disease (ADPKD) for over 30 years.

With continuous NIH funding for over 20 years, she has led the PKD Foundation as Chair of the Scientific Advisory Committee, creating new funding mechanisms for fellowships and establishing the FASEB research conference in PKD, now in its 15th year.

She established the role of the renin-angiotensin-aldosterone system in hypertension and the increased incidence of asymptomatic intracranial aneurysms (5.5%) in ADPKD. She led efforts to develop an FDA-approved prognostic imaging biomarker (MR-based total kidney volume) in the CRISP study. TKV measurement of cyst burden has led to new treatments including rigorous blood pressure control (the HALT PKD trial) and vasopressin V2 antagonist therapy (the TEMPO trials) where inhibition of the vasopressin V2 receptor slows disease progression.

Her efforts have resulted in worldwide approval for the first disease modifying therapy for ADPKD.


Vivekanand Jha

 ISN President

As part of its Collaboration Plan with the World Health Organization (WHO), the ISN i3C (International Consortium CKDu Collaborators) group has developed a CKDu Observatory Map to facilitate the exchange of information and knowledge in order to raise awareness of the urgent issue of Chronic Kidney Disease of unknown etiology.

Be the first to access the Observatory Map as well as additional comprehensive information on CKDu from May 7, 2020.

The ISN and the International Pediatric Nephrology Association (IPNA) have agreed to extend and formalize their existing partnership to include collaboration on a number of ISN programs and activities, demonstrating a mutual commitment to the global advancement of pediatric nephrology.

This partnership seeks to increase and strengthen the links between both societies through the ISN-IPNA Fellowships and the ISN’s Sister Renal Centers (SRC) Program. The next application deadline for the Fellowship and the Sister Renal Centers Program is October 1.

Pediatric representation on the ISN Regional Boards will help ensure that pediatric nephrology-specific issues can be shared with ISN leadership so that the ISN-IPNA collaboration is able to enhance kidney care for children around the globe.

Through this collaboration, all IPNA members will now receive full access to ISN’s Academy portal to explore over 8000 hours of educational with selected content in 7 languages.

In addition, both organizations will jointly organize up to 3 webinars per year and develop new e-learning materials to expand and improve the quality and quantity of online educational content available on pediatric nephrology.

ISN President, Vivek Jha explains: “Both ISN and IPNA are committed to building the capacity of healthcare professionals. Ultimately, this is to improve patient care – especially in areas where care is needed most through education and training.

Bradley Warady, IPNA Treasurer, comments “It is very rewarding to see something so positive for the nephrology community arise in the setting of the pandemic and all of the associated unfortunate outcomes.”

Applications to the ISN Emerging Leaders Program are now open, apply here. The application session is open until June 15, 2020.

The ISN welcomes early-career professionals interested in shaping the direction of kidney health to work alongside a network of international healthcare experts to develop leadership skills.

Find out more about the ISN ELP Program here.

A webinar will be broadcast on May 18 and 20 to provide more information on the program including scope, opportunities, eligibility criteria, applications, and program timeline.

Please choose the time and date that is most convenient and register before the webinar:

Webinar May 18 at 11 am CEST

Webinar May 20 at 5 pm CEST

 Register now
 Register now


ISN President, Vivek Jha (India), will be the main presenter and moderator. Members of the ELP Steering Committee, including Rumeyza Kazancioglu (Turkey), Adrian Liew (Singapore), and Saraladevi Naicker (South Africa), will be present to guide you through the program and answer questions.

Contact Marie-Pierre Smal at for more information.

The ISN-TTS STC Program was launched in 2013 as a joint initiative between the ISN and the Transplantation Society (TTS) to develop transplantation services in low and middle-income (LMIC) countries either by pairing an experienced center to help build on an existing low-level transplant program; or by assisting an established regional nephrology service to develop a renal transplant program.

The STC Program has proved to be extremely popular and successful, growing substantially to include centers that continue to progress to successive levels of the program.

Here are just two examples of the significant impact the program has had on centers:

Emerging Institution: the Foundation for Children with Kidney Diseases in Guatemala (FUNDANIER)

Supporting Institution: the University of California in Los Angeles (UCLA)

In 2013, a sister center partnership was established between the University of California in Los Angeles (UCLA) and the Foundation for Children with Kidney Diseases in Guatemala (FUNDANIER). The ultimate goal of this collaboration is to establish a deceased donor program in Guatemala.

A general pathologist received training in nephropathology at UCLA to gain the skills required to set up a local nephropathology laboratory at the National University of Guatemala.

A team from UCLA was invited to train local surgeons in laparoscopic donor nephrectomy. Local professionals were also trained in human leukocyte antigen (HLA) typing and cross-matching. UCLA donated a Luminex system to the FUNDANIER center.

A local physician was trained as a transplant coordinator to head the national committee of donations at the Roosevelt Hospital in Guatemala. The aim is to set up a transitional clinic to decrease the number of renal transplant rejections.

FUNDANIER is ensuring that all programs in the country adhere to the Declaration of Istanbul.

Dr. Randall Lou Meda, a pediatric nephrologist from Fundanier, praised the support from TTS and ISN, stating that this type of collaboration “is key in the developing world” and can “change the shape of the world and the lives of many people.” He confirms that, having graduated, the next step is to share the experience gained from the relationship with UCLA by providing training to other centers in the region.

Watch the video here.

Emerging Institution: Al-Shifa Hospital, Gaza

Supporting Institution: Royal Liverpool University Hospital (RLUH)

Since 2013, a collaboration sponsored by the ISN-TTS Sister Transplant Centers Program has been established between a team from the Royal Liverpool University Hospital in the UK and the Al-Shifa Hospital in Gaza permitting the transfer of skills, technology, and education.

El Shifa is the largest hospital in Gaza and treats over half of the region's 500 kidney failure patients. According to staff from RLUH, many patients there are in desperate need of transplants but because doctors are unable to leave the region, they cannot access the training they need to carry out transplant operations. During the 2008 war, half of all patients in need of dialysis died because they were unable to reach a hospital in time.

In 2013, the Royal Liverpool hospital traveled to the Gaza strip to complete the first-ever kidney transplant in the region. They faced a specific set of challenges including a lack of equipment, simple medication, and the constant threat of war.

51 kidney transplants have since been carried out in Gaza, with a 94 percent one-year graft survival rate. The team also set up the first tissue-typing lab in the region and provided crucial transplantation equipment such as a plasma exchange machine and specialist theatre equipment.

This pairing has helped educate local healthcare professionals toward the goal of establishing a transplant center in Gaza so that kidney transplantation can become a regular activity in the region, giving every patient with kidney failure the chance of a normal life.

Watch the video here.

Prof Paul N Bennett (Australia), Prof Marie Richards (UAE), Michele Trask (Canada), A/Prof Rachael C Walker (NZ), Stefaan Claus (Belgium), Henriette Nygard (Norway), A/Prof Reena George (India), Dr. Ying Xu (China), Prof Ana Figueiredo (Brazil), Constance Monote (Senegal), Nashon Kagwe (Tanzania), Reena Moodley (South Africa) and Jo-Ann Donner (Canada).

2020: The Year of the Nurse and the Midwife

 In 2020, the world has witnessed unprecedented chronic disease rates, the COVID-19 outbreak, and mass population displacement caused by conflicts. Nurses provide vital care in each of these circumstances with the world needing them working and optimizing their education and training.

The first State of the World’s Nursing Report from the WHO and its partners celebrates the nursing workforce.1 Nurses from the International Society of Nephrology Kidney Health Professionals Working Group (ISN KHPWG) join this celebration by presenting an overview of the global nephrology nursing workforce and identifying global issues in nephrology nursing care to mark the Year of the Nurse and Midwife.


Global Kidney Disease

Kidney disease affects over 850 million people throughout2 the world signifying its status as a global public health priority. An estimated 1.7 million people die annually from acute kidney injury (AKI) and over 2 million people die from chronic kidney disease (CKD) because of limited access to kidney disease care and renal replacement therapies. These mortality data highlight inequities in kidney disease prevention and kidney care globally, driven by social determinants of health and political factors.3


Nephrology Nursing Practice

Globally, nephrology nurses are the largest professional group responsible for the provision of care for AKI, CKD, and advanced kidney disease, known as end-stage kidney disease (ESKD). Nephrology nursing scope of practice is responsible for kidney care across the continuum, ranging from disease prevention, treatment, dialysis, supportive therapy, kidney transplant care, and palliative care. Patients with kidney disease have complex needs and many comorbidities, therefore in many parts of the world, the nurse’s role is broad including nutrition, social work, vascular access, primary care, family support, infection control, safety and quality, technical and water treatment expertise. The responsibilities for nephrology nurses can range from health promotion and prevention on a larger scale, to independently running dialysis centers without on-site medical support.

Expanded autonomous roles for nurses in nephrology, such as patient and nurse education, transplant coordinator, home peritoneal dialysis and home hemodialysis, dialysis access (including catheter placement), anemia management, pre-dialysis or CKD care and the advanced role of Nurse Practitioner reflect the very high expertise and varied roles of nephrology nurses. Furthermore, nurses play a major role in early screening and kidney prevention, ensuring strict control of blood sugars and blood pressure to prevent or limit chronic kidney damage.


Nephrology Nursing Workforce Challenges

Nephrology nurse shortages are present in over 80% of low-income countries (LICs) and over 60% of lower-middle-income countries (LMICs).4 The involvement of nephrology nurses worldwide is, however, vital to provide equitable kidney care for all. Nephrology nurses in many parts of the world that lack access to kidney specialists can provide care through standard algorithms and advanced practice that can increase prevention and treatment capacity, which positively impacts the public health burden posed by kidney disease. Nurse practitioner care improves renal outcomes in patients with chronic kidney disease (CKD).5-7

Unfortunately, nephrology nurses are frequently undervalued, underpaid, and poorly resourced. Challenges in nephrology nursing include a lack of specialized education, professional recognition, attractive career paths, and education in quality improvement, research, and leadership, particularly in low- and middle-income countries.


What can be done

    • Strive for health systems that deliver people-centered, integrated, multisectoral, and comprehensive primary healthcare services aimed at prevention, early detection, and treatment of NCDs and their risk factors
    • Enhance and recognize nephrology nursing’s role in the early detection and management of AKI and CKD by investing in resources to build an integrated nursing workforce development1,8
    • Recognize that registered nurses must be major participants in the decision-making, planning, delivery, and evaluation of care9
    • Training for nurses in symptom assessment, communication skills, advanced care planning, supportive care, and the use of prognostic models needs to be developed. Of particular importance is additional training of those caring for children and young people in LMICs, where ESKD care options are limited10
    • Prepare specific skill sets/resource hub for the delivery of both hemodialysis and peritoneal dialysis utilizing inter alia nurses10
    • Undertake efforts to resolve the nursing shortage, including measures to assure appropriate funding to address the shortage of nursing faculty and the availability of nursing mentors for new graduates and nurses with limited practice experience9
    • Strengthen collaboration between doctors, the nursing sector, patients, healthcare authorities and all stakeholders involved to increase understanding of what is locally feasible to reduce the burden and consequences of kidney disease and improve kidney care11

Nephrology nurses are well placed to deliver integrated care for diseases that are common among patients with kidney disease including hypertension, diabetes, cardiovascular disease, and multiple infectious diseases and therefore can be key individuals engaged in leading the delivery of complex, high-quality holistic care.


  1. World Health Organization. State of the world's nursing 2020: investing in education, jobs and leadership. Geneva: World Health Organisation;2020.
  2. Jager KJ, Kovesdy C, Langham R, et al. A single number for advocacy and communication – worldwide more than 850 milliion individuals have kidney diseases. Kidney Int. 2019;96(5):1048-1050.
  3. Bello A, Levin A, Lunney M, et al. Global Kidney Health Atlas: A report by the International Society of Nephrology on the Global Burden of End-stage Kidney Disease and Capacity for Kidney Replacement Therapy and Conservative Care across World Countries and Regions. Brussels, Belgium2019.
  4. Bennett PN, Walker RC, Trask M, et al. The International Society of Nephrology Nurse Working Group: Engaging Nephrology Nurses Globally. Kidney Int Rep. 2019;4(1):3-7.
  5. Gaietto KJ, Brooks MV. The Shortage of Expert Nephrology Nurses in Hemodialysis: A Literature Review. Nephrol Nurs J. 2019;46(6):577-585.
  6. Peeters MJ, van Zuilen AD, van den Brand JA, et al. Nurse practitioner care improves renal outcome in patients with CKD. J Am Soc Nephrol. 2014;25(2):390-398.
  7. Walker RC, Marshall MR, Polaschek NR. A prospective clinical trial of specialist renal nursing in the primary care setting to prevent progression of chronic kidney: a quality improvement report. BMC Fam Pract. 2014;15:155.
  8. Berns JS, Saffer TL, Lin E. Addressing Financial Disincentives to Improve CKD Care. J Am Soc Nephrol. 2018;29(11):2610-2612.
  9. American Nephrology Nurses Association. American Nephrology Nurses Association 2020 HEALTH POLICY STATEMENT. 2020; Accessed 24th April 2020.
  10. Harris DCH, Davies SJ, Finkelstein FO, et al. Increasing access to integrated ESKD care as part of universal health coverage. Kidney International. 2019;95(4): S1-S33.
  11. Yousif KI, Abu-Aisha H, Abboud OI. The effect of an educational program for vascular access care on nurses' knowledge at dialysis centers in Khartoum State, Sudan. Saudi J Kidney Dis Transpl. 2017;28(5):1027-1033.

World Kidney Day (WKD) has released its Impact Report from the WKD 2020 Campaign which highlighted the importance of lifestyle interventions to prevent kidney diseases.

On March 12, 2020, over 1200 WKD activities in almost 100 countries raised awareness of accessible approaches toward kidney health.

Diverse regional activities marking WKD around the world are showcased in additional in-depth reports provided by individual countries demonstrating the dedication and innovation of participants as well as the tangible impact they make by raising awareness of kidney health in the media and within local communities.

In 2018, Sandra Wagner (France), Angie Aguilar-Gonzalez (Guatemala), and Amarasiri de Silva (Sri Lanka/USA) received ISN-H4KH (Hydration for Kidney Health) Grants for their respective projects.

All three recipients had their abstracts accepted for presentation at WCN’20 and, consequently, published in Kidney International Reports.

Sandra Wagner et al. investigated the association between Uosm and eGFR decline; and the risk for end-stage kidney disease (ESKD) in patients with moderate or advanced CKD.

SAT-095 Urine Osmolarity And Chronic Kidney Disease Progression In The Ckd-Rein Cohort, Wagner, S. et al., Kidney International Reports, Volume 5, Issue 3, S43

Angie Aguilar-Gonzalez et al. evaluated the fluid intake in healthy Guatemalan children and adolescents; considering volumes and types of fluid and timing of consumption in an area of high prevalence of kidney disease of unknown cause.

SAT-125 Hydration Patterns In Guatemalan Children And Adolescents In An Area With High Prevalence Of Chronic Kidney Disease Of Unknown Cause, AGUILAR, A. et al., Kidney International Reports, Volume 5, Issue 3, S53 - S54

Amarasiri de Silva examined whether the prevalence and progression of CKDu in patients were reduced as a result of introducing reverse osmosis (RO) water as an alternative form of drinking water and how affected people in the region perceived the changes brought about by the new source of drinking water.

SUN-133 The Effects On Patients With Chronic Kidney Disease Of Unknown Etiology In Sri Lanka Of The Use Of Purified And Reverse Osmosis Water For Drinking, DE SILVA, A., Kidney International Reports, Volume 5, Issue 3, S256 - S257

The Hydration for Kidney Health (H4KH) Research Initiative was supported by Danone Nutricia Research.

Young ISN members have been at the forefront of the global fight against COVID-19. In this article, Marina Wainstein, Rolando Claure-Del Granado, and Chimota Phiri share their experience of managing COVID-19 patients in Australia, Bolivia, and Malawi respectively highlighting the challenges young nephrologists face.

Brisbane, Australia (Marina Wainstein)

As for most people around the world, I think few of us here could imagine the impact this outbreak would have, not just on our health system, but on the daily rhythm and comforts of our lives. Australia has, thus far, been spared from the large-scale infection and death rates seen in other places around the world. Nevertheless, we continue to be in a state of partial lockdown and our health structures and operations are only just contemplating a return to the traditional models of care. In our hospital, wards were geographically re-structured to minimize staff traffic and to accommodate a burden of COVID-infected patients that has yet to come. Our outpatient clinics changed almost completely to phone consultations, forcing us to audit and triage our lists to select only the very few that required in-person attention. I found this especially difficult working with a predominantly home dialysis and transition group of patients for whom close follow-up, planning, training, and importantly, reassurance and support are key. Despite these challenges, I have been overwhelmed by our patients’ gratitude and empathy and the dedication and steadfastness of our staff. As a pregnant clinician through these times, I have felt the protection and concern of my colleagues for my well-being and the enormous solidarity that exists among our medical community.

Cochabamba, Bolivia (Rolando Claure-Del Granado)

I think one of the most important aspects of the COVID-19 pandemic has been the psychological impact on nephrologists and other healthcare workers due to lack of organization and clear directives from health care authorities in terms of outpatient dialysis operations, the organization of a referral center for COVID-19 positive patients, the lack of PPE, and false information (unreliable sources from social media). All of these issues have caused them to feel anxious and distressed. The workload has dramatically increased especially for young nephrologists and fellows, and some of them have started to show early signs of burnout. This is partly because the Bolivian Minister of Health has withdrawn personnel over 60 years old from hospitals and health care centers if they have chronic diseases such as diabetes and hypertension, and any pregnant personnel. This has had a significant impact on the physicians and other health care workers who remain working at hospitals and health care centers in Bolivia.

We have to take practical steps to prepare our nephrologists, fellows, and nurses to give the best care possible for patients with kidney disease during the COVID-19 pandemic and to prevent transmission by giving them online lectures on COVID-19 and kidney disease, create infographics in Spanish of different practical issues like how to educate patients, and how to organize hemodialysis units.

Fortunately, so far we haven’t had any COVID-19 positive patients with ESKD on chronic dialysis; I think this could be explained in part by education campaigns - launched for patients and their families, social distancing, and the early lockdown established by the national government just 2 weeks after the first 2 cases of COVID-19 were reported.

Blantyre, Malawi (Chimota Phiri)

Malawi has not been spared from the COVID-19 pandemic. So far we have recorded 33 confirmed cases with 3 deaths, but the actual number of infections may be underestimated as testing is not happening on a large scale. As a response to COVID-19, most of the clinics have been scaled down including general nephrology and hypertension clinics but patients on immunosuppression will be seen as per schedule.

With the government issuing restrictions on public gatherings and transport, the public transport fee has gone up rendering it difficult for health workers and patients to get to and from the hospital. Recently, government health workers went on strike to demand availability of personal protective equipment (PPE) and help to mitigate rising transport costs. This had an impact on patients with kidney disease who could not be properly cared for in the ward or access renal services appropriately. Luckily, this has been sorted out swiftly by the government and now services have returned to normal.

As all the patients attending chronic hemodialysis come from the community, we have trained our dialysis team to screen patients when they access the service as there is community transmission already of COVID-19. The challenge that we have now is dialysis of COVID-19 patients (either those on chronic hemodialysis or those who develop acute kidney injury as a complication of COVID19). Ideally, we should have a portable dialysis machine that could be moved around for patients in isolation who may benefit from dialysis.

Malawi is a landlocked country and is dependent on supplies being transported from other countries, like South Africa. Hence, lockdown measures and limitations on movement might negatively impact dialysis supplies. We are uncertain of how long the lockdown measures in neighboring countries will last so that we can replenish our supplies.

The ISN and Kidney International surveyed nephrologists across six continents, representing the ten ISN Regions, to assess the impact of COVID-19 on dialysis patients and staff and health system responses to the pandemic specific to dialysis.

Access the reports here.

The ISN Global Kidney Health Atlas team has prepared summary slides of the ISN GKHA 2019 focusing on each ISN region individually.

ISN invites members to share the results from their region with colleagues and key stakeholders to support discussions on and advocate for kidney health care with relevant national and regional health/policy/education officials.

The new material contains background information on the project as well as desk research and survey data from 2019. A user manual and narrative script, in support of the PowerPoint presentation, are also available to download.

 The documents* for each region (Africa, Eastern and Central Europe, Latin America, Middle East, NIS and Russia, North America and the Caribbean, North and East Asia, Oceania and South East Asia, South Asia, Western Europe) are

 Available here



Use region-specific presentations during the current global novel Coronavirus (COVID-19) pandemic: Find key results from your region through scorecards (available in the presentation) and share via social media or other media and press channels.

 The ISN welcomes your input on these presentations. Please contact us at

* user manual; ISN GKHA 2019 presentation slides of each ISN region; presentation script on each ISN region.

Tuesday, 28 April 2020 08:26

ISN stands with the WHO

The International Society of Nephrology (ISN), with its mission to improve kidney health worldwide and ensure that all people have equitable access to sustainable kidney health, has noted with concern the decision by President Donald Trump to suspend funding to the World Health Organization (WHO).

As an organization in official relations with the WHO, the ISN recognises the important role played by the agency in promoting the message of essential healthcare and universal health coverage to all people around the world through a range of activities that include coordinating the global response to infectious disease outbreaks, ensuring system-level response to care with protection of the worst off through optimal sharing of expertise, and better access to diagnostics and medicines.

The global healthcare community has appreciated the constant support by the United States of America to WHO. Withdrawal of support would seriously destabilise the ongoing global response to the COVID-19 pandemic, especially in terms of protection to the poorest and the most vulnerable. We also need to support and work together with the WHO to ensure that the health systems around the world are able to support fully also the patients with pre-existing chronic conditions, including kidney disease. The ISN, representing the global kidney health community, stands with the WHO and reiterates the need for a global health agency more than ever.

Thursday, 23 April 2020 09:45

 ISN General Academy

Notice to attend meeting of the ISN General Assembly
(via online webinar)

Dear Member,

The ISN General Assembly meeting was due to take place at 7:00 am on 28 March 2020 during the World Congress of Nephrology 2020 in Abu Dhabi. We regret that the current global health situation did not allow for the WCN’20 to proceed as planned, and that we were not able to hold the ISN General Assembly meeting in person.
I am pleased to notify you that the ISN General Assembly meeting will instead take place via online webinar. 2 sessions will be held to allow for all time zones:

  • Friday, 22 May 2020 from 7:00 to 8:00 CEST, and
  • Friday, 22 May 2020 from 19:00 to 20:00 CEST.

Convert these times and dates to your own time zone here.

To register for the ISN General Assembly meeting webinar please click HERE.
Thank you for registering by 21 May 2020.

Please note:

  • You will need to attend only ONE of the sessions.
  • After registering, you will receive a confirmation email containing information about joining the webinar.
  • Only ISN members in good standing at the time of the session will be entitled to attend the meeting.

Please see below the agenda for the meeting:

  1. Welcome & Introductions
  2. ISN Financial Report
  3. ISN Membership
  4. ISN Activities update
     a.    Bridging the Gaps
     b.    Building Capacity
     c.    Connecting Community
  5. ISN 2020-2021
  6. Q&A

I look forward to speaking with those of you who are able to join us next month.
Yours sincerely,


Vivekanand Jha

 ISN President

The ISN and the Asian Pacific Society of Nephrology (APSN) have sustained a successful collaboration over the last decade working together to advance nephrology in the Asia-Pacific region, notably through the ISN Fellowship, Sister Renal Centers (SRC), Clinical Research (CR), and Continuing Medical Education (CME), and Kidney Care Network Programs.

Since 2010, 5 Clinical Research projects; 13 CME meetings; 17 Fellows; and 9 SRC pairs have been co-sponsored by ISN and APSN. A small sample of the outstanding results are highlighted below.

Nattachai Srisawat, an investigator from Thailand, received funding in 2015 for his Clinical Research project on AKI epidemiology in Southeast Asia. The project, completed in 2019, led to the publication of two articles (available here and here)in peer-reviewed journals. Dr. Srisawat won 3rd prize in the Clinical Research Awards organized at WCN 2019 in Melbourne, Australia. These awards recognize the three best posters derived from ISN Clinical Research projects.

Seow Yeing Yee, a Fellow from the Kuala Lumpur Hospital in Malaysia, trained at the Royal Prince Alfred Hospital in Australia from 2018-2019. She trained in clinical transplantation and plans to set up a kidney-paired exchange program in Malaysia to improve transplant rates. According to host mentor, Prof. Steven James Chadban, Dr. Yee is a potential future leader in transplantation in Malaysia and Asia, experienced to manage pre-transplant workup and post-transplant patient care.

The Viet Duc Hospital in Vietnam and the Juntendo University Hospital in Japan partnered between 2014 and 2019 through to the Sister Renal Centers Program and graduated in 2020. Training was received through six Continuing Medical Education (CME) courses in Renal Pathology throughout the partnership. Further courses took place in nephrology, dialysis, and transplantation covering all aspects of kidney diseases. Staff from the Pathology and Kidney Diseases and Dialysis departments of the Viet Duc Hospital attended short-term training courses in Japan.

The number of kidney biopsies carried out per year in the Viet Duc Hospital increased from 50 cases in 2014 to 300 cases in 2019. The Viet Duc Pathology department has become a center of reference for seven other hospitals in the region. Collaborative relationships between nephrologists and other specialists in Hanoi and Northern Vietnam have been established as well as between local and international specialists creating the potential for future research projects and motivating young professionals to work in the field.

As the implementation arm of the ISN 0by25 initiative, the Kidney Care Network (KCN) project consists of a series of implementation interventions that support centers in low-resource settings to develop integrated kidney care services. One of the four sites worldwide to have successfully launched the project is the Dharan Site in Nepal. An official partner of the ISN 0by25 Initiative, APSN has supported the Nepal KCN unit to become a well-established local ‘Network’ providing training in integrated kidney care across the region. Local advocacy efforts have increased in Nepal to ensure that good practices in integrated kidney care are sustained in the region.

In 2019, under the leadership of then ISN president, David Harris, and APSN Program Chair, Masaomi Nangaku (current APSN President), the APSN and the ISN co-organized WCN in Melbourne, Australia, alongside the Australian and New Zealand Society of Nephrology (ANZSN). The congress focused on glomerulonephritis, integrated end-stage kidney disease, and topics relevant to global and Asia-Pacific nephrology and offered hands-on courses on the clinical aspects of these topics prior to the scientific program.

ISN President, Vivek Jha, comments: “APSN and ISN have had a long-lasting and wide-ranging partnership aimed at supporting capacity building and research in all aspects of nephrology in the Asia-Pacific region. In addition to advancing kidney health through training and education, this partnership has fostered innovations, such as the Affordable Dialysis Prize.

The ISN looks forward to a continuing fruitful partnership with the APSN.

Thursday, 16 April 2020 13:54

Global Trials

Every month the ISN-ACT Team lists interesting new randomized controlled trials from around the world.


  • Keeping it simple with restriction: fluid restriction as good as diuretics and oral salt for SIAD
  • Deciding HDF or HD: nothing to lose sleep over

See the latest trials here.

New WCN’20 Content Available on the ISN Academy

Additional WCN’20 posters, provided by presenters, are now available online at the ISN educational portal, the ISN Academy: consult posters, poster talks, and visual abstracts.

The ISN Educational Ambassadors Program (EAP) was launched in 2009 to provide renal centers in developing countries with visiting international experts, recognized by the ISN, to provide specific hands-on training and help develop new skills or services needed in the host institution.

Through this program, centers around the world receive the guidance needed to develop new services and community-based research or screening programs.

For one to four weeks, Educational Ambassadors visit an emerging center to help lay the groundwork for a potential long-term collaboration between the host center and the ISN ambassador, extending the mentorship via teleconferences or videoconferences where necessary.

ISN Ambassadors advise on clinical cases and research, assist in the implementation of new projects and initiatives in the emerging centers, as well as help empower local professionals, including nurses and technicians, to improve the quality of life and survival rate of patients. Some host centers have started dialysis programs after the visit of the ISN ambassador.

The overall impact of the program is demonstrated through these recent collaborations made possible through the EAP.

Dr Picca gives training to staff at Bambino Gesù Hospital.

Dr Picca gives training to staff at Bambino Gesù Hospital.

Dr Stefano Picca, pediatric nephrologist and former Head of Dialysis Unit at Bambino Gesù Children's Hospital in Italy, has been an active ISN Educational Ambassador often linking his educational role to the Saving Young Lives project.

In 2018, Dr. Picca collaborated with Laurence Adonis-Koffy at Abidjan’s Centre Hospitalier Universitaire in Yopougon, Ivory Coast, to design a much-needed lecture on pediatric acute kidney injury, its causes, and treatment.

In 2019, he joined forces with Younoussa Keita, one of only two trained nephrologists at Hôpital Aristide Le Dantec in Senegal, to hold a week-long course specifically focused on training doctors and nurses in hemodialysis and peritoneal dialysis treatment for children with acute kidney injury, providing guidance that was central to setting up a long-awaited pediatric unit.

Dialysis and transplant training session at Yangon Children’s Hospital, Myanmar.

Dialysis and transplant training session at Yangon Children’s Hospital, Myanmar.

In 2018, Dr Yi Yi Khin, from Yangon Children’s Hospital (YCH) in Myanmar, organized an EA visit from Ambassador Kar Hui Ng from the National University of Singapore. Dr. Ng spent a week at the host center to give training in dialysis and transplantation and to provide local medical professionals with the confidence and infrastructure to perform their first pediatric renal transplantation.

This event was widely featured in the local press bringing it to the attention of Burma's Ministry of Health who pledged to increase resources into pediatric nephrology.

Dr. Ng commented on her greatest reward from the visit: “The big smile on the transplanted patient!”, explaining that the young patient “no longer has to stay in the hospital for years to receive chronic hemodialysis. She can go home and go to school.” 

Dr. Martin Lewis (far right) with staff members at University of Port Harcourt Teaching Hospital (UPTH) in Nigeria.

Dr. Martin Lewis (far right) with staff members at University of Port Harcourt Teaching Hospital (UPTH) in Nigeria.

ISN Educational Ambassador Malcolm Lewis, pediatric nephrologist at the Royal College of Surgeons in Ireland, gave two weeks of training, organized by Dr Felicia Elke, at the University of Port Harcourt Teaching Hospital (UPTH) in Nigeria in August 2019, as a follow-up to previous visits in 2015, 2017, and 2018.

Instruction focused on formal nephrology teaching, detection and prevention of renal disease with a community focus, and practical clinical nephrology with teaching and practice on the wards. Dr. Lewis’ prolonged visit enabled him to oversee the complete management of some patients and, thus, directly impacted the quality of their care.

Dr. Lewis helped develop a pediatric Renal Registry for Nigeria in collaboration with a local registry committee. All 38 pediatric units in Nigeria are now enrolled. Data entry tools were created on a secure website, easily accessible by mobile phone, and data collection began on September 1, 2019.

This data is an invaluable tool for securing state and federal funding for the service. The response to the project from the Transplant Association of Nigeria was so favorable that Dr. Lewis was asked to assist with the development of an adult registry.

According to Dr. Lewis, the presence of an Ambassador in UPTH allowed the translation of standard practices into what was feasible with available resources, commenting: “I can vouch for the value of having an experienced pediatric nephrologist going to places of limited resources and working through problems with the local teams…on the ground, dealing with problems as they occur is enlightening and can lead to innovative solutions as well as a strategic plan for development.”

The University of Port Harcourt Teaching Hospital in Nigeria is also in a partnership with a center in New York and another one in the UK as part of the ISN SRC Program.

Rea Judit Jerabekne Vegh (center right) demonstrating hemodialysis techniques to nurses at the Charak Memorial Hospital (CMH) in Nepal.

Rea Judit Jerabekne Vegh (center right) demonstrating hemodialysis techniques to nurses at the Charak Memorial Hospital (CMH) in Nepal.

Rea Judit Jerabekne Vegh, a registered nurse from Diaverum and Guys and St Thomas NHS Hospital in the UK, spent two weeks as an ISN Educational Ambasssador at the Charak Memorial Hospital (CMH), in Pokhara, Nepal, in November 2019. The visit was organized by Dr. Klara Paudel from the host institution.

The aim of the EAP visit was to increase the quality of care in the dialysis center and to provide advanced training to nurses at CMH, empowering them to become leading trainers in the region who are able to make decisions and suggestions concerning their patients and mentor junior staff.

The training centered on hemodialysis and focused on advanced techniques, improvements, and infection control. New techniques, procedures, and infection control measures were implemented immediately improving overall trouble-shooting and critical thinking capacity and positively affecting patient safety.

An interactive theory and practice training course was organized as part of the EAP visit to include nurses from other centers within the region. A patient education program for dialysis patients, “Positive Thinking on Dialysis,” also took place addressing diet, tiredness, and positive thinking. This event appeared in the local newspaper because of the favorable impact it had on the patients.

According to Rea Vegh, the nurses were eager to learn and responded positively to the encouragement to follow new procedures and to become confident enough to make decisions and try new approaches in case of problems. She comments that a highlight of her experience at CMH was: “To see the staff accepting and understanding the new practice as they took the initiative, and from one day to another, started to use some new techniques proving that their critical thinking has improved.”

Rea Vegh plans to establish a WhatsApp group with the nurses to share problems, solutions, and lessons learned. She hopes to visit again when the new unit is in operation saying: “It would be beneficial to spend a whole week on infection control, to help the senior management team with writing standard operating procedures, and start an auditing program.”

ISN is pleased to announce that selected WCN’20 posters as PDFs, poster talks, and visual abstracts will go online at the ISN educational portal, the ISN Academy from April 9 and released in stages throughout the month.

The Young Nephrologists Committee (YNC) is excited to welcome seven new members representing different regions of the globe:

  1. Alexandra Cambier, from France, is a pediatric nephrologist and immunologist with a specialty in pediatric IgA nephropathy. Her primary research interest is the identification of biomarkers for IgA nephropathy in children. She joined the YNC partly to share and explore differences in treatment between children and adults with kidney diseases.
  2. Yosuke Hirakawa is assistant professor of Nephrology in Tokyo, Japan. He joined the ISN and the YNC to gain an international perspective on nephrology and contribute to the advancement of both the ISN and the Asian Pacific Society of Nephrology (APSN).
  3. Shankar Prasad Yadav is a pediatric nephrology Fellow from Nepal who joined the ISN to contribute to the world of Nephrology. He later joined the YNC as a way to network and to get more involved in ISN’s work.
  4. Nikolay Bulanov, a nephrologist and researcher at Sechenov University in Russia, acknowledges that the ISN takes the needs of young nephrologists into account providing good opportunities to improve skills and knowledge in nephrology.
  5. Lili Zhou is currently a professor of nephrology at the Nanfang Hospital at the Southern Medical University in Guangzhou, China. She has devoted the last 17 years to researching the underlying mechanisms of kidney diseases and designing better therapeutic strategies. By serving on the ISN YNC she hopes to foster her career development and contribute to and benefit from an efficient platform for promoting exchange and communication within an international network of young nephrologists.
  6. Caner Alparslan works in a regional hospital in the southeastern part of Turkey where he has established a pediatric nephrology division including a kidney biopsy facility and a pediatric dialysis center. By joining the YNC he aims to promote interventional nephrology among young nephrologists and create a bridge between the YNC and other societies for mutual scientific benefit.
  7. Sabine Karam is an assistant professor of Nephrology at Saint George Hospital University Medical Center in Beirut, Lebanon. She hopes to enhance nephrology education and care in her country through the academic support that the ISN and the YNC can offer. She looks forward to contributing as much as she can to the expansion of ISN missions in the region and worldwide.

The 12th Annual International Conference on Nephrology & Hypertension was organized by the Caribbean Institute of Nephrology, in Kingston, Jamaica, in January 2020.

The conference, themed “Targeting Together Caribbean Kidney Issues,” was coordinated by Dr. Everard Barton from the University of the West Indies, Jamaica. Through its Continuing Medical Education (CME) Program, the ISN supported two speakers at the event: Dr. Frank Brosius, Professor of Medicine and Interim Chief of Nephrology at the University of Arizona; Professor Emeritus-Active Internal Medicine and Physiology at the University of Michigan, USA; and Dr. Guillermo Garcia Garcia, Hospital Civil de Guadalajara,Mexico; Co-Chair of the World Kidney Day Steering Committee and member of ISN Education Working Group,

The conference addressed issues such as cardiovascular and sickle cell disease in the Caribbean, new advances in the management of diabetic kidney disease in patients in the Caribbean, the status of kidney transplant, acute kidney injury and metabolic diseases in the Caribbean, peritoneal dialysis, mineral bone disease, the Caribbean Renal Registry and the scaling up of the Caribbean health care system.

The aim was to enhance collaboration between Caribbean states on kidney diseases and to educate health care providers on risk factors, prevention, and management of kidney diseases, as well as to improve peritoneal dialysis and maintain a regional kidney transplant program within the Caribbean.

ISN is pleased to have been able to support the Caribbean Institute of Nephrology toward improving nephrology care in the region.

At the World Congress of Nephrology 2017 in Mexico, ISN Fellows from around the world created a WhatsApp group to share experience and progress.

Dr. Mohammed Elrggal, from the Nephrology Department at the Kidney and Urology Center in Alexandria, Egypt, initiated a collaborative research project exploring AKI practice patterns in all the Fellows’ home countries. The study was accepted for a poster presentation at WCN19.

In 2019, the group of Fellows continued collaborating to explore disparities in access to kidney transplantation in their respective countries, with a special interest in the data from low-income countries. Initially, 11 Fellows agreed to participate, and the results were submitted as an abstract for WCN20.

Since then, more ISN fellows on the platform have contributed data from their own countries relating to transplantation access. This led to the creation of an ISN Fellows Collaborative Review set up to identify the challenges different regions face in providing universal access to kidney transplantation.

All ISN Fellows, and colleagues who got involved in the project, described data from his/her country on national transplant programs, national kidney transplant registry data, as well as from nephrology societies' databases and data collected from previous publications. The majority of colleagues contributing to the project* are former ISN Fellows or members of the ISN Young Nephrologists Committee.

The research group is confident that this collaborative study will be of value to the ISN community and a manuscript is currently underway to be submitted to Kidney International for consideration.

*Past ISN Fellows:
- Sibel Gokcay Bek (Turkey);
- Elliot Koranteng Tannor (Ghana);
- Aristide Eric Nono Tomta (Cameroon);
- Yannick Mayamba Nlandu (DR Congo);
- Ismoil Rashidov (Tajikistan);
- Khalida Bulhan-Soki (Kenya);
- Maisarah Jalalonmuhali (Malaysia);
- Abduzhappar Gaipov (Kazakhstan).

ISN members:
- Mohamed Essam Elrggal (Egypt);
- Aiperi Asanbek Kyzy (Kyrgystan);
- Sherzod Abdullaev (Uzbekistan).

During the COVID-19 pandemic, it is more important than ever to gather data to advocate for people with kidney disease. Recognizing this, the ISN’s SharE-RR (SHARing Expertise to support the set-up of Renal Registries) group, led by Fergus Caskey, has been working with its global network of registry experts to identify plans to establish COVID-19 surveillance systems and share experiences.

Responses to date have been summarized in a new section on COVID-19 on the ISN website with contact details for more detailed information.

The team is working alongside Thomas Hiemstra at the University of Cambridge, and Chair of the ISN-ACT group, to develop a data entry portal that will allow anonymized data to be collected on people with kidney disease and COVID-19 infection in countries without infrastructure.

This is a rapidly moving field; if you are aware of any activity not included here, or just want to get involved, please get in touch at

Monday, 06 April 2020 08:39

New COVID-19 Resources Available

Please see the latest visual abstracts on COVID-19-related topics in English, Spanish, Portuguese, and French.

Kidney International paper examines therapeutic options for patients with kidney disease.

Henriette Tyse Nygård reports on Anemia in Dialysis Patients in Zanzibar as the first in a series of Nurses’ blog posts in recognition of 2020 as the Year of the Nurse and the Midwife.

Anemia in dialysis patients in Zanzibar

Henriette Tyse Nygård

Dialysis nurse, Haukeland University Hospital, Norway; Dialysis nurse/teacher, MMH, Zanzibar; Student, Masters of Public Health, UIT, Norway; Member of the ISN Kidney Health Professionals Working Group

Anemia is a big challenge in the Mnazi Mmoja Hospital (MMH) in Zanzibar (a group of islands in Tanzania). Most of the anemic patients I saw during my 10 years working as a nurse was during my 2 years in Zanzibar. Getting blood for transfusion is very difficult due to lack of adequate supplies.

The dialysis unit in MMH opened in May 2017. Before this time, patients had to pay for private dialysis or move to the capital of Tanzania. The costs related to private dialysis or traveling to the capital made access to care very difficult for most people.

Dialysis in MMH is free: patients are offered dialysis twice a week. The kits used with the dialysis equipment include erythropoietin (EPO), but not iron sucrose. As a result, patients receive EPO at every treatment without iron sucrose. Iron sucrose is free if it is available in the hospital, but it is often out of stock.

The price for iron sucrose in a private pharmacy is around 6 USD. The cost of checking serum ferritin levels, which must be analyzed at a private laboratory, is around 30 USD and few patients can afford it. Some patients can afford to buy the iron they need, but many cannot. The standard prescribed dose of serum ferritin is 100 mg for 10 treatments for anemic dialysis patients who are started on iron sucrose.

It is hoped that iron sucrose will become available free of charge or at an affordable cost as administering EPO when serum ferritin is low is poor anemia management.

I also hope serum ferritin testing will be available in the laboratory in MMH soon. We know that giving too much iron is dangerous, but we also know that anemia can be fatal.

The staff in Zanzibar are positive, hard-working people that do their best for patients every day despite many challenges. I will forever be grateful for the time I have spent with this amazing crew.

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Tel: +1 567 248 9703
Fax: +1 908 272 7101
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