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Background: The COVID-19 pandemic led to a temporary cessation of bedside teaching for medical students. Although bedside teaching has since resumed, to date, there have been no published data capturing the patient perspective of this teaching modality in the context of a pandemic. Methods: This study was conducted in the Acute Medicine Unit of a large teaching hospital. Patients participating in routine bedside teaching for medical students were invited to enrol in the study. Consenting patients were given a questionnaire after the session, aiming to capture their motivation for participating in bedside teaching, the positives and negatives of doing so, and their level of concern regarding transmission of COVID-19 as a result of participating. Findings: 50 patients were recruited over an 8-month period. 46/50 patients (92%) enjoyed bedside teaching and 48/50 (96%) would recommend taking part to others. The primary motivation for participating was altruism. Most patients (n = 35, 70%) did not report concern regarding COVID-19 transmission. There was, however, a clear relationship between increasing age and concern regarding COVID-19 transmission (OR 1.05, 95% CI 1.01–1.08). Conclusion: Patients involved in bedside teaching in an era following the COVID-19 pandemic continue to enjoy participating. Despite some concern regarding the risk of COVID-19 transmission, the overwhelming majority would recommend participation to others. It is widely recognised that there will be further contagious respiratory virus outbreaks in the future and medical educators have a duty to seek out and advocate for the patient perspective as they remain key stakeholders in successful bedside teaching. [ABSTRACT FROM AUTHOR]

Introduction: The National Registry of Rare Kidney Diseases (RaDaR) collects data from people living with rare kidney diseases across the UK, and is the world's largest, rare kidney disease registry. We present the clinical demographics and renal function of 25,880 prevalent patients and sought evidence of bias in recruitment to RaDaR., Methods: RaDaR is linked with the UK Renal Registry (UKRR, with which all UK patients receiving kidney replacement therapy [KRT] are registered). We assessed ethnicity and socioeconomic status in the following: (i) prevalent RaDaR patients receiving KRT compared with patients with eligible rare disease diagnoses receiving KRT in the UKRR, (ii) patients recruited to RaDaR compared with all eligible unrecruited patients at 2 renal centers, and (iii) the age-stratified ethnicity distribution of RaDaR patients with autosomal dominant polycystic kidney disease (ADPKD) was compared to that of the English census., Results: We found evidence of disparities in ethnicity and social deprivation in recruitment to RaDaR; however, these were not consistent across comparisons. Compared with either adults recruited to RaDaR or the English population, children recruited to RaDaR were more likely to be of Asian ethnicity (17.3% vs. 7.5%, P -value < 0.0001) and live in more socially deprived areas (30.3% vs. 17.3% in the most deprived Index of Multiple Deprivation (IMD) quintile, P -value < 0.0001)., Conclusion: We observed no evidence of systematic biases in recruitment of patients into RaDaR; however, the data provide empirical evidence of negative economic and social consequences (across all ethnicities) experienced by families with children affected by rare kidney diseases., (© 2024 International Society of Nephrology. Published by Elsevier Inc.)

Background: Individuals with rare kidney diseases account for 5-10% of people with chronic kidney disease, but constitute more than 25% of patients receiving kidney replacement therapy. The National Registry of Rare Kidney Diseases (RaDaR) gathers longitudinal data from patients with these conditions, which we used to study disease progression and outcomes of death and kidney failure., Methods: People aged 0-96 years living with 28 types of rare kidney diseases were recruited from 108 UK renal care facilities. The primary outcomes were cumulative incidence of mortality and kidney failure in individuals with rare kidney diseases, which were calculated and compared with that of unselected patients with chronic kidney disease. Cumulative incidence and Kaplan-Meier survival estimates were calculated for the following outcomes: median age at kidney failure; median age at death; time from start of dialysis to death; and time from diagnosis to estimated glomerular filtration rate (eGFR) thresholds, allowing calculation of time from last eGFR of 75 mL/min per 1·73 m 2 or more to first eGFR of less than 30 mL/min per 1·73 m 2 (the therapeutic trial window)., Findings: Between Jan 18, 2010, and July 25, 2022, 27 285 participants were recruited to RaDaR. Median follow-up time from diagnosis was 9·6 years (IQR 5·9-16·7). RaDaR participants had significantly higher 5-year cumulative incidence of kidney failure than 2·81 million UK patients with all-cause chronic kidney disease (28% vs 1%; p<0·0001), but better survival rates (standardised mortality ratio 0·42 [95% CI 0·32-0·52]; p<0·0001). Median age at kidney failure, median age at death, time from start of dialysis to death, time from diagnosis to eGFR thresholds, and therapeutic trial window all varied substantially between rare diseases., Interpretation: Patients with rare kidney diseases differ from the general population of individuals with chronic kidney disease: they have higher 5-year rates of kidney failure but higher survival than other patients with chronic kidney disease stages 3-5, and so are over-represented in the cohort of patients requiring kidney replacement therapy. Addressing unmet therapeutic need for patients with rare kidney diseases could have a large beneficial effect on long-term kidney replacement therapy demand., Funding: RaDaR is funded by the Medical Research Council, Kidney Research UK, Kidney Care UK, and the Polycystic Kidney Disease Charity., Competing Interests: Declaration of interests ERM reports support for the current manuscript from VHL UK/Ireland and consulting fees from MSD. SM is chair of OxalEurope. MS reports support for the current manuscript from a Medical Research Council UK Precision Medicine programme grant (MR/R013942/1) and consulting fees from Travere Therapeutics. RJC reports support for the current manuscript from Kidney Research UK. JAS reports support for the current manuscript from Kidney Research UK, Northern Counties Kidney Research Fund, and the Medical Research Council UK (all payments to institution). JAS is Academic Vice President of the UK Kidney Association. FWKT reports support from the National Institute for Health and Care Research Imperial Biomedical Centre. DN is the UK Kidney Association Director of Informatics Research. DPG reports support for the current manuscript from St Peter's Trust for Kidney Bladder and Prostate Research, Medical Research Council, Kidney Research UK, Kidney Care UK, and Polycystic Kidney Disease Charity (all payments to institution). DPG chairs the Rare Diseases Committee of the UK Kidney Association and reports fees for consulting and presenting from Novartis, Alexion, Calliditas, Sanofi, Britannia, and Travere. All other authors declare no competing interests., (Copyright © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Background: Early identification of chronic kidney disease (CKD) can help delay or prevent its progression, but the opportunities for systematic screening of patients are not well defined., Aim: To define the prevalence of CKD Stages 3-5 and related anaemia among acute medical admissions., Design: Retrospective analysis., Methods: We studied all acute medical admissions to a major London teaching hospital during one year. The lowest creatinine, highest haemoglobin (Hb) and average mean corpuscular volume (MCV) were determined for 3 months before and after admission. Patients were categorized as CKD Stages 3-5 if the highest estimated GFR (eGFR) was <60 ml/min/1.73 m2. CKD-related anaemia was diagnosed if these patients had Hb <11 g/dl with normal MCV., Results: A total of 6073 patients were studied: male 49.0%, age 65.4 +/- 19.6 years (mean +/- SD), creatinine 82.7 +/- 46.7 micromol/l, eGFR 89.1 +/- 32.5 ml/min/1.73 m2, Hb 13.6 +/- 1.73 g/dl, MCV 87.7 +/- 7.2 fl. There was an inverse correlation between eGFR and age (r2 = 0.5; P < 0.001). Males were younger than females (63.5 +/- 18.4 years vs. 67.3 +/- 20.5) and had higher eGFR (93.6 +/- 34.1 vs. 84.7 +/- 30.2 ml/min/1.73 m2; P < 0.001). A total of 743 patients (12.2%) had raised creatinine >110 micromol/l, however using eGFR <60 ml/min/1.73 m2, 1075 patients (17.7%) were identified. The patients were categorized as follows: Stage 3: 950 (15.6%), Stage 4: 100 (1.7%), Stage 5: 25 (0.4%). Ninety-nine (9.2%) of the 1075 patients had normocytic anaemia., Conclusion: We have found a high prevalence of CKD Stages 3-5 (17.7%) among acute medical admissions, of whom 9.2% had a related anaemia. Our findings highlight an important opportunity (amongst the 1.9 million acute medical admissions annually in England) for detecting patients with CKD.