The ongoing spectre of the COVID-19 pandemic looms large and central in the minds of those planning the 2021 National Kidney Foundation’s Spring Clinical Meetings (NKF SCM21). The conference, which runs April 6-10, will feature the latest perspectives on the effects of COVID-19 on the kidneys.

The sessions “include a focus on health disparities with COVID-19, and acute kidney disease and management in COVID-19 infections,” says Mitchell H. Rosner, MD, chair of the SCM21 program committee.

One important question currently surrounding the interactions between COVID-19 infection and the kidney “is whether acute kidney injury is due simply to critical illness and sepsis or directly related to COVID-19,” explains Rosner, professor and chair of the Department of Medicine of the University of Virginia Health System in Charlottesville.

“There is a lot of evolving literature and continued controversy in this issue which will be discussed,” in session 278 on April 7, “Acute Kidney Injury in the COVID Era,” he adds.

Another timely topic will be further insight into pending recommendations from a task force charged with reassessing the race coefficient for calculating estimated glomerular filtration rate (eGFR) in people who self-identify as Black.

“We are really excited about this year’s meeting and there are many sessions that highlight hot and emerging topics in nephrology,” Rosner said in an interview. 

“For instance, we have several sessions that focus on a new era in treating diabetic kidney disease with several new medications that have recent clinical trial results, such as the sodium-glucose cotransporter 2 (SGLT-2) inhibitors, and the mineralocorticoid receptor antagonists (MRAs).”

“Our focus has been on trying to give all clinicians the latest practical and most relevant knowledge to help them help patients with kidney disease.”

Racial Justice as the Keynote 

Rosner emphasized a key focus of the meeting will be on racial disparities.

“Our focus on health disparities continues with a plenary on April 8 by Aletha Maybank, MD, MPH, chief health equity officer for the American Medical Association, whose presentation will center on the importance of institutionalizing and operationalizing racial equity work during COVID-19 and beyond,” he  explains.

Tara I. Chang, MD, co-chair of the SCM21 program committee, agrees this discussion is key: “I am particularly looking forward to the keynote address by Dr Maybank on operationalizing racial justice. It’s such an important and timely topic given the Black Lives Matter movement and recent spotlight on the violence against the Asian American and Pacific Islander community.

“I’m also hoping to catch the Fellows’ Trivia Night session on April 8,” adds Chang, a nephrologist at Stanford University Medical Center, Stanford, California, in an interview.  “It will be interesting to see how fierce the competition gets among the fellows despite being virtual, and I think will have important implications for future strategies in educational engagement.”

Will the NKF/ASN Joint Task Force Report? Time Will Tell

One “much anticipated hot topic” during the virtual meeting will be session 252 on April 9: “Reflections from the NKF/ American Society of Nephrology (ASN) eGFR Task Force on Reassessing the Inclusion of Race in Diagnosing Kidney Diseases.”

Last August, the NKF and ASN formed a joint task force to revisit use of the race coefficient for people who self-identify as Black when calculating their eGFR. This upward adjustment first appeared in a 1999 revision of the eGFR formula, the Modification of Diet in Renal Disease study equation, and again in an improved calculation formula from the Chronic Kidney Disease Epidemiology Collaboration in 2009. In both cases, the rationale was that these formulas systematically underestimate the eGFR in Black individuals.

The SCM21 session features five speakers who are all task force members, including the group’s two co-chairs.

Rosner emphasized that although he is “sure it will be watched closely and heavily attended,” even he doesn’t know whether the task force will use this venue to release its awaited interim report. “I do not know what content will be presented,” he confides.

SCM21: Virtual From the Start Means Great Flexibility

Unlike SCM20, which pivoted from live to virtual just weeks before the sessions began, this year’s edition had an all-virtual format from the start.

“All our planning was based upon knowing that we were going virtual this year. This helped tremendously and gave us increased flexibility,” explained Rosner. “For example, we could include more sessions without a restriction based on the number of rooms we had. We could more easily engage international speakers and be creative in thinking how to engage the audience better. The other advantage of an all-virtual meeting is that people have a lot of flexibility in how and when to engage with the content of the meeting.”

For Chang, other pluses of the virtual meeting include “a lot more flexibility in how we format the sessions regarding the length, number of speakers, etc,” she said. “With the ability to pre-record sessions, we are also able to get speakers to participate who otherwise would have had to decline. We also get speakers from around the world to participate since no one has to travel, and the same can be said of our attendees.”

But all-virtual meetings also have clear downsides. “I will, of course, miss the informal meetings that happen, when people attend in person,” adds Chang. “Running into folks at the coffee stand or while walking the poster halls. But we’ll try our best to replicate some of those informal experiences as best we can in the virtual sessions,” she promises.

Rosner concurs. “Interpersonal connections and networking are critical aspects of any meeting. We know that a virtual meeting is suboptimal and have tried to find ways to allow people to connect,” he says. Several sessions will include live audience interactions, including two poster discussion hours on April 7 and 9 that will together showcase 13 of the top-scoring submitted abstracts.

While the SCM21 organizers hope for live sessions next year, they foresee retaining some positive elements of the virtual approach.

“There is great enthusiasm for the virtual meeting and a great registration thus far, but I think people are eager to get back together in person. I do think that the virtual format has great flexibility and that there will always be some virtual component moving forward,” predicts Rosner.

“We received excellent feedback from last year’s last-minute virtual meeting, and I think many are excited for this year’s meeting too. In future years, we do envision having a virtual component even when we’re back to holding in-person meetings, because of the flexibility it offers to both the speakers and the attendees,” agrees Chang.

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