Building a global nephrology community online

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When the British Medical Journal became the first medical journal to go online in 1995, the flow of information online was strictly one-way. Journals and other sites were the expert providers of information, and visitors to the site were passive readers.

Today, sites like the Renal Fellow Network (RFN) are opting for a new model. The RFN has three editors who write and post articles, and who keep the site in order. But the majority of information comes from a global community of nephrology experts who want to share their knowledge, research, and experiences.

Matthew Sparks, a 2011 graduate of Duke's nephrology fellowship program who joined Duke's faculty this year, became involved with the RFN shortly after its inception in 2008, eventually becoming it's deputy editor.

“There were many web-based resources available at the time that were fantastic in terms of content but lacked the ability to effectively interact and learn with the authors,” says Sparks.

Case in point: this April, a physician based in Salt Lake City posted an article about pruritus, or itchy skin, which is a common, stubborn problem among dialysis patients. The condition can occur for many reasons, some obscure and some still not understood, and attempts to manage the condition are often unsuccessful.

Within 24 hours of her post, half a dozen nephrologists from across the United States and from the United Kingdom had responded. Some detailed their personal experiences with patients. Others discussed other possible causes of the disease, and different dialysis treatments used in the U.S. and Europe. One physician wrote back to discuss a literature review highlighted at a recent meeting at the National Kidney Foundation.

The RFN currently has more than 20 contributing authors, and receives 30,000 unique visitors a month from around the globe. It is partnered with the National Kidney Foundation and endorsed by the American Society of Nephrology.

The site has additional benefits for nephrology fellows, its primary audience, Sparks says. Fellows can post and share information on grants, conferences and courses.

The accessibility of the site also allows fellows to brush up on their knowledge even with the time restraints that come with a busy schedule. “As a fellow you’re typically so busy during your clinical year that you don’t have the chance to pick up and read a textbook. With the RFN, you can read about new subjects, and always delve deeper later if a subject piques your interest,” Sparks says

Sparks, who completes his fellowship this summer and will join the Duke nephrology faculty this fall, calls his time with the RFN “an overwhelmingly positive experience.”

“We really don’t have an agenda or specific list of topics that we cover. The Renal Fellow Network is truly a grass-roots initiative and thus we never really know what the next post will be.”