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Long Professor of Medicine and Genetics and chief of nephrology at Yale University School of Medicine, are the senior authors of the paper.

“It’s not for everyone,” said Dr. Mark Sarnak, chief of the nephrology division at Tufts Medical Center.

He earned a bachelor’s degree and then in 1965 a medical degree from Johns Hopkins University, followed by a fellowship in pediatric nephrology at the University of Minnesota.

"It can't help but feel like a massive failure when we have such a catastrophic loss of patients," said Dr. Michael Heung, a clinical professor of nephrology at the University of Michigan.

Attention to palliative care in nephrology has lagged behind its use for advanced cancer, for instance.