Us renal fellows are likely to take for granted the fact that virtually all dialysis buffers used today are bicarbonate-based buffer systems. The bicarbonate-CO2 buffer system is the dominant buffer system in the human body, patients without renal…
This is an interesting figure, taken from the 2008 USRDS (United States Renal Disease System) Atlas, which illustrates where patients in the U.S. are getting their dialysis from these days. Nearly 63% of all patients are getting dialysis…
This morning’s Renal Grand Rounds was an interesting talk given by Edmund Lowrie, a nephrologist currently employed by Fresenius Dialysis who has been studying measurements of dialysis adequacy for several decades. In his talk, he made the case…
Recent review in the latest issue of Nature Clinical Practice Nephrology entitled “Skin problems in chronic kidney disease.” They tackle the usual suspects (calciphylaxis, nephrogenic systemic fibrosis) as well as some lesser-known dermatologic conditions which appear with a…
In the most recent issue of C-JASN there is an intriguing article entitled “Ethical and Legal Obligation To Avoid Long-Term Tunneled Catheter Access” by Rehman et al, in which the authors argue strongly that tunneled catheters should be…
I heard a talk today by one of the fellows in our program who is also the senior author on this recent JASN article: Phosphorus Binders and Survival on Dialysis. Interestingly, even though the current KDOQI Guidelines recommend…
It doesn’t take long for the renal fellow to realize that a huge chunk of ESRD hospital admissions are due to catheter-related bacteremia, and a number of different algorithms exist for the management of dialysis catheter-related infections. Typically,…
In the U.S., erythropoietin is typically delivered as 3x/week intravenous injections in the ESRD population. This turns out to be a fairly significant cost, as Medicare-related payments for EPO comprise about 25% of the ESRD budget, which itself…
Intradialytic hypotension is a relatively common complication in dialysis patients. Here are some of the common therapeutic options to deal with this: 1. Increase the dry weight: one cause for intradialytic hypotension is simply over-ultrafiltration–if a patient is…
The Journal C-JASN has begun a new monthly feature: “The Nephrology Hall Of Fame”, in which each month an outstanding contributor to the field of Nephrology will be honored by an article describing their major contributions. The first-ever…
