We are well-versed in describing to our soon-to-be ESRD patients their options: kidney transplant, hemodialysis, or peritoneal dialysis. However, in many developing countries, these options do not exist, or there may be a significant delay in getting them…
There is an interesting article in the most recent New England Journal of Medicine describing the epidemiology of the now infamous Baxter heparin recall which occurred over the past year or so. In brief, a Missouri pediatric dialysis…
Reverse osmosis (RO) is a critical aspect of providing the large volume of relatively purified dialysate water to dialysis patients worldwide. If you’ve never taken a peek at the water treatment room in your hospital’s dialysis unit (it…
Check out this video I found of the alleged first-ever home dialysis patient in England. Very civilized, except for the fact that it looks like the patient is using a permanent femoral dialysis catheter–something which would be used…
DOPPS is an acronym which stands for “Dialysis Outcomes and Practice Patterns Study.” It is one of the largest prospective study of ESRD patients worldwide and is comprised of a random sampling of dialysis patients in a random…
The Hemoglobin A1c has proven to be one of the most utilized and helpful tests in the management of diabetes. Instead of relying on random blood sugars to adjust a diabetic’s insulin regimen, the HgbA1c (which increases in…
Ototoxicity–which can occur via both auditory and vestibular mechanisms–is one of the major side effects of aminoglycoside use, particularly in dialysis patients. A recent paper looked at N-acetyl cysteine (NAC) as a potential strategy for preventing ototoxicity in…
The constant “K” pops up in many forms in nephrology, particularly in the realm of dialysis, as each dialysis membrane has its own characteristic K values. There is first and foremost the Kt/V equation, the currently accepted…
The term “Middle Molecules” is a little confusing, in part due to its evolving definition. It was initially used to describe anything not dialyzed off by the older dialyzer membranes of the 1970s, which predominantly filtered out only…
Infectious metastases (e.g., infective endocarditis, epidural abscess, liver & lung abscesses, etc) are unfortunately not uncommon in the ESRD population, particularly in those with in-dwelling catheters. I have personally seen several cases of epidural abscesses as a fellow,…
