To determine if a patient receiving hemodialysis newly diagnosed with a malignancy might benefit from aggressive cancer treatment, an oncologist colleague posed the following question to me: “What is the typical survival rate for end-stage kidney disease (ESKD)…
As a new pediatric nephrology fellow, my first weeks taking care of patients on hemodialysis were overwhelming. Each of my patients had complex problems and intricate physiology, and I initially learned to focus on the numbers – clearance,…
Hemodialysis 101: The “key” to KT/V urea Namrata Krishnan, Assistant Professor of Medicine at Yale has hit it out of the park. She has a fantastic online module to understand hemodialysis kinetics. This module is jam packed with…
When I first began learning about Nephrology, I came across ‘dialysis dementia’, a progressive and fatal condition described in hemodialysis patients. Several studies in the 1970s implicated aluminium found in phosphorus binders and dialysate water as the cause….
I have the distinct advantage and pleasure of having an Internist as my spouse. Rarely a dinner goes by without a case discussion. Recently, she brought up an all-too-common case… One of her ‘’favorite’’ ESRD patients had died…
I ran into a colleague from Children’s Hospital over the weekend and she pointed me in the direction of this great education website that they have created for the education of students, residents and fellows. In particular, they…
At renal grand rounds this week, I presented a case of a gentleman who presented with fevers, confusion, and lower extremity pain during dialysis. The patient would spike low grade fevers pre-HD and then fevers up to 105…
Global warming is a growing threat to our health. Dialysis, while sustaining the lives of millions worldwide, has a significant environmental impact. Think of your last dialysis order. Perhaps the Kd was 500 ml/min for four hours. That’s…
What if we could do more frequent dialysis? Would this improve QOL as potentially seen in the original FHN trial or even improve survival as seen in recent longer-term FHN follow-up? What if we had more resources to…
We had an interesting discussion yesterday about a young patient with ESRD secondary to diabetic nephropathy who was recently initiated on hemodialysis and reported headaches, chest heaviness and shortness of breath during dialysis sessions associated with a rise…
