One of the most important concepts in nephrology is that of chronic systemic inflammation and its role in increased cardiovascular (CV) risk in patients with chronic kidney disease (CKD) and those on dialysis. Despite a significant research effort…
It is well known that patients who are referred to see a nephrologist earlier in the course of their disease are more likely to start dialysis with a functioning fistula and have better overall survival relative to those…
Although diabetes and hypertension rates in developing countries is rising to match that seen in developed regions, care for patients with end-stage renal disease is still a nascent field. I recently visited Dhaka, Bangladesh. I was able to…
In this week’s NEJM, Foley and colleagues published a retrospective analysis of the End-Stage Renal Disease Clinical Performance Measures Project (CPM) cohort examining the association of the long interdialytic break (i.e. Friday to Monday for MWF patients and…
Back in 1999, UCSF researchers strapped some high tech motion detectors onto about 30 patients on dialysis and compared one week’s worth of activity to that of matched controls. Mind you, these control patients were selected to be…
Even in my limited experience as a first year fellow, it seems that the decision to institute RRT seems to hinge on an idiosyncratic blend of patient and center-specific parameters. I was not surprised to learn that there…
Here’s an update on the recent financial upheaval in the world of dialysis reimbursement. The expanded bundling payment system was officially implemented in January 2011, and most dialysis units have now switched over to this new billing practice….
As nephrology fellows we see a lot of Acute Kidney Injury (AKI) on the inpatient consultative service. When AKI in the hospital requires dialysis people and their families naturally want to know whether this means long term dialysis…
One of the major problems we struggle with in haemodialysis patients is excess, volume, inter-dialytic weight gain and ultrafiltration. Despite constant reminders by nursing staff, physicians and nutritionists, patients seem to find it extremely hard to restrict their…
The recent publication of the landmark FHN Daily Trial was a step forward in our understanding of dialysis care. One of the authors, Dr. Brent Miller from Washington University School of Medicine in Saint Louis, is giving a…
