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end-stage renal disease

Bundling

It’s a hot topic amongst dialysis centers around the country: bundling. Here’s my attempt to explain it in a brief manner. If anybody has corrections or comments about this explanation, feel free to make them known. With the…

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Amazing Dialysis Biker

Wow. In case you hadn’t heard the news, Shad Ireland, a 37 year-old dialysis patient, recently completed a cross-country bike trip which involved cycling from California to Washington, DC. Mr. Ireland has been on dialysis for 27 years,…

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When To Refer For Dialysis Access?

Despite the knowledge that AV fistulas and grafts give superior outcomes when compared to dialysis catheters, there remain a large chunk of patients who begin dialysis without a fistula or graft. Conversely, there are also examples of “unnecessary…

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GI Bleeding in ESRD Patients

While the GI & renal systems are not typically linked together, there are a few aspects to managing a GI Bleed in patients with CKD/ESRD which are somewhat unique.   For instance, angiodysplasias in the stomach, duodenum and…

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Why Do U.S. ESRD Patients Do So Poorly?

The Dialysis Outcomes and Practice Patterns Study (DOPPS) is an important longitudinal study of ESRD patients in multiple countries, and is the source of much respected epidemiologic data on dialysis patients worldwide. Interestingly, the DOPPS estimated the crude…

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Why doesn’t this catheter work?

Dialysis catheters:  the bane of the renal fellow’s existence. I’m sure there are some of you who actually like putting in catheters and are quite good at it, and while I will admit that an efficient line placement…

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Aggrenox for Maintaining AV Graft Patency?

A very significant percentages of ESRD patient admissions derive from clotted dialysis access–the “lifeline” dialysis patients require in order to survive on dialysis. Any maneuver or treatment which is successful in preventing, or even delaying, access thrombosis would…

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Dialysis in the Elderly

The rate of patients >75 years of age initiating dialysis has grown substantially in the U.S. over the past two decades.  This has to do with several factors, including improvements in medical technology enabling people to live long…

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