Back in August 2012, I wrote a provocative editorial in this space titled, “How About Twice-Weekly Hemodialysis?” This was the first time the topic of dialysis provided less frequently than 3 times a week was brought up in the 21st century. I argued that because kidney function worsens gradually, dialysis treatment should be gradual and…
Many nephrologists and other healthcare providers (HCPs) have enthusiastically embraced the July 10 presidential executive order titled, “Advancing American Kidney Health Initiative.” The 3 main components include a reduction in the end-stage renal disease (ESRD) rate by 25% by 2030; a substantial increase in home dialysis so that 80% of new ESRD patients can receive…
Hyperkalemia, defined as a serum potassium level above 5.3 mmol/L, develops in many patients with chronic kidney disease (CKD). The abnormality can precipitate serious adverse outcomes, including dysrhythmias and sudden cardiac death, so patients with elevated blood potassium levels may be referred to emergency departments or urgent care facilities for immediate therapy. As a result,…
Does this patient have malnutrition and inflammation complex from chronic kidney disease? A 78-year-old Caucasian male patient with end stage renal disease (ESRD) has been on maintenance hemodialysis three times/week for the past 3 years. He has been using a forearm loop arteriovenous graft (AVG) as dialysis access. During a routine evaluation in the dialysis…
