Nephrology

End stage kidney disease

Questions discussed in this category

Do you take any different approaches for patients with end stage kidney disease who are about to be initiated on intermittent hemodialysis and have residual renal function?

1 Answer available

Are there instances when you do not recommend tunneled dialysis catheter exchange in patients on hemodialysis who are found to have bacteremia?

4 Answers available

Would you recommend transition to hemodialysis for a patient with calciphylaxis, hyperphosphatemia, and ESKD on peritoneal dialysis?

2 Answers available

Would you recommend desmopressin for a patient with ESKD receiving thrice weekly hemodialysis who is hospitalized for a persistent gastrointestinal bleed not amenable to usual interventional treatment strategies?

1 Answer available

What treatment options would you consider for a young patient with limited mobility, low bone mass and multiple vertebral compression fractures who is on dialysis for advanced kidney disease?

1 Answer available

Do you find adding fludrocortisone helpful in treating persistent hypotension in HD patients already on midodrine and without evidence of adrenal insufficiency?

5 Answers available

How do you counsel patients on peritoneal dialysis regarding the safety of engaging in aerobic and resistance exercises, considering the risk of developing abdominal wall complications?

1 Answer available

How do you approach palliative conversations about what patients can expect when deciding to stop maintenance dialysis?

1 Answer available

Are there instances when you dose sodium zirconium cyclosilicate more than once daily for long term therapy for patients with end stage kidney disease and hyperkalemia?

1 Answer available

Are there instances where you may transiently transition a perioperative ESKD on PD inpatient from peritoneal dialysis to hemodialysis if they are likely to receive a large volume of fluid?

Invited Professor Series Video: Volume Management and Access Troubleshooting in Peritoneal Dialysis - Claretha Lyas, MD

2 Answers available

What are your top takeaways from ASN 2024?

1 Answer available

Are there any instances when you would not perform 3 consecutive daily dialysis sessions when initiating a patient on hemodialysis?

2 Answers available

How often do you recommend basic metabolic panel checks in a hospitalized ESKD patient on thrice weekly hemodialysis and for whom hyperkalemia is not of major concern?

2 Answers available

Do you recommend a daily B complex multivitamin for patients with end stage kidney disease who are receiving peritoneal dialysis?

1 Answer available

Would you recommend adding a daytime dwell over an additional nighttime exchange to achieve volume and clearance targets for an ESKD patient who recently stopped making urine and has been receiving only nighttime automated peritoneal dialysis?

3 Answers available

Do you avoid sodium zirconium cyclosilicate use in your patients with ESKD and hyperkalemia who also have peripheral edema?

1 Answer available

Is there a serum phosphorus level you would consider too low to safely perform hemodialysis?

2 Answers available

What is your approach to managing insomnia in an ESKD patient?

2 Answers available

Do you recommend avoiding ESAs in pregnant patients with anemia of chronic kidney disease who also have preeclampsia?

1 Answer available

How do you approach the management of persistent hyperphosphatemia in ESKD patients who are non-adherent to phosphate binders?

1 Answer available

How do you approach a patient request to decrease hemodialysis time when Kt/V values are above target but serum phosphorus remains poorly controlled?

2 Answers available

How would you approach a patient with end stage kidney disease on peritoneal dialysis who has an adequate Kt/V but persistent azotemia?

1 Answer available

What recommendations do you offer for patients who have a peritoneal dialysis catheter and who wish to swim?

2 Answers available

How frequently do you recommend flushing a peritoneal dialysis catheter for patients with ESKD who are hospitalized and are not currently undergoing peritoneal dialysis?

6 Answers available

Do you recommend daily topical exit site antibiotic use for patients with a peritoneal dialysis catheter that is only currently being accessed for once weekly flushes?

2 Answers available

Do you recommend starting anti-fungal prophylaxis for patients on systemic antibiotics who have a peritoneal dialysis catheter that is only currently being accessed for once weekly flushes?

1 Answer available

How do you adjust your management strategy to address the unique needs of anuric end-stage kidney disease patients when treating diabetic ketoacidosis?

1 Answer available

What is your approach to ESA use in patients with ESKD and active malignancy on treatment?

2 Answers available

What is your preferred fill volume, dialysis solution, and dwell time for patients with suspected peritoneal dialysis associated peritonitis who arrive to the hospital with a dry abdomen?

2 Answers available

Given the risk of hypocalcemia in dialysis dependent patients treated with denosumab, what is the best method of treatment for osteoporosis for these patients, and should we be transitioning to a different agent?

2 Answers available

How do you time 24 hour urine collections when calculating creatinine clearance for patients receiving thrice weekly hemodialysis?

2 Answers available

Should GLP1 R agonists be used as first line glucose lowering agents in patients with ESKD and DM2?

1 Answer available

Would you consider reducing the dialysate sodium concentration to 135 meq/L as a strategy to decrease interdialytic weight gain in a hypervolemic ESKD patient?

Miskulin, et al., PMID 38349776

1 Answer available

What sort of telehealth approaches do you pursue for a newly diagnosed end stage kidney disease patient starting peritoneal dialysis or home hemodialysis?

1 Answer available

Should CT coronary calcium score be avoided in dialysis patients in light of presumed high prevalence of CAC in this population?

3 Answers available

What is your blood pressure threshold to hold an ESA for patients with ESKD, anemia, and hypertension?

2 Answers available

Are there instances when you recommend femoral vein dialysis catheter placement in patients newly started on hemodialysis in an effort to preserve upper extremity future fistula options?

1 Answer available

What is your PTH target for patients with ESKD and brown tumor?

2 Answers available

What is your approach to managing intradialytic cramping that recurs despite multiple dry weight adjustments in a patient with ESKD?

2 Answers available

Do you recommend antibiotic prophylaxis for an ESKD patient with a tunneled dialysis catheter who is planned for a dental procedure?

2 Answers available

How long after surgical repair of a pleuroperitoneal leak do you resume peritoneal dialysis?

1 Answer available

What is your approach to safely performing hemodialysis in a patient with a fistula who is hospitalized for altered mental status and unable to remain still?

1 Answer available

How do you manage patients with end stage kidney disease and recurrent ascites who do not have any evidence of cardiac or liver disease?

3 Answers available

Do you initiate peritoneal dialysis with an incremental strategy to ease patients into their treatment, even though it might lead to frequent lab monitoring and the risk of underdialysis?

Auguste & Bargman, PMID 36208963

3 Answers available

What is the maximum diuretic regimen recommended in patients with end-stage kidney disease who have residual renal function and volume overload?

4 Answers available

What is your approach to determining which patients with ESKD and pruritis should be started on difelikefalin?

2 Answers available

What are your strategies for safely prescribing peritoneal dialysis for patients who have pets at home?

4 Answers available

How often do you check carnitine levels in your patients with end stage kidney disease on hemodialysis?

2 Answers available

What is your approach to managing osteoporosis in patients with end stage kidney disease?

1 Answer available

Do you avoid ESAs in patients with end stage kidney disease who also have heart failure due to increased risk of stroke?

2 Answers available

Do you increase the frequency of hemodialysis for patients with calciphylaxis?

3 Answers available

What considerations do you take when managing a patient with end stage kidney disease on peritoneal dialysis who is planning on undergoing PEG tube placement?

1 Answer available

What are your management strategies for patients with end stage kidney disease on hemodialysis who develop hypercalcemia of immobility?

1 Answer available

Do you recommend placement of a backup AV fistula in an advanced CKD patient who is planning to do peritoneal dialysis?

Prior retrospective studies have suggested a lower rate of future catheter use with a backup AVF in place (Haralabopoulos et al., PMID 32852703).

4 Answers available

How do you distinguish between primary and tertiary hyperparathyroidism in a patient with ESRD?

1 Answer available

What is your approach to monitoring for recovery in a patient with non-oliguric AKI requiring dialysis?

4 Answers available

Between mean arterial pressure (MAP) and blood pressure (BP), which do you use when prescribing hemodialysis to instruct a hold on additional ultrafiltration should the value become too low?

1 Answer available

How do you advise an ESKD patient who wants to drink pickle juice to reduce intradialytic muscle cramps?

3 Answers available

What are the important aspects that you mention when consenting patients for hemodialysis?

1 Answer available

How do you manage severe intra-dialytic hypertension that is not responsive to dry weight challenge in an asymptomatic patient with ESKD?

1 Answer available

Do you intensify the dialysis prescription for patients with end stage kidney disease who develop uremic pericarditis despite regular dialysis sessions?

3 Answers available

For which patients with calciphylaxis would you recommend a parathyroidectomy?

3 Answers available

How do you manage hemodialysis for an ESKD patient presenting with severe hyponatremia and a serum sodium more than 10 mEq/L below the lowest available dialysate sodium concentration?

1 Answer available

What is your approach to establishing a dry weight in a pregnant patient with ESKD on hemodialysis given the expectation of weight increase and pregnancy-related edema?

2 Answers available

What is your approach to determining the need for continued isolation in the dialysis unit for an ESKD patient who had a positive hepatitis B surface antigen one year ago but who now has a negative HbsAg in the absence of treatment?

1 Answer available

Do you stop activated vitamin D (ie paricalcitol) in your dialysis patients who have hyperphosphatemia despite low phosphate diet and phosphorus binder adherence?

1 Answer available

How do you determine the fill volume of icodextrin for a volume-overloaded ESKD on PD patient considering that the dwell may last throughout the day?

Invited Professor Series Video: Volume Management and Access Troubleshooting in Peritoneal Dialysis - Claretha Lyas, MD

1 Answer available

How long would you wait for outflow to improve before consulting surgery in a peritoneal dialysis patient with an outflow obstruction who is prescribed laxatives for catheter migration?

Invited Professor Series Video: Volume Management and Access Troubleshooting in Peritoneal Dialysis - Claretha Lyas, MD

1 Answer available

How soon after an intervention is done for peritoneal catheter inflow or outflow obstruction is it advisable to repeat the Kt/V?

Invited Professor Series Video: Volume Management and Access Troubleshooting in Peritoneal Dialysis - Claretha Lyas, MD

1 Answer available

What are some considerations to make when managing a patient on peritoneal dialysis who develops acute pancreatitis?

1 Answer available

What are your top takeaways from ASN 2023?

2 Answers available

Do you recommend continuing SGLT2 inhibitors in patients with diabetic kidney disease and congestive heart failure who have been taking the medication for several years and later develop end stage kidney disease?

3 Answers available

What strategies have you used to help patients with advanced kidney disease who are asymptomatic understand the severity of their condition?

3 Answers available

For a patient interested in home dialysis modalities, what are some key points that you discuss with them to help them make a decision on peritoneal dialysis versus home hemodialysis?

1 Answer available

Do you use mannitol when initiating patients on intermittent hemodialysis?

1 Answer available

When do you avoid or stop erythropoietin-stimulating agents in patients with anemia and end stage kidney disease?

1 Answer available

What adjustments do you make to a hemodialysis prescription for a patient with a recent stroke?

3 Answers available

When do you avoid or stop iron agents in patients with anemia and end stage kidney disease?

1 Answer available

Do you recommend continuing peritoneal dialysis in an ESKD patient on peritoneal dialysis who is diagnosed with encapsulating peritoneal sclerosis since abdominal symptoms may worsen when peritoneal dialysis is stopped?

1 Answer available

How do you manage recurrent hemodialysis filter clotting in an in-center ESKD patient with heparin-induced thrombocytopenia?

1 Answer available

Do you recommend targeting a higher Kt/V in an ESKD patient on hemodialysis with pruritis and a Kt/V of 1.4?

1 Answer available

In what instances might you recommend twice daily 7.5% icodextrin to patients on peritoneal dialysis?

1 Answer available

When would you recommend adding peritoneal dialysis to a patient with oxalosis who is already receiving hemodialysis?

1 Answer available

What considerations do you make to the dialysis prescription for a pregnant patient on peritoneal dialysis?

1 Answer available

What is your blood pressure goal for a pregnant patient on hemodialysis?

1 Answer available

How soon after an end stage kidney disease patient receives a MRI study with gadolinium contrast do you perform their next hemodialysis session?

1 Answer available

What is your approach to the use of intravenous sodium thiosulfate for the management of calciphylaxis in a patient with end stage kidney disease and on hemodialysis?

1 Answer available

Do you proceed with outpatient hemodialysis for an asymptomatic ESKD patient who has missed the last three hemodialysis sessions?

1 Answer available

Do you prefer that hospitalized peritoneal dialysis patients use their own home dialysis equipment during the admission?

2 Answers available

Do you give a short-acting antihypertensive before starting outpatient hemodialysis on an asymptomatic ESKD patient with a predialysis blood pressure of more than 200/100?

1 Answer available

What is your PTH threshold for referring an ESKD patient with secondary hyperparathyroidism on maximum medical therapy for parathyroidectomy?

1 Answer available

Do you treat low 25-OH vitamin D levels in those with end stage kidney disease?

1 Answer available

What is the preferred timing for removal of a peritoneal dialysis catheter in a patient who has transitioned to hemodialysis?

1 Answer available

What is the antifungal prophylaxis regimen that you use in patients on peritoneal dialysis who are receiving antibiotics?

1 Answer available

Papers discussed in this category

Semin Dial, 2010 May 10

Why dialysis patients need combination therapy with both cholecalciferol and a calcitriol analogs.

Perit Dial Int, 2022 Mar

ISPD peritonitis guideline recommendations: 2022 update on prevention and treatment.

Radiology, 2021 Jan

Use of Intravenous Gadolinium-based Contrast Media in Patients with Kidney Disease: Consensus Statements from the American College of Radiology and the National Kidney Foundation.

Renal failure, 2006

Intraperitoneal sodium thiosulfate for the treatment of calciphylaxis.

American journal of nephrology, 2014

Oxalate quantification in hemodialysate to assess dialysis adequacy for primary hyperoxaluria.

Clinical journal of the American Society of Nephrology : CJASN, 2015-11-06

Peritoneal Equilibration Test and Patient Outcomes.

Perit Dial Int, 2020 Jan 21

International Society for Peritoneal Dialysis practice recommendations: Prescribing high-quality goal-directed peritoneal dialysis.

Am J Kidney Dis, 2009 Apr 25

The importance of residual kidney function for patients on dialysis: a critical review.

Perit Dial Int, 2017 Jul-Aug

Length of Time on Peritoneal Dialysis and Encapsulating Peritoneal Sclerosis - Position Paper for ISPD: 2017 Update.

Semin Nephrol, 2017 Jan

Encapsulating Peritoneal Sclerosis.

Hemodialysis international. International Symposium on Home Hemodialysis, 2013 Oct

Changing the hemodialysis prescription for hemodialysis patients with subdural and intracranial hemorrhage.

The New England journal of medicine, 2015 Sep 17

Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes.

The New England journal of medicine, 2020 Sep 24

Dapagliflozin in Patients with Chronic Kidney Disease.

American journal of kidney diseases : the official journal of the National Kidney Foundation, 2019 Apr 27

Hypertonic Mannitol for the Prevention of Intradialytic Hypotension: A Randomized Controlled Trial.

Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis, 2021 Nov 07

Physical activity and exercise in peritoneal dialysis: International Society for Peritoneal Dialysis and the Global Renal Exercise Network practice recommendations.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2009-07-01

Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 Update by the Infectious Diseases Society of America.

Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis, 2010 May-Jun

Acute pancreatitis in peritoneal dialysis patients: diagnosis in the icodextrin era.

Kidney research and clinical practice, 2018 Mar 31

Use of fludrocortisone for intradialytic hypotension.

Kidney international, 2001 Mar

Role of diuretics in the preservation of residual renal function in patients on continuous ambulatory peritoneal dialysis.

American journal of nephrology, 1992

Acute and long-term effects of therapy with high-dose furosemide in chronic hemodialysis patients.

Kidney research and clinical practice, 2019 Mar 31

Efficacy of triple diuretic treatment in continuous ambulatory peritoneal dialysis patients: A randomized controlled trial.

The Journal of surgical research, 2019-12

Safety of Laparoscopic Gastrostomy in Children Receiving Peritoneal Dialysis.

Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis, 2011 May-Jun

Adult peritoneal dialysis patient with Tenckhoff and percutaneous endoscopic gastrostomy catheters.

The International journal of artificial organs, 2022 Jan 17

Is percutaneous gastrostomy tube insertion contraindicated in adult peritoneal dialysis patients? A single-centre experience of three successful cases: It is time to revisit.

Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis, 2024 Jan 24

Percutaneous endoscopic gastrostomy in children receiving peritoneal dialysis: A tertiary centre long-term experience and literature review.

Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis, 2023 Jan 04

A different PET test: The relationship between pet ownership and peritonitis risk in the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS).

The New England journal of medicine, 2009-11-19

A trial of darbepoetin alfa in type 2 diabetes and chronic kidney disease.

The New England journal of medicine, 2006 Nov 16

Correction of anemia with epoetin alfa in chronic kidney disease.

Kidney360, 2022 Dec 18

Incremental Peritoneal Dialysis-Definition, Prescription, and Clinical Outcomes.

Kidney international reports, 2021 Dec 01

Incremental Versus Standard (Full-Dose) Peritoneal Dialysis.

Circulation, 2008 Jun 09

Bacteremia associated with toothbrushing and dental extraction.

Special care in dentistry : official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry, 1999 May-Jun

Prophylactic antibiotic therapy prior to dental treatment for patients with end-stage renal disease.

Nephrology (Carlton, Vic.), 2004 Jun

Antibiotic prophylaxis in dialysis patients undergoing invasive dental treatment.

Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis, 2019

Creating and Maintaining Optimal Peritoneal Dialysis Access in the Adult Patient: 2019 Update.

Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis, 2023 May 26

ISPD Catheter-related Infection Recommendations: 2023 Update.

Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis, 2020 Jan 17

Accuracy of the estimation of and the implications this has when applying / for measuring dialysis dose in peritoneal dialysis.

American journal of kidney diseases : the official journal of the National Kidney Foundation, 2020 Sep

KDOQI Clinical Practice Guideline for Nutrition in CKD: 2020 Update.

Blood purification, 2020 Jan 15

Report of Dialysis-Induced Hypophosphatemia Leading to Reversible Encephalopathy Prevented by Adding Phosphorus to the Dialysate.

Clinical journal of the American Society of Nephrology : CJASN, 2008 Sep 24

Peritoneal phosphate clearance is influenced by peritoneal dialysis modality, independent of peritoneal transport characteristics.

Scientific reports, 2020 Oct 15

Phosphate clearance in peritoneal dialysis.

The New England journal of medicine, 2024 Oct 26

Bi- and Monoallelic Variants and Chronic Kidney Disease in West Africans.

Atencion primaria, 1997 Sep 30

[The existing differences between adolescent girls served on a first visit in a family planning center in 2 time periods].

The New England journal of medicine, 2024 Oct 25

Long-Term Effects of Empagliflozin in Patients with Chronic Kidney Disease.

Nephron, 1986

Intraabdominal pressures during natural activities in patients treated with continuous ambulatory peritoneal dialysis.

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