Toggle navigation

Category: Applied Clinical Practice

Peritoneal Dialysis in the Pandemic and Post-Pandemic World

Opinion article International Practice Considerations After COVID-19 As England moves into the recovery phase from COVID-19, it is worth reflecting on newly enacted changes in clinical practice that should be sustained going forward. This could be particularly helpful to my colleagues in the United States, still in the midst of the pandemic. In the United… Read More

Peritoneal Dialysis in the United States Amidst COVID-19

Opinion article Clinical Practice Learnings with Potential Post-Pandemic Application The world is amidst a public health crisis related to the COVID-19 pandemic. COVID-19 will remain a primary healthcare concern until a vaccine and effective medications are discovered, which may take many more months.1 End Stage Renal Disease (ESRD) patients are at particularly high risk of… Read More

Decreasing Non-COVID-19 Hospitalizations in Dialysis Patients

Opinion article Physician and Physician Extender Clinical Practice Considerations Caring for Dialysis Patients During the COVID-19 Epidemic On March 13, 2020, the US administration instituted a national emergency, as nearly 200,000 COVID-19 cases presented worldwide.1 This a novel disease and a rapidly evolving situation in the U.S., with the number of newly confirmed cases increasing… Read More

Transitioning from Peritoneal Dialysis to Hemodialysis

During the past decade, the use of peritoneal dialysis (PD) in the United States has grown substantially.1 In 2009, 7.5% of dialysis patients were treated with PD; by 2016, the statistic had increased to 10.0%.1 And according to the United States Renal Data System (USRDS), 10.5% of dialysis patients with new Medical Evidence Report (“2728”)… Read More

Recasting Kidney Failure as Cardiovascular Disease

Total Medicare expenditures on the health care of patients with permanent kidney failure have steadily risen to more than $35 billion per year, although per capita expenditures on the care of dialysis patients have been relatively stable in recent years.1 This conflict in trends can be readily explained by the seemingly unstoppable increase in the… Read More

When is More Frequent Hemodialysis Beneficial?

In 2017, Medicare Administrative Contractors (MACs) began to promulgate draft local coverage determinations that include restrictive language regarding Medicare reimbursement for additional hemodialysis sessions. An important element of the draft determinations is medical justification, or the clinical conditions that constitute evidence-based rationale for the prescription of more frequent hemodialysis. Suri and Kliger, who were both… Read More

Cardiac Arrhythmia: An Ominous Side Effect of Thrice-weekly Hemodialysis?

Many studies represent incremental gains in our understanding of human pathophysiology. Some studies, especially large randomized clinical trials, can singlehandedly change the standard of care. Other studies, at the most unexpected times, flash a signal that raises the question of whether the widely accepted standard of care is simply inadequate. In the April 2018 issue… Read More

Hypertension in Dialysis Patients

The link between hypertension, left ventricular hypertrophy, heart failure, and sudden death is clear. In the dialysis population, persistent hypertension is observed in the majority of patients, making it a fundamental and unmet challenge. Accumulating evidence shows that ambulatory blood pressure is a better predictor of survival than in-unit blood pressure—and, importantly, that ambulatory blood… Read More

International Guidelines for Increased Hemodialysis Time and Frequency

During the past 10 years, there has been a proliferation of research about intensive hemodialysis, including both longer and more frequent hemodialysis sessions. The accumulation of data from studies has led to the development of clinical practice guidelines about hemodialysis time and frequency, with a focus on identifying indications for increasing time and frequency.  … Read More

  • Stay Current

    Receive email updates on trends, findings, and opinions related to more frequent hemodialysis.
  • We will not send or sell your information to any 3rd parties.
  • This field is for validation purposes and should be left unchanged.