Tag Archives: Dialysis

ESRD Needs Different Blood Pressure Management (from normal patients)

It turns out that the relationship between blood pressure management and mortality is very different for ESRD patients than for the population as a whole. First, systolic blood pressure has a more significant correlation (than diastole) with mortality. And, the relationship is U-shaped (higher mortality at low systolic pressures for older patients and higher mortality for high systole for younger patients; 140/90 seems acceptable for all age cohorts). Continue reading

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Let’s Get Moving- Exercise is critical for health AND disease therapy

We know that exercise provides both physical and emotional improvement. We can reduce our girth and aggression; but it can help treat and improve the lives of breast cancer survivors, Parkinson’s Disease sufferers, dialysis patients, and those with autoimmune diseases. Continue reading

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Home hemodialysis may resurge…

Before Medicare began underwriting dialysis care, home dialysis treatment was a significant modality. New criteria also arose that led to shortened (4 h) treatment that was considered superior. Current research indicates that noctural, more frequent dialysis (at home) is actually superior. Continue reading

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Bioartificial Kidney Proof of Concept Completed

Dialysis has always been a stepping stone in the treatment of kidney failure. The goal is to provide a kidney transplant or a true “artificial” kidney (pun intended)- one that replaces virtually all the functionality of the real kidney. A step in that direction is described herein. Continue reading

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Bicarbonate Dialysis is better (Dialysis, part 3)

Just because a product was good under one set of circumstances, does not mean it does not need improvement. When dialysis was inefficient, acetate-bufered dialysate afforded an easy means to provide dialysis therapy. As treatments got more efficient (shorter), the more physiologic bicarbonate dialysate was needed. Ascorbic acid was also used (on occasion) to preclude chlorine-based hemolysis. Continue reading

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Dialysis glimpses, part 2

New technology improves dialysis results so that treatment can now occur in 6, rather than 12, hours. HR-1 of 1972 is passed, which provides for Medicare payments to all dialysis patients. The need for patient selection committees (now popularized as “death panels”) for dialysis is obviated. Continue reading

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Dialysis Glimpses from the 60’s and 70’s

Dialysis therapy in the 1960’s and 1970’s was a long process. Not every one could get treated. These are reminisces from those periods- when coil and flat plate units were used and each dialysis involved long preparation times, as well as long treatment times. Continue reading

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Le Plus Ca Change, Le Plus Ca Meme Chose….

I have been interested and involved in dialysis for 5 decades. There are more than 500,000 patients in the US (6% of the Medicare budget). There have been death panels and a switch from fee-based to evidence-based outcomes payments. We can, maybe, use this to learn what the new health care system for the US will become. Continue reading

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