How are our patients dealing with these tremendous costs?

Do you have ppl in ur clinic to help pts obtain these medicines at an affordable cost?

Source: Primer on Diabetes Management www.vumedi.com/video/primer...

⚠️ Calciphylaxis is a debilitating and painful condition that is hard to treat.

▶️ Do you use daily dialysis as part of treatment? If so, what criteria do you use?

#askrenal

pubmed.ncbi.nlm.nih.gov/21872378/

doi.org/10.1093/ndt/...

Seems good, but what does "un-ionized" mean? 😵‍💫

"Resident physicians secure the first *unionized* contract at MGH.."

www.wgbh.org/news/health/...

Please don't do this!

This figure stuffs a lot of information in one graph: outcome, program size, comparator, length of follow up, and type of assistance.

Comprehensive, but so hard to read => wasteful.

journals.lww.com/cjasn/abstra...

Except that predictions worked in reverse!!

Washed the dishes

Cleaned the kitchen

Going to sit down.

Then, Apple Watch:
😵‍💫

Be careful when interpreting BNP in CKD/ESKD patients.

This graph shows BNPs in CKD patients withOUT HF.

kidney function-specific thresholds for N-terminal pro-B-type natriuretic peptide in heart failure risk prediction among patients with chronic kidney disease

heart.bmj.com/content/earl...

"Patients" are "people".

Sadly, having the dialysis equipment and supplies at home is a constant reminder of their illness.

Imagine seeing the machine as your enemy! 😢

pubmed.ncbi.nlm.nih.gov/27253517/

Besides the lost confidence in urine anion gap, does anyone see a problem with this ASN's BRCU slide? @askrenal.bsky.social @nephjc.bsky.social

Not everything ages this well!

@kidneyboy.bsky.social

And this figure shows the validated standardized tools we used to evaluate these patients.

These are evaluations for frailty, dependency, symptoms (physical and emotional), cognitive function, and patient activation.

pubmed.ncbi.nlm.nih.gov/38974818/

Something doesn't make sense. It should be that PD < HD nurse demand.

Likely it's the shear dynamics of turnover in the PD populn compared to HD.

Training new patients (takes ++ resources) and then not maintaining them on PD long enough (good if transplanted).

Lessons from the 1600’s.

The first lesson was that coercing the locals to produce gold and food won’t work.

The second is interesting, as humans still seem to struggle with it.

Nurses can provide more care than non-nurses, eg:

- Connecting/disconnecting the PD lines (separate discussion)

- Higher level observation of patient condition.

- other eg administer antibx.

Some rprts showed PD peritonitis even lower than self-care.

#CJASN
pubmed.ncbi.nlm.nih.gov/32188636/