At the #NKFClinicals to see @rajmehrotra1122 win the Michael Lazarus distinguished scholar award.
His lecture begins, “Consider the patients’ lived experience” #NKFClinicals
Dr: “Labs look good”
Patient: “but doctor why do I feel like crap”
Dialysis is a 4-6 hour time commitment. There is no other chronic condition that takes a greater commitment by patients.
One way to help patients is give them a choice of modality.
#NKFClinicals
The past:
Home dialysis is for some people by some doctors for some time
And this is an improvement from the truly horrible
“PD is a second class therapy for second class patients provided by second class doctors”
#NKFClinicals
PD is good #NKFClinicals
There is no difference in mortality PD v HD
As we have expanded the PD population we are not adding people that are bad candidates that may do worse. Not happening. New additions are doing fine. #NKFClinicals
#NKFClinicals
Wow. @rajmehrotra1122 is giving a masterclass on delivering a compelling keynote. Great slides. Powerful message. #NKFClinicals
The second half of his talk will focus on symptom management.
So much research focused on mortality, but one of the top complaints in fatigue. We should be paying attention to dialysis associated fatigue. It doesn’t always have to be mortality. #NKFClinicals
Doctors think the solution to every problem is more dialysis
Patients want the least amount of dialysis necessary. #NKFClinicals
Depression should he treated and addressed regardless of the downstream effect. #NKFClinicals
Not all uremic symptoms gets better with dialysis.
Appetite does improve with dialysis
Dyspnea gets better with dialysis
Total number of symptoms does not go done with dialysis
Depression does not improve with dialysis
#NKFClinicals
More dialysis did not improve insomnia.
Shown in both HEMO and FHN #NKFClinicals
Cognitive behavior therapy is effective but is a big ask for people that are already going to dialysis three days a week. #NKFClinicals
A shout out to CKD associated pruritus and difelikefalen #NKFClinicals
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