Offering #dialysis to patients with a new diagnosis of #malignancy is always an emotive and complex affair if they present with an #AKI or #renaldysfunction Sometimes it’s pretty clear - like in the 30 something who presents with a cervical cancer , bilateral hydronephrosis and K of 7- one will usually explain to The patient what’s the issue and buy them time for intervention which buys time for an oncology consult and further mx

Speaking to a trainee doctor a few weeks ago who is scarily like me when I was a trainee - we both discussed having been labelled #aggressive at various points as men in the same scenario have been labelled #assertive I looked up what they mean; aggressive according to the Cambridge English Dictionary is “behaving in an angry and violent way towards another person” & the more positive “assertive” is someone who “behaves confidently and is not frightened to say what they want or believe”.

What’s the evidence for #sharesource from @baxter_intl for RPM in #PD #pdlive Looking at the data collected so far for #sharesource #PDlive

Diabetes in PD #pdlive and looking at continuous glucose monitoring - no studies looking at accuracy of the same @m_alikaramat Planned study looking at CGM in #peritonealdialysis #pdlive @m_alikaramat

#improvePD #pdlive - looking at various aspects of PD care @ImprovePd Developing a prognostic model for patients on #PD #PDlive

Existing models over or under estimated mortality

#pdlive QOL data on a PD vs from @DOPPStudy from prof Brown Better QOL on PD in all areas in all@countries #pdlive

Benefits of incremental PD #pdlive - better patient QOL How do define incremental PD? #pdlive

How does your unit remove #PD catheters no longer in use @askrenal so it looks like the majority of folk u open surgical technique to remove #PD catheters - but is there any evidence to suggest that one technique is superior over the other?

I listened to (while doing some admin) @ISPD1 webinar on dispelling #myths in #peritoneal #dialysis by the inimitable @PD_perls- really interesting content and I’ve added some of my own myths that I’ve been presented with over the years that I’ve lead the service @HeartlandsUHB Myth #1- Previous abdominal surgery and PD are not compatible..

This is the commonest reason why patients are not offered PD
Advanced laparoscopic tube placement can do away with most issues as this slide shows:

As a jobbing nephrologist a great deal of my time goes towards preparing patients for #kidney#transplants with #covid19 happening I hadn’t realised this @gokdigo Clinical Practice Guideline on the Evaluation and Management of Candidates for Kidney Transplantation was out These are my notes from a @isneducation webinar on kidney transplantation and cancer

kdigo.org/wp-content/upl…

Thank you @ISNkidneycare @ISPD1 for the webinar on #PD in #AKI

Lots of food for thought

Just been looking through my notes - AKI reported in up to a third of ITU patients and just under half of them may require RRT with #COVID19

1
I’ve been on call the last 4 days

Some reflections about #COVID-19 in renal patients ( this is based on my observations and is not clinical advice)

•in dialysis patients COVID isn’t always severe
•Many have mild symptoms – important to screen and isolate 2

•UF on non-dialysis days really helps with symptomatic relief of SOB
• Best to keep lungs on the ‘crispy’ side- aids recovery
• Unilateral lung involvement common on CXR
• Be aware of AVF thrombosis