Peritoneal Dialysis Doctors

04/12/2025

Important advice for kidney health. Your nephrologist and his staff should be appreciative of calls from patients asking before taking medication, which often goes a long way from prevent preventing problems down the road. Advice of avoiding this type of medication should be given to every patient on their first visit.

Diabetic patients may develop kidney damage if they have uncontrolled blood sugar. The kidneys in diabetics are forced to work extra hard to filter their blood, which if carried on over years can lead to irreversible damage to the kidneys. If the blood sugar is controlled, the risk of kidney damage is reduced. If kidney injury is identified in the early stages by screening methods, your doctor can prescribe medications which can prevent or reduce additional damage to the kidneys. Yearly kidney screening for diabetics is key and early referral to a nephrologist at the development of protein in your urine is essential. If you are a diabetic, be asking these questions at your visit with your P*P. diabetes

09/23/2024

NEW Commentary by Michael Granda on the :

Selecting a dialysis modality is both a science and an art, and requires assessing a number of patient factors, preferences, and criteria. On first glance, eligibility for peritoneal dialysis (PD) catheter placement would seem to be a more objective determination but is surprisingly limited in evidence. Many nephrologists believe that prior abdominal surgery is at least a relative contraindication for PD. Indeed, post-operative adhesions are common, have been associated with reduced PD efficacy, and with extensive adhesions are considered an absolute contraindication. Prior abdominal surgery is also suggested to contribute to dialysate leakage by compromising the integrity of the abdominal or pleural wall. Enter Wazaira Khan et al, who using the International Society of Peritoneal Dialysis (ISPD) North American PD Catheter Registry, examined the risk of prior abdominal surgery with PD catheter abandonment (removal before use), interruption of PD, or termination of PD due to catheter-related complications.

Read more at: https://bit.ly/47x0u8c

08/03/2024

Amazing event for NKFF!

The NKF Rich Salick Pro-Am Surf Festival is the largest non-profit surfing event in the WORLD! 🌎 come watch pro surfers or compete yourself! 🏄‍♀️ Join us October 12 to 14 at the famous Cocoa Beach Pier! 🌞For more information https://www.facebook.com/NKFsurf2?mibextid=LQQJ4d

03/19/2024

National reporting of .

FREE National reporting of peritonitis in individuals receiving PD is needed. Establishing a formal surveillance system for PD peritonitis reporting in the US is important; rates of PD peritonitis are at least 4 times greater than rates of HD vascular access catheter-related infections, associated with adverse outcomes, and the US government has stated strong interest in increasing PD utilization. In this pilot study, Muthana Al Sahlawi et al demonstrated the feasibility of a national uniform web-based peritonitis reporting system across a diverse cohort of PD facilities in the US. Their findings are consistent with overall peritonitis rates we have previously reported for 24 US sites in the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS).

It was encouraging that 93% of episodes reported as peritonitis met the ISPD diagnostic criteria. Out of the 32 episodes that did not meet ISPD diagnostic criteria, 75% were diagnosed based on abdominal pain and/or cloudy effluent alone. These features can be nonspecific for peritonitis and can be the result of various non-infectious causes, resulting in unnecessary antibiotic treatment in the face of a normal effluent cell count and negative cultures. Most facilities (82.5%) in this study indicated having no access to the PD effluent cell count results before treatment initiation, with an average turnaround time of more than 24 hours in 44% of facilities, which may explain continuation of treatment in the face of an initially normal cell count.

https://bit.ly/3QNrbik

10/06/2022

New drug for ADPKD given orphan drug status by FDA.

The FDA has granted orphan drug designation to PXL770, a first-in-class direct adenosine monophosphate-activated protein kinase activator designed by Poxel to treat autosomal-dominant polycystic kidney disease, according to a press release.According to the release, this designation follows the compl...

01/15/2022

Burnout among Nephrologists in the United States
In a study of 457 US nephrologists surveyed in 2019, 106 (23.2%) reported burnout; the
most commonly reported primary drivers of burnout were number of hours worked and
electronic health record requirements. Caring for $25 vs. 26-75 patients per week,
practicing in academic vs. non-academic settings, and spending time with other
responsibilities vs. patient care were each independently associated with nearly 70% lower
odds of burnout after adjusting for age, gender, race, and international medical graduate
status. Free-text responses also emphasized disinterested health care systems and
dissatisfaction with remuneration as drivers of burnout. The findings are published in Kidney
Medicine.

10/08/2021

Singer Adele appeared in a fashion shoot in American Vogue magazine, highlighting her 100 pound weight loss, achieved over 2 full years. She has been stunned by the backlash, especially from women, who harshly criticized her new look, commenting they preferred her the “old way”. Crediting a low sugar unprocessed foods diet, and commitment to an exercise regimen, Adele has commented at age 33 and a single mother, she felt the need to be at her optimal health in order to single-handedly raise her son. Adele told Vogue, “I understand why some women especially were hurt. Visually I represented a lot of women. But I’m still the same person. She added, “I thought, If I can make my body physically strong, and I can feel that and see that, then maybe one day I can make my emotions and my mind physically strong.” Adele made positive decisions for her health, she should be applauded, and not criticized. Few physicians are brave enough to say it, but obesity is not only bankrupting Americans’ health… it’s bankrupting our country. And patients need to hear this.

08/25/2021

Treating Antibody-Mediated Rejection in Transplant Recipients.

The optimal regimen for the treatment of acute and chronic antibody-mediated rejection (AMR) in kidney transplant recipients is unclear. A. Al Jurdi and

08/01/2021

Your thyroid gland makes T4 (inactive thyroid hormone) and a tiny bit of T3(active thyroid hormone). However, most conversion of T4 to T3 occurs outside of the thyroid gland, particularly in the liver. Impaired liver function, such as the rapidly growing diagnosis of non alcoholic fatty liver disease, may negatively affect this conversion even if liver enzymes appear to be within normal limits. And no amount of Levothyroxine can correct this. You must first cure the fatty liver by adopting a whole food, low sugar, low carbohydrate diet. Without healing your liver, weight loss efforts will be very unlikely to be a successful. Did your endocrinologist tell you that? (Not likely) If you carry weight in your abdomen, it is likely you have fatty liver. Fatty liver often occurs without elevation of liver enzymes. Ask your P*P to screen you for fatty liver or refer you to a liver specialist.

05/26/2021

Donor vs Recipient Size Mismatch and Graft Function.

Introduction Transplanting kidneys small for recipient’s size results in inferior graft function. Body surface area (BSA) is related to kidney size. We used the BSA index (BSAi) (Donor BSA/Recipient BSA) to assess whether the renal graft size is sufficient for the recipient. Methods We included 26...

05/26/2021

Minimal Change Disease following Moderna Vaccine.

The immunologic response following several varieties of vaccination has been described as a potential trigger for the development of both de novo as well as recurrent minimal change (MCD) disease (1). There have been emerging cases, including that described by Kervella et al. of MCD shortly after va...