KIDNEY NEWS NOW
We post the most recent news about Kidney Disease, Dialysis and Treatment.
- Clinical Scenario: Patient Care Through POLST
Physician orders for life-sustaining treatment (POLST) forms are crucial tools in ensuring that patient treatment preferences are respected and followed, particularly during medical emergencies. As hospitalists, integrating POLST into patient care can significantly enhance decision-making processes, aligning treatments with the patient’s wishes. Here, we present a clinical scenario demonstrating the application of POLST in a hospital setting, emphasizing the importance of electronic documentation in the patient’s medical record. Case Mr. John Smith, an 85-year-old male… ... read more - Benefits of Oral Nutrition Supplements (ONS)Being on dialysis means your body may need extra protein and sometimes more calories to stay strong. But it can be tough to eat well or enough when you feel tired, nauseous, your taste changes, or you have a low appetite. Your dietitian or doctor may recommend an oral nutrition supplement (sometimes referred to as ONS) to help when your protein or calorie intake is low. What are ONS? Oral nutrition supplements come… ... read more
- Coding Corner: Spoonful of Sugar
A 46-year-old woman is admitted to the hospital with an exacerbation of chronic obstructive pulmonary disease (COPD) requiring intensification of her inhaler regimen, initiation of corticosteroids, and initiation of 4 L/min oxygen support via nasal cannula. She does not require oxygen at baseline and has a history of diabetes mellitus for which she takes metformin and glipizide. On day two, her blood sugar is noted to be consistently above 300 mg/dL since admission and requires… ... read more - To RAASi or Not to RAASi, That is the Question
Clinical question: Should angiotensin-converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARBs) be discontinued or continued in advanced chronic kidney disease (CKD) patients? Background: Guidelines do not provide specific guidance on continuing or stopping ACEi or ARB for advanced CKD. Study design: Multi-center, randomized, open-label trial Setting: United Kingdom Synopsis: Randomizing 411 adult patients across 37 centers with stage 4 or 5 CKD (estimated glomerular filtration rate < 30 ml/min/1.73 m2), the STOP ACEi study… ... read more - ASCO Guideline for the Use of Opioids for Adults with Cancer or Cancer Treatment
Ms. Parikh Clinical question: What are expert recommendations for the use of opioids for adults with pain from cancer? Background: Pain is a common consequence of cancer and cancer treatment. There are limited guidelines focused solely on opioid use in a patient with cancer. Study design: The evidence base included 31 systematic reviews and 16 randomized controlled trials published between January 1, 2010, and February 17, 2022. Synopsis: The American Society of Clinical… ... read more - ACLF Grade 3 Predicts Risk of Respiratory Failure with Terlipressin Use
Ms. Boyle Clinical question: Which risk factors predict new-onset respiratory failure during terlipressin use for the treatment of patients with rapidly deteriorating kidney function attributed to type 1 hepatorenal syndrome (HRS-AKI)? Background: Terlipressin, a synthetic vasopressin analog, has long been an international standard of care for HRS-AKI under the European Clinical Practice Guidelines. The agent offers two attractive advantages to norepinephrine, another vasoconstrictive agent employed for the treatment of HRS-AKI, in that terlipressin… ... read more - Hospitalist Co-management Takes Practice But Can Enhance Patient Care
Clearly defined roles are crucial when establishing a co-management program Co-management continues to evolve as hospital leaders and hospitalists find the best ways to use skills and expertise from various specialties, including their own, to benefit patient care. Orthopedic surgery, neurosurgery, and other surgical specialties are commonly part of hospitalist co-management programs. Dr. Shaughnessey “These surgical specialty teams are often less familiar with managing medical complexity, and allowing the surgical team to… ... read more - A Roadmap for New DEI Officers in Hospital Medicine Programs
In May 2020, the murder of George Floyd sparked a national call to action within the field of medicine. The goal was to promote diversity, truly include underrepresented populations in the workforce, and shift the focus from health equality to health equity. Studies have consistently demonstrated that diversity enhances the quality of patient care and financial outcomes.1 A year later in April 2021, the Journal of Hospital Medicine published an article titled Advancing Diversity, Equity,… ... read more - Spice Things Up with the New Bold Flavors CookbookFollowing a kidney diet can be challenging, especially when it feels like you are giving up the foods you love. That’s why DaVita dietitians created the latest installment of Today’s Kidney Diet cookbook: Bold Flavors. There are 10 brand new recipes created just for this book! This cookbook is packed with vibrant, mouthwatering recipes that can help make sticking to a kidney-friendly diet easier and much more enjoyable. Say goodbye to bland meals… ... read more
- DRG Downgrades
Clinical coding is a meticulous task that translates patient notes into specific International Classification of Diseases, Tenth Revision (ICD-10) codes, crucial for billing and insurance claims. Coupled with this coding, clinical validation ensures that documented diagnoses correlate with the patient’s presenting symptoms, signs, investigations, and treatment. While these processes are foundational for medical billing, they are highly complex and are used by both healthcare centers and insurance companies. Insurance companies have their own set coding… ... read more - Precision Medicine in Sepsis Diagnosis
Sepsis, a life-threatening syndrome induced by infection, has been a leading cause of hospitalization and death in U.S. healthcare settings and accounts for more hospital admissions and spending than any other condition.1,2 Early and effective diagnosis and treatment of sepsis, along with prevention, have been a patient-safety focus to improve outcomes and reduce mortality. Unfortunately, sepsis remains a significant challenge within the medical community due to its elusive nature and rapid progression.2 The heterogeneous presentation… ... read more - Coding Corner: Documenting Sepsis AccuratelyA 4-year-old female is admitted to the hospital with pneumonia and started on IV antibiotics. You see her after she has been admitted and start some IV fluids for presumed sepsis. On day two, the patient improves, and you are asked by your institutional coder to clarify whether this patient truly has sepsis and to document it accordingly. What documentation is necessary for sepsis? Sepsis can safely be documented using the Sepsis-3 criteria from the… ... read more
- Seizing the Moment: Hospitalists’ Roles in Reproductive Care
A 25-year-old woman is admitted to your service with acute kidney injury due to lupus nephritis in the setting of chronic kidney disease, diabetes, and hypertension. She mentions having menstrual cramps, and upon review of her labs, you see she has a negative human chorionic gonadotropin. In your social history, you recall her mentioning she has one child and is sexually active with her husband. On review of her medications, you do not see contraception… ... read more - Weight Loss for Transplant (Part 2)What happens when lifestyle changes like diet and exercise do not lead to significant weight loss? This approach was discussed in our previous “Weight Loss for Transplant” article. It can take a long time to make permanent habit changes that lead to losing weight and, more importantly, keeping weight off. Below we will discuss possible different options for weight loss. This can be the case for many reasons: Weight gain that leads… ... read more
- Coding Corner: Breathless and BleedingA 62-year-old man is admitted to the hospital with an exacerbation of chronic obstructive pulmonary disease (COPD) requiring intensification of his inhaler regimen, initiation of IV corticosteroids, and initiation of oxygen support with bilevel-positive airway pressure. He does not require oxygen at baseline and has a history of chronic back pain for which he takes twice daily naproxen. By day three he has steadily improved oxygen demands and is successfully weaned to 3 L/min by… ... read more
- Demystifying Performance Measures
A 73-year-old woman presents with syncope, generalized weakness, and frequent falls on a Friday afternoon. Past medical history includes coronary artery disease, aortic stenosis, atrial fibrillation treated with apixaban, type 2 diabetes mellitus, and hypothyroidism. Emergency department evaluation reveals sepsis secondary to a urinary tract infection. A CT scan of the head yields no acute findings. An echocardiogram was ordered due to syncope in the context of a history of aortic stenosis. The hospitalization was… ... read more - IV Sodium Thiosulphate for Calciphylaxis of CKD: A Systematic Review and Meta-analysis
Clinical question: Does IV sodium thiosulphate improve skin lesions and survival in patients with chronic kidney disease (CKD) experiencing calciphylaxis? Background: Calciphylaxis, also called calcific uremic arteriolopathy, is a painful skin condition caused by the calcification of microvessels in the skin. It is associated with risk factors such as end-stage renal disease, abnormal calcium and phosphate homeostasis, vitamin K deficiency, obesity, diabetes, rapid weight loss, and being female. Early detection and prompt treatment are essential… ... read more - Navigating the Promotion Process
When she joined the faculty of the University of Texas Southwestern in Dallas as a junior member in 2011, Christiana Renner, MD received mentorship in areas such as clinical care and leadership. Dr. Renner But on the academic side, little was available. There was, she felt, no one available to help guide her through the process of publishing scholarly articles. “For my first four, five, six years as faculty at UT Southwestern I did… ... read more - Weight Loss for TransplantAs you may know, people living with end stage kidney disease (ESKD) rely on dialysis treatments to live. However, dialysis is just one treatment option. DaVita believes kidney transplant is the ideal treatment option for eligible patients. A kidney transplant can give someone with ESKD a longer, better quality of life. With a transplant, patients may live up to 10 years longer than those who remain on dialysis. Kidney transplant recipients may also… ... read more
- Protein Pasta, Please!What is protein pasta? Simply put, it is a pasta product that has enough plant protein sources to become a protein-dense food. This is a great option to include in your diet if you are looking for alternative food choices to increase your protein intake, looking for more plant protein options, follow a vegetarian diet or if you do not like meat-heavy meals. These pastas also add nutritional value to your meals. Benefits of… ... read more
- Update in Hospital Medicine
Dr. Zahir Kanjee (left) and Dr. Suchita Shah Sata educated—and entertained!—with their updates in hospital medicine. This year’s annual Update in Hospital Medicine transported learners to the San Diego Zoo where they heard from dynamic speakers Dr. Suchita Sata and Dr. Zahir Kanjee. They took the audience on a fun-filled “rounding trip” to the zoo, discussing literature from 2023 that led to key practice updates and confirmations in pneumonia, sepsis, venous thromboembolism (VTE)… ... read more - Challenging Anticoagulation Scenarios: How to Have Smooth Sailing through Choppy Waters
Keeping abreast of updates in anticoagulation guidelines is important for physicians to provide optimal patient care. Multiple changes to recommendations for anticoagulation have been made in the last few years, and this session provided vital updates to existing practice. This session addressed the use of anticoagulants in antiphospholipid syndrome, the use of anticoagulants in patients with obesity, bariatric surgery, chronic kidney disease (CKD) or hemodialysis, and new changes to the de-escalation of antiplatelets in… ... read more - The Great Debate 2024: Controversies in Perioperative Medicine
There are a great many debates in medicine. This perioperative topic lecture looked at the controversy of perioperative atrial fibrillation and a second topic of post-operative troponin screenings. The audience voted before and after to see if the presented arguments had swayed anyone’s opinion. The argument put forth by the debaters was also not necessarily the opinion of the debater, though Dr. Shen nearly convinced herself during her arguments to change her own opinion. Both… ... read more - MED-TED Teaching Competition
The inaugural MED-TED teaching competition saw seven contestants compete against each other to teach a topic in under eight minutes. This innovative session included attending hospitalists with fewer than five years of experience out of residency. A panel of judges scored each presentation to determine who should come out of the competition victorious. If any contestant went over eight minutes, a point was deducted. The first contestant, Dr. Arges, discussed “Pulmonary Complications of Cirrhosis.”… ... read more - Solving Major Problems: Major Bleeding and Major Surgery for Patients on Anticoagulants
This interactive session posed real-life scenarios for hospitalists who frequently deal with difficult anticoagulation questions and grounded it all with the evidence. The first case discussed was an elderly female on a direct oral anticoagulant (DOAC) for atrial fibrillation (AF) and acetylsalicylic acid (ASA) for coronary artery disease (CAD) who is admitted for symptomatic anemia. Despite an esophagogastroduodenoscopy, colonoscopy, and capsule endoscopy, no source of bleeding is found. The question is, when would you… ... read more - Update on Clinical Guidelines
In a packed room, Dr. O’Leary, chief of the division of hospital medicine, associate chair for quality in the department of medicine, and vice president of quality for Northwestern Memorial HealthCare in Chicago, delivered a case-based exploration of everyday clinical scenarios managed by adult hospitalists. His opening dialogue exuded a passion for evidence-based medicine, yet he humbly acknowledged his limited expertise in the extensive realm of clinical guidelines. Prior to embarking on our journey, he… ... read more - Breakfast Anyone?Eating breakfast can have many positive effects on your health and well-being. In fact, studies show that overall diet quality is better among people who eat breakfast. Start your day off with a healthy blend of protein, fat and carbohydrates (mainly from whole foods) to help stabilize your blood sugar and reach protein, nutrient and fiber goals. Skip sugary options as they offer no health benefits and could cause problems in the… ... read more
- New Cookbook: Small Spaces CookingMeals can be challenging to prep when you don’t have a lot of space to work with. You may have a small apartment, small kitchen in general, or you may even be camping without a lot of space or resources. The latest Today’s Kidney Diet cookbook, Small Spaces Cooking, offers recipes and ideas to prepare healthy, kidney-friendly meals with limited space or kitchen gadgets. Cramped kitchen? No sweat. DaVita dietitians have packed this… ... read more
- “Why Do I Have to Limit Dairy?”If you are on dialysis, you may be wondering why you must limit dairy. It is hard to make dietary changes, especially if you have grown up drinking cow’s milk, eating cheese and enjoying ice cream. End Stage Kidney Disease and Minerals Most people on dialysis have been diagnosed with end stage kidney disease (ESKD). That means the kidneys are functioning at 15% or less (1). Since kidneys play a role in maintaining… ... read more
- The protective effects of naringenin, a citrus flavonoid, non-complexed or complexed with hydroxypropyl-β-cyclodextrin against multiorgan damage caused by neonatal endotoxemia.PMID: Int J Biol Macromol. 2024 Apr ;264(Pt 1):130500. Epub 2024 Feb 28. PMID: 38428770 Abstract Title: The protective effects of naringenin, a citrus flavonoid, non-complexed or complexed with hydroxypropyl-β-cyclodextrin against multiorgan damage caused by neonatal endotoxemia. Abstract: BACKGROUND: Endotoxemia is a severe and dangerous clinical syndrome that results in elevated morbidity, especially in intensive care units. Neonates are particularly susceptible to endotoxemia due to their immature immune systems. There are few effective treatments for… ... read more
- Effects of Psidium guajava L. leaves extract on blood pressure control and IL-10 production.PMID: Biomed Pharmacother. 2022 Nov ;155:113796. Epub 2022 Oct 6. PMID: 36271572 Abstract Title: Effects of Psidium guajava L. leaves extract on blood pressure control and IL-10 production in salt-dependent hypertensive rats. Abstract: Psidium guajava (guava) leaves extract displays anti-hypertensive properties by mechanisms not yet fully understood. Here, we investigated whether sympathetic drive and immune signaling mechanisms are involved with the antihypertensive effect of the guava extract in a model of salt-dependent hypertension. Raw guava… ... read more
- The effects of pomegranate consumption on blood pressure in adults.PMID: Phytother Res. 2024 Feb 27. Epub 2024 Feb 27. PMID: 38410857 Abstract Title: The effects of pomegranate consumption on blood pressure in adults: A systematic review and meta-analysis. Abstract: Considering the main component of cardiovascular disease and due to the high prevalence of hypertension, controlling blood pressure is required in individuals with various health conditions. Randomized clinical trials (RCTs) which studied the effects of pomegranate consumption on blood pressure have shown inconsistent findings. As… ... read more
- Garlic prevents the oxidizing and inflammatory effects of sepsis induced by bacterial lipopolysaccharide.PMID: Heliyon. 2023 Nov ;9(11):e21230. Epub 2023 Nov 14. PMID: 38045135 Abstract Title: Garlic prevents the oxidizing and inflammatory effects of sepsis induced by bacterial lipopolysaccharide at the systemic and aortic level in the rat. Role of trpv1. Abstract: Garlic () possesses healing properties for diseases like systemic arterial hypertension, cancer and diabetes, among others. Its main component, allicin, binds to the Transient Receptor Potential Vanilloid Type 1 (TRPV1). In this study, we investigated TRPV1's… ... read more
- Try the new Feel-Good Foods CookbookFood is the fuel our bodies need to function, just like a car uses fuel to run. Many whole foods have vitamins and nutrients that can help with our body’s heart health, provide antioxidants and support a healthy gut. The latest Today’s Kidney Diet cookbook, Feel-Good Foods, offers recipes that use kidney-friendly whole foods, and ideas for using them in your meals and snacks. These feel-good recipes use ingredients such as mushrooms, peppers,… ... read more
- The Struggle to Juggle: Tips for Managing Multiple Diet RestrictionsManaging multiple diet restrictions can feel like a struggle at times. It is like trying to juggle a few balls, and keep them all in the air, while someone keeps tossing more and more of them at you. The kidney diet itself, with its multiple components, can be a challenge. Many dialysis patients have other health concerns (diabetes, high blood pressure, heart disease, etc.) that require additional dietary modifications for optimum health. This… ... read more
- Vitamin D: The “Sunshine” VitaminVitamin D is an essential nutrient; we need to eat foods rich in vitamin D and spend time outdoors to maintain adequate levels in our body. So, the next time you eat a salmon burger outside in the sun, you’ll be getting vitamin D in two ways. Read on to learn why vitamin D is so important for the body and ways to get it. Dietary Sources and Health Benefits Vitamin D2 (ergocalciferol)… ... read more
- Comment on Juicy Facts about Stone Fruits by Jackie Termont, RDNectarines tend to be a lower acid food. Plums do have a higher acid level, similar to grapefruit, blueberries or lemons. ... read more
- Comment on Apple Portion with Clipping Path by Jackie Termont, RDDefinitely understand that, here are a few articles to help. Many things to manage in kidney disease, but a healthy diet can be an important component to slow the progression. Also including a link for fining local dietitians that specialize in earlier stages of kidney disease. https://www.davita.com/education/kidney-disease/basics/how-to-slow-the-progression-of-chronic-kidney-disease https://www.davita.com/diet-nutrition/articles/advice/diet-and-nutrition-goals-for-people-with-stage-3-chronic-kidney-disease https://sites.google.com/view/ckdrd/home ... read more
- Comment on Recipes for Air Fryers, Pressure Cookers and More in Our Latest Cookbook by Jackie Termont, RDIt can definitely be overwhelming. The renal diet is not a one size fits all, so even as dietitians we look at blood work to guide our recommendations. Whole foods and less processed foods are best, lower sodium, not a lot of additives. You can sign up for a free myDaVita account to be able to see and download all of our cookbooks in the library. I will also link to some information on diabetes… ... read more
- Comment on Food Facts Friday: Greek Yogurt by Jackie Termont, RDWhole grain is a good choice, because it has not been striped of nutrients. It provides fiber and other vitamins and minerals. It may have a slightly higher phosphorus content, but your body only absorbs some of that phosphorus. ... read more
- Comment on 8 Food Trends Made Kidney-Friendly: Part 2 by Jackie Termont, RDHere is a link to the Diet and Nutrition section of DaVita.com. It has recipes, articles, videos and more tools for nutrition. https://www.davita.com/diet-nutrition ... read more
- Comment on Food Facts Friday: Greek Yogurt by MaryStage 3. White bread is an inflammatory so is whole grain better? ... read more
- Comment on Apple Portion with Clipping Path by Leonard GutmanI’m a stage 3 ckd patient very interested in keeping it there. ... read more
- Comment on Recipes for Air Fryers, Pressure Cookers and More in Our Latest Cookbook by Nicole CrissHello. We are looking for a cookbook for managing my husband’s high phosphorus. and a good renal diet. We get so confused on what we can have and can’t have due to him also just being diagnose with diabetes to . ... read more
- Comment on 8 Food Trends Made Kidney-Friendly: Part 2 by Janet CosaresI want to have a Kidney diet tips.Can you send me.Thank you ... read more
- Comment on Juicy Facts about Stone Fruits by Anndoes fruit like plums, nectarines have acid in them ... read more
- 8 Food Trends Made Kidney-Friendly: Part 2Social media is ripe with new recipes and foods that have become trendy. In this post, we continue our list of recent food trends and how to make them more kidney-friendly. From cottage cheese ice cream to pasture-raised meat and eggs, there are many options for trying these trends while sticking to your kidney diet. 1. Cottage Cheese Ice Cream You’ve probably heard of pairing cottage cheese with fruit, but have you… ... read more
- Recipes for Air Fryers, Pressure Cookers and More in Our Latest CookbookSmall kitchen appliances such as air fryers have become popular in the last few years, and it’s no wonder—they can help make cooking easier. There are many creative recipes and cookbooks that use updated pressure cookers, waffle irons and more to make healthy meals. Use our latest Today’s Kidney Diet cookbook, Small Appliance Cooking, to try out this cooking trend and make kidney-friendly meals using your favorite kitchen gadgets. You’ll find 14… ... read more
- Food Trends Made Kidney-Friendly: Part 1If you are on social media, you have likely seen many new recipes or foods “go viral” this year. However, you may wonder if these foods and recipes are safe for your kidney diet. Here are four food trends and ways to make them more kidney-friendly. 1. Charcuterie Boards Charcuterie boards are popular appetizers featuring a serving board topped with cured foods such as deli meat, cheese, pickles, bread and crackers.… ... read more
- Food Facts Friday: White RiceSome people may think white rice is as boring as it looks. But hidden away in the back of your pantry is an important staple for many cultures. In fact, people started eating rice as early as 2500 B.C. It was even added to the mortar used to hold together the Great Wall of China! White rice is often associated with Asian cultures; however, it is also an important part of American diets.… ... read more
