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| Archive for 2003 | Archive for 2002 | Archive for 2000 | Archive for 1999 |
| Archive for 1998 | 1997 | 1995-1996 |
January 7 - 14, 2004
Making Sense: A Scientific Approach to IV Iron 
(ASN Renal Week 2003; Official Luncheon Symposium; San Diego, November, 2003)
Dr. Danielson: What are the chemical structures and iron core sizes of iron dextran, sucrose, and gluconate? What are their plasma half-lives? Where does labelled IV iron go after injection into the body? Dr. Aronoff: What did the USRDS study show regarding mortality and IV iron dextran use? What were results from the North American trials? The European EPIBACDIAL trial? Does IV iron increase the risk of infection? Of oxidative damage? Of cardiovascular risk? Should we give IV iron above a ferritin level of 500 ng/mL? Dr. Van Wyck: What is labile iron? Does it occur with dextran, gluconate and sucrose? What is the relation of IV iron core size to various measures of labile iron, including direct donation to transferrin? What are the signs and symptoms of a free iron reaction, and at what infusion rates are these seen with available preparations?
Literature Review: A Year in Nephrology - Fluids and Electrolytes 
(Jose Arruda, MD; ASN Renal Week 2003; San Diego, November, 2003)
How are WNK1 and WNK4 involved in Gordon's syndrome? Does this involve the Na-Cl cotransporter directly? What is new about distal RTA and mutations in H-ATPase? Which subunit defects are associated with hearing loss? How is the anion exchanger involved in Southeast Asia ovalocytosis? How does Dent's disease affect chloride transport, PTH, and phosphaturia? New clinical papers: HIV and acidosis; Metabolic alkalosis after liver transplantation; Hyperkalemia with aldosterone antagonists; Hyponatremia in marathon runners; Use of vasopressin antagonists to treat hyponatremia; Renal salt wasting vs. SIADH.
ASN Renal WeekUnlocking the Secrets to Treating Acute Renal Failure
Patient stratification in PICARD; ARF as a multidimensional disease process; Repopulation of the kidney with bone marrow stem cells after injury.
(Mehta, Star, Cantley) (more...)
Literature Review - The Year in Nephrology: Renal Parenchymal Diseases and Fluids & Electrolytes
Parenchymal disorders; Fluids and Electrolytes (see full slide/audio this week)
(Salant, Arruda) (more...)
Vascular Biology: Understanding the Role of Renal Vasculature in Disease Processes
Endothelial activation: Intracellular signaling; Uric acid makes a comeback
(Pober, Johnson) (more...)
December 31 - January 6, 2004
Potassium: Key Physiologic Principles, Hypokalemic and Hyperkalemic Disorders. Part 2 of 2.
(Biff Palmer, MD; ASN Board Review Course; San Francisco, August, 2003)
How do various diuretics and disturbances in renal sodium and potassium handling increase distal delivery and increase renal K excretion? How do calcium and magnesium handling differ in Bartter and Gitelman syndromes? What is the workup for hyperkalemia? How do different forms of acidosis cause or not cause hyperkalemia? What is the mechanism of hyperkalemic periodic paralysis? How do the pathogeneses of pseudohypoaldosteronism types I and II differ? What is current management of acute and chronic hyperkalemia?
ASN Renal WeekBone in ESRD: Abnormal Bone Turnover or Bone Mass or Both?
Biomechanics of fracture; Osteoprotegerin / RANK ligand; Bisphosphonates and statins - the mevalonate pathway in bone; The cardiovascular - bone link
(Turner, Dunstan, Mundy, Price) (more...)
New Insights into Immunosuppressive Therapy
Tolerance induction protocols; The high risk recipient; Immunosuppressive therapy for the high risk patient; Immunosuppression in pediatric patients: Ideal candidates for minimization
(Vincenti, Gaston, Knechtle, Harmon) (more...)
December 19 - 30, 2003
Potassium: Key Physiologic Principles, Hypokalemic and Hyperkalemic Disorders. Part 1 of 2.
(Biff Palmer, MD; ASN Board Review Course; San Francisco, August, 2003)
What are the factors that influence IC/EC distribution of potassium? What is the basic physiology of renal potassium excretion in the principal and alpha-intercalated cells? How do distal sodium delivery and aldosterone interact to maintain potassium homeostasis? What are common causes of hypokalemia due to cell shifting? GI loss? Why does laxative abuse give you hypokalemia with alkalosis? What are the main causes of elevated renin and/or aldo? What's new about Liddle syndrome, syndrome of AME, and activating mutations of the mineralocorticoid receptor? (Part Two to be posted on Dec 30th.)
ASN Renal WeekAudiofile selection - ASN 2003 (San Diego) (5-10 talks)
United States Renal Data Systems (USRDS): Infectious Complications in the ESRD Patient.
Infection in CKD and non-CKD; Infections in HD vs. CAPD patients; Pediatric dialysis and transplant patients; Adult transplant patients - bacterial, viral, and fungal
(Murray, Foley, Chavers, Kasiske) (more...)
Modifiable Proactive Patterns and Outcomes for Hemodialysis Patients: New Results from the DOPPS
Mineral metabolism practices and outcomes; Cardiac drugs - practices and outcomes; Health-related QOL; Vascular access
(Kerr, Andreucci, Mapes, Greenwood) (more...)
December 11 - 17, 2003
Serologic Diagnosis of Glomerular Disease. Part Two of Two.
(Gerald Appel, MD; ASN Board Review Course; San Francisco, August, 2003)
What is the differential Dx for patients with low serum complement? What serologic test might confirm the diagnosis? How does one diagnose renal disease due to anti-phospholipid syndrome? How can we best follow the course of active lupus nephritis? What tests should one order when faced with nephrotic syndrome in an elderly patient?
ASN Renal WeekAudiofile selection - ASN 2003 (San Diego) (5-10 talks)
Preserving Renal Function after Kidney Transplantation
Early renal function; a surrogate for long-term graft survival; Renal function and post-transplant cardiovascular disease; Cyclosporine withdrawal and avoidance strategies
(Hariharan, Meier-Kriesche, Hricik) (more...)
Technological Innovations in Peritoneal Dialysis
Continuous flow PD using the dual lumen catheter; Peritoneal membrane function testing - matching the test to the therapy; Continuous flow PD: Pros and cons; Non-glucose-based PD solutions.
(Piraino, Teitelbaum, Amerling, Gokal) (more...)
Intravenous Iron Management for Pharmacists: Safety, Efficacy, Dosing and Pharmacoeconomic Considerations 
(Thomas Comstock, PharmD; Medical Education Resources Pharmacist CE; December, 2003).
Dr. Comstock presents a soup to nuts review of the causes of anemia in ESRD, the location of various iron stores, when IV iron is needed, as well as the various advantages and disadvantages of IV iron preparations. This program, prepared by Medical Education Resources, is intended for pharmacists and offers 2.0 Pharmacist CE credit hours. (It is not intended for physicians or nurses).
December 3 - 9, 2003
Serologic Diagnosis of Glomerular Disease. Part One of Two.
(Ronald Falk, MD; ASN Board Review Course; San Francisco, August, 2003)
Which is the best test for nephritic streptococcal infection? Which antibodies are the most sensitive and specific to diagnose lupus? What is the special usefulness of anti-histone antibodies? What are the diagnostic criteria for anti-phospholipid syndromes? How can we follow activity of lupus nephritis serially? What are the traps in interpreting tests to diagnose ANCA-related and other vasculitis?
November 26 - December 2, 2003
Anion Gap Metabolic Acidosis
(Michael Emmett, MD; ASN Board Review Course; San Francisco, August, 2003)
Who was Dr. Gamble and what is a Gamblegram? What does the mnemonic K-U-S-M-A-L-E signify? What is the implication of the NAD/NADH ratio in lactic acidosis? In ketoacidosis? How do the toxic alcohols, including methanol and ethylene glycol cause acidosis and how is this treated? When are anion gap acidoses reversible via metabolism? via renal excretion? How does acidosis change as CKD progresses? How do we identify anion gap acidosis coexisting with metabolic alkalosis? When can an anion gap acidosis be convertedto a hyperchloremic acidosis? How does diabetic ketoacidosis evolve into hyperchloremic acidosis?
November 20 - 26, 2003
Hypotension on Dialysis: Pathogenesis and Treatment. Part Two of Two.
(William Henrich, MD; ASN Board Review Course; San Francisco, August, 2003)
How does cool temperature dialysis work? What are its effects on vascular resistance? What are the cardiac effects? Is there a risk of postdialysis BP crashing? Among the usual methods of combatting dialysis hypotension, including isolated ultrafiltration, sodium ramping, and cool temperature dialysis, which one works best? Can you diagnose the mystery case with refractory dialysis hypotension and a bandaged leg? (The CME post-test for these talks will be up shortly).
November 11 - 17, 2003
Hypotension on Dialysis: Pathogenesis and Treatment. Part One of Two.
(William Henrich, MD; ASN Board Review Course; San Francisco, August, 2003)
How common is acute episodic hypotension vs. chronic persistent hypotension on hemodialysis? What is the role of the sympathetic nervous system? What is the Bezold-Jarisch reflex and what potential role can it play? What effect do serotonin reuptake inhibitors have on sympathetic tone? What is the role for sertraline in treating dialysis hypotension? How does dialysis sodium level and sodium ramping impact this condition? Part two of this talk will be presented in 1-2 weeks.
November 2 - 9, 2003
Addressing The Ongoing Clinical Debate: Implications of Iron Therapy
(National Kidney Foundation Kidney Learning System Program, November, 2003)
Based on a symposium held at the NKF Spring Clinical Meeting in Dallas earlier this year. Stivelman: What is the clinical relevance of the K/DOQI guidelines for management of anemia of chronic kidney disease? What are the Clinical Performance Measures for anemia and how can they best be implemented? Warnock: What are the benefits of anemia correction? What are the benefits of iron therapy? What is the infection risk associated with parenteral iron? Coyne: What are efficacy and safety issues in choosing an IV iron preparation? What is prudent use of iron dextran? What do the studies of iron gluconate and iron sucrose show? What is the experience with higher dose use of iron gluconate and iron sucrose? Technical note: The source audiotape had problems. Audio for Dr. Stivelman's talk is not provided for this reason. We suggest that you print out the "small slide" version of this talk for review.
Issues of Volume Regulation. Case Discussions. Part Two of Two.
(ASN Board Review Course; San Francisco, August, 2003)
We finish up with two more cases. Weisberg: What do we do in a patient with severe heart failure and compromised kidney function who is not responding to diuretics? Continuous furosemide infusion? Dopamine? Nesiritide? Extracorporeal ultrafiltration? Sterns: A patient presents with nonketotic hyperosmolar syndrome and a glucose of 1400 mg/dL. What does his serum sodium of 146 mM mean? How do we correct for hyperglycemia? What is the new correction factor? How do we calculate sodium and water replacement? How can we use the hematocrit to estimate water deficit? CME now available for parts 1 and 2 of these case presentations.
October 25 - November 1, 2003
Issues of Volume Regulation. Case Discussions. Part One of Two.
(ASN Board Review Course; San Francisco, August, 2003)
In opera you have the three tenors. The ASN has the three renal physiologists, leading case discussions at the 2003 Board Review course that dealt with issues of volume regulation. Weisberg: A young woman develops signs of volume depletion, hemoconcentration, and ascites. What is the diagnosis and how do we treat? Schuster: A patient with nephrotic edema requires symptomatic treatment beyond furosemide 40 mg BID. What are the options for pharmacologic control of his edema? Sterns: This patient has hyponatremia, slight hyperkalemia and renal salt wasting. What is the differential diagnosis and what laboratory test should be considered?
October 18 - 24, 2003
Edema States, Pathophysiology and Therapy. Part Two of Two: Therapy.
(Lawrence Weisberg, MD; ASN Board Review Course; San Francisco, August, 2003)
What are the main sites where diuretics act? What is the mechanism of action, and what are the main adverse effects, of carbonic anhydrase inhibitors, loop diuretics, thiazides, and K-sparing diuretics? What are pharmacokinetic and pharmacodynamic issues that can limit diuretic efficacy? What is the braking phenomenon? What are practical diuretic treatment strategies in congestive heart failure, cirrhotic ascites, and nephrotic syndrome? What are the causes of diuretic resistance?
ADC 2003Audiofile selection - ADC 2003 (Seattle) (5-10 talks)
Invasive vs. Non-Invasive Diagnosis of Renal Bone Disease
Part 1; Part 2
(Malluche, Martin) (more...)
Vascular Access: Arteriovenous Fistula (AVF), Arteriovenous Graft Assessment (AVG) and Cannulation Techniques
Physical assessment and surveillance techniques; Diagnosis and management of complications.
(Peterson, Brouwer) (more...)
Electrolyte Problems in Peritoneal Dialysis Patients ~ Autoregulatory Features
Physiology of ultrafiltration in PD, autoregulation of sodium and potassium removal; physiology of fluid absorption; problem case workshop.
(Nolph, Khanna) (more...)
Maintaining Quality Care in a Dialysis Facility ~ Dealing with the Nursing Shortage
Mandated staffing: pros and cons; Making the most of your available staff: Effective delegation
(Bednar, Schira) (more...)
Education
The National Kidney Disease Education Program; Pre-dialysis education: improving assessment and education for good decision making.
(Hostetter, Campbell) (more...)
October 11 - 17, 2003
Edema States, Pathophysiology and Therapy. Part One of Two: Pathophysiology
(Lawrence Weisberg, MD; ASN Board Review Course; San Francisco, August, 2003)
How does edema affect body water compartment volumes and Starling forces within the systemic capillary wall? How does edema develop in congestive heart failure? What are the roles of renin- angiotensin, sympathetics, vasopressin, endothelin, ANP, nitric oxide, and prostaglandins? What are the three theories of edema formation in hepatic cirrhosis with ascites? Does edema in nephrotic syndrome form because of underfill or because of sodium retention? What are mechanisms of idiopathic edema and of systemic capillary leak syndrome? Next week: Treatment.
ADC 2003Audiofile selection - ADC 2003 (Seattle) (5-10 talks)
Surgical Aspects in Dialysis Patients
Occlusive vascular disease; Feeding jejunostomy in PD patients; Pre-op cardiac evaluation; Parathyroidectomy; Surgical aspects of presternal PD catheter insertion; 10 year experience
(Nichols, Koivunen, Aggarwal, Tarakji) (more...)
Experience of Patients with Chronic Kidney Disease and Dialysis at Kaiser Permanente, a Vertically Integrated Health Care System
K/DOQI guideline application at Kaiser; Anemia and lipid management; Outcomes of disease management programs
(Yeoh, Idroos, Rasgon) (more...)
October 4 - 10, 2003
Regulation of Sodium Balance: A Summary of Practical Physiology
(Victor Schuster, MD; ASN Board Review Course; San Francisco, August, 2003)
What are the body volume spaces and how does sodium figure in each one? What are the methods of regulation of plasma water and extracellular space? How do the glomerular afferent and efferent arterioles as well as the juxtaglomerular apparatus control sodium excretion, volume, and GFR? How and where is sodium absorbed along the nephron? What are the disorders that affect sodium absorption in the distal nephron?
ADC 2003Audiofile selection - ADC 2003 (Seattle) (5-10 talks)
Diagnostic and Interventional Nephrology Session
How to increase fistula use in the USA; Vascular access monitoring; Fistula declotting; Renal ultrasound and renal biopsy; Peritoneal catheter placement; Internal jugular catheter placement; Developing a comprehensive interventional nephrology program
(Besarab, Van Stone, Mishler, O'Neill, Ash, Beathard, Asif) (more...)
Sept. 27 - Oct. 3, 2003
Renal Water Handling: A Summary of Practical Physiology
(Richard Sterns, MD; ASN Board Review Course; San Francisco, August, 2003)
How do total osmolytes distribute in the ICF and ECF, and how does this help us calculate serum sodium changes as a result of water load or dehydration? How does plasma AVP respond to changes in osmolality and control urinary osmolality? How does the nephron control water excretion? What is urea recycling? How does AVP control aquaporins? What are the threats to water conservation and to water elimination?
ADC 2003Audiofile selection - ADC 2003 (Seattle) (5-10 talks)
Dialysis Outcomes and Practice Patterns Study (DOPPS) Update
Quality of Life; Vascular access; Adequacy of dialysis
(Mapes, Dykstra, Held) (more...)
Special Session: Latest Dialysis Findings of the USRDS
Latest findings
(Collins) (more...)
Special Session: Dialysis Dose and Outcomes ~ What Have We Learned from the HEMO and ADEMEX Studies?
The HEMO study; the ADEMEX study
(Depner, Mujais) (more...)
Old and New Optimal PTH Targets: Actions of the New PTH Inhibitor and Implications for Its Use in Guiding Vitamin D Treatment
New PTH targets; New PTH inhibitor
(Martin, Sprague) (more...)
September 20 - 26, 2003
Best Nursing Practices for Central Venous Hemodialysis Catheters
Asif
Brouwer
Dinwiddie
(ANNA Satellite Symposium, Chicago; April, 2003)
Arif Asif: What are the issues with regard to venous catheter insertion? Advantages? Disadvantages? What is the role of ultrasound guidance? What is the best placement site, and the best tip position to use? What are causes of early and late catheter malfunction? How does one treat fibrin sheath formation? What are the options of treating an infected catheter? Debbie Brouwer: What are protocols for routine catheter care? What should comprise routine catheter assesssment? What is special about the way catheter hubs should be approached? Lesley Dinwiddie: How do we approach the problem of catheter occlusion? What are the four potential lytic therapies and what are advantages and disadvantages of each? What did the COOL trial results show? How do we assess for the need for lytic therapy? What's a practical protocol for using the tPA Alteplase? What are cost issues associated with lytic therapy?
Resistant Hypertension Case Discussions: Part Two.
(Robert D. Toto, MD; ASN Renal Week; Philadelphia, November, 2002)
Two additional cases are discussed; the first is a hypertensive patient with hypokalemia and slight hypernatremia, in whom urinary protein excretion is also elevated. The second is a case of refractory hypertension in a transplant recipient.
ADC 2003Audiofile selection - ADC 2003 (Seattle) (5-10 talks)
Managing Failing Hemodialysis Accesses
Managing the patient with a failing hemodialysis catheter; Future directions in use of fibrinolytic agents and treatment of access complications; Managing the patient with a failing access graft.
(Besarab, Rocco, Chopra) (more...)
Influence of Dialysis Solution Quality on Chronic Inflammation
State of the art; Malnutrition, inflammation, atheromatosis (MIA) syndrome; Benefits of ultrapure dialysis solution; Preparation of ultrapure dialysis solution in the Aksys Personal Hemodialysis System; Role of inflammation in the anemia of ESRD.
(Lonneman, Ikizler, Ledebo, Kjellstrand, Lindholm) (more...)
September 13 - 19, 2003
Resistant Hypertension Case Discussions: Part One.
(Robert D. Toto, MD; ASN Renal Week; Philadelphia, November, 2002)
A case of an African American patient with moderately severe hypertension is presented. How would you manage him? What would be your initial therapy? The next step? Then what would you do? This is the last talk we will post in slide/audio from Renal Week 2002. It is the first we are posting in a discussion format. The audiotape unfortunately was suboptimal, but it gets better in Part Two, where three additional cases are to be discussed, next week.
ANNA 2003 Keynote Address: Focus on the Future: Realities, Challenges, and Solutions 
(General Barbara Brannon, MSDN, BSN, CNAA; ANNA Annual Symposium; Chicago; April, 2003)
What were the key factors affecting the nursing profession in the 20th century? How acute is the current nursing shortage? What can we do about this? What are the 10 domains to fulfill the nursing vision? What are the JCAHO recommendations? What are the 10 principles of leadership?
ADC 2003Audiofile selection - ADC 2003 (Seattle) (5-10 talks)
Role of Sodium in Hemodialysis
Sodium balance; Implications for therapy; Neglect of sodium restriction; Intradialytic hypotension and sodium modeling; Thirst, sodium, vasopressin, and interdialytic weight gain; Are sodium profiling and sodium dietary restriction necessary in nocturnal hemodialysis?
(Flanigan, Charra, Sherman, Katzarski, Pierratos) (more...)
Beyond High Flux: Sorbent Technology
Sorbents from bench to bedside, sorbents in acute renal failure and in sepsis; History of hemoperfusion; Sorbents for acute intoxication; Sorbents for special indications
(Ronco, Winchester, Ash) (more...)
September 6 - 12, 2003
Options and Issue in Anemia Management
Dinwiddie
Charytan
Lundell
Aronoff
(ANNA Lunch Symposium, Chicago; April, 2003)
Lesley Dinwiddie: What effect does correction of anemia have on hemodynamics? How might this improve vascular access survival? Chaim Charytan: What are the challenges of using IV iron outside the dialysis unit? What are results with IV iron in PD and in CKD patients? What do we know about dose ranges and infusion times of IV iron products? Erin Lundell: What can be learned from practical experience of managing anemia in a PD unit? What are the keys to success? What are useful IV iron protocols? George Aronoff: What are the risks of IV iron therapy in terms of infection, oxidative stress, and cardiovascular disease?
Can Pharmacologic Interventions Prevent or Treat Acute Renal Failure?
(Richard Lafayette, MD; NKF Spring Clinical Meetings, Dallas. April, 2003)
What are the major causes of ARF in the ICU? What is the pathogenesis? How does ARF affect prognosis? What preventive measures have been shown to work? What treatments have been shown to work? Volume? Furosemide? Mannitol? Dopamine/fenoldapam? N-acetylcysteine? What are the new avant-garde drugs being tested and what are the early results?
ADC 2003Audiofile selection - ADC 2003 (Seattle) (5-10 talks)
Renal Replacement Therapy in Hepatorenal Failure
Pathophysiology; Continuous renal replacement therapy; Anticoagulation; Application of Molecular Absorbent Recirculating System (MARS);
(Safirstein, Davenport, Fischer, Mullen) (more...)
Cardiovascular Disease in Peritoneal Dialysis and Hemodialysis
Troponins, thallium, dobumatine stress echo, and EBCT; Role of conventional risk factors; Ultrafiltration in PD with long dwells; Systemic inflammation syndrome; Pathogenesis of arteriosclerosis in uremia
(Agarwal, Collins, Burkart, Lindholm, Prichard) (more...)
August 30 - September 5, 2003
Assessment of Renal Function in Chronic Liver Disease
(Isaac Teitelbaum, MD; NKF Spring Clinical Meetings, Dallas. April, 2003)
How good are the serum creatinine, the Cockcroft-Gault equation, and the MDRD equation for predicting GFR in patients with liver disease? How does liver failure affect the creatinine generation rate? What GFR does a serum creatinine of 1.2 correspond do in these patients? Are there alternative estimates for creatinine clearance such as cystatin in these patients? What are the clinical implications in decisions for drug dosing and dialysis?
ADC 2003Audiofile selection - ADC 2003 (Seattle) (5-10 talks)
Quotidian Hemodialysis 1
Rationale; Dialysis dose; Kinetics of middle molecules; Hemodynamic considerations; Report of the Daiy Dialysis Registry
(Kjellstrand, Vanholder, Raj, Sherman, Lindsay) (more...)
Quotidian Hemodialysis 2
Access considerations; Remote monitoring; Organization and administration
(Ting, Hoy) (more...)
August 23 - 29, 2003
IV Iron: Patients & Professionals in Dialogue: Addressing Concerns of Hemodialysis Patients
Robbins
Coyne
Colfer
(ANNA Breakfast Symposium, Chicago; April, 2003)
Karen Robbins: What are general ESRD patient concerns and what are concerns specifically relating to IV iron? How can one educate patients regarding anemia and IV iron usage based on current literature and K/DOQI guidelines? What are practical techniques for patient education? Daniel Coyne: Which IV iron agents are available and how do they differ in terms of pharmacokinetics and dosing strategies? What is the safety experience with IV iron dextran, gluconate, and sucrose? What are the results of recent safety studies? Martha Colfer: How can we establish an iron administration protocol based on K/DOQI guidelines? What can we learn from studying the response of individual patients to IV iron repletion? How should nurses work to optimize IV iron management?
ADC 2003Audiofile selection - ADC 2003 (Seattle) (5-10 talks)
Home Hemodialysis 1
Reimbursement; Nursing vs. patient accountability; The patient perspective; Why home hemodialysis?
(Brunson, Anderson, Peckham, John) (more...)
Home Hemodialysis 2
Starting a home HD program - using resources from industry; Incorporating home HD and PD programs; Patient recruitment and assessment for home HD; How to make a home HD program financially sound
(Schneider, Ponferrrada, Dooley, Hynes) (more...)
August 16 - 22, 2003
Treatment of Focal Glomerulosclerosis (FSGS)
(Gerald Appel, MD; NKF Spring Clinical Meetings, Dallas. April, 2003)
What is the effect of race on FSGS subtype? What are predictors of good and poor outcome? When are steroids indicated and for how long? When should cyclophosphamide be used and in what regimen? What are the roles of cyclosporine and mycophenolate mofetil? ACE inbhitors? ARBs? How does FSGS with high-dose pamidronate present? Should FSGS be treated always? What are the new genetic variants associated with FSGS and what implications do they have for therapy if found?
ADC 2003Audiofile selection - ADC 2003 (Seattle) (5-10 talks)
Fundamentals of Extracorporeal Therapies Day 1
How hemodialysis works; Understanding the components of hemodialysis systems; Modes of extracorporeal therapies; Components and intradialytic modeling of dialysis solutions; Dialyzer and machine-related complications: pathogenesis, prevention and treatment.
(Misra, McCarthy, Davenport, Ahmad, Stivelman) (more...)
Fundamentals of Extracorporeal Therapies Day 2
Medical complications of hemodialysis: pathogenesis, prevention and treatment; Intradialytic hypotension, cardiac arrhythmias, intradialytic hypertension, muscle cramps, nausea and vomiting, headache, disequilibrium syndrome dose of dialysis
(Stivelman, Depner) (more...)
Special Workshop on Hemodialysis Machines Commonly Used for Center Hemodialysis
Astra machine by Baxter; 2008K Fresenius machine; Phoenix machine by Gambro
(Hawbecker, Mullen, Warns) (more...)
August 9 - 15, 2003
CPC: The Nephrotic Syndrome
(Julie Lin, MD, MPH; NKF Spring Clinical Meetings, Dallas. April, 2003)
What are the causes of nephrotic syndrome in adults and how has this changed over time? What are the subtypes of FSGS? What are the different presentations of these subtypes and how do their clinical courses differ? How does obesity-related glomerulopathy differ from usual FSGS? This talk is a lead-in to treatment of FSGS, which will be presented next week by Dr. Jerry Appel.
ADC 2003Audiofile selection - ADC 2003 (Seattle) (5-10 talks)
Debate of the Decade: To Revise or Not to Revise Dialysis Dosing Concepts
ADEMEX is a Landmark Study and Calls for New Dialysis Dosing Paradigms in Peritoneal Dialysis and Hemodialysis: Kt/V Should Be Abandoned (Oreopoulos); ADEMEX Had a Design Flaw and Results Cannot Be Generalized: Kt/V Remains the Best Tool for Dialysis Dosing in Peritoneal Dialysis and Hemodialysis (Gotch).
(Oreopoulos, Gotch) (more...)
Optimal vs. Adequate Dialysis
How to define optimal dialysis; Uremic toxins; Are clearances of small molecules approriate indices of adequate dialysis? Hypertension as an index of suboptimal dialysis; Economic impact of optimal dialysis
(Chertow, Vanholder, Lowrie, Charra, Hoy) (more...)
August 2 - 8, 2003
Dialysis Trials in Acute Renal Failure: What Have We Learned?
(Jonathan Himmelfarb, MD; NKF Spring Clinical Meetings, Dallas. April, 2003)
Are we doing better now than 20 years ago? Does early start help? When should we start? Does the membrane matter? What about intermittent HD vs. CRRT? Is there a role for acute PD? How do we measure adequacy and should the optimal dose be for HD? for CRRT?
ADC 2003Audiofile selection - ADC 2003 (Seattle) (5-10 talks)
Update on Infection and Inflammation in Dialysis Patients
Immune defenses; Cytokine release; Icodextrin-related peritonitis; Fungal infections and TB in PD; Peritonitis impact on transport; Exit site care and mupirocin resistance; Recent trends in infection; Update on MRSA and VRE; Review of antibiotic regimens
(Tranaeus, Krediet, Martis, Salzer, Venkatraman, Piraino, Salzer, Finkelstein) (more...)
July 26 - August 1, 2003
Keeping Your Water Safe
(Jim Curtis, CHT; NKF Spring Clinical Meetings, Dallas. April, 2003)
What are the components of a water treatment system? How should each be checked and maintained? Feed water, pretreatment, RO unit, delivery system? What are patient symptoms associated with water contamination in dialysis? Chloramines? Improper pH? Pyrogen reactions? Fluoride? Azide? How should we monitor for chlorine, hardness, conductivity, and pH? What is the best approach to microbiologic and endotoxin testing? What are the new AAMI guidelines in this area?
ASN Renal WeekAudiofile selection - ASN 2002 (Philadelphia) (5-10 talks)
Glomerulonephritis: Intensive Review and Update of the Pathophysiology, Diagnosis, and Therapy of the Key Disorders
Management of nephrotic syndrome; Pathology of MCS and FSGS; Treatment of MCS and FSGS; Management of membranous nephropathy; Spectrum of MPGN; Update on IgA nephropathy; Management of anti-GBM disease; Serologic diagnosis of glomerular disease; Modern therapy of lupus nephritis; Viral GN: HIV, HBV, and HCV; Dysproteinemias, amyloid, LCDD, and fibrillary GN
(Appel, Rennke, Korbet, Cattran, Glassock, Pusey, Falk, Winston) (more...)
ADC 2003Audiofile selection - ADC 2003 (Seattle) (5-10 talks)
Sodium and Fluid Volume Control in Chronic Peritoneal Dialysis Patients
Residual renal function and sodium/water balance; Are PD patients volume expanded? Volume expansion, hypertension, and cardiovascular mortality; Is icodextrin the answer? Is dietary management of sodium intake the answer? Is increased ultrafiltration with hypertonic exchanges the answer? Ultrafiltration failure: diagnosis and consequences; Is dialysis against low sodium dialysate the answer? Why PD patients are fluid overloaded.
(Bargman, Nissenson, Voinescu, Gokal, Akcycek, Faber, Mehrotra, Katzarski, Wang) (more...)
July 19 - 25, 2003
New Treatment Approaches and Clinical Trials in Lupus Nephritis
(Gerald Appel, M.D.; ANS Renal Week 2002, Philadelphia, PA, November, 2002)
What are the new immunologic approaches to treating lupus? What are the preliminary data regarding LJP394? anti-CD40 ligand? blockers of IL-10 and interferon? anti C5 antibody? When is immunoablative therapy (high-dose cytoxan with stem cell autotransplantation rescue) indicated? How does mycophenolate stack up against cyclophosphamide both as maintenance therapy and as inductive therapy?
ASN Renal WeekAudiofile selection - ASN 2002 (Philadelphia) (5-10 talks)
Epoietin-associated Pure Red Cell Aplasia: Clinical and Pharmaceutical Update
Immunogenicity of therapeutic proteins; Case reports and investigations; Pharmaceutical evaluation of bulk drug and formulations; Basic science research; PRCA - the way forward
(Schellekens, Knight, Sharma, Jolliffe, Rossert) (more...)
Debates in Renal Failure
Vitamin D analogues vs. Standard therapy
(Coburn vs. Slatopolsky) (more...)
ADC 2003Audiofile selection - ADC 2003 (Seattle) (5-10 talks)
Update on Biofilms
Role of biofilms in HD and PD infections; What have we learned from buried PD catheters?; Peritonitis due to exit-site infections; Indications for removal of a hemodialysis access.
(Dasgupta, Mehrotra, Teitelbaum, Katyal) (more...)
Update in diabetes
The coming pandemic of diabetic nephropathy; Pre-empting diabetic complications
(Friedman) (more...)
Controversy: Do calcium-based phosphate binders kill patients?
Yes (Chertow); No (Friedman)
(Chertow, Friedman) (more...)
July 12 - 18, 2003
Defining Acute Kidney Failure - The Acute Dialysis Quality Initiative (ADQI)
(John Kellum, M.D.; NKF Spring Clinical Meetings, Dallas, TX. April 2003)
How do we define acute renal failure? Low urine output? Rise in creatinine? What should the cutoffs be? When is the creatinine generation rate reduced in ARF? Is it lower or higher than normally? How should we quantify creatinine clearance in ARF? Dr. Kellum is a key member of the Acute Dialysis Quality Initiative. Workgroups have been meeting regularly to address a number of experimental and clinical issues in the area. Many fascinating working papers are available at the ADQI website.
ASN Renal WeekAudiofile selection - ASN 2002 (Philadelphia) (5-10 talks)
Bone Disease in Dialysis and Transplant Patients
Renal osteodystrophy, therapy, and vascular calcification; Treatment of vascular calcification with bone morphogenetic proteins; PTH fragments in ESRD; Role of bisphosphonates on post-transplant bone loss
(Hruska, Davies, Gonzales, Cunningham) (more...)
Resistant Infection in Dialysis Units
Epidemiology; Mechanisms of antibiotic resistance; Strategies to avoid resistant infection; New antibiotic agents
(Tokars, Rice, Szczech, Jenkins) (more...)
ADC 2003Sleep abnormalities in Dialysis Patients
Pathophysiology and diagnosis; Pulmonary function and gas exchange during hemodialysis; Sleep apnea in dialysis patients; Improvement of sleep apnea with nocturnal hemodialysis; Clinical correlates of sleep behavior (KOPE Study)
(Sahota, Brooks, Hamburger, Pierratos, Rocco) (more...)
Dialysis in the Elderly
Complications of hemodialysis in the elderly; Outcomes of HD and PD in the elderly from registries; Special issues
(Ing, Collins, Oreopoulos) (more...)
July 4 - 11, 2003
No slide/audio talk this week.
ASN Renal WeekAudiofile selection - ASN 2002 (Philadelphia) (5-10 talks)
Hormones and End-Stage Renal Failure
Estrogen deficiency; Androgen deficiency; Conjugal function; Treating hypogonadism
(Holley, Johansen, Feldman, Stehman-Breen) (more...)
New Approaches in the Treatment of Crescentic GN
Role of new GBM antigens; Macrophages in renal inflammation; Cell-mediated aspects of crescentic GN; Therapies for crescentic GN
(Kalluri, Rees, Tipping, Pusey) (more...)
ADC 2003Audiofile selection - ADC 2003 (Seattle) (5-10 talks)
Preventing Complications and Promoting Health in ESRD
Preventing CV disease; Preventing malnutrition; Preventing infection and inflammation; Health promotion; Rehabilitation - team approach; Preventing diabetic complications
(Pritchard, McCann, Faber, Mendelssohn, Witten, Haas) (more...)
June 27 - July 3, 2003
Hepatitis C Virus - Associated Kidney Diseases
(David Roth, M.D.; NKF Spring Clinical Meetings, Dallas, TX. April 2003)
What is the natural course of HCV-associated renal disease? What is the pathology, and how does it differ from idiopathic MPGN? What are new theories about pathogenesis? How are lymphocytes involved? What is the role for interferon? Ribavirin? How does HCV-associated renal disease manifest in the renal allograft? How effective are preventive measures? How can disease in the allograft be treated?
ASN Renal WeekAudiofile selection - ASN 2002 (Philadelphia) (5-10 talks)
Novel Alternatives to Hemodialysis
Overview of solute removal in non-diffusive modalities; Solute removal vs. protein loss in hemofiltration; Daily hemofiltration; Adsorptive techniques applied to treat ESRD
(Clark, Santoro, McCarthy, Winchester) (more...)
Peritoneal Clearances: Changing Perspectives
Overview of recent studies; New PD DOQI guidelines; European PD adequacy guidelines; PD adequacy studies from Asia
(Bargman, Burkart, Hutchinson, W-K Lo) (more...)
ADC 2003Audiofile selection - ADC 2003 (Seattle) (5-10 talks)
Medical Director's Session
Quality management; Infection control
(Rutherford, Alter) (more...)
PD case forum
Failing kidney transplant - when to initiate dialysis and when to re-transplant; PD patient with volume overload
(Jassal, Burkart) (more...)
Time Management for Health Professionals
Mars perspective; Venus perspective
(K Nolph; G Nolph) (more...)
Overview Lecture
K/DOQI predialysis care guidelines
(Ikizler) (more...)
June 20 - 26, 2003
Nutrition Across the Continuum of Care in Kidney Disease
(Judy Beto, Ph.D., R.D., F.A.D.A., NKF Spring Clinical Meetings, Dallas, TX. April 2003)
From the Dietitian track of the NKF Meeeting: How do dietitians adjust their approach to patients across various age groups and across different spectra of renal disease? How do recent changes in food composition, including protein and calcium supplementation of foods, affect dietitian practice? What are practical methods and networking tool that dietitians can use to improve patient care?
ASN Renal WeekAudiofile selection - ASN 2002 (Philadelphia) (5-10 talks)
The Hemodialysis Catheter Conundrum: Update
Acute vascular access function and complications; Tunneled catheters: insertion, design, function; Prevention and treatment of infection in tunneled catheters; New subcutaneous access devices
(Oliver, Beathard, Blankestyn, Schwab) (more...)
The Harmful Effects of Glucose in Peritoneal Dialysis
Glucose harm to the peritoneal membrane; Histopathology of the peritoneum in PD; Mechanisms of glucose toxicity; Clinical strategies to miminize glucose toxicity
(Davies, Williams, De Vriese, Jorres) (more...)
ADC 2003Audiofile selection - ADC 2003 (Seattle) (5-10 talks)
Clinical Topics
Did King Herod have kidney disease?; Avoiding catastrophic dialysis initiation; PD prescription in the post-ADEMEX era; Long-acting EPO; How to best preserve residual renal function in dialysis patients; Pregnancy in dialysis patients; Endocrine function
(Hirschmann, Pennell, Bargman, Nissenson, Misra, Hou, Lim) (more...)
June 13 - 19, 2003
Glomerulonephritis: the Deposition Diseases
(Steve Korbet, M.D., NKF Spring Clinical Meetings, Dallas, TX. April 2003)
There are two parts to this talk. The link to PART TWO is at the end of PART ONE. How do we classify the fibrillary glomerulopathies? How is amyloidosis defined, and what are the subtypes? What is the pathology and the basic approach to treatment? What are the results of stem cell transplantation in AL-amyloidosis? What about immunoglobulin-mediated non-amyloid deposition disease (MIDD)? How is this different? How is this treated? In part two Dr. Korbet discusses ITG - immunotactoid glomerulopathy. How do we explain the large vs. small fibris? How is the pathology different? Wat is the response to treatment?
ASN Renal WeekAudiofile selection - ASN 2002 (Philadelphia) (5-10 talks)
Long-Term Outcomes in Renal Transplantation
Impact of acute rejection on allograft; Are new immunosuppressants improving outcomes? Effects of age and gender on long-term outcomes; Death after renal allograft failure
(Kasiske, Hariharan, Kaplan, Meier-Kriesche) (more...)
Current Concepts in Vitamin D Therapy
Overview of Vitamin D metabolism and action; Role of the vitamin D receptor; Goals of therapy
(Christakos, Dusso, Coburn) (more...)
ADC 2003Audiofile selection - ADC 2003 (Seattle) (5-10 talks)
PD Fundamentals - Day 2
Complications due to raised IP pressure; PD solutions; PD and kidney Tx; PD in post-surgical patients; PD in patients with acute renal failure; Peritonitis: case studies; Exit-site care
(Mahale, Piraino, Venkataraman, Teitelbaum, Oreopoulos, Faber, Prowant) (more...)
Education Workshop, Part 3.
Applying what we've learned: discussion of participants teaching challenges
(TenBrink) (more...)
June 6 - 12, 2003
Introduction to Laboratory Values
(Jim Zazra, M.D., NKF Spring Clinical Meetings, Dallas, TX. April 2003)
This talk was targeted for Dialysis Technologists, but all renal caregivers can benefit. How do accuracy and precision differ? How do we standardize? What is the role of CAP (College of American Pathologists)? How do biological variation, analytical variation, and clinical variation differ? What happens when there is no gold standard? How does the method affect results? Practical aspects: lower ranges for new PTH assays; does shipping affect bicarbonate values? How do albumin assays differ?
ASN Renal WeekAudiofile selection - ADC 2003 (Seattle) (5-10 talks)
Lupus Nephritis: an Update on Therapy
IV cyclophosphamide and IV methylprednisolone; Sequential oral cyclophosphamide and azathioprine; Mycophenolate mofetil-based therapy; Investigational approaches and trials in progress
(Balow, Chan, Lai, Appel) (more...)
ADC 2003Audiofile selection - ADC 2003 (Seattle) (5-10 talks)
PD Fundamentals - Day 1
Future of Nephrology: ASN Perspective; PD access; Ultrafiltration; Solute removal; High dose iron sucrose; PD adequacy; Electrolyte transport
(Narins, Flanigan, Krediet, Gokal, Blake, Burkart, Nolph) (more...)
Education Workshop, Part 2.
The teaching-learning process: Focus on the learner
(TenBrink) (more...)
May 29 - June 5, 2003
System Barriers to Creating the Best Angioaccess for Our Patients
(Jeff Sands, M.D., NKF Spring Clinical Meetings, Dallas, TX. April 2003)
What are outcome differences among access types? How do the Europeans compare? What are the barriers to improving prevalence of AV fistulas in dialysis patients? Where are the leverage points at the CKD stage? The ESRD stage? The failed access stage? What percentage of patients with catheters have blood vessels that should support an AV fistula?
ASN Renal WeekThe African American Study of Kidney Disease and Hypertension (AASK Trial)
Introduction; Protocol and power; Low vs. usual BP control; Comparison of ACE-I, beta blockers, and CCBs; Interaction of proteinuria with BP control and drug selection; Translation of AASK results into clinical practice.
(Douglas, Greene, Toto, Bakris, Norris, Luke) (more...)
ADC 2003Industry Speaks VI
HD machine disinfection and biofilm; Innovations in dialysis; Slowing progression of cardiac calcification.
(Mishkin, Wells, Chertow) (more...)
Advances in Understanding Peritoneal Transport
Update on aquaporins; Neovascularization; High transport and neovascularization - prevention and management.
(Krediet, Margetts, Voinescu) (more...)
Education Workshop, Part 1.
The teaching-learning process: Focus on the learner
(TenBrink) (more...)
May 22 - 28 2003
Practical Management of Secondary Hyperparathyroidism: From Basic Science to Clinical Medicine
Jueppner
Slatopolsky
Martin
(ASN Annual Meeting Official Evening Symposium, November, 2002)
Dr. Jueppner: What are the various actions mediated by parathyroid hormone? What does PTH 7-84 peptide do, and why is this important in uremia? How do the new generation of PTH assays work? Dr. Slatopolsky: In a 5/6 nephrectomized rat model, what effects does 19-nor have on serum creatinine, phosphorus, PTH, parathyroid gland growth, and bone histology? Dr. Martin: How does hyperphosphatemia impact on outcomes, and what should serum phosphorus targets be? What effect does sevelamer have on coronary calcification and on lipid profiles? How do the calcemic effects of 19-nor and calcitriol differ in animal models and in humans? What could account for the survival advantage in patients taking 19-nor vs. calcitriol? How do the new PTH assays work and what should be the target PTH levels with the new assays in both CKD and ESRD?
Clinical Strategies to Minimize Glucose Toxicities to the Peritoneal Membrane
(Achim Jörres, M.D., ASN Renal Week, Philadelphia, PA. November, 2002)
What are the biological and clinical consequences of glucose degradation products in PD solutions? What are the novel methods being used to develop PD solutions without GDPs? What are the potential roles of amino-acid solutions and icodextrin in terms of minimizing exposure to GDPs and advanced glycation end-products?
ASN Renal WeekNephrotoxicity of Calcineurin Inhibitors (CI) and CI-Sparing Protocols
Mechanism of nephrotoxicity; Mycophenolate use for cyclosporine sparing; Cyclosporine withdrawal/avoidance with sirolimus
(Bennett, Weir, Grinyo) (more...)
The Changing Spectrum of Acute Renal Failure in the ICU
ARF in children; Treating ARF in patients with liver disease; Protecting the kidney - strategies and results
(Bunchman, Gonwa, Mehta) (more...)
ADC 2003Audiofile selection - ADC 2003 (Seattle) (5-10 talks)
Industry Speaks IV
Blood tubing and delivered blood flow rate; New CAPD connectors; Safety of IV iron
(Bregel, Woods, Aronoff, Charytan, Aaronson) (more...)
Industry speaks V
Water treatment for home HD; Citrate dialysate for patients with clotting problems
(Jonsson, Ahmad) (more...)
May 15 - 21, 2003
Confronting Change in Nephrology Practice: Knowledge, Strategies, Tools (Part Two of Two)
Maddux
Mattern
Hostetter
Kulkarni
Blaser
Harms
Kuffner
Mecum
(RPA Annual Meeting, Washington, D.C., March, 2003)
This year we are posting all of the main audiofiles from the RPA meeting accompanied by Lecture Notes where available. The idea is, that you can download these to burn a CD, and listen in your car, and print out the lecture notes as a .pdf file.
Part Two consists of 8 lectures dealing with informatics, education, legislation, and HIPAA: Information Systems for CKD (Maddux and Mattern); National Kidney Disease Education Program (Hostetter); Legislative Issues (Kulkarni); RPA advocacy agenda (Blaser); Does your practice measure up? (Harms); Tools to help with HIPAA compliance (Kuffner); HIPAA compliance on a budget (Mecum).
ASN Renal WeekAudiofile selection - ASN 2002 Renal Week (5-10 talks)
Developments in Nephrolithiasis
Genetics of hypercalciuria; Bone mineralization and hypercalciuric stone disease; Molecular basis of cystinuria; Microorganisms and calcium stone disease
(Bonnardeaux, Asplin, Goodyer, Goldfarb) (more...)
New K/DOQI Guidelines - 2002
New guidelines on lipids; Recommended management of bone metabolism and disease in CKD
(Kasiske, Moe) (more...)
Literature Review - Dialysis
Peritoneal dialysis, Hemodialysis, Dialysis in ARF
(Piraino, Lameire, Palevsky) (more...)
ADC 2003Audiofile selection - ADC 2003 (Seattle) (5-10 talks)
Industry Speaks III
Daily hemofiltration; Advances in catheter exit site care; Industry role in CKD
(Hull, Mishkin, Mujais) (more...)
Industry speaks II
Line securement in home-based care; Testing for peritonitis in the home; Computerized patient record; Cyclase-activating PTH and the PTH inhibitor ratio; Managing failing PD catheter
(Tollini, Rutherford, Pollak, Cantor, Golper) (more...)
May 8 - 14, 2003
Confronting Change in Nephrology Practice: Knowledge, Strategies, Tools (Part One of Two)
Owen
Kliger
Golper
Nissenson
(RPA Annual Meeting, Washington, D.C., March, 2003)
This year we are posting all of the main audiofiles from the RPA meeting accompanied by Lecture Notes where available. The idea is, that you can download these to burn a CD, and listen in your car, and print out the lecture notes as a .pdf file.
Part One consists of 6 lectures dealing primarily with CKD: RPA Year in Review (Owen); Scope of Chronic Kidney Disease (Kliger); RPA Clinical Practice Guideline on Appropriate Patient Preparation for RRT (Owen); Integrating Nurse Practicioners and Physician Assistants in Nephrology Practice (Golper); Physician Payment for CKD Care: A Case Study (Amedia, Lawson, Hamburger); Louis H. Diamond Lecture: What is the Role of Disease Management in the Care of CKD Patients? (Nis
