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Printable Handouts
Navigable Slide Index
- Introduction
- Disclosures
- The reality of end stage kidney disease in some places around the world
- Patient in 2012 from a country in Sub-Saharan Africa
- What next step would you recommend?
- What are the options?
- Is this patient an exception?
- Income-related variability in access to KRT
- Extent of financial crisis suffered by the families of the patients
- How many patients may have died prematurely in 2010? (1)
- How many patients may have died prematurely in 2010? (2)
- Number of premature deaths due to lack of access to therapy
- The situation is expected to get worse
- Estimated number of premature deaths
- Translating these projections into numbers for 2019
- De-constructing hemodialysis: what is essential?
- Conventional HD
- alloHD concept
- alloHD – blood flows on both membrane sides
- Transport between patient and buddy
- Critical areas to be addressed (1)
- Critical medical questions
- Can alloHD provide adequate solute removal?
- Pediatric patient dialyzed against adult 'buddy'
- Dialysis adequacy – pediatric patient
- Adult patient dialyzed against adult 'buddy'
- Dialysis adequacy – adult patient
- Can viruses cross the HD membrane?
- Transfer of low-molecular weight single-stranded DNA
- alloHD – use cases
- alloHD as a means to increase RRT choices
- Critical areas to be addressed (2)
- Ethical issues (1)
- Ethical issues (2)
- Science, technology and societies' choices
- The many faces of accepting risk (1)
- The many faces of accepting risk (2)
- Highly diverse legal situation regarding surrogate mothership
- alloHD progress
- Bench experiments with urea and potassium
- Summary
- Acknowledgements
Topics Covered
- Limitations in kidney replacement therapy
- Conventional hemodialysis
- Allo-hemodialysis
- Ethical, medical and technical aspects of allo-hemodialysis
- Use cases for allo- hemodialysis
- Deployment hemodialysis models for allo-hemodialysis
- Progress and timeline of allo-hemodialysis deployment
Links
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External Links
Talk Citation
Kotanko, P. (2021, April 28). Allo-hemodialysis: a novel approach to address the global shortfall in dialysis [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved December 6, 2024, from https://doi.org/10.69645/DQTH7547.Export Citation (RIS)
Publication History
Financial Disclosures
- Peter Kotanko is an employee of the Renal Research Institute, New York, NY, a wholly owned subsidiary of Fresenius Medical Care North America. He holds stock in Fresenius Medical Care North America.
Other Talks in the Series: The Kidney in Health and Disease
Transcript
Please wait while the transcript is being prepared...
0:00
Hi, this is Peter Kotanko.
I'm a kidney doctor and research director at the Renal Research Institute in New York.
Today's presentation is about allo-hemodialysis,
a novel approach to address the global shortfall in dialysis.
0:20
First, let me indicate my disclosures.
I'm an employee of the Renal Research Institute in New York,
a wholly-owned subsidiary of Fresenius Medical Care.
I hold stock in Fresenius Medical Care and I receive author royalties from UpToDate.
0:36
I wanted to share with you some personal experience concerning
the reality of end-stage kidney disease in some places around the world.
0:46
This is about a patient who I met in 2012 in a sub-Saharan country;
she was a woman in her late 50s, single,
and she had commenced hemodialysis about eight weeks previously because of her end-stage renal disease.
She was treated with one to two sessions a week, and the last session had been about five days ago.
She presented with shortness of breath, pitting edema, rales,
bilateral pleural effusions, and muscle wasting.
Her appetite was poor,
she had no signs or symptoms of encephalopathy,
and she still had some residual urine volume.
The potassium was slightly elevated, and she
was on furosemide and antihypertensive medication.
The situation was complicated by the fact that the patient
had run out of funds to pay for her dialysis.
My question to you is:
what next step would you recommend initiating?
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