ASN Maintenance Dialysis 2022 (On-Demand and Livestream)

Advances in Maintenance Dialysis Care: Addressing Challenges and Evolving Therapies

Introduction

Hemodialysis, peritoneal dialysis (PD), and other forms of renal replacement therapy are essential treatments for end-stage renal disease (ESRD). Significant progress has been made in developing and improving maintenance dialysis modalities, offering patients a wider range of options. This article explores the latest advancements in maintenance dialysis, providing a comprehensive overview of key challenges and therapeutic strategies for healthcare professionals.

Evidence-Based Dialysis Modalities

• Home-Based Dialysis: Shifting the focus from in-center hemodialysis to home-based modalities, such as peritoneal dialysis or home hemodialysis, has numerous advantages. It empowers patients with greater autonomy, flexibility, and cost-effectiveness.

• Transitioning to Home Dialysis: Healthcare providers must effectively prepare patients for the transition to home-based dialysis, ensuring they are equipped with the necessary knowledge, skills, and support systems.

• Dialysis Quality Assessment: Assessing the quality of home dialysis programs is crucial to ensure optimal patient outcomes. This involves evaluating metrics such as patient satisfaction, clinical efficacy, and adherence to best practices.

Management of Comorbid Conditions

Patients with ESRD often suffer from a range of comorbid conditions that can impact their dialysis management. These include:

• Cardiovascular Disease: Managing hypertension, hyperlipidemia, and other cardiovascular risk factors is essential to prevent complications in dialysis patients.

• Calcium-Phosphorus Metabolism: Dialysis patients may develop disturbances in calcium, phosphate, and parathyroid hormone (PTH) levels, which require careful monitoring and targeted interventions.

• Itch and Restless Legs Syndrome: These common symptoms in dialysis patients can significantly impact their quality of life and require specific treatment approaches.

Challenges in Vascular Access

Vascular access is essential for hemodialysis, but often presents challenges related to vessel patency, thrombosis, and stenosis. This article explores:

• Managing Vascular Access Complications: Healthcare providers must be proficient in managing vascular access complications, such as fistulas, grafts, and catheters, to ensure adequate dialysis delivery.

• Strategies for Improving Patency: Understanding the latest techniques for vessel repair, fistula revision, and catheter placement is crucial for maximizing vascular access longevity.

Patient-Centered Symptom Management

Beyond addressing physiological parameters, healthcare providers must focus on alleviating symptoms that impact the well-being of dialysis patients. This includes:

• Pain Management: Managing pain associated with dialysis access, procedures, and chronic conditions is essential for improving patient comfort and compliance.

• Insomnia: Addressing sleep disturbances prevalent in dialysis patients can significantly enhance their quality of life and overall health.

• Goal-Directed Therapy: Implementing treatment strategies tailored to individual patient needs and goals ensures optimal outcomes and satisfaction.

Content on Demand Presentations

The article provides a comprehensive list of on-demand presentations covering various aspects of maintenance dialysis care, including:

• Dialysis initiation and prescription
• Management of itch, restless legs syndrome, pain, and insomnia
• Antihypertensive and calcium-phosphate management
• Remote monitoring, telehealth, and big data in dialysis
• Goal-directed dialysis care
• Dialysis emergencies
• Transplant workup for dialysis patients
• Home dialysis education and complications
• Cardiovascular event prevention in dialysis patients
• Hemodialysis catheter management

Livestream Presentations

In addition to on-demand content, the article highlights livestream presentations focusing on:

• Home Therapy Program Management: This session explores strategies for optimizing home dialysis programs, including patient selection, education, and support systems.

• Tough Cases in Dialysis Access: Experts discuss challenging vascular access cases, providing insights into management strategies and best practices.

This article serves as a valuable resource for healthcare professionals involved in the care of patients with kidney failure. It offers a comprehensive overview of the latest advancements in maintenance dialysis, empowering providers with the knowledge and skills to deliver optimal patient care.