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2008 Kidney Symposium:
Options for End-Stage Renal Disease (ESRD)
by Kevin Sperling, MD
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1. Intro
2. Outline
3. Medicare patients & costs
4. Projections through 2020
5. Aging population
6. Dialysis Options
7. Time spent discussing
8. First modality stats
9. Patient's perspective
10. Patient's choice of therapy
11. Home dialysis equipment
12. Daily Hemodialysis
13. Multiple Comorbidities
14. Nocturnal Dialysis study
15. Calcium and Phosphorus
16. Use of Ca and P binders
17. Short Daily Dialysis study
18. Daily Dialysis study
19. Comparison of Conventional to Short Daily Dialysis
20. Cost Savings
21. Indications for starting sDHD
22. Strong indicators
23. Postulated Advantages of Quotidian dialysis
24. Quotidian Dialysis II
25. Kidney Transplantation
26. Transplant: First-line therapy
27. Incident ESRD & transplants
28. Waitlist study
29. Who is a candidate?
30. Contraindications to Transplantation
31. Transplant vs Waiting list
32. Transplant outcomes
33. Other transplant benefits
34. Probability of CHF
35. Survival after CHF
36. Quality of Life benefits
37. Happy Patients
38. Types of Kidney Transplants
39. Survival rates
40. Graft Survival rates
41. Donor rates
42. One problem
43. Evaluation Process

44. Steps in evaluation process
45. Routine tests
46. Misc. requirements
48. Timing of Transplantation
49. Disease Course
50. Relative Risk of Death
51. 10-Year Graft Survival
52. Preemptive Transplants
53. Annual Revenue
54. Immunosuppression
55. Graft Survival
56. Calcineurin Inhibitors
57. Rat glomerulus after 2 weeks of cyclosporin
58. CNI Side Effects
59. CNI Side Effects, cont'd
60. Metabolic Interactions that Increase CNI
61. Metabolic Interactions that Decrease CNI
62. Antiproliferative agents
63. Other Adverse Effects of Immunosuppressants
64. Primary Cause of Death in Kidney Transplant Recipients, 2000-2002
65. Malignancies
66. Risk factors for developing post-transplant cancer
67. PTLD
68. Risk Factors for PTDM
69. Screening
70. Target Blood Pressure for Kidney Transplant Recipients
71. Target Serum Lipid Levels for Kidney Transplant Recipients
72. Hematologic Complications
73. Post-transplant Bone Loss
74. Osteoporosis: Screening and Diagnosis
75. Prevalence of Nonadherence
76. Why do grafts fail?
77. Why grafts fail, cont'd.
78. Why grafts fail, cont'd.
79. Summary
80. Models of Transplant