KDIGO Conversations in Nephrology

Episode 19 is the third episode in KDIGO's three-episode series on acute kidney injury (AKI), hosted by Dr. Kathleen Liu (University of California at San Francisco, United States).

In this episode, Dr. Liu and Dr. Claudio Ronco (International Renal Research Institute of San Bortolo Hospital, Italy) discuss recent advancements and best practices surrounding Extracorporeal Blood Purification within the complex scenario of multiorgan support. This thought-provoking discussion, explores:

• Recent clinical trials suggesting minimal benefits of early CRRT in AKI for critically ill patients. The conversation delves into whether these findings translate to patients experiencing multiorgan failure, exploring the potential differentiating factors.

• The potential of CRRT to extend beyond renal support. The discussion explores how CRRT might offer support to other vital organs in the setting of multiorgan system failure.

• The role of current CRRT technology in eliminating inflammatory mediators. Dr. Ronco sheds light on the capabilities of current technology and its potential impact on the inflammatory response.

Join Dr. Liu and Dr. Ronco for an insightful exploration of extracorporeal blood purification’s evolving role in optimizing care for critically ill patients. 

This episode is supported by an independent educational grant from Baxter.

Episode 18 is the second episode in KDIGO's three-episode series on acute kidney injury (AKI), hosted by Dr. Kathleen Liu (University of California at San Francisco, United States). In this episode, Dr. Liu is joined by Dr. Kianoush Kashani (Mayo Clinic, United States) to discuss the rising importance of personalized care in AKI treatment. They delve into the world of digital health, exploring how digital decision support tools can empower clinicians and improve patient outcomes.

This episode will address:

• Digital Health: Dr. Kashani breaks down the concept of digital health and its applications in the context of AKI management.

• The Power of Digital Tools: Discover how digital decision support systems can aid clinicians in early detection, risk stratification, and personalized treatment plans for AKI patients.

• Personalized Care for AKI: Dr. Liu and Dr. Kashani explore why a one-size-fits-all approach doesn't work for AKI, and how digital tools can pave the way for individualized care.

• Optimizing KRT Outcomes: Learn how digital health can improve decision-making around KRT, leading to better patient outcomes.

Tune in for this informative discussion on leveraging the power of digital health to personalize AKI care.

This episode is supported by an independent educational grant from Baxter.

This is the first episode in KDIGO's new 3-episode series on acute kidney injury (AKI), hosted by Dr. Kathleen Liu (University of California at San Francisco, United States).
In this episode, Dr. Liu is joined by Dr. Jay Koyner (University of Chicago, United States) to discuss the emerging field of persistent acute kidney injury (AKI).

They delve into the question: what exactly is persistent AKI, and how does it differ from severe AKI? Dr. Liu and Dr. Koyner explore the key factors clinicians should consider when evaluating a patient's risk of developing persistent AKI. They also highlight the latest developments in this area of nephrology research, leaving listeners with valuable insights into the diagnosis and management of persistent AKI.

Join us as we discuss:

• What is persistent AKI, and how is it distinguished from severe AKI?

• What clinical factors should be considered when assessing a patient's risk of persistent AKI?

• What are some of the new developments in the field of persistent AKI research?

• How can this knowledge be applied to improve patient care?

This episode is supported by an independent educational grant from Baxter.

In this episode,  Dr. Peter Lin (Canadian Heart Research Centre, Canada) and  Ikechi Okpechi (University of Alberta, Canada) discuss the right time to refer patients with CKD to a nephrologist. This episode also addresses rapid CKD progression and the utility of risk prediction equations.  This episode is supported by an independent educational grant from AstraZeneca.

Join host Dr. Peter Lin (Canadian Heart Research Centre, Canada) in conversation with Dr. Joel Topf (Oakland University, William Beaumont School of Medicine, USA) as they discuss how to combat CKD progression and the role of non-pharmacological vs pharmacological interventions. This episode will explore whether foundational therapies are underused and how to tailor the right treatment for the right patient at the right time. This episode is supported by an independent educational grant from AstraZeneca.

In this episode, Dr. Peter Lin (Canadian Heart Research Centre, Canada) and Dr. Magdalena Madero (National Heart Institute Mexico City, Mexico) discuss best practices for CKD evaluation and measurement. This episode focuses on the importance of assessing GFR and albuminuria, identifying the causes of CKD, CKD progression, and when more accurate GFR measures (such as cystatin) should be conducted. This episode is supported by an independent educational grant from AstraZeneca.

Join host, Dr. Peter Lin (Canadian Heart Research Centre, Canada) and Dr. Lekha Tummalapalli (Weill Cornell Medicine, United States) as they discuss the importance of early CKD detection. This episode explores risk factors, screening for CKD, and country specific factors to take into account when screening for CKD. This episode is supported by an independent educational grant from AstraZeneca.

Show Notes:

https://kdigo.org/conferences/early-identification/

 

https://www.theisn.org/blog/2023/05/22/new-quick-guide-to-early-ckd-identification-and-intervention-for-primary-care-settings-available-in-50-languages-by-year-end/

 

https://www.theisn.org/initiatives/ckd-early-screening-intervention/

In this episode, host Dr. Vladimir Tesar (General University Hospital, Prague) and Dr. David Jayne (Addenbrooke's Hospital, United Kingdom) discuss the roles of various agents in the induction and maintenance treatment of ANCA- associated vasculitis. They will explore the use of rituximab and complement inhibition in treating ANCA-associated vasculitis. This episode will address the gaps in knowledge and ongoing research in the field of ANCA-associated vasculitis. This episode is supported by Amgen.

In this episode, host Dr. Vladimir Tesar (General University Hospital, Prague) and Dr. Micheal Walsh (McMaster University, Canada) explore the benefits of plasma exchange for patients with ANCA-associated vasculitis. This episode discusses how to identify patients who may benefit from plasma exchange and the role of plasma exchange in patients with double-positive ANCA and anti-GBM. The utility of rituximab in those also treated with plasma exchange will be addressed. This episode is supported by Amgen.

Join host, Dr. Vladimir Tesar (General University Hospital, Prague), in conversation with Dr. Duvuru Geetha (Johns Hopkins University School of Medicine, United States) as they discuss the main causes of delays in diagnosis of ANCA-associated vasculitis and the different ways to increase awareness of the disease. This episode will also discuss the role of kidney biopsy in the optimal management and monitoring of these patients. This episode is supported by Amgen.

Join host, Dr. Marlies Ostermann (Guy's and St Thomas' Hospital, United Kingdom), in conversation with Dr. Sandra Kane-Gill (University of Pittsburgh School of Pharmacy, United States) as they discuss the importance of drug stewardship when treating critically ill patients. This episode will examine various terms such as drug-induced acute kidney injury, drug-associated acute kidney injury, and nephrotoxicity. Dr. Kane-Gill will also discuss how multiorgan support may influence drug dosing and aspects of nutrition and micronutrient supplementation for patients with AKI. This episode is supported by an independent educational grant from Baxter.

In this episode, KDIGO Conversations in Nephrology host, Dr. Marlies Ostermann (Guy's and St Thomas' Hospital, United Kingdom), and Dr. Rinaldo Bellomo (University of Melbourne, Australia) will discuss the importance of hemodynamic stabilization in protecting kidney function for patients on kidney replacement therapy. This episode will also discuss the different strategies and therapies available for maintaining such stability. Urgent questions for future research will also be addressed. This episode is supported by an independent educational grant from Baxter.

Join host, Dr. Marlies Ostermann (Guy's and St Thomas' Hospital, United Kingdom), in conversation with Dr. Javier Neyra (University of Alabama in Birmingham, United States) as they explore the role of kidney replacement therapy in managing fluid overload. They will discuss optimal monitoring and how best to remove fluid safely and effectively, including the evaluation of patients’ response to fluid removal prescription. This episode will also address the ongoing gaps in knowledge in the field. This episode is supported by an independent educational grant from Baxter.

Join KDIGO Conversations in Nephrology host, Dr. Roberto Pecoits-Filho, in conversation with Dr. Chuck Herzog as they explore the challenges that occur when managing dyskalemia. They address the consequences of hyperkalemia and hypokalemia. They also discuss how both hospitalized patients and outpatients are affected by hyperkalemia. Dr. Roberto Pecoits-Filho is Senior Research Scientist at Arbor Research and Professor of Medicine at the Pontifical Catholic University of Paraná. Dr. Chuck Herzog is Professor of Medicine at the University of Minnesota, and a cardiologist at Hennepin County Medical Center. This episode was supported by CSL Vifor.

Join KDIGO Conversations in Nephrology host, Dr. Roberto Pecoits-Filho, in conversation with Dr. Patrick Rossignol as they discuss approaches to RASi optimization. Additional topics include: Monitoring of creatinine and potassium What happens after? Is the GP responsible for follow-up? When to discontinue, when to return? Lack of communication between specialties How different specialties react differently to different values Dr. Roberto Pecoits-Filho is a nephrologist and Senior Research Scientist at Arbor Research and Professor of Medicine at the Pontifical Catholic University of Paraná. Dr. Patrick Rossignol is a Professor of Therapeutics, a nephrology and vascular medicine specialist, and head of Nancy Plurithematic Clinical Investigation Center (CIC)-Inserm, France. This episode was supported by CSL Vifor.

Join host, Dr. Roberto Pecoits-Filho, and Dr. Catherine Clase as they discuss the benefits of RASi utilization. Additional topics include: The role of RASi in the management of CKD progression Outcomes ACE / ARBs Is RASi underutilized? Is it worth not to discontinue? The impact of the KDIGO Blood Pressure Management in CKD Guideline and Diabetes Management in CKD Guideline on RAASi utilization and future challenges Dr. Roberto Pecoits-Filho is Senior Research Scientist at Arbor Research and Professor of Medicine at the Pontifical Catholic University of Paraná,  Dr. Catherine Clase is a nephrologist and Professor of Medicine at McMaster University and Editor in Chief of the Canadian Journal of Kidney Health Disease.  This episode was supported by CSL Vifor.

Dr. Ravi Mehta and Theresa Mottes discuss which key components are needed when starting a quality improvement program (QI) for acute dialysis and why those components are needed. They also discuss how to get leverage to implement a QI program and the keys to a successful CRRT quality program. This episode was supported by Baxter.

Dr. Ravi Mehta and Dr. Ashita Tolwani discuss best practices on anticoagulation and citrate use, why circuit patency and integrity are important for CRRT, and how and when to use anticoagulation. They also discuss preferred methods for anticoagulation and the parameters that should be monitored for circuit integrity. This episode was supported by Baxter.

In this episode, Dr. Ravi Mehta and Dr. Marlies Ostermann discuss the controversy around defining the optimal timing for starting dialysis in critically ill patients. Dr. Osterman highlights the most relevant parameters that influence when to offer, start, and stop dialysis and gives a comprehensive review of the recent trials on the timing of dialysis. And finally, both presenters address the challenges of managing patients during the COVID-19 pandemic. This episode was supported by Baxter.