The Changing Practice of Dialysis: Policy to Economics to Education: The Kardos Renal Grand Rounds

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End-stage-renal disease requiring dialysis affects over two million patients worldwide, yet before our eyes, fundamental assumptions about dialysis have been changing. In this Kardos Renal Grand Rounds, Visiting Professor Christopher Chan from Toronto General Hospital will discuss the changing practice of dialysis, from policy to economics to education, discussing the novel use of home dialysis and how he integrates clinical, basic science, and implementation science to improve the care of patients with kidney disease.

Christopher Chan, MD, is director of the Division of Nephrology, professor of medicine and holds the R Fraser Elliott Chair in Home Dialysis at Toronto General Hospital. He is the deputy physician in chief of economic, the medical lead of Connected Care at the University Health Network and won the Temetry Faculty of Medicine Dean’s Award for his leadership and impact on renal replacement therapy. He has championed and defined clinical use of home dialysis, leading and coordinating a large network dedicated to the clinical and basic science aspects of optimal dialysis delivery.

Note: Closed captions will be available within 48-72 hours after posting.

Lekshmi Santhosh: Introduction
00:02:39-01:00:18 – Christopher Chan, MD (director of the Division of Nephrology, professor of medicine and holds the R Fraser Elliott Chair in Home Dialysis at Toronto General Hospital)
Lekshmi Santhosh: Closing

See previous Medical Grand Rounds:
• March 24: The 2022 Gurpreet Dhaliwal Lecture in Medicine: There Is an “I” in TEAM

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• March 17: Improving the Care of Patients with Rheumatologic Diseases: From Bench to Bytes to Bedside
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• March 10: International Women’s Day
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• March 3: The New “Endemic Phase” and a Vaccine Update
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See all UCSF Covid-19 grand rounds, which have been viewed over 3M times, here:


Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information.

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  1. I keep my house very clean, but I have 2 cats. What are your rules concerning animals, especially since the odds are that some homes are not as clean as they could be?

  2. The skills needed to do home peritoneal dialysis are motor, cognitive, and psychological. It helps if the patient has a healthy spouse or child living with them to monitor and manage equipment, and if the family or patient can report symptoms promptly and accurately. This is all a high bar for many seniors, and leads them to seek dialysis at a facility. I doubt these docs have been in patient homes and seen how they live. Reality would shock them. Homecare staff see it all, and we don't advocate for home dialysis once we see how poorly people manage in their own homes. We want them to avoid a crisis.

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