How many times per day during your dialysis rounds do you find the personnel a bit stressed near a patient suffering from an episode of intradialytic hypotension?

And they are actually looking at you for the magic solution!

A lot of things are simultaneously passing from your mind but sometimes you are not absolutely sure if you are doing the right thing…

Despite the giant leaps of Nephrology in recent decades, intradialytic hypotension is still an important problem of daily practice affecting about 20% of hemodialysis patients. 

We feel that this is bad for the patients but we are not sure whether our acts and decisions are validated, whether they are the right ones.

So we’ll try to explore the options available with a world leader on the subject, Andrew Davenport from the University College of London, United Kingdom.

Do you want to know the name of the magic treatment?

A treatment that improves the endurance and the force of the patients ? A treatment that makes them feel better and less tired? A treatment that improves their autonomy, their capacities for the daily tasks and their quality of life?

A treatment that improves the blood pressure control, the lipid and metabolic profile? And all that for free? Without pills?

Do you want to know the name of this treatment? Come closer, I ‘ll share with you the secret! It is the physical activity!!!

In this podcast we’ll discuss physical activity with Professor Alice Smith from the University of Leicester. Alice is Professor of Lifestyle medicine and leads the Leicester Kidney Lifestyle Team, an internationally renowned multidisciplinary research group which aims to help kidney patients achieve the best possible health and wellbeing through appropriate lifestyle management. Her teams’ research portfolio includes ~20 single- and multi-centre clinical trials and has recruited some 10000 participants from across England.

Life expectancy is rising in most of the world and with it we have a rising number of elderly individuals in our society. We are used to the type of medicine that is best suited for younger patients – identify the disease, give the best and most effective treatment and cure the patient. However, in elderly individuals the goals might be completely different. Do you think we are going to far sometimes? Are we really treating the patient or are we sometimes just treating the numbers.  If you’re thinking about these things, you might be on the right track. We have been talking about these things with Elke Schaeffner a well known expert in the field of CKD and elderly populations.

One of the most cheeky subjects in Nephrology is the diagnostic and therapeutic interventions on the nutritional status of CKD patients.

It is cheeky because when it is not good it may kill the patient and also because it is one of the typical subjects that we « think » we know » but when we scratch a little bit we realise there are huge undiscovered avenues to explore.

In order to know a bit more about it, check on the new episode of the ERA podcast "A pinch of Salt" concerning Nutrition in CKD with prof Giorgina Piccoli, Chair of the European Renal Nutrition (ERN) Working Group.