"My whole life changed." - Dialysis and Kidney Transplantation (ESRD, Part II)

In the final episode of the ESRD series, Dr. Montano and Bernstein discuss the implications and mechanisms behind dialysis and our patients share their experiences with both dialysis and kidney transplantation.

=== Outline ===

Chapter 1: Approaching dialysis

Chapter 2: Hemodialysis vs peritoneal dialysis

Chapter 3: Practicalities of living on dialysis

Chapter 4: Kidney transplantation

=== Learning Points ===

1. Hemodialysis and peritoneal dialysis are the two primary options for long-term renal replacement therapy. The two modalities are very different, and the patient’s lifestyle and individual needs should be considered when choosing a form of dialysis.
2. The decision to start dialysis is complex and should involve shared decision-making between the patient and their healthcare team with open communication. 
3. Dialysis significantly impacts patients’ lives by requiring them to change their daily routines and dietary restrictions. Beyond this, it can significantly impact their emotional and social well-being. 
4. Kidney transplantation offers a potential for improved quality of life and further longevity, as compared to dialysis options.

=== Our Expert(s) ===

Dr. Paul Bernstein graduated from Union College in 1982, where he earned a BA in Biology.  He then attended the Albert Einstein College of Medicine, where he was elected to AOA.  In 1988, he joined the Yale Traditional Internal Medicine Residency, serving as Chief Resident from 1991-1992.  From 1992-1995, he was a Yale nephrology fellow, and after that, he joined the faculty at the University of Rochester.  From 1997-2000, he was an APD for the University of Rochester Primary Care Residency, and from 2000-2012, he was Program Director for the Internal Medicine Residency at Rochester General Hospital.  

=== Further Reading ===

1. NIH National Institute of Diabetes and Digestive and Kidney Diseases: Facts about Peritoneal Dialysis
   https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/peritoneal-dialysis
2. Wong B, Ravani P, Oliver MJ, Holroyd-Leduc J, Venturato L, Garg AX, Quinn RR. Comparison of Patient Survival Between Hemodialysis and Peritoneal Dialysis Among Patients Eligible for Both Modalities. Am J Kidney Dis. 2018 Mar;71(3):344-351. doi: 10.1053/j.ajkd.2017.08.028. Epub 2017 Nov 22. PMID: 29174322. 

=== About Us ===

The Primary Care Pearls (PCP) Podcast is created in collaboration with faculty, residents, and students from the Department of Internal Medicine at the Yale School of Medicine. The project aims to create accessible and informative podcasts about core primary care topics centered around real patient stories. 

Host: Josh Onyango

Producers: Helen Cai, Josh Onyango

Logo and Name: Eva Zimmerman

Theme music and Editing: Helen Cai, Josh Onyango

Other background music: Aaron Kenny, The Tides, TrackTribe, Dan Bodan, Astron, Asher Fulero,  VYEN, The Soundlings

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