[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-176695-105":53,"doc-detail-176695-en":126},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":119,"head_meta":121,"extra_data":123,"updated_unix":125},105,"en","renal-replacement-therapy-what-the-pcp-needs-to-know","Renal Replacement Therapy - What the PCP Needs to Know","","Renal Replacement Therapy: What the PCP Needs to Know equips primary care clinicians to recognize indications for renal replacement therapy and to guide patients through evidence-based decision-making. It covers hemodialysis, peritoneal dialysis, kidney transplantation, and comfort care, emphasizing timely referral using eGFR thresholds, patient education, and selection of dialysis modality. The module highlights dialysis access considerations, multidisciplinary KDIGO-aligned care, medication management to delay RRT, and vaccination strategies for hepatitis B and pneumococcal disease, alongside blood pressure targets across dialysis and transplant.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":11,"@type":70,"position":76},"https://docshare.wps.com/template/presentations/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/renal-replacement-therapy-what-the-pcp-needs-to-know/176695/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/renal-replacement-therapy-what-the-pcp-needs-to-know/176695.png","ImageObject",442,249,{"name":88,"@type":89},"Miles","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/vnd.openxmlformats-officedocument.presentationml.presentation","2026-10-26","2026-09-02",true,{"@type":98,"interactionType":99,"userInteractionCount":8},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"When should a PCP refer patients with progressive CKD for renal replacement therapy planning?","Question",{"text":108,"@type":109},"Referral is recommended early, using eGFR \u003C 30 mL/min/1.73 m2, and transplant center referral when eGFR is \u003C 20 mL/min/1.73 m2. Early referral supports preparation, education, and avoidance of emergent dialysis starts.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"Which vascular access type is associated with better outcomes for hemodialysis?",{"text":113,"@type":109},"An arteriovenous fistula is associated with better outcomes compared with grafts and temporary catheters. The module emphasizes that access patency and early detection of stenosis are critical.",{"name":115,"@type":106,"acceptedAnswer":116},"What vaccination approach is highlighted for patients with ESRD or progressive CKD?",{"text":117,"@type":109},"Hepatitis B vaccination is emphasized because many ESRD patients mount lower and shorter-lived antibody responses; vaccination benefit is still expected for a substantial proportion. Annual influenza vaccination and pneumococcal vaccination are also recommended, with revaccination within 5 years for appropriate patients.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},176695,1791739084,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":8,"category_name":11,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":8,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":135,"language":136,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":61,"update_tm":140,"read_time":141},13056703019404,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","Renal Replacement Therapy: What the PCP Needs to Know\nClick to edit Master subtitle style\nLearning Objectives\nDescribe treatment options for renal replacement therapy to improve awareness and understanding.\nUse evidence-based strategies to manage patients with kidney failure in need of renal replacement therapy  to improve outcomes.\nManage patients receiving dialysis or living with a kidney transplant, from a primary care perspective.\nQuestion 1\nA patient with progressive CKD has opted for hemodialysis for renal replacement therapy. Which type of vascular access is associated with better outcomes in hemodialysis patients?\nA. Central venous cuffed catheter\nB. Arteriovenous graft\nC. Arteriovenous fistula\nD. Temporary central venous catheter\nQuestion 2\nAnother patient  with progressive CKD is considering a kidney transplant. Which one of the following statements is correct?\nA. CKD patients can be referred to a transplant center when their GFR is \u003C 20 mL/min/1.73m2\nB. Pre-emptive and live kidney transplants are associated with better graft survival\nC. Most common cause of kidney transplant loss is death with a functional transplant\nD. All of the above\nRenal Replacement Therapy Overview and Considerations for the PCP\nIndications for Renal Replacement Therapy\nHyperkalemia\nMetabolic acidosis\nFluid overload (recurrent CHF admissions)\nUremic pericarditis (rub)\nOther non specific uremic symptoms: anorexia and nausea, impaired nutritional status, increased sleepiness, and decreased energy level, attentiveness, and cognitive tasking, …\nTreatment Options for Renal Replacement Therapy\nESRD\nHemodialysis\nKidney Transplant\nPeritoneal Dialysis\nComfort Care\nTreatment Options for Renal Replacement Therapy\nESRD\nHemodialysis\nKidney Transplant\nPeritoneal Dialysis\nComfort Care\nDialysis Options\nDialysis\nHemodialysis\nPeritoneal Dialysis\nIn-Center HD (3 x week)\nHome HD (short daily, nocturnal)\nManual (CAPD)\nCycler (CCPD)\nHome\nIncident Patient Counts (USRDS)by 1st Modality\nUSRDS 2013 ADR\nTotal Medicare ESRD expenditures, by modality\nPeriod prevalent ESRD patients.\nUSRDS 2013 ADR\nRefer patients early, when eGFR \u003C 30 ml/min/1.73 m2\nEducation about types of renal replacement therapy:\nHemodialysis (vascular access +++)\nPeritoneal Dialysis (QOL advantage +++)\nKidney Transplantation\nRefer when eGFR \u003C 20 ml/min/1.73 m2\nLiving kidney transplant (family, friends)\nBuild time on list before dialysis initiation\nEven transplant before dialysis initiation (pre-emptive)\nNo PICC lines for patients with eGFR \u003C 45 mL/min/1.73m2\nReferral and Education for Patients with Progressive CKD\nAdvantages of Timely Referral in Patients with Progressive CKD\nImproves patient preparation for RRT\nGreater use of permanent vascular access\nAvoidance of emergent hemodialysis initiation\nGreater utilization of transplantation and self-care dialysis (i.e., peritoneal dialysis or home hemodialysis)\nManagement of medications which may help to delay the need for RRT\nGives the nephrologist adequate time to counsel patients through this challenging transition in their lives\nKDIGO Transplant Guidelines\nMedical Health and Wellness: Components of Multidisciplinary Care in Progressive CKD\nEducation and counseling about different RRT modalities, transplant options, and vascular access surgery\nProtocols for laboratory and clinic visits; with attention to CKD and CVD-associated comorbidities (e.g., high blood pressure)\nEthical, psychological, and social care (e.g., social bereavement, depression, anxiety)\nDietary counseling and education on other lifestyle modifications (e.g., exercise, smoking cessation)\nVaccination program\nKDIGO Transplant Guidelines\nEarly Vaccination for Hepatitis B: Too Often Forgotten!\nPatients with ESRD have  response to vaccination\n(Secondary to general suppression of immune system)\nAfter Hepatitis B vaccination in ESRD patients:\n50 – 60 % develop antibodies, compared to > 90% in patients without renal failure\nHave Lower titers\nHave protective levels for shorter duration\nStevens C","cbCaip8Bnf60TF52","https://ap.wps.com/l/cbCaip8Bnf60TF52","pptx",1724256,64,"English","# Learning Objectives\n# Renal Replacement Therapy Overview and Considerations for the PCP\n## Indications for Renal Replacement Therapy\n## Treatment Options for Renal Replacement Therapy\n## Dialysis Options\n# Referral and Education for Patients with Progressive CKD\n## Advantages of Timely Referral\n## Medical Health and Wellness: Multidisciplinary Care\n## Early Vaccination for Hepatitis B\n## Other Considerations for Vaccination\n# Management of High Blood Pressure\n# Hemodialysis Principles and Vascular Access","[{\"question\":\"When should a PCP refer patients with progressive CKD for renal replacement therapy planning?\",\"answer\":\"Referral is recommended early, using eGFR \\u003c 30 mL/min/1.73 m2, and transplant center referral when eGFR is \\u003c 20 mL/min/1.73 m2. Early referral supports preparation, education, and avoidance of emergent dialysis starts.\"},{\"question\":\"Which vascular access type is associated with better outcomes for hemodialysis?\",\"answer\":\"An arteriovenous fistula is associated with better outcomes compared with grafts and temporary catheters. The module emphasizes that access patency and early detection of stenosis are critical.\"},{\"question\":\"What vaccination approach is highlighted for patients with ESRD or progressive CKD?\",\"answer\":\"Hepatitis B vaccination is emphasized because many ESRD patients mount lower and shorter-lived antibody responses; vaccination benefit is still expected for a substantial proportion. Annual influenza vaccination and pneumococcal vaccination are also recommended, with revaccination within 5 years for appropriate patients.\"}]","Renal Replacement Therapy - What the PCP Needs to Know | PPTX",1788325261,22]