Alison Thomas

Hi Jordan, This is a terrific post. This is a huge quality of life issue for our patients on in-centre hemodialysis. If we could truly understand the importance of phosphate reduction in this patient population, then our messaging to patients would be much easier. As you know, often our q 6 weekly lab results are not in keeping with how the patient is doing on dialysis. In fact, the better the values, often the worse the patient is eating and feeling (particularly with phosphorus). It's time we re-evaluated this practice!

Great presentation Dr. Weinstein! Being devil's advocate though - while I understand some of the concerns about SEBs, I can't help but wonder if there were strict enough policies put in place by an agency such as Health Canada - and it were safe - why wouldn't this be a good thing? We have all seen the impact of a supply chain problem with a solitary supplier resulting in lack of available drug or product for patients in need. This is a scary situation - and I am not the patient! I cannot imagine how vulnerable they would feel. Maybe we should be working with Health Canada to ensure the standards are clearly outlined and stringent enough to make this happen in a safe manner - are there any pharmacists out there who would care to comment?

This is an excellent teaching tool and should be reviewed by all cannulating hemodialysis nurses as a reminder of the importance of physical examination of the AV access.