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Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

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Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
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Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration01:28

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Glomerular filtration rate (GFR) can be estimated from serum creatinine using the modification of diet in renal disease (MDRD) formula or the chronic kidney disease–epidemiology collaboration (CKD–EPI) equation. Both methods are widely used in clinical practice to assess kidney function and guide treatment decisions.The MDRD equation does not require weight or height measurements and is normalized to the body surface area of 1.73 m², considered the average adult surface area.
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Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

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In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
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Factors Affecting Renal Clearance: Renal Impairment01:17

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Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
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Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant01:25

Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant

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In patients with renal disease, dosage adjustments are necessary to maintain therapeutic plasma drug concentrations and prevent toxicity or subtherapeutic exposure. Renal impairment alters drug pharmacokinetics, especially in conditions like uremia, where changes such as prolonged elimination half-life and altered apparent volume of distribution can significantly affect drug disposition. These changes require careful modification of the dosing regimen to achieve the desired clinical...
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Chronic Kidney Disease I: Introduction01:25

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Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
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Related Experiment Video

Updated: Apr 23, 2026

Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform
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Differences in Telemedicine Use Between Rural and Urban Medicare Beneficiaries With Kidney Failure.

Joel T Adler1, Arnold E Kuk2, Layla Parast3

  • 1Division of Transplantation, Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas at Austin, Austin, TX.

Kidney Medicine
|April 22, 2026
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Summary

Telehealth use surged for kidney failure patients during COVID-19, especially in urban areas. However, persistent racial and ethnic disparities highlight the need for equitable access to advance health equity.

Keywords:
End-stage kidney diseaseMedicaredigital accesshealth disparitiesmental health servicesrural healthtelehealthtelemedicinevirtual care

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Area of Science:

  • Nephrology
  • Health Services Research
  • Public Health

Background:

  • Telemedicine presents a solution for healthcare access disparities in kidney failure patients.
  • This study investigates telehealth utilization and urban-rural differences pre- and during the COVID-19 pandemic.

Purpose of the Study:

  • To examine telehealth utilization patterns among kidney failure patients.
  • To compare urban-rural differences in telehealth use before and during the COVID-19 pandemic.

Main Methods:

  • Retrospective observational cohort study of 787,959 Medicare beneficiaries with kidney failure (2017-2021).
  • Analysis of urban versus rural residence, telehealth claims, and demographic factors before (Jan 2020) and during (Jan 2021) the pandemic.
  • Multivariable logistic regression and geographic variation analysis using county-level data.

Main Results:

  • Rural patients initially showed higher telehealth use, but urban patients had significantly higher utilization during the pandemic.
  • The relative increase in telehealth use was greater among urban patients.
  • African American patients were less likely to use telehealth; utilization varied by dialysis modality.

Conclusions:

  • Telehealth use significantly increased for kidney failure patients during the pandemic, with a notable rise in urban areas.
  • Persistent racial, ethnic, and social disparities in telehealth access were observed.
  • Promoting equitable telehealth access is crucial for advancing health equity in kidney failure care.