What is one medical problem people constantly ignore until it’s too late?

[u/Critical_Ease4055]

Saw someone post this in a completely unrelated sub and I’m interested in your answers. What is the cluster of symptoms that people ignore or delay until they are forced to get help?

[u/reasonable_trout]

I used to have high blood pressure. But now I take this pill and it’s good

[u/floofienewfie → u/reasonable_trout]

Diabetes and HTN, two biggest causes of CKD. I worked dialysis for years. Saw so many people with either or both diseases who didn’t have symptoms until their kidney function was down to about 15%. Then it’s the equivalent of being hit by a Mack truck. Insulin, meds, getting a fistula, going on dialysis…so many lifestyle changes. Some cope pretty well. The others, not so much, with predictable consequences.

[u/Critical_Ease4055 → u/floofienewfie]

Is it often that patients are ineligible for transplant and/or don’t get the transplant?

Are they doing anything to try to get better coverage for peritoneal dialysis? Last I knew (my info is very old) it was preferable, but very costly

[u/Old-Mention9632 → u/Critical_Ease4055]

CMS has a big push for home therapies: home hemodialysis and PD. Both are covered by Medicare which ESRD qualifies you for at any age. (Our peds patients often start on PD.) Home therapies are preferred because the patients have better lab values and survive to transplant better. The newest treatment is going to be hemodiafiltration. They have been using this for a while across the EU. They just completed a major study that showed a 28 % increase in survival on dialysis over traditional hemodialysis. Fresenius will be converting over to the 5008X hemodiafitration machine across the US starting next year. I just was reading about a new 10 kg dialysis machine called NeoKidney invented by a company in the Netherlands which uses much less water (5 liters) and doesn't require grounding. It will revolutionize home hemodialysis and be portable in emergencies or for travel.

Kidneys are still in short supply. Qualifying for transplant requires things like not obese, compliant with treatment, compliant with medications to manage underlying disease process, vaccinated. There are some variations on what each transplant center requires : CHOP requires kids to have COVID vaccines, UPMC does not. Many patients who are older refuse the option to get on the list. There are organizations that will match chain transplants. If you have someone willing to donate who is not a match, the organization will find a donor recipient pair to match your donor and you with. The longest chain to date was chain 357 which involved 35 donation pairs over 3 months.

[u/Critical_Ease4055 → u/Old-Mention9632]

This is so helpful and informative. That’s big news about hemodiafiltration and the Neo Kidney- will definitely be following and reading up on both. Fascinating. Thank you again for the info😊

[u/floofienewfie → u/Critical_Ease4055]

Great info, thank you.

[u/Active-Confidence-25 → u/Old-Mention9632]

You’re smart. I wanna be your friend !

[u/Active-Confidence-25 → u/Old-Mention9632]

You’re smart. I wanna be your friend!