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Nephrologist Manjula Tamura discusses the downsides of kidney dialysis, especially for old or frail patients. Her field has set its sights on offering alternatives, including supportive medical management without dialysis, dialysis in increments, wearable artificial kidneys, and transplanted kidneys from genetically modified pigs – in addition to advances in preventive care that can help humans avoid kidney failure in the first place. Dialysis can extend life, she says, but it is a lifestyle change. The goal is to ensure that every patient’s choice aligns with their values and life goals, Tamura tells host Russ Altman in this episode of Stanford Engineering’s The Future of Everything podcast.
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Chapters:
(00:00:00) Introduction
Russ Altman introduces guest, Manjula Tamura, a professor of medicine and nephrology at Stanford University Medical School.
(00:02:58) The Kidney’s Vital Role
The kidney’s role and why its failure is life-threatening.
(00:04:51) Causes of Kidney Failure
The leading causes of kidney failure in developed countries.
(00:07:58) Kidney Transplantation
The feasibility, barriers, and supply challenges of kidney transplantation.
(00:09:50) The Dialysis Process
How hemodialysis and peritoneal dialysis work and patient experiences.
(00:14:07) The Evolution of Dialysis Treatment
The history of dialysis and how Medicare’s expansion influenced its use.
(00:18:48) Study Design: Emulating Clinical Trials
Using VA electronic health records to simulate trials on dialysis.
(00:25:31) Findings: Survival vs. Time at Home
The trade-offs between extended survival and reduced time at home.
(00:27:02) Quality of Life and Dialysis
Measuring quality of life impacts through electronic health records.
(00:30:32) The Future of Kidney Treatments
Innovations like xenotransplantation and wearable artificial kidneys.
(00:33:04) Conclusion
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