Channel Title: BC Renal Channel Description: The BC Renal network plans and monitors the delivery of province-wide kidney care services. Using the latest research and collective knowledge of the kidney care community, we address the challenges of kidney disease by: - Planning and monitoring the delivery of province-wide kidney care services - Developing province-wide clinical standards and guidelines - Developing funding models to support best health outcomes - Measuring and reporting on patient and system outcomes - Supporting knowledge-development through research and teaching This channel features our video productions and advertisements on kidney disease and dialysis for patients, their families and health care providers. Please note that BC Renal doesn't control, endorse or recommend any non-BC Renal ads that appear with BC Renal videos. Please see our privacy and data collection policy with regards to social media here: http://www.bcrenal.ca/about/accountability/protecting-patient-privacy <video> Home is Best: Practice Guidelines for Home Hemodialysis – BCR PWR (Dec 2024) Description: Dr. Lap Cheng presents his talk, “Home is Best: Practice Guidelines for Home Hemodialysis, Exploring the Pathway from Hospital to Home,” as part of UBC and BC Renal’s province-wide rounds. 0:05:00 -Background He begins by describing how he and his colleagues created a Best Practices Guidelines (BPG) for equitable, effective and safe delivery of home hemodialysis (HHD), which involved a literature review, surveys, focus groups, data collection and content creation. 0:10:00 – HHD modalities Dr. Cheng provides an overview of different HHD modalities (e.g., conventional, short daily, alternate nightly, nocturnal hemodialysis. He briefly discusses different the pros and cons of different dialysis machines. In-center hemodialysis uses significantly more resources compared to home hemodialysis, mostly because patients who stay home for dialysis have less emissions related to transportation. 0:17:00 – HHD Benefits He notes numerous benefits of HHD, including reduced all-cause mortality, increased blood pressure control and lower medication burdens, among others. He notes some disadvantage, including frequent vascular access complications and self-cannulation phobias. 0:20:00 – Referring Patients to HHD and Overcoming Barriers Dr. Cheng provides an overview of how the HHD guidelines can be used to refer patients. It includes challenges that patients may face in accessing HHD, but which could be overcome. Examples include situational barriers (e.g., financial constraints, inadequate water supply), psychological factors (e.g., depression, anxiety), and functional challenges (e.g., cognitive impairment, frailty). 0:29:00 – Self-cannulation Dr. Cheng notes that self-cannulation can be an especially difficult barrier for patients to overcome. He highlights several techniques to support patients, for example by using smaller needles, creating a sense of safety through practice, using relaxation techniques, and doing tap cannulation. He discusses buttonhole vs rope ladder cannulation options. 0:35:00 – Training patients on HHD Dr. Cheng notes that HHD training schedules can vary greatly, but training should be continued until the patient meet their goals. He walks the audience through a breakdown of a training schedules by the week, with suggested checkpoints to check base with the MDT. 0:39:00 – Other BPG content He also talks briefly about additional content in the guidelines, including patient monitoring and maintenance, special populations, advance care planning, etc. 0:42:00 – Next steps Dr. Cheng says the final draft of the HHD guidelines will be available on the BC Renal website soon, and they hope to promote these guidelines internationally. 0:43:00 – Q&A Dr. Cheng then takes questions from the audience. Click here to join our mailing list to receive the latest news and information from BC Renal: https://app.cyberimpact.com/clients/21780/subscribe-forms/F174304E-EE8A-4CF1-8E17-C75C02CC54BB </video> <video> Early Life Exposures and Future Renal and Cardiovascular Disease - BCR/UBC PWR (Oct 2024) Description: Presentation by Dr. Janis Dionne </video> <video> Amia Cycler - How to Dismantle Description: 0:01 Introduction 0:19 After disconnecting, press next 0:33 Closing clamps on the solution lines 0:51 Opening the door and heater lid 1:05 Clamping the drain line 1:09 Examining and emptying the drain bag 1:22 Removing the used cassette, solution bags and tubing 1:37 Closing the door and heater lid 1:50 Turning the cycler off This video demonstrates the steps involved in dismantling the Baxter Amia cycler. The content is intended to supplement training that is provided by Peritoneal Dialysis programs in British Columbia. Contact your PD program for further direction if required. This video series has been made possible with the support of the Abbotsford Regional Hospital PD Program, BC PD RN Group, BC PD Provincial Committee, BC Renal, and Mat Lo Productions. </video> <video> ANCA-Associated Vasculitis: plasma exchange, glucocorticoids and avacopan - PWR (Nov 2024) Description: Dr. Michael Walsh of McMaster University presents his talk, “ANCA-Associated Vasculitis: plasma exchange, glucocorticoids and avacopan,” as part of UBC and BC Renal’s province-wide rounds. 0:04:35 – ANCA Associated Vasculitis Dr. Walsh starts by providing an overview of ANCA-associated vasculitis (AAV), noting that it can have many different manifestations. He says that, despite some advances in effective treatments, it still entails a high level of mortality and acute kidney failure. He discusses various guidelines on when to treat ANCA-associated vasculitis. 0:12:50 – Plasma exchange in AAV Dr. Walsh points to evidence suggesting that plasma exchange has some benefits, but may not be particularly effective at reducing risk of death or kidney disease. His own team explored this phenomenon in more detail, conducting a study of 700 participants. The results also show no major difference in mortality or kidney failure outcomes. In a much larger meta-analysis, Dr Walsh and his colleagues still didn’t see any benefit of plasma exchange in reducing overall mortality – however, evidence did show it reduced the need for dialysis after one year, although the effect diminishes after that. At the same time, there was an increased risk of infection after one year of plasma exchange. 0:28:15 – Predicting kidney failure risk He points to the ANCA Renal Risk Score (ARRS) as a tool to predict when patients may experience end-stage kidney disease, and when plasma exchange may be worth the increased risk of infection. Dr. Walsh notes his team has another paper pending, which highlights when plasma exchange can be used to reduce risk of kidney failure, but again emphasizes that the risk of infection remains a major issue. 0:38:15 – Plasma exchange guidelines Dr. Walsh discusses KDIGO guidelines for plasma exchange. He shares surveys of patients about shared decision-making, showing that patients valued the benefits and risks of plasma exchange very differently. He emphasizes the need to discuss risks and benefits of AAV treatment carefully with patients. 0:42:20 – Glucocorticoids Dr. Walsh highlight data showing that glucocorticoids regimens, including LoVAS and PEXIVAS. 0:45:08 – Avacopan Dr. Walsh highlights data on avacopan via the ADVOCATE trial, which shows the drug can help facilitate sustained remission, without the toxicity associated with glucocorticoids. He notes numerous cases when risk of glucocorticoid toxicity is particularly high and should be avoided. 0:52:30 – Summary and Q&A Dr. Walsh summarizes his talk, noting that plasma exchange does have a role in preventing dialysis, PLEXIVAS should be tapered off for most patients, and that avacopan is useful, but it has limitations should be considered carefully. He then takes questions from the audience. Click here to join our mailing list to receive the latest news and information from BC Renal: https://app.cyberimpact.com/clients/21780/subscribe-forms/F174304E-EE8A-4CF1-8E17-C75C02CC54BB </video> <video> Amia Cycler - How to Set Up Description: 0:01 Introduction 0:19 Place your cycler on a clean, flat surface beside your bed 0:25 Wash your hands using soap and water 0:37 Gathering your supplies 0:57 Turning the cycler on 1:18 Testing phase 2:00 Set up 3:49 Opening the solution bags 4:26 Examining the solutions using SEAL 4:46 Opening the cycler and heater lid 5:06 Opening and inspecting the cassette 5:40 Following the cycler prompts 6:21 Placing the organizer on the machine 6:36 Unravelling the cassette and placing it on the door 7:19 Placing the heater bag in the heating tray 7:21 Closing the front door and heater lid 7:51 Removing the patient line and placing it in the patient line holder 8:40 What to do if you are using a drain bag 9:13 What to do if you are not using a drain bag 9:30 Press the test button when completed to start the testing phase 9:45 When test is complete press Next 9:51 Put on a mask, re-wash hands with hand sanitizer 10:07 Connecting the solutions 11:44 The priming process This video demonstrates the steps involved in setting up the Baxter Amia cycler. The content is intended to supplement training that is provided by Peritoneal Dialysis programs in British Columbia. Contact your PD program for further direction if required. This video series has been made possible with the support of the Abbotsford Regional Hospital PD Program, BC PD RN Group, BC PD Provincial Committee, BC Renal, and Mat Lo Productions. </video> <video> Claria Cycler - How To Connect Description: 0:01 Introduction 0:20 Steps to take before connecting to the cycler 0:28 Connecting to the cycler 1:04 Press the green button on the cycler This video demonstrates the steps involved in connecting the Baxter Homechoice Claria cycler. The content is intended to supplement training that is provided by Peritoneal Dialysis programs in British Columbia. Contact your PD program for further direction if required. This video series has been made possible with the support of the Abbotsford Regional Hospital PD Program, BC PD RN Group, BC PD Provincial Committee, BC Renal, and Mat Lo Productions. </video> <video> ਗੁਰਦੇ ਦੀ ਚੰਗੀ ਸਿਹਤ ਲਈ 31 ਸੁਝਾਅ / 31 Tips for Good Kidney Health Description: ਕਿਡਨੀ ਹੈਲਥ ਮਹੀਨੇ ਦੇ ਹਿੱਸੇ ਵਜੋਂ ਸਾਡੇ #KidneyHealthChallenge ਸੁਝਾਵਾਂ ਦਾ ਇੱਕ ਵੀਡੀਓ ਸੰਕਲਨ। ਵਧੇਰੇ ਜਾਣਕਾਰੀ ਲਈ BCRenal.ca 'ਤੇ ਜਾਓ, ਫਿਰ ਸਿਹਤ ਜਾਣਕਾਰੀ - ਰੋਕਥਾਮ ਅਤੇ ਜਨਤਕ ਸਿਹਤ - ਕਿਡਨੀ ਹੈਲਥ ਮਹੀਨਾ 'ਤੇ ਕਲਿੱਕ ਕਰੋ। A video compilation of our #KidneyHealthChallenge tips as part of Kidney Health Month. For more information visit BCRenal.ca, then click Health Info - Prevention & Public Health - Kidney Health Month. </video> <video> 保持腎臟健康的 31 個建議 / 31 Tips for Good Kidney Health Description: 本視頻是腎臟健康月#KidneyHealthChallenge腎臟健康建議合集。欲了解更多信息，請瀏覽 BCRenal.ca，然後點擊 Health Info - Prevention & Public Health - Kidney Health Month。 A video compilation of our #KidneyHealthChallenge tips as part of Kidney Health Month. For more information visit BCRenal.ca, then click Health Info - Prevention & Public Health - Kidney Health Month. </video> <video> Acknowledging and Respecting self-determination of Indigenous Health and Wellness (Oct 2024) Description: Acknowledging and Respecting Self-determination of Indigenous Health and Wellness – BCR PWR (Oct 2024) Jocelyn Jones, Craig Settee and Catherine Turner present their talk, “Acknowledging and Respecting Self-determination of Indigenous Health and Wellness,” as part of BC renal and UBC’s province-wide rounds. 0:04:40 – Intro Each of the speakers takes a turn introducing themselves and acknowledging the lands they are on. Settee begins by noting that there is no single Indigenous or Western way of knowing, and it’s important to not “homogenize or “other” by reducing vast and various traditions in simplistic and generic terms. 0:09:10 – Indigenous Kidney Health Resource Jones talks about how the Can-SOLVE CKD network aims to support the Truth and Reconciliation Calls to Action #18, 19 and 23. She shares a video describing a new Indigenous kidney health video series called Meno Ya Win. It offers a wealth of resources for Indigenous people living with kidney disease, but also care providers who may work with Indigenous people, including: patient experience videos, dialysis demonstration videos, learning modules and lesson plans. 0:15:50 – Can-SOLVE CKD Background Jones provides background information on the Can-SOLVE CKD network, including funding and how patient partners shape its research priorities. Turner highlights 6 guiding “R” principles that the network follows, which include: respect, reciprocity, relevance, reflection, relationships and reconciliACTION. 0:24:05 – Case Study Turner then shares a case study where a research team in Alberta established a relationship with Indigenous people using a two-eyed seeing approach rooted in the 6 R’s. This involved meeting with Indigenous leaders and community members, listening to stories, and creating spaces to amplify Indigenous voices. 0:26:00 – Indigenous Measures of Success Next, Turner provides an overview of different ways that research teams can evaluate the success of their projects using Indigenous measures of success (e.g., how well does the research align with the priorities of the community, build community capacity, support resurgence of traditions, ensure self-determination, etc). She highlights several projects and publications from Can-SOLVE CKD that are prime examples of culturally safe partnerships with Indigenous communities, including the Kidney Check project which provides point-of-care kidney health screening in rural and remote Indigenous communities. 0:32:10 – The Indigenous People’s Engagement and Research Council (IPERC) Jones gives an overview of the Indigenous Peoples’ Engagement and Research Council, which helps amplify Indigenous voices within the Can-SOLVE CKD network, and supports Indigenous perspectives and partnerships in research. 0:38:00 – Decolonization Settee emphasizes the importance of decolonization and provides an overview of a learning pathway researchers can take to build culturally safe and respectful partnerships with Indigenous peoples. It includes land acknowledgments, KAIROS blanket exercises, OCAP principles, a webinar series on Indigenous Research and Ethics Protocols, the role of Knowledge Keepers in Research, and a “cultural competency knowledge bundle” of additional resources to look into for ongoing learnings. Settee elaborates on why engaging with Knowledge Keepers is particularly important. 0:50:10 – Questions and Answers The panel members take questions from the audience. Click here to join our mailing list to receive the latest news and information from BC Renal: https://app.cyberimpact.com/clients/21780/subscribe-forms/F174304E-EE8A-4CF1-8E17-C75C02CC54BB </video> <video> Secondary & Tertiary Hyperparathyroidism: A Surgical Perspective – BCR PWR (Oct 2024) Description: Dr. Sam Wiseman presents his talk, “Secondary & Tertiary Hyperparathyroidism: A Surgical Perspective,” as part of BC Renal and UBC’s province-wide rounds. 0:06:00 – Introduction of Secondary HPT Dr. Wiseman begins by talking about secondary hyperparathyroidism (SHPT), which is marked by abnormal concentrations of calcium and phosphorous, as a physiological adaptation to progressive kidney disease. As a result, nodules form on parathyroid glands. He discusses the KDIGO guidelines for treating patients with SHPT, noting that when people don’t respond to medical therapy, surgery to remove part of all of the parathyroid glands is an option. 0:14:00 – Benefits of Parathyroidectomy He notes numerous benefits of surgery to remove the parathyroid, including a reduction in all cause mortality and cardiovascular mortality compared to patients treated with medical treatment. 0:16:00 – Parathyroidectomy for Tertiary HPT Dr. Wisman notes there is a lack of consensus regarding the exact definition for tertiary hyperparathyroidism (THPT), and provides on overview of symptoms. He highlights data from some small studies showing that surgery is also superior compared to medical treatment for people with tertiary HPT. 0:20:00 – Pre-operative Process Dr. Wiseman talks about how a Sestamibi scan and ultrasound can help with pre-operative planning. He discusses preoperative issues and management strategies (e.g. cacitrol, vitamin D repletion, preoperative electrolytes in dialysis patients, etc.) 0:25:00 – Operative Approach for Secondary HPT He then delves into the operation itself, describing the subtotal parathyroidectomy approach (removal of 3.5 glands) versus the total parathyroidectomy approach (removal of all 4 glands) with or without autotransplantation, for SHPT. He highlights data comparing the different approaches, finding them comparable, although total parathyroidectomy autotransplantation involved a few more cons (e.g., longer hospital stays). 0:37:00 – Operative Approach for Tertiary HPT Dr. Wiseman notes that no single operation is uniformly recommended for tertiary HPT cases. He then discusses ways for intraoperative PTH monitoring and highlights AAES recommendations on decision-making. Parathyroid cryopreservation allows for delayed autotransplantation of parathyroid glands and can be stored up to a year in BC, he notes. 0:44:00 – Surgical Outcomes Lastly, Dr. Wiseman provides on overview of surgical outcomes for SHPT and THPT. (e.g., hungry bone syndrome), and chances of persistence or recurrence. He notes the surgeon volume influences parathyroid parathyroidectomy outcomes. 0:47:00 – Conclusions and Q&A Dr. Wiseman summarizes his key points before taking questions from the audience. Click here to join our mailing list to receive the latest news and information from BC Renal: https://app.cyberimpact.com/clients/21780/subscribe-forms/F174304E-EE8A-4CF1-8E17-C75C02CC54BB </video> <video> Amia Cycler - How to Connect Description: 0:01 Introduction 0:20 Gathering your supplies 0:33 Wash your hands with soap and water and put on a mask 0:42 Connecting the patient line to the transfer set 1:19 Opening the transfer set 1:30 Press the start button to begin, remove your mask This video demonstrates the steps involved in connecting the Baxter Amia cycler. The content is intended to supplement training that is provided by Peritoneal Dialysis programs in British Columbia. Contact your PD program for further direction if required. This video series has been made possible with the support of the Abbotsford Regional Hospital PD Program, BC PD RN Group, BC PD Provincial Committee, BC Renal, and Mat Lo Productions. </video> <video> Hypertension and Renal Denervation: What’s new from the nephrologist’s perspective? – PWR (Dec 2024) Description: Dr. Sheldon Tobe, Dr. Syed Obaid Amin, and Dr. Jesse Bittman present their talk, “Hypertension and Renal Denervation: What’s new from the nephrologist’s perspective?” as part of UBC and BC Renal’s province-wide rounds. 0:05:00 – Hypertension facts Dr. Tobe starts by providing some quick facts about hypertension, noting it is very prevalent and that blood pressure lowering treatments work well to reduce major cardiovascular events. Of note, awareness among doctors about hypertension in women has dropped over the last 10 years, although the reasons are not clear. 0:08:00 – Renal Denervation Treatment He then talks about renal nerve denervation (RDN) as a treatment for hypertension, including radiofrequency ablation and ultrasound, which can reduce blood pressure. He notes that animal studies are suggesting that treating the branches and the distal artery provides better treatment. 0:13:05 – Case Study Dr. Bittman provides a case study of a 54-year-old woman with persistent hypertension despite many medications, and a 62-year-old man who had a stroke. 0:17:10 – Role of RDN in hypertension management Dr. Amin starts by talking about how the sympathetic nervous system is related to hypertension. He notes that over the years the ablation techniques have improved, better targeting the distal regions of the renal arteries. He then highlights landmark studies on RDN as a treatment for hypertension. In the HTN-OFF MED Pivotal study, data shows that RDN can reduce blood pressure within 3 months of the procedure being done. A longer follow up study shows the effect can be sustained at 3 years post-procedure. Dr. Amin notes there was no major safety issues, or renal injury, flagged in these studies. 0:33:00 – Ultrasound Dr. Amin provides a brief overview of the RADIANCE trial to evaluate ultrasound as a treatment, showing similar reductions in blood pressure. 0:36:20 – Summary Dr. Amin provides an overview of his talk, noting that RDN provides a significant, safe and sustained reduction in blood pressure, regardless of the technique. 0:37:50 – Interventional Hypertension Clinic Dr. Tobe provides an overview about how his clinic at Sunnybrook plans RDN treatment of hypertensive patients. He talks about how they decide who receives RDN, where assessment is done via a multidisciplinary team and shared decision-making. Patients must have uncontrolled hypertension on current therapy, and may be at increased risk of cardiovascular events. 0:42:05 – Q&A The panel takes questions from the audience, including where the procedure is available across Canada. Click here to join our mailing list to receive the latest news and information from BC Renal: https://app.cyberimpact.com/clients/21780/subscribe-forms/F174304E-EE8A-4CF1-8E17-C75C02CC54BB </video> <video> Amia Cycler - How to Disconnect Description: 0:01 Introduction 0:20 When your treatment is complete 0:37 Closing the transfer set and patient line 1:00 Clean your hands with hand sanitizer and put on a mask 1:09 Get a new mini cap and inspect it 1:21 Removing the transfer set and placing the new mini cap on it 1:33 Securing the catheter to your skin This video demonstrates the steps involved in disconnecting the Baxter Amia cycler. The content is intended to supplement training that is provided by Peritoneal Dialysis programs in British Columbia. Contact your PD program for further direction if required. This video series has been made possible with the support of the Abbotsford Regional Hospital PD Program, BC PD RN Group, BC PD Provincial Committee, BC Renal, and Mat Lo Productions. </video> <video> Claria Cycler - How to Set Up Description: 0:01 Introduction 0:20 Washing your hands 0:37 Gathering your supplies 0:57 Turning the cycler on 1:15 Connecting to the network 1:40 Opening your dialysis solution bags 2:11 Examining the solutions using SEAL 2:30 Placing the bag on the heater 2:40 Press the green button to start 2:45 Following the cycler prompts 3:23 Opening the cassette door and loading the tubing 3:44 Hanging the organizer on the door 4:01 Press the green button to start the self testing stage 4:19 Getting the drain line ready 5:30 Put on a mask, clean hands with sanitizing gel 5:40 Connecting the lines and solution bags 7:19 Final check 7:39 Priming the cycler This video demonstrates the steps involved in setting up the Baxter Homechoice Claria cycler. The content is intended to supplement training that is provided by Peritoneal Dialysis programs in British Columbia. Contact your PD program for further direction if required. This video series has been made possible with the support of the Abbotsford Regional Hospital PD Program, BC PD RN Group, BC PD Provincial Committee, BC Renal, and Mat Lo Productions. </video> <video> Claria Cycler - How to Disconnect Description: 0:01 Introduction 0:21 What to do when your therapy is finished 0:28 Press the green button when you are ready to disconnect 0:34 Closing the transfer set and the clamps on all lines, including the drain line 0:51 Press the green button 1:00 Put on a facemask and clean your hands using hand sanitizer 1:15 Open the mini cap package 1:21 Disconnect the cycler patient line 1:27 Applying the new mini cap This video demonstrates the steps involved in disconnecting the Baxter Homechoice Claria cycler. The content is intended to supplement training that is provided by Peritoneal Dialysis programs in British Columbia. Contact your PD program for further direction if required. This video series has been made possible with the support of the Abbotsford Regional Hospital PD Program, BC PD RN Group, BC PD Provincial Committee, BC Renal, and Mat Lo Productions. </video>

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Description

The BC Renal network plans and monitors the delivery of province-wide kidney care services. Using the latest research and collective knowledge of the kidney care community, we address the challenges of kidney disease by:

- Planning and monitoring the delivery of province-wide kidney care services
- Developing province-wide clinical standards and guidelines
- Developing funding models to support best health outcomes
- Measuring and reporting on patient and system outcomes
- Supporting knowledge-development through research and teaching

This channel features our video productions and advertisements on kidney disease and dialysis for patients, their families and health care providers. Please note that BC Renal doesn't control, endorse or recommend any non-BC Renal ads that appear with BC Renal videos. Please see our privacy and data collection policy with regards to social media here: http://www.bcrenal.ca/about/accountability/protecting-patient-privacy

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