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.Have a question for Russ? Send it our way in writing or via voice memo, and it might be featured on an upcoming episode. Please introduce yourself, let us know where you're listening from, and share your quest. You can send questions to [email protected] Reference Links:Stanford Profile: Manjula Kurella TamuraConnect With Us:Episode Transcripts >>> The Future of Everything WebsiteConnect with Russ >>> Threads / Bluesky / MastodonConnect with School of Engineering >>> Twitter/X / Instagram / LinkedIn / FacebookChapters:(00:00:00) IntroductionRuss Altman introduces guest, Manjula Tamura, a professor of medicine and nephrology at Stanford University Medical School.(00:02:58) The Kidney’s Vital RoleThe kidney’s role and why its failure is life-threatening.(00:04:51) Causes of Kidney FailureThe leading causes of kidney failure in developed countries.(00:07:58) Kidney TransplantationThe feasibility, barriers, and supply challenges of kidney transplantation.(00:09:50) The Dialysis ProcessHow hemodialysis and peritoneal dialysis work and patient experiences.(00:14:07) The Evolution of Dialysis TreatmentThe history of dialysis and how Medicare’s expansion influenced its use.(00:18:48) Study Design: Emulating Clinical TrialsUsing VA electronic health records to simulate trials on dialysis.(00:25:31) Findings: Survival vs. Time at HomeThe trade-offs between extended survival and reduced time at home.(00:27:02) Quality of Life and DialysisMeasuring quality of life impacts through electronic health records.(00:30:32) The Future of Kidney TreatmentsInnovations like xenotransplantation and wearable artificial kidneys.(00:33:04) Conclusion
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