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Risks and Options With Gadolinium-Based Contrast Agents in Patients With CKD: A Review

Gadolinium-based contrast agents (GBCA) improve the diagnostic capabilities of magnetic resonance imaging. Although initially believed to be without major adverse effects, GBCA use in patients with severe chronic kidney disease (CKD) was demonstrated to cause nephrogenic systemic fibrosis (NSF). Restrictive policies of GBCA use in CKD and selective use of GBCAs which bind free gadolinium (Gd+3)…

The current and future landscape of dialysis

Dialysis is a life-saving therapy; however, costs of dialysis are high, access is inequitable and outcomes are inadequate. This Review describes the current landscape of dialysis therapy from an epidemiological, economic, ethical and patient-centred framework, and describes initiatives that are aimed at stimulating innovations in the field to one that supports high-quality, high-value care.

Challenges and novel therapies for vascular access in haemodialysis

Effective treatment of kidney failure depends on reliable vascular access; however, options for chronic vascular access for haemodialysis have remained unchanged for decades. This Review evaluates the key existing challenges in establishing and maintaining vascular access and describes novel and innovative technologies under development that address these issues.

Innovations in dialysis: the user’s perspective

The need for innovation in dialysis is long overdue. As past and present users of dialysis we are fully aware of the limitations of current dialysis modalities. The time for complacency is over — developers must engage with dialysors to ensure that our needs are met so that we can live the best life possible. Let us share our dream for devices that will enable us to enjoy life.

Regulatory approaches to stimulate innovative renal replacement therap

Regulations for market access and reimbursement of medical devices vary across jurisdictions, complicating the development of innovative technologies for world-wide use; however, several converging regulatory principles are now emerging. Here we discuss approaches by which regulatory and related agencies can promote innovation and boost the effectiveness of regulatory processes to expedite…