Module 1: Foundations of In-Center Hemodialysis

• Epidemiology & Outcomes
  • Global and U.S. prevalence trends: disparities in health equity, access, and outcomes
  • Mortality drivers: cardiovascular disease, infections, withdrawal of care
  • Age, race/ethnicity, socioeconomic influences on initiation and modality choice
  • Modality distribution and referral patterns
• Uremic Toxicity: Pathophysiology & Clinical Impact
  • Neurologic, hematologic, dermatologic, and gastrointestinal sequelae
  • Toxin classification: small solutes, middle molecules, protein-bound
  • Uremic solute burden: guanidines, indoles, middle molecules
  • Uremia Sequelae: uremic pruritus, polyneuropathy, platelet dysfunction, neurological, cardiovascular, dermatologic
• Initiation Strategies
  • Shared decision-making during modality selection: patient values vs physiological triggers
  • Timing for chronic kidney disease progression vs. acute decompensation
  • Inpatient “urgent-start” pathways and transitional dialysis planning