Clinical Expertise · Dialysis

Dialysis Management — Hemodialysis & Peritoneal Dialysis in South Jersey

Comprehensive oversight of hemodialysis, peritoneal dialysis, and continuous renal replacement therapy — from access planning through long-term adequacy and quality-of-life optimization.

Modality selection: HD vs. PD vs. transplant

Choosing a renal replacement modality is one of the most consequential decisions in advanced CKD. Each option — in-center hemodialysis, home hemodialysis, peritoneal dialysis, and pre-emptive transplant — fits different lifestyles, comorbidities, and vascular profiles. Dr. Kottarathara's modality counseling sessions cover medical eligibility, schedule impact, fluid management, and long-term cardiovascular outcomes, so patients and families make an informed choice rather than a default one.

Hemodialysis & vascular access

For hemodialysis patients, durable vascular access is the single most important factor in long-term outcome. Early surgical referral for arteriovenous fistula (AVF) creation, structured maturation surveillance, and prompt management of access dysfunction reduce catheter dependence and infectious complications.

Peritoneal dialysis

PD offers preserved residual renal function, hemodynamic stability, and lifestyle autonomy. Dr. Kottarathara has co-authored research on encapsulating peritoneal sclerosis in PD patients receiving kidney transplant (presented at ASN 2016), and integrates that experience into long-term PD risk monitoring.

CRRT in the ICU

Continuous renal replacement therapy is reserved for hemodynamically unstable critically ill patients. Bedside CRRT management at Virtua Voorhees, Virtua Marlton, and Jefferson Kennedy hospitals includes circuit prescription, anticoagulation strategy, and electrolyte targeting in the context of sepsis, multi-organ failure, or post-cardiac-surgery acute kidney injury.

Schedule a consultation

For dialysis access planning, modality counseling, or transfer of care, reach the practice at 347-285-1474 or metallicarun@gmail.com.

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