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Your search term(s) "Dialysis" returned 150 results.

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Assessing Health Status and Health Care Utilization in Adolescents With Chronic Kidney Disease. Journal of the American Society of Nephrology. 16(5): 1427-1432. May 2005.

Few validated health status measures have been assessed in children with chronic kidney disease (CKD). This article reports on a study undertaken to assess the validity of a generic health status measure, the Child Health and Illness Profile-Adolescent Edition (CHIP-AE), in adolescents with CKD. The case-control study was performed to assess scores on the CHIP-AE in adolescents with CKD compared with two control groups of age-, socioeconomic-, and gender-matched peers and to compare health of patients who had chronic renal insufficiency (CRI), were on dialysis, and were posttransplantation. Seven pediatric nephrology centers recruited the 113 patients (mean age, 14 years; 39 CRI, 21 dialysis, 53 posttransplantation). Compared with 226 control subjects, patients with CKD had lower overall satisfaction with health and more restriction in activity. Positively, patients with CKD had more family involvement, better home safety and health practices, and better social problem-solving skills and were less likely to participate in risky social behaviors or to socialize with peers who engaged in risky behavior. Patients who received dialysis were less physically active and experienced more physical discomfort and limitations in activities than did transplant or CRI patients. The authors conclude that patients with CKD have poorer functional health status than age-matched peers. Among CKD patients, dialysis patients have the poorest functional health status. The medical and surgical status of adolescents with CKD clearly has an impact on their level of social role functioning and the resources that they have available to meet the challenges of living with CKD and becoming well-functioning adults. 5 tables. 23 references.

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Cardiac Disease in Dialysis Patients. In: Clinical Dialysis. 4th ed. New York, NY: McGraw-Hill. 2005. pp. 741-754.

This chapter on cardiac disease in dialysis patients is from a comprehensive textbook on the clinical management of patients on dialysis. The author first reviews animal models of uremia and the cardiovascular system, then considers diagnostic tests for coronary artery disease and for cardiac morphology and function. Additional sections cover prevalence, incidence, prognosis, risk factors (including smoking, poor glycemic control, hypertension, lipid abnormalities, anemia, uremia, inflammation, dialysis access problems, bacteremia, and oxidative stress), and research studies on patient management for cardiac patients on dialysis. The author concludes that risk factor management in dialysis patients is dependent on their enormous cardiovascular risk. Although the chapter includes therapy targets advocated by the major professional associations, the author emphasizes the need for safety over guideline attainment. 1 figure. 1 table. 165 references.

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Caregiving by Families and Friends of Adults Receiving Dialysis. Nephrology Nursing Journal. 32(6): 621-631. November-December 2005.

Individuals with kidney failure requiring dialysis often require the support of family and friends to manage their illness and treatment at home. This article reports on a study of the activities of caregivers of adults on dialysis and how the behaviors evolved over time. The authors conducted interviews with 37 caregivers and found that caregivers had a wealth of caregiving abilities and activities that were often supported by a strong knowledge base. Caregiving activities were categorized into five interdependent dimensions: appraising, advocating, juggling, routinizing, and coaching. Caregivers also described specific caregiving tasks, including dialysis-related activities; management of diet, medications, and symptoms; and personal care. The authors conclude that particularly in light of the trend toward self-care and home care and the reality that many caregivers combine caregiving responsibilities with other family and employment responsibilities, it is imperative that nurses and other health providers understand the care provided by caregivers so they can support the development of caregiving abilities and performance of caregiving activities. 3 tables. 34 references.

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Chronic Dialysis and Access-Related Morbidities in Children. Dialysis and Transplantation. 34(5): 278-282. May 2005.

This article reports on a study of the scope of morbidity facing children with end stage renal disease (ESRD). Morbidity data were collected prospectively during three separate periods from October 2001 through April 2003 from all children (aged 1 to 18 years) maintained on either chronic hemodialysis (HD) or peritoneal dialysis (PD) within the ESRD Network of New England. Data were obtained on 26 HD patients and 33 PD patients. The results showed that despite the use of recombinant human erythropoietin (EPO), anemia was often noted (48.9 percent of PD patients; 33.3 percent of HD patients). A low serum albumin was seen commonly in PD patients (53.2 percent) versus that in HD patients (11.9 percent). Growth failure occurred in 36 percent of the patients and correlated directly with years of renal failure. Dialysis access malfunction, dialysis access-related infection, and hypertension accounted for most of the patient morbidity and nearly all of the hospitalizations. HD access failures were twice as common with central venous catheters and arteriovenous grafts as they were with arteriovenous fistulas. Approximately one-third of HD and PD patients experienced an access-related infection. Hospitalization was necessary in 75 percent of the cases of access failures, 85 percent of the cases of dialysis access-related infections, and 40 percent of the cases of hypertension. 3 figures. 32 references.

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Clinical Dialysis. 4th ed. New York: McGraw-Hill. 2005. 1167 p.

This textbook offers a comprehensive overview of the care of patients who are undergoing dialysis therapy. Forty-seven chapters cover a wealth of topics, including the history of the development of hemodialysis (HD) and peritoneal dialysis (PD), vascular access, technological aspects, hollow-fiber dialyzers, biocompatibility, anticoagulation, kinetic modeling, optimizing dialysis in pediatric patients, complications during HD, dialyzer reuse, HD in children, peritoneal access devices, the physiology of PD, the clinical use of PD, infections in PD, infection and host defense, PD in pediatric patients, acid-base homeostasis, nutrition, growth and growth hormone treatment, liver disease in dialysis patients, gastrointestinal diseases in dialysis patients, hematologic aspects of chronic kidney disease, cardiac disease in dialysis patients, hypertension in HD, lipoprotein metabolism and dyslipidemia, endocrine dysfunction in chronic kidney disease, neurologic aspects of dialysis, diabetes and dialysis, drug usage in dialysis patients, the psychosocial adaptation of dialysis patients, psychosocial care of children on dialysis, high-flux renal replacement therapies, quality and accountability in dialysis, sorbent dialysis, continuous renal replacement therapy, pediatric hemofiltration, preemptive kidney transplantation in infancy, quotidian dialysis, HD access in children, surgical issues in pediatric PD, renal osteodystrophy, and the management of anemia. Each chapter concludes with a lengthy list of references; a detailed subject index concludes the volume.

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Clinical Implications of Larger Molecules. In: Clinical Dialysis. 4th ed. New York, NY: McGraw-Hill. 2005. pp. 223-236.

Dialysis can correct many of the derangements associated with uremia, but some clinical symptoms usually persist despite adequate removal of low-molecular-weight solutes. This residual syndrome experienced by most dialysis patients includes anorexia, muscle wasting, neuropathy, pruritus, increased susceptibility to infection, prolonged recovery from infection, and poor wound healing. This chapter on the clinical implications of larger molecules is from a textbook on the clinical management of dialysis patients. The authors discuss morbidity, mortality, and larger retained solutes; the identification, characterization, and bioactivity of larger uremic toxins; beta2 microglobulin and dialysis-related amyloidosis (DRA); granulocyte-inhibiting proteins; parathyroid hormone; protein-bound uremic toxins; anemia and larger retained solutes; elimination of beta2 microglobulin by dialysis, hemofiltration, and adsorption; peritoneal dialysis; daily and nocturnal hemodialysis; and the treatment and prevention of DRA. 3 tables. 125 references.

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Clinical Use of Peritoneal Dialysis. In: Clinical Dialysis. 4th ed. New York, NY: McGraw-Hill. 2005. pp. 421-490.

This chapter on the clinical use of peritoneal dialysis (PD) is from a comprehensive textbook on the clinical management of dialysis patients. The author first explores the history, evolution, and current status of PD, then outlines the different modalities of PD, including continuous ambulatory PD, automated PD, and continuous cyclic PD. The next section addresses the selection of therapy, primarily selection between hemodialysis (HD) and PD and the impact of patient choice, the influence of residual renal function, comorbidity, survival, the incidence of fewer viral infections on PD, quality of life, and cost of therapy. Other topics covered in the chapter include PD solutions, biocompatibility, techniques to assess peritoneal function, techniques to assess peritoneal anatomy, the adequacy of PD, the PD prescription, clinical outcomes obtained with PD, complications, and PD in the treatment of specific medical conditions, including acute renal failure, diabetes mellitus, edema, hyperkalemia, hypercalcemia, metabolic acidosis, pancreatitis, hypothermia, and drug overdose. The author notes that the quest for the optimal prescription and dose of dialysis remains an important subject of investigation. 20 figures. 11 tables. 860 references.

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Continuous Renal Replacement Therapy. In: Clinical Dialysis. 4th ed. New York, NY: McGraw-Hill. 2005. pp. 991-1012.

Continuous renal replacement therapy (CRRT) is a group of related therapies designed to provide uninterrupted renal support to critically ill patients over a period of days. This chapter on CRRT is from a comprehensive textbook on the clinical management of patients on dialysis. The author discusses the history of CRRT, the nomenclature in present use, mechanisms of solute transport in CRRT, determinants of solute clearance, vascular access, arteriovenous access, the extracorporeal circuit, other equipment used, dialysate and replacement fluids, dosing of CRRT, selection of modality, and drug dosing during CRRT. The author concludes that the advantages of CRRT over conventional dialysis include more stable control of fluid, electrolyte, and solute balance; improved cardiovascular stability; and greater ability to maintain fluid balance despite the administration of large volumes of hyperalimentation solution and other obligatory fluids. 9 figures. 4 tables. 134 references.

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Development of Hemodialysis and Peritoneal Dialysis. In: Clinical Dialysis. 4th ed. New York, NY: McGraw-Hill. 2005. pp. 1-26.

This chapter, from a textbook on the clinical care of dialysis patients, reviews the history of the development of hemodialysis and peritoneal dialysis. The author tells the story of those who had the vision and courage to risk everything in search of effective treatment for renal failure. The author offers a critical-path analysis of how the various components of renal care were brought together and evolved into the treatment techniques used today. The author discusses the first investigators, the first dialyzer, other membrane researchers, vividiffusion, the high-flow dialyzer, other membrane research, the first plate dialyzer, the first clinical dialysis, the emergence of manufactured membranes, the Kolff era, the first dialysis in the United States, development of the Kolff-Brigham kidney, other developers of artificial kidneys, the use of artificial kidneys in Korea in 1952, the Skeggs-Leonards dialyzer in Norway, the Seattle artificial kidney program, development of dialyzing fluids, prophylactic dialysis, the beginning of chronic dialysis, the hollow-fiber kidney, the development and coming of age of peritoneal dialysis, dialysis for the patient with diabetes, and the growth of home care. The chapter is illustrated with black-and-white photographs of some of the medical equipment discussed. 16 figures. 75 references.

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Diabetes and Dialysis. In: Clinical Dialysis. 4th ed. New York, NY: McGraw-Hill. 2005. pp. 877-890.

Diabetes-associated kidney disease (diabetic nephropathy) is the leading cause of end stage renal disease (ESRD) in the United States and much of the rest of the world. This chapter on diabetes and dialysis is from a comprehensive textbook on the clinical management of patients on dialysis. The authors of this chapter discuss the progression of renal disease and choice of uremia therapy in patients with diabetes, extrarenal disease, hemodialysis, continuous ambulatory peritoneal dialysis (CAPD), transplantation, and rehabilitation. In the section on hemodialysis, the authors discuss mortality and comorbid conditions, vascular access, blood glucose, hyperlipidemia, oxidative stress, inflammation, control of intravascular volume, retinopathy, and vasculopathy. The authors emphasize that, as renal failure progresses, concomitant evaluation of medical problems, physical abilities, lifestyle, and social support, together with patient education, must be undertaken in an attempt to slow the progression of renal failure and make good decisions about the choice of uremia therapy. 3 tables. 100 references.

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