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

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Hemodialysis in Children. In: Clinical Dialysis. 4th ed. New York, NY: McGraw-Hill. 2005. pp. 293-308.

While most children with chronic kidney failure will eventually be treated with renal transplantation, nearly half of these children will be placed on hemodialysis while awaiting their transplants. In addition to the children with chronic dialysis needs, there is a population of children with acute renal insufficiency who may require a period of hemodialysis during acute illness and recuperation. This chapter on hemodialysis (HD) in children is from a textbook on the clinical management of dialysis patients. The authors caution that, with children, the whole task of providing care becomes even more daunting as the physical and psychosocial effects of HD and especially chronic HD therapy may adversely affect important aspects of normal childhood growth and development. The authors discuss epidemiology, the physiology of HD in children, the dialysis prescription, vascular access, the acute HD setting, HD in chronic renal failure, anemia, osteodystrophy, growth, the cognitive effects of HD, complications of HD, and the adequacy of HD. The authors note that there is preliminary evidence that optimizing caloric intake and diet and intensifying dialysis to achieve higher-than-normal measures of dialysis adequacy improves growth and pubertal development in children. 3 figures. 1 table. 66 references.

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Hemodialysis in Children: General and Practical Guidelines. Pediatric Nephrology. 20(8): 1054-1066. August 2005.

Over the past 20 years children have benefited from major improvements in both the technology and clinical management of dialysis. This article offers general practical guidelines for hemodialysis (HD) in children. The authors note that morbidity during dialysis sessions has decreased with seizures being exceptional and hypotensive episodes rare. Pain and discomfort have both been reduced with the use of chronic internal jugular venous catheters and anesthetic creams for fistula puncture. The authors offer specific guidelines in the areas of the dialysis unit, water quality, the dialysis machine, blood lines; principles of blood purification, extracorpeal blood access and circulation, dialyzer membranes, the dialysate, post-dialytic dry weight assessment and adjustment, assessments (of urea dialytic kinetic, dialysis dose, and protein intake), dialysis dose and outcome, and dialysis adequacy and monitoring. Although the optimum dialysis dose requirement for children remains uncertain, reports of longer duration or daily dialysis show they are more effective for phosphate control than conventional HD. In children, HD has to be individualized and viewed as an integrated therapy considering their long-term exposure to chronic renal failure treatment. The authors stress that dialysis is usually seen only as a temporary measure for children compared with renal transplantation because the latter enables the best chance of rehabilitation in terms of education and psychosocial functioning. 1 figure. 6 tables. 83 references.

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Hidden Phosphorus in Popular Beverages. Nephrology Nursing Journal. 32(4): 443-448. July-August 2005.

In order to maintain normal blood phosphorus levels in patients on dialysis, patient education has emphasized adherence to prescription phosphate binder drugs and maintenance of a low phosphorus diet. In addition to the standard advice to avoid dairy products and legumes, education also focused on lower phosphorus protein foods and beverages. However, current food-processing practices have stepped-up the use of phosphorus additives the ensure the quality and flavor of their products. This article considers the hidden phosphorus content of many popular beverages. The problem with phosphorus additives may be unique to the renal community because these phosphorus additives are highly absorbable. In a typical mixed diet of grains, meat, and dairy, only 60 percent of the dietary phosphorus is absorbed, whereas phosphoric acid and various polyphosphates and pyrophosphates are almost 100 percent absorbed. The author discusses how to identify these new, higher phosphorus foods and the importance of reading food and beverage labels. The article includes a chart that lists the sodium, potassium, and phosphorus content of many popular beverages. 1 table. 10 references.

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High-Flux Renal Replacement Therapies. In: Clinical Dialysis. 4th ed. New York, NY: McGraw-Hill. 2005. pp. 949-962.

Conventional hemodialysis (HD), consisting of three sessions per week lasting 3 to 4 hours each, remains the major modality of life-supporting therapy in patients with chronic kidney disease (CKD). By enhancing the various components of solute clearance (diffusion, convection, and adsorption), high-flux HD improves overall solute removal capacity and enlarges the spectrum of removable substances. Diffusive clearance enhances small solute removal, convective clearance favors medium- and high-molecular-weight solute removal, and adsorptive clearance facilitates removal of reactive solutes according to their electrostatic or chemical reactivity. This chapter on high-flux renal replacement therapy is from a comprehensive textbook on the clinical management of patients on dialysis. The chapter covers the technical prerequisites for high-flux therapies, high-flux hemodialysis (HF-HD), hemofiltration, hemodiafiltration (HDF), unconventional methods, clinical results, and the risks and hazards of high-flux therapies. The authors conclude that high-flux modalities offer the most effective renal replacement therapy (RRT) for the patient with end stage renal disease (ESRD). By combining the use of ultrapure dialysis fluid and synthetic hemocompatible membranes, these high-flux modalities considerably improve the hemocompatibility model profile of the HD system. 8 figures. 2 tables. 61 references.

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Hollow-Fiber Dialyzers: Technical and Clinical Considerations. In: Clinical Dialysis. 4th ed. New York, NY: McGraw-Hill. 2005. pp. 85-100.

Dialyzers containing hollow-fiber membranes are now used almost exclusively for hemodialysis (HD) therapy. This chapter on the technical and clinical considerations of hollow-fiber dialyzers is from a textbook on the clinical care of dialysis patients. Hollow-fiber dialyzers display relatively low blood-compartment resistance, which results in high blood-flow rates at acceptable axial (arterial-to-venous) pressure drops. In the first part of the chapter, hollow-fiber membranes are discussed specifically, including the chemical composition and physical characteristics of commonly used membranes. The author also reviews the membrane characteristics that determine solute and water permeability. The remainder of the chapter deals with properties of the dialyzer itself, with emphasis on the major determinants of performance characteristics. 5 figures. 84 references.

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Infection Control for Peritoneal Dialysis (PD) Patients. Atlanta, GA: Centers for Disease Control and Prevention. 2005. 4 p.

Peritoneal dialysis (PD) is a practical and commonly used treatment for kidney failure. Because a soft tube (catheter) is present in the abdominal cavity for this treatment, special care must be taken by PD patients and their medical providers to prevent infection, especially following natural disasters when flooding may be present, access to medical supplies may be limited, or PD patients may be living in temporary housing. This fact sheet, from the Centers for Disease Control and Prevention, reviews disaster safety and prevention strategies for PD patients. Topics covered include exit site infection; peritonitis; preventing exit site infections; general exit site care; exit site care with vinegar for wet, red or sore sites; and other infection control considerations. The fact sheet offers practical, specific suggestions for infection control steps and patient care management. 13 references.

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Infections in Peritoneal Dialysis. In: Clinical Dialysis. 4th ed. New York, NY: McGraw-Hill. 2005. pp. 491-514.

Peritonitis and peritoneal catheter infections cause significant morbidity in peritoneal dialysis (PD) patients, accounting for the majority of catheters lost and for transfer to hemodialysis, either temporarily or permanently. This chapter on infections in PD is from a comprehensive textbook on the clinical management of patients on dialysis. The first section covers catheter infections, including definitions and diagnosis, organisms causing catheter infections, and prevention strategies. The latter section discusses peritonitis, including epidemiology, risk factors, etiology, presentation and diagnosis, treatment strategies, and prevention. The authors conclude that, in order to achieve low rates of peritonitis, the PD program must offer constant surveillance. Root-cause analysis should be carried out for every episode of peritonitis to determine the etiology, so that future preventive measures can be implemented. Experienced and dedicated PD nurses are important in maintaining a PD program with low infection rates. 8 figures. 8 tables. 287 references.

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Invasive and Innovative Nephrology. Renal Failure. 27(3): 255-258. 2005.

This article explores the role of interventional nephrology in the current and future practice of modern nephrologists. The authors describe the interventional procedures available at the Overton Brooks Veterans Affairs Medical Center (OBVAMC), the first federal health care provider in the nation offering such services. The authors report their early experience in successfully providing complete care to veterans with renal failure. The OBVAMC is an acute care facility providing nephrology support to hospitalized veterans; the facility also handles access-related issues for eligible chronic dialysis patients. The authors analyzed all procedures performed between June 2000 and September 2003. The procedures were performed in the cardiac catheterization laboratory or in the surgical operating rooms. A total of 366 procedures were performed: 110 tunneled cuffed catheter (TCC) placements, 157 temporary dual lumen catheters, 36 TCC removals, 30 fistulograms, 24 thrombectomy-angioplasty, 1 stent placement, 3 Tenckhoff catheter placements, 3 central venograms, and 2 accessory vein ligations. The authors conclude that the interventional nephrology experience at OBVAMC has been successful and that interventional nephrology programs can be developed in any tertiary care hospital. 1 table. 12 references.

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Kidney Dialysis. IN: Physician's Guide to Medicare Coverage of Kidney Dialysis and Kidney Transplant Services. Baltimore, MD: Centers for Medicare and Medicaid Services. May 2005. pp. 15-21.

This chapter on kidney dialysis is from a booklet that provides information on Medicare for physicians who have patients with permanent kidney failure. The booklet explains how these patients can qualify for Medicare, how Medicare helps pay for kidney dialysis and kidney transplants, and where to get more information and assistance. This chapter reviews the treatment options for end-stage renal disease (ESRD), including peritoneal dialysis, hemodialysis, and home dialysis. Other topics include how dialysis adequacy is determined, deciding which payment option to choose for home dialysis, home dialysis drugs covered by Medicare, treatments and equipment that are not covered by Medicare, and what Medicare patients pay for dialysis in a dialysis facility, dialysis in a hospital, doctors' services, dialysis when traveling, and for transportation to dialysis facilities. Sidebars provide specific examples and important bullet points. Tables summarize some of the information presented. 3 tables.

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Kinetic Modeling in Hemodialysis. In: Clinical Dialysis. 4th ed. New York, NY: McGraw-Hill. 2005. pp. 153-202.

This chapter on kinetic modeling in hemodialysis is from a textbook on the clinical management of dialysis patients. The authors note that the clinical goals of modeling in dialysis therapy are to improve clinical understanding of control of the uremic syndrome by dialysis and to prescribe and deliver adequate, reproducible, and quantified doses of dialysis for a variety of solutes. The uremic syndrome is only partly responsive to adequate dialysis therapy, and there is variable ongoing morbidity, such as reduced taste and appetite, mild sensory neuropathy, renal osteodystrophy, and other clinical problems, even in well-dialyzed patients. The authors describe the development of several modeling techniques used for a variety of solutes for clinical application. Topics include an overview of urea kinetic modeling, applied single-pool urea kinetic modeling, applied double-pool kinetic modeling, modeling for inorganic phosphate (iP), kinetic continuous and intermittent clearances, and the pharmacodynamics of erythropoietin therapy. The chapter concludes with a glossary of kinetic modeling terms. 58 figures. 2 tables. 110 references.

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