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

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Changing the Course of PD: The Provincial Peritoneal Dialysis Joint Initiative. Nephrology News & Issues. 22(2): 36-40. December 2007.

This article describes the Provincial Peritoneal Dialysis Joint Initiative, a Canadian program designed to support the use of peritoneal dialysis (PD) in patients needing dialysis. The initiative calls for increasing the use of PD in Ontario from 17 percent to 30 percent of the dialysis population by 2010 and promoting integrated delivery of PD services throughout Ontario. The initiative has two primary goals: to remove the barriers to increased PD use in the province within a coordinated, quality, and cost-efficient accessible chronic kidney disease (CKD) system that covers the continuum of services for patients; and to provide the necessary tools and techniques to support and guide the standardizing of PD processes and patient care. The author outlines the three-phase implementation plan, summarizes the key core service components that need enhancements or monitoring, and explains why he does not support the conclusions and approach the coordinating committee advocates. The author focuses on the problem of emphasizing PD to the detriment of efforts to increase daily home hemodialysis, as well as the unrealistic goals of achieving 30-percent coverage in such as short period of time. 16 references.

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Classes Help Patients Manage Depression. In Control. 4(2): S2. June 2007.

This brief newsletter article provides information about depression in patients who are undergoing dialysis treatments and how it can be managed with group classes. The author describes a 6-week pilot program of classes used in the dialysis clinic at the University of South Florida, in Tampa. The article reports on patient enrollment, the program itself, and the positive results experienced by the patients who completed the series of classes. The class content focused on education about the biological components of depression, psychotropic medications, and cognitive-behavioral techniques. A comparison of patients’ self-reports before and after the series of classes showed a significant decrease in depression; a control group that did not attend the classes showed an increase in depression scores over the 6-week period. 1 figure 2 references.

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Clinical Indicators and Preventive Health. American Journal of Kidney Diseases. 49(1): s111-s128. January 2007.

End-stage renal disease (ESRD) patient complexity poses many challenges for providers, public health officials, and policy makers. This chapter on clinical indicators and preventive health in this patient population is from a special supplemental issue of the American Journal of Kidney Diseases that presents excerpts from the 18th annual report from the U.S. Renal Data System on the ESRD program in the United States; data through 2004 is included. The Annual Data Report (ADR) also presents information on patients with chronic kidney disease (CKD) and assesses care of at-risk populations and international comparisons of ESRD. This chapter examines progress toward guidelines set by the National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (K-DOQI) and toward other targets for clinical care. The authors look at trends in vascular access use and in access events and complications, at diabetes care, and at patient adherence to prescription drug therapy. The chapter includes figures on anemia treatment and EPO resistance, and anemia management. The chapter concludes with data on the use of preventive care—glycosylated hemoglobin testing, lipid testing, and vaccinations—in the ESRD population as a whole. 57 figures.

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Comorbid Diseases in Patients on Dialysis: The Impact on Anemia. Nephrology Nursing Journal. 34(01): 72-75. January-February, 2007.

This continuing education article considers the impact of comorbid diseases on anemia in patients on dialysis. The author notes that patients who are on dialysis frequently present with a multitude of comorbid diseases. These diseases include hypertension, coronary artery disease, congestive heart failure, diabetes mellitus, cardiomegaly, left ventricular hypertrophy, peripheral vascular disease, peptic ulcer disease, cellulitis or gangrene, gastrointestinal bleed, and cancer. Many of these conditions can either directly aggravate pre-existing anemia, or lead to acute or chronic inflammatory or infectious conditions that can lower hemoglobin levels. Awareness of these conditions and their compounding effect on anemia can help nurses when interpreting the results of longitudinal trends in hemoglobin. The author concludes that management of these patients requires an individualized approach to assess for the presence of multiple conditions that may be affecting hemoglobin levels and to adjust therapies, as appropriate, to minimize the impact on anemia-related outcomes. 3 tables. 12 references.

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Cost Associated With Home Dialysis. At Home with AAKP. 1(1): 12-13. October 2007.

This article is from a new magazine about home dialysis for patients with kidney disease. In the article, the author considers the costs involved in home dialysis, noting that both in-center and home dialysis options are covered by Medicare, Medicaid, and many private insurers. Basic supplies, including dialyzers, lines, needles, tape, gauze pads, dialysate, home scale, and laboratory supplies for home dialysis are covered by insurance, just as they are in a dialysis clinic. However, some out-of-pocket expenses may be incurred, notably water system revisions and electrical connections. Other costs may include storage area, shelving, increased waste disposal due to used lines and equipment, a reclining chair, telephone costs, and assistance from a home helper. A brief section notes that for home peritoneal dialysis, few additional expenses are incurred.

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Costs of CKD and ESRD. American Journal of Kidney Diseases. 49(1): s205-s222. January 2007.

This chapter on costs is from a special supplemental issue of the American Journal of Kidney Diseases that presents excerpts from the 18th annual report from the U.S. Renal Data System on the ESRD program in the United States; data through 2004 is included. The Annual Data Report (ADR) also presents information on patients with chronic kidney disease (CKD) and assesses care of at-risk populations and international comparisons of ESRD. This chapter addresses the economics of caring for patients with ESRD and CKD. Figures of overall costs are followed by actuarial tables and related figures on components of Medicare Part A and Part B costs, and by a summary of ESRD program expenditures. The authors update the annual data on per person per year costs, present comprehensive data on components of care, and show costs for vascular access procedures. The chapter concludes with data on Medicare risk (Medicare Advantage, Part C) patients. 53 figures. 3 tables.

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Depression and Dialysis. In Control. 4(2): S1, S4. June 2007.

This newsletter article provides information about depression in patients who are undergoing dialysis treatments. The author considers the different rates of depression reported in people with dialysis, focusing on four factors that may result in varying estimates of prevalence: different screening tools, different medical professionals, different cultural values, and different timing. The article goes on to recommend that health care providers and patients focus on the level of depressive symptoms and their impact on health, mortality, and quality of life, rather than on diagnosing clinical depression. A final section discusses the importance of identifying and treating depressive symptoms, as they have a negative impact on patient outcomes and quality of life. The author notes that screening tools are useful to identify patients who might benefit from help, such as medications that can improve symptoms. 11 references.

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Depression and Kidney Disease. In Control. 4(2): P1, P4. June 2007.

This article provides information about depression in patients who have kidney disease, particularly those who being treated with dialysis. The author outlines common symptoms of depression, encouraging readers who experience these symptoms for longer than 2 weeks to consult with their health care provider for help. The article goes on to stress that depression can be treated successfully, usually with medications or counseling, or both. The author suggests that patients consider using a home form of dialysis to help ease depression and experience a better quality of life. A final section offers ideas for contacting support groups and visiting websites for more information. A five-question quiz is included for readers to test their knowledge about depression and diabetes; the answers are provided elsewhere in the newsletter issue. 3 references.

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Dialysis and PKD Patients: An Analysis. Nephrology News & Issues. 21(9): 36, 37. August 2007.

This article focuses on the treatment of patients with polycystic kidney disease (PKD) before the need for renal replacement therapy and during chronic dialysis. The authors discuss the complications of PKD, including renal pain, hematuria, and renal infection; the extrarenal manifestations of PKD, including gastrointestinal involvement, hepatic synthetic dysfunction, cardiac valve abnormalities, hypertension, and brain aneurysms in patients with a strong family or personal history of same; the use of heparin in these patients; the use of dietary sodium restriction, diuretics, and antihypertensive medications used to control volume and blood pressure; the role of remaining kidney function, even in patients who require dialysis to maintain health; patient candidacy for dialysis; the decision between home dialysis versus in-center care; the choice between hemodialysis and peritoneal dialysis; and the importance of adequate nutrition to decrease hospitalizations, improve survival, increase independence, and improve sense of well-being. The authors note that PKD patients are generally good candidates for survival and have a survival advantage compared with patients with end-stage renal disease (ESRD) from other causes.

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Dialysis Care Clinical Handbook. New York, NY: National Kidney Foundation. 2007. 156 p.

This clinical handbook summarizes the Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines and recommendations from the 2006 updates regarding hemodialysis adequacy, peritoneal dialysis adequacy, vascular access, anemia in chronic kidney disease (CKD), and cardiovascular disease in adult dialysis patients. The handbook provides a practical strategy for applying the statements and recommendations from the KDOQI in a real-world setting. Specific topics covered include planning for dialysis, initiating dialysis, monitoring dialysis adequacy, quality assurance, patient education, measuring peritoneal membrane function and ultrafiltration volume, preserving residual kidney function, maintaining euvolemia, family and caregiver education, preparation for permanent hemodialysis vascular access, treatment of vascular access complications, identifying patients with anemia in CKD, cardiovascular disease evaluation at initiation of dialysis, vascular heart disease, cardiomyopathy, dysrhythmia, peripheral vascular disease, the management of cardiovascular disease in patients on dialysis, the role of external defibrillation, and the management of cardiovascular risk factors, including smoking, dyslipidemia, and physical activity. The guidelines and recommendations in each section are organized according to the way a patient presents and thus do not follow the numerical sequence of the guidelines. All guideline and recommendation statements, tables, graphs, and figures in each section are identified by the guideline or recommendation number for easy cross-referencing. Clinicians are referred to the full guidelines and recommendations for more detailed analysis of the available data. Readers are referred to the KDOQI website at www.kdogi.org for references. 12 figures. 41 tables.

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