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

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Dialysis Patients’ Need for Protein. In Control. 4 (1): S1,S4. March 2007.

This newsletter article focuses on the importance of protein in the diet of patients who are on dialysis. The author notes that protein-energy malnutrition (PEM) is a common problem in people on dialysis and may be due to loss of appetite, protein catabolism caused by dialysis, chronic inflammation, and other reasons. Dialysis patients need more protein than the average healthy adult because they lose protein during dialysis and because kidney disease alters the body’s ability to use and process amino acids, the building blocks for muscles and healthy cells, organs, and bones. The article briefly reviews the most recent version of the KDOQI Clinical Practice Guidelines for Nutrition in Chronic Renal Failure and discusses the realities of meeting these goals in the real world. Comprehensive nutritional counseling remains the intervention most recommended to help improve nutritional status. Individualized sessions with a dietitian can help identify the many factors that may be interfering with the patient eating enough protein. These factors may include nondialysis-related issues such as dental problems, depression, low-protein ethnic food preferences, or lack of funds. A final section considers the role of increased dialysis treatments to improve nutritional status. 9 references.

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Directory of ESRD Network Organizations 2007. Midlothian, VA: Forum of ESRD Networks. 2007. 54 p.

This 2007 Directory lists all the end stage renal disease (ESRD) network organizations, as well as the executive directors, chairs, review board chairs, and ESRD-related staff for Medicare and Medicaid services. The document lists Network office and staff information, including names, contact information, and email addresses for the 18 Networks: ESRD Network of New England, Inc.; IPRO: CKD Network for New York, Inc.; TransAtlantic Renal Council; ESRD Network 4, Inc.; Mid-Atlantic Renal Coalition; Southeastern Kidney Council, Inc.; FMQAI: The Florida ESRD Network; Network 8, Inc.; The Renal Network, Inc.; Renal Network of the Upper Midwest, Inc.; Heartland Kidney Network; ESRD Network Organization No. 13; ESRD Network of Texas, Inc.; Intermountain ESRD Network, Inc.; Northwest Renal Network; Western Pacific Renal Network, LLC; and Southern California Renal Disease Council, Inc. The document also includes sections on special projects, dialysis organizations, renal-related organizations, and the ESRD Forum Board of Directors. The volume is spiral-bound for ease of use.

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Double-Digit Growth in '07 Seen in Midsized Chains. Nephrology News & Issues. 21(8): 42-44, 46, 48, 50. July 2007.

This article reports on the growth of the renal care provider industry. The author briefly reports on some general trends, noting that growth has been minimal among the largest dialysis chains and most of the growth has come from the midsized dialysis chains, those with 3,500 patients or less. While all the dialysis chains in the survey, with the exception of one, showed some growth in 2006–2007, most are showing that growth in the hemodialysis market. Only one provider, Satellite Healthcare, had a peritoneal dialysis patient population in the double digits (17.7 percent). The author reports data from a ranking of the 10 largest dialysis chains in the United States. The bulk of the article consists of profiles of these 10 dialysis chains. For each entry, the author provides the name, address, contact information, number of clinics, number of patients, a map of the chain’s coverage area, and a brief description as provided by the chain. The 10 chains included are: Fresenius Medical Care North American, DaVita Inc., Dialysis Clinic Inc., Renal Advantage Inc., DSI Renal Inc., American Renal Associates Inc., Liberty Dialysis LLC, Satellite Healthcare Inc., U.S. Renal Care Inc., and Dialysis Corporation of America.

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End Stage Renal Disease Briefing Book For State And Federal Policymakers: A Guide to Kidney Disease Awareness And Education. Revised ed. Pitman, NJ: American Nephrology Nurses Association. 2007. 19 p.

This booklet provides basic information about end-stage renal disease (ESRD) for state and federal policymakers, offering an overview of kidney disease awareness and education. The booklet includes 14 chapters: chronic kidney disease (CKD) and ESRD, diabetes and CKD, hypertension and kidney disease, anemia and CKD, bone disease from CKD, current modalities for treating CKD, kidney transplantation, vascular access for dialysis, a blueprint of a typical dialysis facility, a typical day in the life of a nephrology nurse, the advanced practice nurse, Medicare payment policies, CKD resource websites, and the American Nephrology Nurses’ Association (ANNA). Readers are referred to the ANNA website for position statements, health policy agendas, resources and tools, and ESRD activities (www.annanurse.org). 10 figures. 1 table. 15 references.

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ESRD Providers. American Journal of Kidney Diseases. 49(1): s191-s204. January 2007.

The growing numbers of end-stage renal disease (ESRD) patients and dialysis units has been associated with a dramatic expansion of free-standing, for-profit providers, and approximately 70 percent of units are now for-profit. This chapter on ESRD providers 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 focuses on ESRD providers and the provider community. Figures describe provider growth, provider compliance with care guidelines, and differences in the provision of preventive care. Additional analyses look at anemia management by unit type and affiliation. The authors also present data on Bayesian hospitalization and mortality ratios, looking at how these ratios differ by unit affiliation. 40 figures.

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Evaluating Patients Perceptions of End-Stage Renal Disease. Nephrology News & Issues. 21(6): 44-49. May 2007.

This article reports on a study undertaken to evaluate patients’ perceptions of end-stage renal disease (ESRD). The authors note that the problem of noncompliance to hemodialysis is a pervasive problem in the renal community and is characterized by missed and shortened treatments. They approach this problem by considering ways to identify the patients’ unique needs and to then incorporate those needs into the delivery of dialysis care, in hopes of increasing patient adherence to treatment. The social workers at the University of South Florida Dialysis Center created and implemented a questionnaire that was designed to find out patients’ confidence in and perception of success levels of specific aspects of treatment. The participants were 54 patients (n = 27 males), ranging in age from 22 to 86, with a mean age of 51. The majority of patients, 70 percent, were African-American, followed by 13 percent Caucasian and 11 percent Hispanic. Medication, diet, fluid restrictions, and treatment were addressed separately. Diet represented the prescribed treatment regimen that patients felt the least successful with; fluid was the next area of treatment that patients where felt minimal success. The authors conclude that the implications of this survey are that patients’ perceptions do not coincide with their perceived self-efficacy. Although patients’ responses indicate that they are aware of the importance of adhering to treatment and possess the self-confidence to successfully carry out treatment regimens, success may be limited due to their degree of noncompliance. The authors conclude with a brief discussion of the study limitations and the implications of the results for interdisciplinary health teams who are working to improve patient adherence to treatment regimens. 5 figures. 3 tables. 8 references.

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Expecting the Worst: How Disaster Management is Taking the Kidney Community by Storm. Nephrology News & Issues. 21(10): 44, 46, 50. September 2007.

This article reviews increased attention to disaster management in the kidney community. Partially stimulated by the experiences after Hurricane Katrina, disaster preparedness protocols are being established and reviewed by dialysis centers and other providers of medical care. The author notes that without power and clean water, the basic requirements for dialysis are not possible. The author shares the disaster management protocol used at the Fresenius Medical Care centers, nearly 100 of which were affected by Hurricanes Katrina and Rita. Their protocol includes contracts with generator companies, water companies, and gasoline companies, and the use of a patient disaster preparedness hotline. The article briefly describes the work of the Kidney Community Emergency Response (KCER) Coalition, a group working to minimize disruption to dialysis and transplant services in emergencies. KCER’s website is at www.KCERCoalition.com. The author concludes by reminding readers of the importance of individual patient preparation for emergencies. One sidebar considers whether non-clinic-based dialysis would be a better option in disaster-prone areas. 3 figures.

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Experience and Evidence: Is There Enough to Support Funding Daily In-Center Dialysis?. Nephrology News & Issues. 21(12): 42-47. November 2007.

Recent evidence has demonstrated the health benefits of short daily hemodialysis (sDHD) sessions at home. This article considers whether there is enough evidence to support the funding of in-center dialysis undertaken on a daily basis, rather than the traditional schedule of three times weekly. The authors describe the Humber River Regional Hospital in Toronto, Ontario, Canada, which has an in-center daily dialysis program that offers services to 31 patients. They discuss the experiences of patients, the challenges for the health care team, and funding issues. Although the increased obligation of traveling daily to the dialysis center seems overwhelming, patients report there is a net gain in hours of productivity and well-being. sDHD has been shown to result in improvements in blood pressure and cardiac function. The authors conclude that although daily hemodialysis at home has a better financial and social benefit profile, daily in-center dialysis appears to be a good option for older and frailer patients. Renal providers are encouraged to advocate for funding for this modality that could eventually provide for the best outcomes with the lowest overall expenditures of public dollars. 11 references.

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Feasibility of Using a Personal Digital Assistant to Self-Monitor Diet and Fluid Intake: A Pilot Study. Nephrology Nursing Journal. 34(1): 43-48. January-February, 2007.

This continuing education article considers the feasibility of using a personal digital assistant (PDA) to self-monitor diet and fluid intake in people on hemodialysis therapy. The authors note that patients are often provided with lists of foods to avoid, alternative cooking strategies, or suggestions on how to improve food flavor, but the day-to-day implementation of the complex diet is challenging for patients. The authors conducted a pilot study with three patients on hemodialysis who self-monitored diet and fluid intake for 12 weeks with a PDA. The intervention was delivered as intended and the pilot study demonstrated that patients on hemodialysis can successfully learn to use a PDA to self-monitor their diet and fluid intake. However, the existing market product chosen for the study had several problems related to usability that would have to be addressed for this chronically ill population before proceeding to a formal test of effectiveness. A posttest with which readers can qualify for continuing education credits is appended to the article. 4 tables. 19 references.

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Home Dialysis Was Right For Me! At Home with AAKP. 1(1): 10-11. October 2007.

This article is from a new magazine about the use of home dialysis for patients with kidney disease. In the article, the author shares the experience of one patient who chose home dialysis for his kidney disease, which occurred secondary to diabetes. As a registered nurse, the patient, Keith Sloan, knew that hypertension and diabetes were leading causes of kidney disease. Despite support from his family and workplace, Keith found that the combination or working and doing in-center dialysis were too difficult to maintain. He and his wife, also a nurse, learned about home hemodialysis and implemented it as the standard of his treatment. He describes the adjustments to his new schedule, the benefits of home hemodialysis in terms of energy level and lifestyle, and his eventual treatment with a kidney transplant. A final section describes how Keith and his wife are speaking to kidney patient groups about home dialysis and its benefits. The article is illustrated with full-color photographs of Keith and his wife on a sailboat. 1 figure.

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