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Your search term(s) "Dialysis" returned 150 results.
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Optimizing Dialysis in Pediatric Patients. In: Clinical Dialysis. 4th ed. New York, NY: McGraw-Hill. 2005. pp. 203-222.
This chapter on optimizing dialysis in pediatric patients is from a textbook on the clinical management of patients on dialysis. The author reviews the current information available on the optimal approach to the prescription and quantification of peritoneal dialysis (PD), the predominant mode of dialysis therapy for children through early adolescence. The author presents data on the kinetics of PD, the basis for the peritoneal equilibration test (PET), and the role of this information in the dialysis prescription. A final section covers the prescription of hemodialysis (HD), with specific emphasis on issues of importance to the pediatric population. Specific topics include peritoneal membrane function in children, scaling factor for kinetic studies, the peritoneum as a dialyzing membrane, mass transfer area coefficient, ultrafiltration and convection, peritoneal fluid and lymphatic absorption, principles of the peritoneal equilibration test, pediatric PET procedure, solute equilibration in children, and the adequacy of peritoneal dialysis. The author concludes that in both HD and PD, optimization in children can be achieved only if the dialysis prescription is individualized and based on the patient’s clinical status and some measure of dialysis delivery. 7 figures. 2 tables. 138 references.
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Options for Patients with Kidney Failure. IN: Danovitch, G.M. Handbook of Kidney Transplantation. Philadelphia, PA: Lippincott Williams and Wilkins. 2005. pp. 1-22.
This chapter, from a handbook that offers a practical guide for health care providers who manage kidney transplant patients, outlines the current treatment options for patients with kidney failure. The authors stress that for most patients with kidney failure, kidney transplantation has the greatest potential for restoring a healthy, productive life. However, virtually all transplant recipients have been exposed, at least to some extent, to the adverse consequences of chronic kidney disease (CKD). This must be taken into consideration when planning for renal replacement therapy. The authors review the stages of CKD, demographics of the end-stage renal disease (ESRD) population, hemodialysis, peritoneal dialysis, long-term complications of dialysis (anemia, renal osteodystrophy, uremic neuropathy, amyloidosis, acquired cystic disease, cancer of the kidney and urinary tract, dialysis access failure), transplantation considerations including patient survival, and choosing an appropriate renal replacement therapy. 6 figures. 3 tables. 16 references.
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Oxidative Stress in Chronic Kidney Disease. Nephrology Nursing Journal. 32(6): 683-685. November-December 2005.
Oxidative stress is physiological stress on the body that is caused by the cumulative damage done from free radicals inadequately neutralized by antioxidants. Oxidative stress is commonly associated with the process of aging, but also appears to be increased in persons with chronic kidney disease (CKD) as well as in other chronic diseases, including cancer, heart disease, Parkinson's disease, and depression. This article reviews the problem of oxidative stress in CKD, which is considered a major risk factor, particularly for patients on dialysis. The authors focus on the causes, including nutritional factors, the complications of, and treatment options for oxidative stress. Treatment of oxidative stress includes antioxidant therapy, consisting primarily of vitamin E and vitamin C. These therapies remain controversial and there have been few studies that investigate their use in the CKD population. However, the authors conclude that there is no doubt that correcting the oxidant-antioxidant imbalance in patients with CKD is an important approach to consider for reducing their risk of developing cardiovascular problems. 29 references.
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Parathyroid Hormone, Vitamin D, and Metabolic Bone Disease in Dialysis Patients. In: Clinical Dialysis. 4th ed. New York, NY: McGraw-Hill. 2005. pp. 831-854.
Chronic kidney disease (CKD) leads to disturbances in the homeostatic balance and abnormalities in the parathyroid hormone (PTH) and vitamin D systems; these can result in a spectrum of bone disorders called renal osteodystrophy. This chapter on metabolic bone disease in dialysis patients is from a comprehensive textbook on the clinical management of patients on dialysis. The authors review the advances of the past decade that have led to changes in clinical practice guidelines for the prevention and treatment of renal osteodystrophy. Topics include the epidemiology and pathogenesis of renal osteodystrophy, including abnormalities of phosphorus metabolism, abnormalities of vitamin D metabolism, abnormalities of parathyroid gland function, and abnormal skeletal response to parathyroid hormone; adynamic bone disease and osteomalacia (low-bone-turnover renal osteodystrophy); other factors contributing to metabolic bone disease, including metabolic acidosis, corticosteroids, and growth factors and cytokines; the clinical manifestations of renal osteodystrophy, including musculoskeletal symptoms, metastatic and extraskeletal calcifications, and dialysis-related amyloidosis; the diagnosis and assessment of renal osteodystrophy; and clinical management strategies. Efforts for optimum treatment of patients on dialysis include avoiding the oversuppression of PTH, adjusting dialysate calcium, treating any existing acidosis, and using serial evaluations of bone mineral density. 4 figures. 287 references.
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Pediatric ESRD Peritoneal Dialysis Fact Sheet. Pitman, NJ: American Nephrology Nurses Association. 2005. 4 p.
This fact sheet from the American Nephrology Nurses' Association (ANNA) provides information for classroom teachers, school nurses, and other caregivers about children who are undergoing peritoneal dialysis (PD) as treatment for end-stage renal disease (ESRD). The fact sheet introduces ESRD and its treatments and outlines the different types of PD and their indications. Specific topics include continuous ambulatory peritoneal dialysis (CAPD), automated peritoneal dialysis (APD), care of the peritoneal dialysis catheter, blood pressure control, and common medications used in children on dialysis. The fact sheet includes space to individualize the information about a specific child who may be in the classroom. Readers are referred to the ANNA website at www.annanurse.org for more information.
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Pediatric Hemofiltration. In: Clinical Dialysis. 4th ed. New York, NY: McGraw-Hill. 2005. pp. 1013-1020.
This chapter on pediatric hemofiltration (HF) is from a comprehensive textbook on the clinical management of patients on dialysis. The authors begin with a discussion of the three modes of dialysis (hemodialysis, peritoneal dialysis, and hemofiltration) and the choices to be made for pediatric patients in the acute care setting. The authors then discuss continuous renal replacement therapy (CRRT), continuous venovenous hemofiltration (CVVH), continuous venovenous hemofiltration with dialysis (CVVHD), ultrafiltration, equipment, membranes for HF, tubing, access, dialysate solutions, anticoagulation therapy, nutrition in CRRT, drug clearance, the complications of HF, and expected outcomes in acute renal failure (ARF). The authors conclude that CRRT is effective for the treatment of fluid and solute management in ARF and multi-organ system failure (MOSF). Early intervention with CRRT characterized by aggressive replacement and dialysis fluid parameters as well as the use of citrate anticoagulation results in superior patient outcomes. 2 tables. 26 references.
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Peritoneal Access Devices: Design, Function, and Placement Techniques. In: Clinical Dialysis. 4th ed. New York, NY: McGraw-Hill. 2005. pp. 309-356.
A successful peritoneal access device must transfer large volumes of dialysate into and out of the peritoneal cavity in a minimal amount of time while maintaining normal anatomy, histology, bacteriology, and physiology of the surrounding tissues. This chapter on the design, function, and placement techniques of peritoneal access devices is from a textbook on the clinical management of dialysis patients. The authors discuss fluid flow in peritoneal catheters, the hydraulic function and biocompatibility of catheters, the history and chronology of peritoneal dialysis (PD) catheters, the current design of PD catheters, complications related to PD catheters, the placement of catheters for chronic PD (preoperative care and surgical techniques), postoperative catheter care, the effects of placement techniques on the success of catheters for chronic PD, new placement techniques, management of catheter complications, and removing peritoneal catheters. Complications discussed include exit site infection, cuff extrusion, tunnel tract infection, relapsing peritonitis, mechanical flow dysfunction, and abdominal wall hernias and leaks. 21 figures. 2 tables. 229 references.
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Peritoneal Dialysis in Pediatric Patients. In: Clinical Dialysis. 4th ed. New York, NY: McGraw-Hill. 2005. pp. 514-552.
This chapter on peritoneal dialysis (PD) in pediatric patients is from a comprehensive textbook on the clinical management of patients on dialysis. The author notes that patient selection plays an important part in determining whether a child is placed on PD. If PD is an option for the treatment of chronic renal failure, the psychosocial determinants of the child and his or her family are important. Age, maturation, distance from the dialysis center, and other family characteristics influence the balance of choice between PD and HD. The author explains the components of a typical PD system and the dialysate used, then discusses the different types of PD, the PD prescription, and complications of this therapy. The ultimate goal of dialysis in pediatric patients is renal transplantation, and children on PD are as good candidates for transplantation as those on HD. New dialysis fluids are being developed, and bicarbonate-buffered solutions as well as solutions containing isodextrin are of benefit to patients. Attention to the adequacy of dialysis has led to intensification of the dialysis prescription schedules. 1 figure. 1 table. 151 references.
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Physician's Guide to Medicare Coverage of Kidney Dialysis and Kidney Transplant Services. Baltimore, MD: Centers for Medicare and Medicaid Services. May 2005. 49 p.
This booklet provides information 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. The booklet explains how Medicare helps pay for kidney dialysis and kidney transplant services in the Original Medicare Plan, also known as fee-for-service. If the patients are in a Medicare Advantage Plan—the new name for Medicare plus Choice—which includes Medicare Managed Care Plans, Medicare Private Fee-for-Service Plans, and Medicare Preferred Provider Organization Plans, their plan must give them at least the same coverage as the Original Medicare Plan, but it may have different rules. The booklet includes 11 sections: Medicare basics, Medicare legislation, kidney dialysis, kidney transplants, how Medicare pays for blood, appeals and grievances, other kinds of health insurance, where to get more information, Medicare coverage charts, key definitions—a glossary of terms—and a subject index. The booklet also includes extensive charts and tables that present the information in summarized form.
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Physiology of Peritoneal Dialysis. In: Clinical Dialysis. 4th ed. New York, NY: McGraw-Hill. 2005. pp. 357-384.
This chapter on the physiology of peritoneal dialysis (PD) is from a textbook on the clinical management of dialysis patients. The author discusses the anatomy of the peritoneum, the primary functions of the peritoneum, the peritoneum as a dialysis system, resistance of the peritoneum to solute and water transport, ultrafiltration, solute transport by convection, measurements of peritoneal functions, and peritoneal function after long-term exposure to PD solutions. The author notes that long-term PD is associated with progressive loss of ultrafiltration capability. This may be due to the toxicity of glucose. Replacing glucose with other osmotic agents, changing the sterilization process, replacing the lactate buffer with bicarbonate, and blocking the formation of glucose degradation products (GPDs) may improve membrane preservation during long-term PD management. 12 figures. 3 tables. 227 references.
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