Related Experiment Video
Updated: Jul 15, 2026
09:00
Microdissection of Primary Renal Tissue Segments and Incorporation with Novel Scaffold-free Construct Technology
Published on: March 27, 2018
How end-stage renal disease (ESRD)-medicare developed
1Georgetown University School of Medicine, Washington, DC, USA.
Summary
Uremia, a toxic condition from kidney or systemic diseases, can be fatal. Dialysis and transplantation emerged as treatments, leading to the development of end-stage renal disease (ESRD) Medicare.
Area of Science:
- Nephrology
- Toxicology
- Medical History
Background:
- Uremia is a severe, toxic condition resulting from numerous kidney and systemic diseases, historically challenging medical understanding and treatment.
- Despite its fatal nature, uremia has been a persistent medical challenge since ancient times, driving efforts to prolong patient lifespans.
Observation:
- The development of dialysis and kidney transplantation provided effective, albeit complex and costly, treatments for uremia.
- Catastrophic events like crush syndrome and nephritis during wartime highlighted the urgent need for advanced uremia treatments.
Findings:
- The evolution of substitution therapy for uremia involved integrating clinical, basic science, and industrial technology.
- The legislative establishment of end-stage renal disease (ESRD) coverage, known as ESRD-Medicare, provided a framework for widespread treatment access.
Implications:
- The development of ESRD-Medicare represents a significant societal and governmental response to a critical medical need.
- Understanding the historical progression of uremia treatment, including the political and social organization, offers insights into medical policy development.
Related Concept Videos
01:27Dialysis
Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
01:28Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration
Glomerular filtration rate (GFR) can be estimated from serum creatinine using the modification of diet in renal disease (MDRD) formula or the chronic kidney disease–epidemiology collaboration (CKD–EPI) equation. Both methods are widely used in clinical practice to assess kidney function and guide treatment decisions.The MDRD equation does not require weight or height measurements and is normalized to the body surface area of 1.73 m², considered the average adult surface area. This equation is...
01:30Extracorporeal Removal of Drugs: Peritoneal Dialysis and Hemodialysis
Patients with end-stage renal disease (ESRD) or those experiencing drug overdose often require extracorporeal methods to eliminate accumulated drugs and metabolites. Hemoperfusion, hemofiltration, and dialysis are the primary techniques to rapidly remove harmful substances without disrupting the patient's fluid and electrolyte balance. For those with compromised renal function, dosage adjustments of concurrent medications may be necessary during extracorporeal drug removal.Dialysis is a process...
01:24Nephrotic Syndrome III : Nursing Management
Nursing management for nephrotic syndrome adapts as the disease progresses, with strategies evolving to address advancing symptoms and complications.Early-Stage Management In the early stages, nursing interventions for nephrotic syndrome resemble those used in managing acute glomerulonephritis, focusing on symptom monitoring, fluid balance, and managing mild to moderate edema.Vital Signs: Regularly monitor blood pressure, pulse, respiratory rate, and temperature to promptly identify...
01:25Chronic Kidney Disease I: Introduction
Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
01:28Chronic Kidney Disease III: Interprofessional Care
Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...