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Related Concept Videos

Hemodialysis III: Nursing Management01:25

Hemodialysis III: Nursing Management

The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this measurement...
Chronic Kidney Disease III: Interprofessional Care01:28

Chronic 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...
Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration01:28

Drug 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...
Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant01:25

Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant

In patients with renal disease, dosage adjustments are necessary to maintain therapeutic plasma drug concentrations and prevent toxicity or subtherapeutic exposure. Renal impairment alters drug pharmacokinetics, especially in conditions like uremia, where changes such as prolonged elimination half-life and altered apparent volume of distribution can significantly affect drug disposition. These changes require careful modification of the dosing regimen to achieve the desired clinical...
Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Drug Dosing in Renal Diseases: Measurement of Glomerular Filtration Rate01:25

Drug Dosing in Renal Diseases: Measurement of Glomerular Filtration Rate

The glomerular filtration rate (GFR) is a critical indicator of kidney health, reflecting how well the kidneys filter blood. Changes in GFR can signal potential kidney impairment, necessitating accurate measurement methods to monitor kidney function effectively.Various molecules can serve as markers for GFR measurement, with the ideal marker meeting several specific criteria. It must freely filter at the glomerulus, avoid reabsorption or secretion by the renal tubules, remain unmetabolized, not...

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Related Experiment Video

Updated: Jul 11, 2026

Evaluation of Changes in Hydration and Body Cell Mass with Bioelectrical Impedance Analysis after Exercise Program for Rheumatoid Arthritis Patients
07:44

Evaluation of Changes in Hydration and Body Cell Mass with Bioelectrical Impedance Analysis after Exercise Program for Rheumatoid Arthritis Patients

Published on: July 14, 2023

Quest for V: body composition could determine dialysis dose.

Shubho R Sarkar1, Peter Kotanko, Steven B Heymsfeld

  • 1Weill Cornell Medical Center, New York-Presbyterian Hospital, New York, New York, USA.

Seminars in Dialysis
|September 28, 2007
PubMed
Summary

Smaller dialysis patients face higher mortality. A new hypothesis suggests dialysis dose should be based on visceral organ volume, not total body size, to ensure adequate toxin clearance and improve survival rates.

Related Experiment Videos

Last Updated: Jul 11, 2026

Evaluation of Changes in Hydration and Body Cell Mass with Bioelectrical Impedance Analysis after Exercise Program for Rheumatoid Arthritis Patients
07:44

Evaluation of Changes in Hydration and Body Cell Mass with Bioelectrical Impedance Analysis after Exercise Program for Rheumatoid Arthritis Patients

Published on: July 14, 2023

Area of Science:

  • Nephrology and Metabolic Research
  • Investigating the relationship between body composition, resting energy expenditure, and mortality in chronic kidney disease (CKD) patients undergoing hemodialysis.

Background:

  • Lower body weight in dialysis patients correlates with higher mortality, prompting research into underlying mechanisms.
  • Current dialysis prescription methods, like Kt/V(urea), face challenges related to body size dependency.
  • Resting energy expenditure (REE) and its link to body composition are increasingly studied in CKD.

Discussion:

  • Explores potential mechanisms for increased mortality in smaller hemodialysis patients.
  • Discusses the hypothesis that dialysis delivery should be independent of total body size.
  • Proposes using visceral organ volume (V(organ)) as a more accurate representation of uremic toxin generation.

Key Insights:

  • Smaller patients may require a relatively higher dialysis dose (Kt/V) for equivalent uremic toxin clearance compared to larger patients.
  • Visceral organ volume may be a more appropriate determinant for dialysis prescription than total body volume.
  • Linking REE, body composition, and survival in CKD patients is crucial for understanding mortality disparities.

Outlook:

  • Further research into body composition and metabolic rate in CKD patients is warranted.
  • Developing dialysis prescription models based on organ volume could optimize treatment efficacy.
  • Investigating the impact of dialysis on REE may reveal new therapeutic targets for improving patient outcomes.