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Related Concept Videos

Dialysis01:27

Dialysis

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...
Dialysis01:15

Dialysis

Dialysis is a diffusion-based purification process that separates analyte molecules from a complex matrix. This is accomplished by allowing molecules in the solution to pass through a semipermeable membrane into a liquid on the other side. The membrane is usually made of cellulose acetate or cellulose nitrate, and the second liquid must be miscible with the solution. Ions (e.g., chloride or sodium) or organic molecules (e.g., glucose) can pass through the membrane pores, which generally have...
Hemodialysis I: Introduction01:25

Hemodialysis I: Introduction

Hemodialysis (HD) is a medical treatment that artificially removes waste products, excess fluids, and toxins from the blood when the kidneys are no longer able to perform these functions effectively. In this process, blood is filtered through a semipermeable membrane, allowing for the selective removal of waste while preserving necessary components like blood cells and proteins. Hemodialysis is typically performed in patients with end-stage renal disease (ESRD) or severe kidney...
Hemodialysis II: Procedure and Complications01:24

Hemodialysis II: Procedure and Complications

DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
Extracorporeal Removal of Drugs: Peritoneal Dialysis and Hemodialysis01:30

Extracorporeal 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...
Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications01:25

Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications

Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...

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A Retrograde Implantation Approach for Peritoneal Dialysis Catheter Placement in Mice
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A Retrograde Implantation Approach for Peritoneal Dialysis Catheter Placement in Mice

Published on: July 20, 2022

Selection bias explains apparent differential mortality between dialysis modalities.

Robert R Quinn1, Janet E Hux, Matthew J Oliver

  • 1University of Calgary, Foothills Medical Centre, Calgary, Alberta, T2N 2T9 Canada. rob.quinn@albertahealthservices.ca

Journal of the American Society of Nephrology : JASN
|July 26, 2011
PubMed
Summary
This summary is machine-generated.

Peritoneal dialysis and hemodialysis show similar survival rates for elective patients starting treatment after careful preparation. Previous studies may have been biased by how patients began dialysis urgently.

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A Murine Model of Hemodialysis Access-Related Hand Dysfunction
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A Murine Model of Hemodialysis Access-Related Hand Dysfunction

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Last Updated: May 30, 2026

A Retrograde Implantation Approach for Peritoneal Dialysis Catheter Placement in Mice
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Published on: July 20, 2022

A Murine Model of Hemodialysis Access-Related Hand Dysfunction
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A Murine Model of Hemodialysis Access-Related Hand Dysfunction

Published on: May 31, 2022

Area of Science:

  • Nephrology
  • Clinical Epidemiology
  • Public Health

Background:

  • Dialysis modality choice impacts patient survival.
  • Urgent dialysis initiation introduces bias in mortality comparisons.
  • Previous studies suggest varying risks between peritoneal dialysis (PD) and hemodialysis (HD) over time.

Purpose of the Study:

  • To compare mortality risk between PD and HD.
  • To isolate the association between dialysis modality and mortality.
  • To investigate if the relative risk changes with treatment duration in carefully selected patients.

Main Methods:

  • Retrospective cohort study of 32,285 dialysis patients in Ontario, Canada.
  • Focused analysis on 6,573 patients with elective, outpatient initiation and ≥4 months predialysis care.
  • Adjusted for baseline characteristics to compare survival between PD and HD.

Main Results:

  • No significant difference in survival was detected between PD and HD in the primary analysis.
  • The relative risk of death did not change with duration of therapy in the selected cohort.
  • Time-dependent risk changes were observed when using more inclusive patient criteria, typical of prior research.

Conclusions:

  • PD and HD are associated with similar survival outcomes for incident dialysis patients initiating treatment electively after adequate predialysis care.
  • Selection bias, particularly from urgent dialysis starts, likely explains previously reported time-dependent differences in mortality risk.
  • Findings suggest modality choice may be less critical for survival than patient selection and preparation.