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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...
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...
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,...
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...

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Related Experiment Video

Updated: May 27, 2026

Surgical Techniques for Catheter Placement and 5/6 Nephrectomy in Murine Models of Peritoneal Dialysis
07:11

Surgical Techniques for Catheter Placement and 5/6 Nephrectomy in Murine Models of Peritoneal Dialysis

Published on: July 19, 2018

The "no dialysis" option.

Fliss E M Murtagh1, Lewis M Cohen, Michael J Germain

  • 1Department of Palliative Care, Policy & Rehabilitation, King's College London, Cicely Saunders Institute, UK.

Advances in Chronic Kidney Disease
|November 22, 2011
PubMed
Summary
This summary is machine-generated.

Many dialysis patients have poor prognoses due to age and illness. Discussing the "no dialysis" option is crucial for selecting appropriate candidates and managing their care effectively.

Related Experiment Videos

Last Updated: May 27, 2026

Surgical Techniques for Catheter Placement and 5/6 Nephrectomy in Murine Models of Peritoneal Dialysis
07:11

Surgical Techniques for Catheter Placement and 5/6 Nephrectomy in Murine Models of Peritoneal Dialysis

Published on: July 19, 2018

Area of Science:

  • Nephrology
  • Geriatric Medicine
  • Palliative Care

Background:

  • Increasing numbers of patients initiating dialysis have limited 6-month survival prognoses.
  • Multiple comorbidities, advanced age, and frailty are contributing factors to this trend.
  • The accelerating rate of dialysis withdrawal highlights concerns about patient selection and suitability for renal replacement therapy.

Purpose of the Study:

  • To evaluate the implications of initiating dialysis in patients with limited prognoses.
  • To emphasize the importance of considering and discussing the
  • no dialysis
  • option with patients and their families.
  • To identify patient populations who may benefit from conservative management and to review their medical care.

Main Methods:

  • Retrospective analysis of patient demographics and clinical data.
  • Review of treatment decisions and outcomes for patients initiating dialysis.
  • Identification of factors associated with poor prognosis in dialysis candidates.

Main Results:

  • A significant proportion of new dialysis initiators present with multiple comorbidities and frailty.
  • Patients with limited prognoses may not derive significant benefit from dialysis initiation.
  • The option of "no dialysis" requires careful consideration and individualized patient assessment.

Conclusions:

  • The current approach to dialysis initiation needs re-evaluation for patients with poor prognoses.
  • Open discussions about "no dialysis" are essential for shared decision-making and aligning care with patient goals.
  • Improved identification and management strategies are needed for frail, elderly patients considering dialysis.