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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,...
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...
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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Laparoscopic-Assisted Seldinger Technique for Peritoneal Dialysis Catheter Insertion
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Differences between dialysis modality selection and initiation.

Scott E Liebman1, David A Bushinsky, James G Dolan

  • 1Department of Medicine, Division of Nephrology, University of Rochester, Rochester, NY, USA. scott_liebman@urmc.rochester.edu

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|February 7, 2012
PubMed
Summary
This summary is machine-generated.

Many patients choosing peritoneal dialysis (PD) after education still start hemodialysis (HD). Age over 75, non-white race, and non-glomerular causes of end-stage renal disease (ESRD) predict this HD initiation.

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Area of Science:

  • Nephrology
  • Renal Replacement Therapy
  • Patient Education

Background:

  • Dialysis modality education typically increases peritoneal dialysis (PD) use.
  • However, some patients who choose PD initiate hemodialysis (HD) instead.
  • Predictors for this discrepancy require identification.

Purpose of the Study:

  • To identify factors associated with patients selecting PD but starting HD therapy.
  • To determine predictors of HD use at day 91 among patients who initially chose PD.

Main Methods:

  • Retrospective cohort study of 217 patients receiving dialysis modality education.
  • Collected demographic, social, and clinical data.
  • Multivariable analysis to identify predictors of HD initiation and use at day 91.

Main Results:

  • Of 124 patients choosing PD, 65 started HD.
  • Predictors for starting HD included non-glomerular ESRD, age >75, and unemployment.
  • Predictors for HD use at day 91 included age >75, non-white race, and non-glomerular ESRD.

Conclusions:

  • A significant number of patients choosing PD do not initiate with this modality.
  • Age, race, employment status, and ESRD cause are associated with modality mismatch.
  • Further research is needed to understand and address this discrepancy.