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Related Concept Videos

Hemodialysis I: Introduction01:25

Hemodialysis I: Introduction

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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...
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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).
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Diabetic Nephropathy01:28

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Definition Diabetic nephropathy is a chronic kidney complication that results from prolonged hyperglycemia.Prevalence It is the most common cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD) worldwide, affecting up to half of individuals with diabetes.Pathophysiology • Sustained hyperglycemia triggers multiple hemodynamic and metabolic changes in the kidney. • Early in the disease, increased renal blood flow and glomerular hyperfiltration...
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Hemodialysis II: Procedure and Complications01:24

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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,...
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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...
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Chronic Kidney Disease I: Introduction01:25

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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...
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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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Decrease rate of the renal diameter in chronic hemodialysis patients.

Teiichiro Aoyagi1, Masaaki Tachibana2, Shinji Naganuma3

  • 1Department of Urology, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo Ami, Ibaraki, Inashiki 300-0395, Japan.

ISRN Nephrology
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Summary

Chronic hemodialysis (HD) patients experienced an average annual decrease of 4.3 mm in renal diameter. This shrinkage rate slowed significantly with longer durations of HD treatment.

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Area of Science:

  • Nephrology
  • Radiology
  • Urology

Background:

  • Chronic hemodialysis (HD) is a life-sustaining treatment for end-stage renal disease.
  • Understanding kidney size changes in HD patients is crucial for monitoring disease progression and treatment effects.
  • Previous studies have not extensively detailed renal diameter alterations over time in HD populations without specific kidney diseases.

Purpose of the Study:

  • To evaluate the longitudinal changes in renal diameter among chronic hemodialysis patients.
  • To determine the rate of renal diameter alteration and identify factors influencing it.
  • To investigate the relationship between hemodialysis vintage and the rate of renal size decrease.

Main Methods:

  • Ultrasonography (US) was used to measure the maximum renal diameter in 109 chronic HD outpatients.
  • Patients without severe acquired cystic kidney disease or hereditary polycystic kidney disease were included.
  • Renal diameter measurements were taken 2-3 times, with an average interval of 35.9 months, to calculate the yearly alteration rate.

Main Results:

  • The average decrease rate of renal diameter was 4.34 ± 0.4 mm/year.
  • No significant differences in the decrease rate were observed based on gender, age, or the underlying cause of kidney disease.
  • A higher decrease rate was noted when measurements were taken closer to the initiation of HD, indicating a slowing trend with increased hemodialysis vintage.

Conclusions:

  • Renal diameter progressively decreases in chronic HD patients, averaging approximately 4.3 mm annually.
  • The rate of renal diameter reduction is inversely related to the duration of hemodialysis treatment.
  • These findings highlight the impact of long-term hemodialysis on kidney morphology and suggest that renal size stabilization may occur with prolonged treatment duration.