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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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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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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...
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Hemodialysis I: Introduction01:25

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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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Chronic Kidney Disease IV: Nursing Management01:18

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Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care​.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of...
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Measurement of Tissue Oxygenation Using Near-Infrared Spectroscopy in Patients Undergoing Hemodialysis
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Hemodynamics During Dialysis and Changes in Cognitive Performance.

Dawn Wolfgram, Elisabeth Vogt, Allison L Jahn

    WMJ : Official Publication of the State Medical Society of Wisconsin
    |November 3, 2017
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    Summary
    This summary is machine-generated.

    Cognitive function in hemodialysis patients remained stable over one year. Blood pressure changes during dialysis did not significantly impact cognitive outcomes, though fluid removal rates showed a minor association with executive function.

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    Area of Science:

    • Nephrology
    • Neuroscience
    • Gerontology

    Background:

    • Hemodialysis (HD) patients face higher risks of cognitive impairment.
    • Blood pressure (BP) fluctuations during HD may impact cerebral perfusion and cognitive function.

    Purpose of the Study:

    • To investigate the link between intradialytic hemodynamics and cognitive outcomes over one year in HD patients.
    • To analyze the association between BP and ultrafiltration rate (UFR) changes and cognitive performance.

    Main Methods:

    • A cohort of 50+ year old HD patients without dementia underwent neurocognitive testing at baseline and 1-year follow-up.
    • Demographic, laboratory, and intradialytic BP and UFR data were collected.
    • Linear regression analysis assessed the association between hemodynamic variables and cognitive changes.

    Main Results:

    • Cognitive test scores showed no significant changes from baseline to 1 year.
    • No association was found between BP measures and cognitive changes.
    • Ultrafiltration rate (UFR) was associated with changes in executive functioning test performance.

    Conclusions:

    • Cognitive function in prevalent HD patients is generally stable over a 1-year period.
    • Intradialytic hemodynamic variables, including BP fluctuations, were not associated with cognitive changes.