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Related Concept Videos

Dialysis01:27

Dialysis

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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).
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...
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Dialysis01:15

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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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Acute Kidney Injury V: Interprofessional Care01:20

Acute Kidney Injury V: Interprofessional Care

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Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
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Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

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Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
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Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

236
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
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Hemodialysis III: Nursing Management01:25

Hemodialysis III: Nursing Management

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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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Related Experiment Video

Updated: Jan 5, 2026

Surgical Techniques for Catheter Placement and 5/6 Nephrectomy in Murine Models of Peritoneal Dialysis
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Rationale and Strategies for Preserving Residual Kidney Function in Dialysis Patients.

Tian Li1, Christopher S Wilcox2, Michael S Lipkowitz2

  • 1Department of Medicine, State University of New York Downstate Medical Center, Brooklyn, New York, USA.

American Journal of Nephrology
|October 21, 2019
PubMed
Summary
This summary is machine-generated.

Residual kidney function (RKF) in dialysis patients improves survival and quality of life. Accurately measuring RKF and identifying factors that preserve it are crucial for individualized therapy in end-stage renal disease (ESRD).

Keywords:
End-stage renal diseaseGlomerular filtration rateIncremental dialysisRenal Kt/VUrine volume

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Area of Science:

  • Nephrology
  • Renal Medicine
  • Dialysis Therapy

Background:

  • Residual kidney function (RKF) offers survival benefits in dialysis patients, though mechanisms are not fully understood.
  • Proposed mechanisms include improved volume control, clearance of middle molecules, reduced inflammation, and preserved hormone production.
  • Accurate RKF measurement is vital for identifying loss factors and preservation strategies, enabling personalized treatment.

Purpose of the Study:

  • To review the definition and measurement of RKF, including novel markers.
  • To discuss predictors of RKF loss in new dialysis patients.
  • To explore strategies for preserving RKF in hemodialysis (HD) and peritoneal dialysis (PD) patients.

Main Methods:

  • Literature review of RKF definition, measurement techniques, and preservation strategies.
  • Discussion of proposed RKF measurement markers (e.g., beta2-microglobulin, cystatin C).
  • Analysis of interventions like renin-angiotensin-aldosterone system blockade and biocompatible dialysis components.

Main Results:

  • The average of renal creatinine and urea clearance is a superior RKF estimate compared to urine volume, though 24-h urine collection is challenging.
  • Several strategies, including incremental dialysis and biocompatible materials, are reviewed for RKF preservation.
  • The impact of blood pressure, diuretics, diet, and dialysis modality on RKF requires further clarification.

Conclusions:

  • RKF is a significant prognostic indicator for reduced morbidity, mortality, and improved quality of life in both PD and HD patients.
  • Further research is needed to identify factors influencing RKF.
  • Preserving RKF can lead to better patient outcomes and cost reductions through personalized medicine.