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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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Dialysis01:27

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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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Hemodialysis III: Nursing Management01:25

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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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Hemodialysis II: Procedure and Complications01:24

Hemodialysis II: Procedure and Complications

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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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Peritoneal Dialysis III: Nursing Management01:25

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Peritoneal dialysis, or PD, utilizes the peritoneal membrane as a filter to eliminate excess fluid and waste products. Effective nursing management is essential for ensuring patient safety, preventing complications, and promoting optimal function of the peritoneal dialysis process.Assessment and MonitoringNurses must thoroughly assess the patient before, during, and after each dialysis session. Regular monitoring includes vital signs, daily weight, fluid intake and output, and laboratory values...
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Perspectives in Individualizing Solutions for Dialysis Access.

Silvi Shah1, Micah R Chan2, Timmy Lee3

  • 1Division of Nephrology, Kidney C.A.R.E. (Clinical Advancement, Research and Education) Program, University of Cincinnati, Cincinnati, OH.

Advances in Chronic Kidney Disease
|September 6, 2020
PubMed
Summary
This summary is machine-generated.

New guidelines emphasize a patient-centered approach for dialysis vascular access, focusing on individual needs and timely interventions. This patient-first strategy aims to optimize hemodialysis care by selecting the right access for each unique patient.

Keywords:
Dialysis catheterDisparitiesKidney transplantPeritoneal dialysisarteriovenous access

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Area of Science:

  • Nephrology
  • Vascular Surgery
  • Patient Care

Background:

  • Vascular access is critical for hemodialysis patients.
  • Previous guidelines prioritized arteriovenous fistulas.
  • New Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines adopt a patient-first, life-plan approach.

Purpose of the Study:

  • To review individualized solutions for dialysis vascular access.
  • To address unmet needs in patient-centered vascular access care.
  • To explore opportunities presented by biomedical advances.

Main Methods:

  • Review of current literature and emerging trends in vascular access.
  • Analysis of the shift towards patient-centered care in KDOQI guidelines.
  • Identification of key areas for individualized vascular access solutions.

Main Results:

  • The new KDOQI guidelines focus on "right access, right patient, right time, right reason."
  • Advances in technology offer new ways to personalize vascular access.
  • Unmet needs exist in biological approaches, post-transplant care, and addressing disparities.

Conclusions:

  • A patient-centered approach is essential for optimizing dialysis vascular access.
  • Individualized solutions are needed for biological selection, post-transplant care, and addressing disparities in race, gender, and age.
  • Future research should focus on these areas to improve patient outcomes.