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Related Concept Videos

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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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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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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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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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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Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
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Is Twice-weekly Maintenance Hemodialysis Justified?

Satish Mendonca1, Shweta Bhardwaj2, S Sreenivasan2

  • 1Department of Nephrology, Army Hospital (Research and Referral), New Delhi, India.

Indian Journal of Nephrology
|May 17, 2021
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Summary

Twice-weekly hemodialysis initiation is a viable option, particularly for patients with good residual renal function. This approach maintains stable biochemical and hematological parameters, supporting patient quality of life and access longevity.

Keywords:
Adequacy of dialysisresidual renal functionsurvivaltwice-weekly hemodialysis

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Area of Science:

  • Nephrology
  • Renal Replacement Therapy
  • Public Health

Background:

  • Twice-weekly hemodialysis offers benefits in access longevity, residual renal function preservation, cost-effectiveness, and patient quality of life.
  • This regimen is common in developing nations due to resource limitations.
  • A 3-year follow-up study evaluated outcomes of patients starting on twice-weekly hemodialysis.

Purpose of the Study:

  • To assess the long-term outcomes of patients initiated on a twice-weekly hemodialysis schedule.
  • To evaluate the adequacy of dialysis, cost-effectiveness, and impact on hematological and biochemical parameters over 3 years.

Main Methods:

  • A 3-year observational follow-up of 88 incident hemodialysis patients.
  • Monthly monitoring of dialysis adequacy, hematological, and biochemical parameters.
  • Patients were switched to thrice-weekly hemodialysis if complications arose.

Main Results:

  • Adequate spKt/V and eKt/V were achieved in 68.54% and 48.34% of patients, respectively.
  • Mean hemoglobin was 9.53 g/dl; 74.88% experienced hyperphosphatemia.
  • Mortality rate was 27.27% over 3 years, with a mean time to mortality of 503 days.

Conclusions:

  • Initiating maintenance hemodialysis twice-weekly is a feasible strategy, especially for patients with preserved residual renal function.
  • Biochemical and hematological parameters remained stable and within KDOQI guidelines throughout the study.
  • This approach supports access longevity and patient well-being, with flexibility to increase frequency if needed.