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Related Concept Videos

Dialysis01:27

Dialysis

780
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

Dialysis

979
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...
979
Hemodialysis III: Nursing Management01:25

Hemodialysis III: Nursing Management

325
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...
325
Extracorporeal Removal of Drugs: Peritoneal Dialysis and Hemodialysis01:30

Extracorporeal Removal of Drugs: Peritoneal Dialysis and Hemodialysis

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Patients with end-stage renal disease (ESRD) or those experiencing drug overdose often require extracorporeal methods to eliminate accumulated drugs and metabolites. Hemoperfusion, hemofiltration, and dialysis are the primary techniques to rapidly remove harmful substances without disrupting the patient's fluid and electrolyte balance. For those with compromised renal function, dosage adjustments of concurrent medications may be necessary during extracorporeal drug removal.Dialysis is a process...
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Hemodialysis II: Procedure and Complications01:24

Hemodialysis II: Procedure and Complications

231
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 II: Peritoneal Dialysis Systems and Complications01:25

Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications

174
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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Surgical Techniques for Catheter Placement and 5/6 Nephrectomy in Murine Models of Peritoneal Dialysis
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Withdrawal from Dialysis: Why and When?

Mohan V Bhojaraja1, Pankaj Singhai2, M M Sunil Kumar3

  • 1Department of Nephrology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.

Indian Journal of Palliative Care
|June 30, 2021
PubMed
Summary
This summary is machine-generated.

Patients with end-stage kidney disease may withdraw from dialysis. Shared decision-making and proactive screening help healthcare providers navigate ethical dilemmas and choose between dialysis and conservative care.

Keywords:
Decision-makingdialysispalliative carewithdrawal

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Area of Science:

  • Nephrology
  • Bioethics
  • Palliative Care

Background:

  • End-stage kidney disease (ESKD) patients may opt to withdraw from dialysis.
  • Healthcare providers face ethical challenges balancing patient autonomy and beneficence.
  • Decision-making regarding dialysis withdrawal requires careful consideration of patient wishes and medical condition.

Purpose of the Study:

  • To explore ethical considerations in dialysis withdrawal for ESKD patients.
  • To highlight the importance of shared decision-making in end-of-life care for kidney patients.
  • To propose proactive identification guidelines for managing dialysis withdrawal.

Main Methods:

  • Review of ethical dilemmas in dialysis withdrawal.
  • Discussion of shared decision-making models.
  • Proposal for proactive screening guidelines.

Main Results:

  • Shared decision-making and goal-of-care discussions are crucial for patient-centered choices.
  • Proactive identification guidelines can aid in evaluating dialysis versus conservative care options.
  • An individualized, patient-centered approach is recommended over a disease-oriented one.

Conclusions:

  • Ethical decision-making in dialysis withdrawal requires balancing patient autonomy and beneficence.
  • Proactive identification and patient-centered discussions are key to supporting patients nearing end-of-life.
  • Conservative care should be considered as a viable option alongside dialysis.