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Related Concept Videos

Peritoneal Dialysis III: Nursing Management01:25

Peritoneal Dialysis III: Nursing Management

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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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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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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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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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Peritoneal dialysis (PD) is a procedure that facilitates the exchange of solutes, waste products, electrolytes, and excess fluid between the blood in the peritoneal capillaries and a dialysis solution introduced into the peritoneal cavity.Principles of Peritoneal Dialysis (PD)Diffusion: Waste products such as urea and electrolytes move from high concentrations in the blood to low concentrations in the dialysate across the peritoneal membrane. This mechanism is driven by the concentration...
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Vitamin D Toxicity Managed with Peritoneal Dialysis.

Krystel Feghali1, Kostas Papamarkakis2, Jackson Clark3

  • 1Department of Endocrinology, Diabetes and Metabolism, University of Massachusetts Medical School, Baystate Medical Center, Springfield, MA, USA.

Case Reports in Endocrinology
|July 14, 2021
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Summary

Vitamin D toxicity can cause severe hypercalcemia. Peritoneal dialysis, though typically causing vitamin D deficiency, effectively resolved hypercalcemia in a patient with vitamin D toxicity.

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Area of Science:

  • Nephrology
  • Endocrinology
  • Toxicology

Background:

  • Vitamin D deficiency is a global health concern, leading to increased supplementation.
  • Vitamin D sufficiency is linked to reduced cancer risk and potential COVID-19 benefits.
  • Overingestion of vitamin D can result in toxicity, a rare but serious condition.

Observation:

  • A 75-year-old man presented with severe hypercalcemia, acute kidney injury, and pancreatitis due to vitamin D toxicity.
  • His vitamin D level was over 200 ng/dL, confirmed by liquid chromatography-mass spectroscopy.
  • Standard hypercalcemia treatments were ineffective, with calcium levels rising upon therapy interruption.

Findings:

  • Peritoneal dialysis was utilized as a management strategy for vitamin D toxicity-induced hypercalcemia.
  • Ten sessions of peritoneal dialysis led to the resolution of hypercalcemia.
  • A downtrend in 25-hydroxyvitamin D levels was observed post-peritoneal dialysis treatment.

Implications:

  • This case highlights peritoneal dialysis as a viable, albeit unconventional, treatment for severe vitamin D toxicity.
  • It underscores the importance of monitoring vitamin D levels to prevent toxicity.
  • Further research may explore the efficacy of dialysis in managing vitamin D toxicity.