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Related Concept Videos

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Aortic Regurgitation III: Medical Management

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Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
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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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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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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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Strict control of phosphorus concentration of hemodialysis patients may decrease structural valve deterioration after

Seimei Go1, Tomokuni Furukawa2, Kazunori Yamada2

  • 1Department of Cardiovascular Surgery, Hiroshima University, Kasumi 1-2-3, Minamiku, Hiroshima, Hiroshima, Japan. go55@hiroshima-u.ac.jp.

General Thoracic and Cardiovascular Surgery
|November 19, 2021
PubMed
Summary

Bioprosthetic aortic valve replacement in hemodialysis patients carries a risk of structural valve deterioration (SVD). High preoperative phosphorus levels are linked to increased SVD risk, suggesting phosphorus control may improve outcomes.

Keywords:
Aortic valve replacementControl of phosphorus concentrationHemodialysisStructural valve deterioration

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Area of Science:

  • Cardiology
  • Nephrology
  • Biomaterials Science

Background:

  • Increasing number of hemodialysis patients require aortic valve replacement (AVR).
  • Bioprosthetic valves are commonly used for AVR but risk structural valve deterioration (SVD).

Purpose of the Study:

  • To evaluate outcomes of bioprosthetic valves in hemodialysis patients undergoing AVR.
  • To identify strategies to mitigate SVD risk in this population.

Main Methods:

  • Retrospective analysis of 61 hemodialysis patients undergoing AVR with bioprosthetic valves (2010-2019).
  • Kaplan-Meier survival estimates and univariate Cox regression analyses were performed.
  • Focus on structural valve deterioration (SVD) events and survival rates.

Main Results:

  • Six SVD events (10.7%) occurred, all due to aortic stenosis, with a mean onset of 41.5 months post-AVR.
  • 3-year and 5-year survival rates were 67.9% and 39.5%, respectively.
  • High preoperative phosphorus levels were significantly associated with an elevated SVD risk.

Conclusions:

  • Preoperative phosphorus levels are a modifiable factor influencing SVD risk after AVR in hemodialysis patients.
  • Strict control of phosphorus levels in hemodialysis patients may reduce the incidence of SVD.