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Related Concept Videos

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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Hemodialysis I: Introduction01:25

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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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Hemodialysis III: Nursing Management01:25

Hemodialysis III: Nursing Management

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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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Acute Kidney Injury V: Interprofessional Care01:20

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Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
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Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications01:25

Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications

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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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Continuous Renal Replacement Therapy01:30

Continuous Renal Replacement Therapy

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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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Incremental Hemodialysis: What We Know so Far.

Vivek Soi1,2, Mark D Faber1,2, Ritika Paul1

  • 1Division of Nephrology and Hypertension, Henry Ford Hospital, Detroit, MI, USA.

International Journal of Nephrology and Renovascular Disease
|May 6, 2022
PubMed
Summary

Incremental hemodialysis offers a gradual transition for chronic kidney disease patients, potentially preserving kidney function and improving quality of life. This patient-centered approach requires further research for wider adoption.

Keywords:
hemodialysisincremental dialysistwice-weekly

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Area of Science:

  • Nephrology
  • Renal Replacement Therapy

Background:

  • Standard hemodialysis prescription is often thrice-weekly, based on historical data from prevalent patients.
  • Progressive chronic kidney disease necessitates a transition to kidney replacement therapy.

Purpose of the Study:

  • To explore the concept and benefits of incremental hemodialysis.
  • To evaluate the feasibility and potential advantages of a less frequent dialysis approach.

Main Methods:

  • Review of retrospective and registry data supporting incremental hemodialysis.
  • Analysis of pilot studies demonstrating implementation feasibility.
  • Consideration of residual kidney function and adjuvant therapies.

Main Results:

  • Incremental hemodialysis may preserve residual kidney function and enhance patient quality of life.
  • Optimal candidacy is suggested by urea clearances >3 mL/min and urine volumes >500 mL/day.
  • Barriers include patient acceptance, adherence, and provider workflow adjustments.

Conclusions:

  • Incremental hemodialysis presents a patient-centered alternative to traditional thrice-weekly sessions.
  • Further large-scale randomized controlled trials are necessary to confirm safety and efficacy.
  • Wider acceptance hinges on robust evidence and adaptation of current treatment paradigms.