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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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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).
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Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications01:25

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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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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 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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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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Transitions between dialysis modalities.

Antoine Lanot1,2,3, Clémence Bechade4,5,6, Annabel Boyer4,5

  • 1Normandie Univ, UNICAEN, CHU de Caen Normandie, Néphrologie, 14000, Caen, France. antoine.lanot@gadz.org.

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|July 18, 2022
PubMed
Summary
This summary is machine-generated.

Ensuring smooth transitions between dialysis techniques is crucial for end-stage renal disease patients. Anticipating technique survival issues and planning personalized care pathways improves patient outcomes.

Keywords:
HemodialysisHome hemodialysisPeritoneal dialysisShared-decision makingTransitional care unit

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Area of Science:

  • Nephrology
  • Renal Replacement Therapy

Background:

  • Patient survival in end-stage renal disease (ESRD) is improving due to advancements in dialysis.
  • Transitioning between different dialysis modalities can be challenging for patients.
  • Home dialysis offers benefits but requires significant patient and caregiver commitment.

Purpose of the Study:

  • To explore strategies for ensuring smooth transitions to the optimal dialysis technique at the appropriate time for individual patients.
  • To address the challenges associated with technique survival and modality switching in dialysis care.

Main Methods:

  • Review of current dialysis modalities including peritoneal dialysis (PD), home hemodialysis (HD), and in-center HD.
  • Discussion of the 'home integrated model' of PD followed by home HD as an ideal pathway.
  • Emphasis on shared decision-making and anticipating the need for modality changes.

Main Results:

  • Peritoneal dialysis offers residual kidney function preservation and cost-effectiveness but has limited technique survival.
  • Home hemodialysis demonstrates excellent long-term technique survival.
  • Unplanned transfers between dialysis techniques are linked to poorer patient outcomes.

Conclusions:

  • The choice of initial dialysis modality should include discussions about technique survival and potential future switches.
  • Anticipating transfers from home-based dialysis is essential for better outcomes.
  • Dedicated 'transition care' units can facilitate smoother modality changes for dialysis patients.