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Related Concept Videos

Dialysis01:27

Dialysis

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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).
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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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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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...
128
Peritoneal Dialysis I: Introduction and Procedure01:30

Peritoneal Dialysis I: Introduction and Procedure

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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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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...
168
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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Late Dialysis Modality Education Could Negatively Predict Peritoneal Dialysis Selection.

Takashin Nakayama1, Ken Nishioka1, Kiyotaka Uchiyama1

  • 1Division of Endocrinology, Metabolism and Nephrology Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.

Journal of Clinical Medicine
|July 27, 2022
PubMed
Summary

Late education on renal replacement therapy (RRT) may lead to fewer patients choosing peritoneal dialysis (PD). Earlier RRT education could improve PD selection rates for end-stage renal disease patients.

Keywords:
patient educationperitoneal dialysisrenal replacement therapy

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Area of Science:

  • Nephrology
  • Renal Replacement Therapy
  • Dialysis Modalities

Background:

  • Patients with end-stage renal disease (ESRD) often do not select peritoneal dialysis (PD) for renal replacement therapy (RRT).
  • The reasons for this underutilization of PD remain unclear.
  • The timing of dialysis modality education may influence patient choice.

Purpose of the Study:

  • To investigate the impact of the timing of renal replacement therapy (RRT) education on the selection of peritoneal dialysis (PD).

Main Methods:

  • Single-center retrospective observational study.
  • Included 355 patients initiating maintenance dialysis between April 2014 and July 2021.
  • Logistic regression analysis to assess the association between RRT education timing and PD selection.

Main Results:

  • Only 14.9% of patients selected PD, while 85.1% chose hemodialysis.
  • Higher estimated glomerular filtration (eGFR) at RRT education positively predicted PD selection.
  • Older age and higher Charlson comorbidity index negatively predicted PD selection.

Conclusions:

  • Late RRT education is associated with a biased selection against PD.
  • Optimizing the timing and content of RRT education is crucial for informed patient choice and potentially increasing PD utilization.