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Related Concept Videos

Kidney Transplant I: Introduction01:28

Kidney Transplant I: Introduction

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A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
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Kidney Transplant II: Surgical Procedure01:26

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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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Kidney Transplant III: Nursing Management01:16

Kidney Transplant III: Nursing Management

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Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
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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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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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Chronic Kidney Disease III: Interprofessional Care01:28

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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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Induced demand in kidney replacement therapy.

Steef Redeker1, Emma K Massey2, Ruben G van Merweland1

  • 1Department of Psychiatry, Erasmus MC, Section of Medical Psychology and Psychotherapy, Rotterdam, the Netherlands.

Health Policy (Amsterdam, Netherlands)
|August 8, 2022
PubMed
Summary
This summary is machine-generated.

Overutilization of in-center dialysis and underutilization of home dialysis and transplantation are driven by healthcare policy. Limiting dialysis capacity can improve patient outcomes and reduce costs.

Keywords:
DialysisInduced demand for healthcare servicesKidney replacement therapyKidney transplantation

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Area of Science:

  • Nephrology
  • Healthcare Policy
  • Health Economics

Background:

  • Kidney replacement therapy (KRT) faces challenges, including declining home dialysis use and stable transplant rates.
  • Significant inter-hospital variation exists in kidney transplantation referral rates.
  • Current healthcare policies inadvertently promote in-center dialysis over other modalities.

Purpose of the Study:

  • To analyze the supply-and-demand dynamics in kidney replacement therapy.
  • To identify the impact of healthcare policy on KRT modality utilization.
  • To propose policy interventions for optimizing KRT provision.

Main Methods:

  • Analysis of trends in home dialysis, transplantation, and in-center dialysis utilization.
  • Examination of healthcare policy's influence on supplier-induced demand.
  • Assessment of financial disincentives related to dialysis facility capacity.

Main Results:

  • A substantial decline in home dialysis patients over recent decades.
  • Stabilization of kidney transplantation rates in recent years.
  • Healthcare policy contributes to overutilization of in-center dialysis and underutilization of home dialysis and transplantation.

Conclusions:

  • Supplier-induced demand, driven by in-center dialysis overcapacity and financial disincentives, leads to suboptimal patient care and increased costs.
  • Reducing in-center dialysis capacity is the most effective strategy to align supply with demand.
  • Policy changes are needed to improve patient outcomes and lower societal costs in kidney replacement therapy.