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Related Concept Videos

Hemodialysis I: Introduction01:25

Hemodialysis I: Introduction

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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 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,...
42
Dialysis01:27

Dialysis

369
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...
369
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...
50
Continuous Renal Replacement Therapy01:30

Continuous Renal Replacement Therapy

54
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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Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications01:25

Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications

44
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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Related Experiment Video

Updated: Jul 23, 2025

Creating Radio-cephalic Arteriovenous Fistula in the Forearm with a Modified No-Touch Technique
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Options for Dialysis and Vascular Access Creation.

Yana Etkin1, Karen Woo2, London Guidry3

  • 1Division of Vascular and Endovascular Surgery, Department of Surgery, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.

The Surgical Clinics of North America
|July 16, 2023
PubMed
Summary

Choosing between peritoneal dialysis (PD) and hemodialysis (HD) for end-stage kidney disease (ESKD) requires a patient-centered approach. Developing an ESKD Life-Plan ensures appropriate access, considering evolving techniques and shared decision-making.

Keywords:
Arteriovenous fistulaArteriovenous graftDialysis accessHDPeritoneal dialysisTunneled dialysis catheter

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Area of Science:

  • Nephrology
  • Renal Replacement Therapy
  • Patient-Centered Care

Background:

  • End-stage kidney disease (ESKD) impacts a significant patient population in the United States.
  • Dialysis modality selection (peritoneal dialysis vs. hemodialysis) necessitates a personalized strategy.
  • The development of a comprehensive ESKD Life-Plan is essential for optimal patient outcomes.

Purpose of the Study:

  • To emphasize the importance of patient-centric decision-making in choosing between peritoneal dialysis (PD) and hemodialysis (HD).
  • To highlight the critical role of an ESKD Life-Plan in guiding access selection.
  • To advocate for the investigation of advanced and complex access techniques.

Main Methods:

  • Review of current practices and literature regarding dialysis access.
  • Emphasis on shared decision-making principles in clinical practice.
  • Consideration of evolving percutaneous access techniques for both PD and HD.

Main Results:

  • The selection of dialysis modality and access should be tailored to individual patient needs and circumstances.
  • Complex access options should be explored when standard approaches are insufficient.
  • Further research into novel percutaneous access methods is warranted.

Conclusions:

  • A patient-centric ESKD Life-Plan is crucial for optimizing dialysis access.
  • Shared decision-making and palliative care integration are vital components of CKD and ESKD management.
  • Exploration of evolving techniques like percutaneous access can enhance treatment options.