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Related Concept Videos

Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

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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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Chronic Kidney Disease IV: Nursing Management01:18

Chronic Kidney Disease IV: Nursing Management

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Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care​.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of...
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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

Acute Kidney Injury V: Interprofessional Care

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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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Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

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Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
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Acute Kidney Injury VI: Nursing Management01:22

Acute Kidney Injury VI: Nursing Management

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Acute Kidney Injury (AKI) results in an inability to maintain fluid, electrolyte, and acid-base balance. Effective nursing management is critical in improving patient outcomes and includes comprehensive patient assessment and targeted interventions.Comprehensive Patient AssessmentA detailed history collection is essential, focusing on any recent infections, nephrotoxic medication use, or chronic conditions such as hypertension and diabetes that may contribute to AKI. During the physical...
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Updated: Jul 15, 2025

Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform
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Shared decision making in elderly patients with kidney failure.

Mehmet Kanbay1, Carlo Basile2, Yuri Battaglia3,4

  • 1Division of Nephrology, Department of Medicine, Koc University School of Medicine, Istanbul, Turkey.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|September 24, 2023
PubMed
Summary

Chronological age is an insufficient measure for elderly patients with kidney failure. Individualized treatment decisions, considering frailty and comorbidities, are crucial for optimal outcomes in this growing population.

Keywords:
elderly patientsfrailtyhemodialysisperitoneal dialysisvascular access

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Area of Science:

  • Gerontology
  • Nephrology
  • Geriatric Medicine

Background:

  • The definition of 'elderly' (≥65 years) overlooks significant health heterogeneity in older adults.
  • Aging global population increases chronic diseases like chronic kidney disease (CKD), often progressing to kidney failure.
  • Frailty is common in elderly patients with kidney failure, necessitating careful assessment for treatment decisions.

Purpose of the Study:

  • To review the complexities in selecting optimal treatment pathways for elderly and frail patients with kidney failure.
  • To highlight the challenges posed by comorbidities, survival rates, and quality of life in this demographic.
  • To advocate for a revised research agenda and improved clinical decision-making processes.

Main Methods:

  • Review of existing literature, acknowledging limitations of retrospective and observational studies.
  • Discussion of challenges in treatment selection (hemodialysis, peritoneal dialysis, conservative management).
  • Emphasis on the need for a multidisciplinary approach involving various healthcare professionals.

Main Results:

  • Current evidence is often limited by biases and lack of confounder adjustment, hindering treatment guidance.
  • A one-size-fits-all approach is inadequate for the diverse clinical needs of older patients with kidney failure.
  • The heterogeneity of the elderly population requires tailored management strategies.

Conclusions:

  • A dedicated research agenda is essential to address critical issues in managing elderly patients with kidney failure.
  • Prospective studies and systematic reviews combining observational and interventional data are recommended.
  • Shared decision-making, integrating patient preferences with evidence, is vital for personalized treatment choices.