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Related Concept Videos

Dialysis01:27

Dialysis

309
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...
309
Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

88
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
88
Factors Affecting Renal Clearance: Renal Impairment01:17

Factors Affecting Renal Clearance: Renal Impairment

91
Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
91
Heart Failure Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

375
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
375

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Decisional Regret Surrounding Dialysis Initiation: A Comparative Analysis.

Aditya S Pawar1,2, Bjorg Thorsteinsdottir2,3, Sam Whitman4

  • 1Beth Israel Deaconess Medical Center, Boston, MA.

Kidney Medicine
|March 4, 2024
PubMed
Summary
This summary is machine-generated.

Patients with high decisional regret after starting dialysis often feel resignation and self-blame. Low regret patients show positivity and self-compassion, indicating potential targets for supportive interventions.

Keywords:
Hemodialysispatient-centered careperitoneal dialysisshared decision making

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Area of Science:

  • Nephrology
  • Psychology
  • Health Services Research

Background:

  • Dialysis presents a significant treatment burden, necessitating patient alignment with care preferences.
  • Understanding decisional regret is crucial for improving patient adherence and outcomes.

Purpose of the Study:

  • To explore the factors contributing to decisional regret in patients undergoing dialysis.
  • To differentiate the experiences of patients with high versus low decisional regret.

Main Methods:

  • A mixed-methods explanatory sequential design was employed.
  • 78 patients completed surveys assessing decisional regret and illness intrusiveness.
  • 21 patients participated in semistructured interviews, categorized by high or low decisional regret.

Main Results:

  • High decisional regret patients exhibited resignation, disrupted self-perception, and self-blame.
  • Low decisional regret patients demonstrated positivity, integrated dialysis into their identity, and practiced self-compassion.
  • Differences in emotional responses and coping mechanisms were observed between the two groups.

Conclusions:

  • Patient approaches to adversity post-dialysis initiation vary significantly based on decisional regret levels.
  • Identifying distinct emotional responses can inform the development of targeted patient support interventions.
  • Addressing decisional regret may enhance the quality of life for individuals on dialysis.