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Related Concept Videos

Dialysis01:27

Dialysis

286
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...
286
Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

77
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...
77
Heart Failure Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

355
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...
355
Factors Affecting Renal Clearance: Renal Impairment01:17

Factors Affecting Renal Clearance: Renal Impairment

69
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...
69
Renal Drug Excretion: Tubular Reabsorption01:25

Renal Drug Excretion: Tubular Reabsorption

144
Tubular reabsorption, a process occurring post-glomerular filtration of drugs in the renal tubule, is a critical determinant of drug half-life. During the process of renal excretion, as the glomerular filtrate progresses to the distal convoluted tubule (DCT), drugs that are highly permeable, lipophilic, and nonionized undergo passive reabsorption from the tubular fluid into the surrounding peritubular capillaries. This reabsorption process restricts their elimination through the kidneys. This...
144
Drug Elimination by Renal Route: Tubular Reabsorption01:22

Drug Elimination by Renal Route: Tubular Reabsorption

3.3K
During the process of renal excretion, as the glomerular filtrate progresses to the distal convoluted tubule (DCT), drugs that are highly permeable, lipophilic, and nonionized undergo passive reabsorption from the tubular fluid into the surrounding peritubular capillaries. This reabsorption process restricts their elimination through the kidneys. However, the majority of drugs are either weak acids or weak bases, and their ionization level is dependent on pH. By altering the pH of urine, the...
3.3K

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Updated: Jun 18, 2025

Surgical Techniques for Catheter Placement and 5/6 Nephrectomy in Murine Models of Peritoneal Dialysis
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Prognostication After Dialysis Withdrawal.

Sarah So1,2, Kelly Chen Lei Li3

  • 1Department of Renal Medicine, Nepean Kidney Research Center, Nepean Hospital, Kingswood, Sydney, New South Wales, Australia.

Kidney International Reports
|July 31, 2024
PubMed
Summary
This summary is machine-generated.

Withdrawal from dialysis has a median survival of 4 days for peritoneal dialysis and 6 days for hemodialysis. Psychosocial reasons for withdrawal are associated with longer survival times, aiding end-of-life care discussions.

Keywords:
chronic kidney diseasedialysis withdrawalend stage kidney diseasekidney supportive carerenal supportive care

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Area of Science:

  • Nephrology
  • Palliative Care
  • Clinical Prognostication

Background:

  • Dialysis withdrawal is a common cause of death in patients on kidney replacement therapy.
  • Prognostic information is crucial for end-of-life care counseling but is limited after dialysis withdrawal.
  • This study investigates survival times and associated factors following dialysis withdrawal.

Purpose of the Study:

  • To determine the median survival time after withdrawal from dialysis.
  • To identify patient and dialysis-related factors associated with prognosis after withdrawal.

Main Methods:

  • Retrospective cohort study using registry data from Western Renal Services.
  • Included adult patients who withdrew from peritoneal dialysis (PD) or hemodialysis between January 1, 2016, and June 30, 2022.
  • Primary outcome: time from last dialysis session to death.

Main Results:

  • Median survival was 4 days (IQR: 3-10) for PD (n=53) and 6 days (IQR: 2-11) for hemodialysis (n=186), with no significant difference (P=0.72).
  • For PD, withdrawal reason was the only significant factor (P=0.01), with psychosocial reasons linked to longer survival (P=0.002).
  • For hemodialysis, withdrawal reason (P=0.001), urine production (P=0.005), serum sodium (P=0.02), and smoking status (P=0.009) were significant.

Conclusions:

  • Median survival after dialysis withdrawal is short, with psychosocial reasons associated with longer survival.
  • Findings can inform clinical discussions on prognostication and end-of-life planning for patients and families.