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Dialysis

Dialysis

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...

Factors Affecting Renal Clearance: Renal Impairment

Factors Affecting Renal Clearance: Renal Impairment

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...

Renal Failure: Dose Adjustments

Renal Failure: Dose Adjustments

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.
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Heart Failure Drugs: Diuretics

Heart Failure Drugs: Diuretics

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...

Hormonal Regulation

Hormonal Regulation

The renin-aldosterone system is an endocrine system which guides the renal absorption of water and electrolytes, thus managing blood pressure and osmoregulation. Activation of the system begins in the kidneys with a small cluster of cells adjacent to the afferent and efferent blood vessels of the renal corpuscle. As the nephrons are filtering blood, juxtaglomerular cells monitor blood pressure. If they detect a decrease in pressure, they release the hormone renin into the bloodstream.

Factors affecting Blood pressure

Factors affecting Blood pressure

Several physiological and lifestyle factors influence blood pressure (BP). Understanding these factors is crucial as they are significant in patient education and blood pressure management.
Physiological Factors:

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Related Experiment Video

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A Murine Model of Hemodialysis Access-Related Hand Dysfunction

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Risk Factors for Mortality Among Patients on Hemodialysis in India: A Case-Control Study.

Suresh Sankarasubbaiyan¹, Carol A Pollock², Urmila Anandh³

¹NephroPlus Dialysis Centers, Hyderabad, Telangana, India.

Indian Journal of Nephrology

|May 12, 2025

Summary

Lower education, public insurance, catheter access, low hemoglobin, and low albumin are linked to higher mortality in Indian hemodialysis patients. These factors highlight areas for intervention to improve patient survival.

Keywords:

Chronic kidney disease End-stage renal disease Hemodialysis Mortality Risk factors

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Area of Science:

Nephrology
Public Health
Epidemiology

Background:

Mortality rates in hemodialysis (HD) patients remain high, surpassing those in many solid organ cancers.
Despite advancements, understanding specific mortality risks in diverse populations like those in India is crucial.

Purpose of the Study:

To investigate mortality risk factors among a large cohort of Indian hemodialysis patients.
To identify demographic, clinical, and socioeconomic factors associated with increased mortality in this population.

Main Methods:

A case-control study was conducted across 203 Indian HD centers from January to March 2021.
Demographic, dialysis, clinical, and socioeconomic data were collected and analyzed for non-survivors (cases) and age-matched survivors (controls).

Main Results:

Key factors associated with higher mortality included lower educational status, dialysis under public insurance, temporary catheter vascular access, hemoglobin levels below 8 g/dL, and serum albumin below 3.5 g/dL.
Increased hospitalizations in the three months preceding death were also more frequent among non-survivors.
Factors like gender, BMI, dialysis frequency, HD vintage, diabetes, and heart failure history did not significantly differ between groups.

Conclusions:

Low hemoglobin, temporary catheter use, low serum albumin, lower education, and public insurance are significant predictors of poorer survival in Indian HD patients.
These findings underscore the need for targeted interventions and policy adjustments within public-payer systems to enhance patient outcomes.