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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).
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Dialysis is a diffusion-based purification process that separates analyte molecules from a complex matrix. This is accomplished by allowing molecules in the solution to pass through a semipermeable membrane into a liquid on the other side. The membrane is usually made of cellulose acetate or cellulose nitrate, and the second liquid must be miscible with the solution. Ions (e.g., chloride or sodium) or organic molecules (e.g., glucose) can pass through the membrane pores, which generally have...
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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...
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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,...
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Cuestiones éticas en la terapia de diálisis

Vivekanand Jha1, Dominique E Martin2, Joanne M Bargman3

  • 1The George Institute for Global Health, New Delhi, India; University of Oxford, Oxford, UK.

Lancet (London, England)
|February 28, 2017
PubMed
Resumen
Este resumen es generado por máquina.

El tratamiento de la enfermedad renal en etapa terminal, en particular la diálisis, presenta desafíos éticos globales. Abordar estas cuestiones es crucial para el bienestar del paciente y una política de atención sanitaria equitativa.

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Área de la Ciencia:

  • Salud pública
  • La bioética
  • Política de salud

Sus antecedentes:

  • El tratamiento de la enfermedad renal terminal (ERC) es un problema económico y de salud pública importante a nivel mundial.
  • La terapia de reemplazo renal, incluida la diálisis, implica dilemas prácticos y éticos complejos.
  • El análisis y la orientación éticos existentes para la toma de decisiones sobre el tratamiento con ESKD son limitados.

Objetivo del estudio:

  • Proporcionar una visión general de las principales cuestiones éticas en la provisión de diálisis en todo el mundo.
  • Identificar las prioridades para una mayor investigación y gestión de estos desafíos éticos.
  • Presentar recomendaciones preliminares para orientar la práctica y la política en el cuidado de la diálisis.

Principales métodos:

  • Revisión de las consideraciones éticas en la provisión global de diálisis.
  • Identificación de los dilemas clave para los pacientes, los médicos y los responsables políticos.
  • Síntesis de las recomendaciones preliminares para la práctica y la política ética.

Principales resultados:

  • El tratamiento de ESKD plantea preocupaciones éticas con respecto a los intereses del paciente, el acceso a la atención y la justicia.
  • Minimizar las influencias financieras, garantizar la calidad de la atención y proteger a los grupos vulnerables es fundamental.
  • Es necesario mejorar el análisis ético y la orientación práctica para los responsables de la toma de decisiones.

Conclusiones:

  • La provisión de diálisis en todo el mundo requiere una cuidadosa consideración de numerosas cuestiones éticas.
  • Abordar estos dilemas es esencial para mejorar los resultados de los pacientes y la equidad en la atención médica.
  • El desarrollo de marcos éticos sólidos y orientación práctica es una prioridad para la gestión global de la ESKD.