家庭血液透析技术生存:见解和挑战
Estelle Tran1, Oliver Karadjian2, Christopher T Chan3
1Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland.
BMC nephrology
|July 11, 2023
概括
家庭血液透析 (HHD) 提供了好处,但面临的挑战是患者的保留. 本综述探讨了影响HHD技术生存的因素,以及改善末期病患者长期坚持治疗的策略.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 脏替代疗法治疗 脏替代疗法
- 患者的坚持 患者的坚持
背景情况:
- 家庭血液透析 (HHD) 对末期病 (ESKD) 患者在临床结果,生活质量和成本效益方面具有优势.
- 尽管兴趣增加,HHD的采用是有限的,与高停产率相关的重大挑战.
研究的目的:
- 综合审查当前关于HHD技术生存的知识.
- 确定导致HHD衰减的临床因素.
- 提出预防HHD停产的策略.
主要方法:
- 关于HHD技术生存的现有文献的全面叙事审查.
- 分析与HHD患者脱离相关的临床因素.
- 探索增强HHD技术生存的潜在策略.
主要成果:
- 在HHD中,技术生存率低于最佳,许多因素导致患者停止治疗.
- 识别和解决这些因素对于改善长期HHD成功至关重要.
- 特定的可修改实践和有针对性的干预措施可以提高患者的留守率.
结论:
- 提高HHD技术的生存率需要更深入地了解消耗因素和实施有针对性的策略.
- 专注于高风险患者,优化培训和修改当前做法是持续HHD治疗的关键.
- 加强策略是必要的,以支持患者选择家庭透析方式.
相关概念视频
Hemodialysis II: Procedure and Complications
42
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,...
42
Hemodialysis I: Introduction
57
Hemodialysis (HD) is a medical treatment that artificially removes waste products, excess fluids, and toxins from the blood when the kidneys are no longer able to perform these functions effectively. In this process, blood is filtered through a semipermeable membrane, allowing for the selective removal of waste while preserving necessary components like blood cells and proteins. Hemodialysis is typically performed in patients with end-stage renal disease (ESRD) or severe kidney...
57
Hemodialysis III: Nursing Management
50
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...
50
Dialysis
369
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...
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...
369
Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications
44
Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...
44
Continuous Renal Replacement Therapy
54
Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
54


