腹膜透析的停止:到问题的根源
Paola Piarulli1,2, Valerio Vizzardi1, Federico Alberici1
1Division of Nephrology and Dialysis, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia and ASST Spedali Civili, Brescia, Italy.
Journal of nephrology
|September 25, 2023
概括
腹腔透析 (PD) 与血液透析相比,提供了生存益处和成本优势. 然而,诸如老年和并发症等因素增加了戒断风险,而培训和及时护理则影响了早期和晚期学率.
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
- 慢性病管理 慢性病管理
背景情况:
- 全球慢性病 (CKD) 负担需要有效的置换疗法.
- 腹腔透析 (PD) 通常是首选的初始透析方式,比起血液透析,显示出生存优势和成本效益.
- 在全球范围内,PD的获取有限和使用不足凸显了了解停药因素的必要性.
研究的目的:
- 审查最近关于腹膜透析中止风险因素的文献.
- 区分PD停药的早期和晚期阶段.
- 为患者选择和PD的临床管理提供信息.
主要方法:
- 对最近的医学文献进行叙述性审查.
- 分析与停用PD相关的风险因素.
- 在PD启动后的早期和晚期之间进行区分.
主要成果:
- 医疗中心的大小,年龄较大和并发症是停用PD治疗的常见风险因素.
- 不良的技术培训和迟到的科转诊与早期PD退学有关.
- 护理人员的需求,患者的倦怠和住院病例与晚期PD退学有关.
结论:
- 了解特定的风险因素对于优化PD患者选择和管理至关重要.
- 需要就PD临床相关结果的定义达成共识,以更好地满足患者的需求.
- 解决已识别的风险因素可能会改善PD坚持和患者的结果.
相关概念视频
Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications
26
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...
26
Peritoneal Dialysis I: Introduction and Procedure
41
Peritoneal dialysis (PD) is a procedure that facilitates the exchange of solutes, waste products, electrolytes, and excess fluid between the blood in the peritoneal capillaries and a dialysis solution introduced into the peritoneal cavity.Principles of Peritoneal Dialysis (PD)Diffusion: Waste products such as urea and electrolytes move from high concentrations in the blood to low concentrations in the dialysate across the peritoneal membrane. This mechanism is driven by the concentration...
41
Peritoneal Dialysis III: Nursing Management
31
Peritoneal dialysis, or PD, utilizes the peritoneal membrane as a filter to eliminate excess fluid and waste products. Effective nursing management is essential for ensuring patient safety, preventing complications, and promoting optimal function of the peritoneal dialysis process.Assessment and MonitoringNurses must thoroughly assess the patient before, during, and after each dialysis session. Regular monitoring includes vital signs, daily weight, fluid intake and output, and laboratory values...
31
Dialysis
346
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...
346
Hemodialysis II: Procedure and Complications
27
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,...
27
Hemodialysis III: Nursing Management
31
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...
31


