Clinical Practice Of Dialysis Interventional Nephrology

Dialysis is a medical procedure which is performed in people with acute kidney failure or Stage 5 chronic kidney disease. In this procedure the excess solutes, toxins and water from the blood are removed externally. This is also known as renal replacement therapy. It can be permanent or temporary. It is generally temporary in cases where kidney transplantation is due. The procedure can be classified into three primary and two secondary types. Peritoneal dialysis, hemodialysis and hemofiltration are the primary types, while intestinal dialysis and hemodiafiltration are the secondary types. Dialysis is initiated based on a number of acute and chronic indications. The presence of acidemia, fluid overload, uremia and electrolyte abnormality indicates the need for dialysis. There have been major advances both in terms of technology and clinical management of dialysis. This book traces the progress of interventional nephrology and highlights some of its key practices. The various sub-types of dialysis along with technological progress that have future implications are glanced at herein. This book is meant for students who are looking for an elaborate reference text on dialysis.

This book provides a comprehensive, state-of-the-art overview of interventional nephrology. Similar to the previous edition, this text describes a direct approach to clinical problems encountered by the community of care providers who treat chronic kidney disease and dialysis patients. Practical scenarios faced on a day-to-day basis are presented by experts in the field, utilizing the latest scientific information. The book also features updated therapeutic guidelines and fully revised and new chapters. Written by the foremost authorities in the field, Interventional Nephrology: Principles and Practice, Second Edition is a must-have resource for clinicians and practitioners who treat and manage patients with hemodialysis and peritoneal dialysis access problems.

A complete guide to every aspect of interventional nephrology—an essential text for students, residents, fellows, and clinicians This timely resource examines all relevant aspects of interventional nephrology, from the history of nephrology to the principles governing the latest vascular access techniques. Heavily illustrated with full-color procedural drawings and featuring an easy-to-follow design, the book includes contributions from many leading authorities in the field whose insights combine to form an unprecedented, clinically rigorous survey of interventional nephrology. Interventional Nephrology opens with an instructive look at the origins of hemodialysis access; an overview of the history of interventional nephrology in the U.S. and abroad; and clinically relevant coverage of vascular access outcomes. The high-yield coverage continues with a probing assessment of ethics, public policy, and practice guidelines, illuminating such pivotal topics as industry partnerships and conflicts of interest. The principles that support interventional nephrology techniques are also extensively reviewed, encompassing everything from vascular mapping to peritoneal dialysis catheter removal, while the following section delves into the key surgical aspects of vascular access. Finally, the book provides useful perspectives on how political and policy affairs impact current practice. FEATURES Illustrated with precise full-color drawings and radiographs that highlight both normal and vascular anatomy and clarify the management of vascular access problems Streamlined design and helpful pedagogy, including chapter-opening learning objectives, numerous tables, and concept-clarifying figures Complete overview of the core principles underlying interventional nephrology practice and techniques, covering vascular mapping, monitoring and surveillance of arteriovenous access, venous angioplasty, tunneled catheters, renal ultrasonography, and much more Discussion of vascular access in special populations and the role of pharmacologic agents in preserving vascular access provides evidence-based insights that are pertinent to the everyday practice of interventional nephrology In-depth emphasis on the surgical aspects of vascular access reviews sites, types, and creation of arteriovenous fistulae; secondary arteriovenous fistula; and surgical options for vascular anomalies Forward-thinking coverage of basic and translational science considers future directions in vascular access science; flow dynamics, maturity, and access failure; neointimal hyperplasia; pharmacologic prevention of access dysfunction; and device innovation

Historically, clinical decisions in renal medicine have been challenged by the scarce availability of robust supportive evidence. Not only are the number of randomized controlled trials (RCTs) in Nephrology the third lowest amongst the medical specialties but in many instances the trials themselves are of poor quality. In addition, practice has been further influenced by extrapolation from the outcomes of general population clinical trials which exclude renal patients. The difference between the ideal trial participant and real complex cases encountered in daily practice is well recognized and further compounded in renal patients with complex pathophysiology - this ultimately makes decision making in this subset of patients a real challenge. Recently, there has been a growing interest in conducting well designed RCTs in different areas of renal medicine. However, though clinical guidelines are helpful in providing the clinicians with a frame of best available evidence for a clinical condition, it denies the unique nature of each individual patient. This book offers a thorough and critical appraisal and evaluation of the key published clinical trials that have shaped current practice in nephrology, dialysis and transplantation. It will help the practicing physician close the gap between the inflexible and generalized nature of clinical guidelines and the day-to-day clinical decision-making for individual patients. It will provide the clinician with the tools required to investigate and extract the appropriate guidance to apply to individual cases in daily practice. Moreover, it will help improve the ability of junior colleagues to appraise available evidence in a systematic way when there is lack of local guidelines or when the guidelines are difficult to apply due to logistic constraints or barriers. Lastly, this book will serve as a reference for key clinical trials in different areas of renal medicine together with literature and authors views of these trials and their impact on changing practice.​

Extending from the outpatient management of cardiovascular and kidney disease, to hospital-based decision making in patients with cardio-renal disease and complex interfaces such as hemodialysis in patients with ventricular assist device support, this book serves as a single reference point for cardiology and nephrology clinicians and researchers dealing with the significant overlap areas between these two specialties. Chapters cover the physiology, biomarkers, therapeutic agents and full spectrum of these comorbidities and feature separate sections on cardiovascular and CKD evaluations, stratification of kidney transplant patients, lipid management in CKD, interventional strategies and hypertension. Leaders in cardiology, nephrology, hypertension and lipidology bring together the latest evidence with their collective clinical experience into this invaluable resource.This textbook is an essential resource for physicians and allied professionals practicing cardiology, nephrology, students and physician trainees, to deepen their understanding of this crucial field.

Moving beyond the science of hemodialysis access, this collection of clinical cases covers procedural and practical aspects of arteriovenous fistula, arteriovenous graft, dialysis catheter, draining veins, central veins, arterial interventions and hand ischemia. World experts in the disciplines of interventional nephrology, interventional radiology and surgery offer creative visions of their practice and provide insights on topics from routine access creation to advanced novel techniques. Dialysis Access Cases presents solutions to problems encountered in practice while capturing the art of this medical discipline and challenging procedure.

This book is a thorough guide to dialysis that will assist in the effective treatment of patients. Current knowledge on all aspects of dialysis, including the most recent advances, is presented and the various techniques used in dialysis patients are described step by step. Both hemodialysis and peritoneal dialysis are fully considered. The coverage of hemodialysis explains the procedure and its indications and provides guidance on challenging topics such as vascular access, response to acute and chronic complications, and on-line hemodiafiltration. The discussion of peritoneal dialysis includes explanation of peritoneal physiology, the principles of prescription, and the treatment of peritonitis and exit site infection. A summary of updated dialysis-related guidelines is included at the end of the book. The lucid text is supported by more than 200 full-color illustrations that clarify anatomy, vascular/peritoneal access, and dialysis procedures and techniques. The Essentials of Clinical Dialysis will be of value for all who are involved in the management of dialysis patients and will be a helpful guide for training of physicians and healthcare associates in the dialysis center.

This practical book covers the basic principles and practice of dialysis access management, a crucial part of the care of patients undergoing hemodialysis. It has been written in an easy-to-read, step-by-step format to help facilitate learning and understanding of the procedures and has been supplemented with numerous operative photographs and diagrams demonstrating the commonly performed dialysis access exams, interventions, procedures and surgeries. Dialysis access management is an essential text for residents, fellows and physicians who are learning or practicing in dialysis and/or dialysis access management, especially in the fields of nephrology, radiology, surgery and vascular medicine.