Prescribing Hemodialysis

What regulation shall we have for the operation? Shall a man transfuse he knows not what. to correct he knows not what. God knows how (l)? Dr. Henry Stubbs Royal College of Physicians circa 1670 If dialysis therapy were a new phannaceutical product being evaluated by the FDA now, it might not be approved for marketing. The recommended dose, its potential toxicity, the side effects of under-or over-dialysis as well as its efficacy have been the subject of very few studies. The high mortality rate associated with the treatment may raise a few eyebrows. That it is a life-saving modality of treatment is undoubtedly true for more than 100,000 patients in the United States and for more than a million patients world wide. Because dialysis has extended the lives of many people by a variable period of time, most nephrologists have "rested on their laurels" and did not vigorously pursue studies to optimize these treatments. But facts have a way of intruding in all our lives and the facts are that the overall mortality rate of dialysis patients in the United States is rising and stands close to 25% per year and is closer to 33% per year for patients between the ages of 65 and 74 (2). These mortality figures are considerably higher for age-adjusted dialysis populations in Europe and particu larly in Japan, and certainly for the age-adjusted nonnal population.

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 book is an evidence-based review of the practical challenges of dealing with patients receiving dialysis. The first section covers technical and procedural considerations such as choosing the hemodialysis membrane and choosing the best dialysis option. The second section covers clinical considerations such as infection and the treatment of specific renal disease complications. The book includes numerous illustrations and tables and drug charts for dialysis patients. This edition's current outcomes chapter has been expanded to include patient depression and improving quality of care. New chapters cover dialysis in the ICU, valvular heart disease, and pre-emptive renal transplantation.

Continuous Renal Replacement Therapy (CRRT) is the standard of care for management of critically ill patients with acute renal failure. Part of the Pittsburgh Critical Care series, Continuous Renal Replacement Therapy provides concise, evidence-based, bedside guidance about this treatment modality, offering quick reference answers to clinicians' questions about treatments and situations encountered in daily practice. Organized into sections on theory, practice, special situations, and organizational issues, this volume provides a complete view of CRRT theory and practice. Tables summarize and highlight key points, and key studies and trials are included in each chapter. The second edition has been updated to include a new chapter on the use of biomarkers to aid in patient selection and timing, extensive revisions on terminology and nomenclature to match current standards, and the most up-to-date information on newly developed CRRT machines.

The expanding importance of health as a global issue has focused attention on the value of applying the concept of global public goods from economics to international health.

Get all the facts and build your expertise on the fast-growing practice of home hemodialysis The use of home hemodialysis is becoming more popular every year. Home dialysis modalities not only provide more flexibility for patients, they are associated with numerous benefits, including improved cardiovascular parameters and better quality of life. Most dialysis resources tend to focus on in-center hemodialysis with little to no discussion of home hemodialysis. The Handbook of Home Hemodialysis aims to change that with focused, detailed coverage on the topic. This timely, one-of-a-kind resource offers everything you need to build your expertise on the subject. It’s also small enough to fit in your pocket and designed to provide accurate, easy-to-find answers on the fly. Clear drawings and illustrations clarify and highlight key information. The Handbook of Home Hemodialysis provides essential information on: The of history home hemodialysis Vascular access Patient recruitment and training Prescribing home hemodialysis Water handling Laboratory parameters/monitoring Emerging benefits Common complications Special populations Remote monitoring Building a home dialysis program, and more