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Renal Disease; Fluid and Electrolyte Disorders
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Haemodialysis is usually performed for around 4 hours three times a week. Blood is pumped past a semipermeable membrane and water, ions and small molecules pass across the membrane into dialysis fluid (Figure 8.20). By controlling the composition of this dialysis fluid, it is possible to control the removal of substances from the blood. If blood is forced past the membrane at a higher pressure, ultrafiltration of plasma also occurs. The membrane is usually in the form of small hollow fibres in a large cartridge and heparin is usually given to prevent blood clotting in the dialysis machine. Blood can be pumped from the body through large bore central venous catheters or needles placed in an arteriovenous fistula, which is formed by joining an artery to a vein in the arm.
Diabetic Nephropathy
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Treatment of GBM diabetic neuropathy avoiding nonsteroidal anti-inflammatory drugs (NSAIDs) and cyclooxygenase-2 (COX-2) inhibitors. Their use may cause poor BP control, and reduce effects of antihypertensive drugs. Medications and dosing of oral hypoglycemics are critical. The patient at high risk for progressive renal deterioration should be referred to a nephrologist for consultation to manage renal failure. Other options include hemodialysis, peritoneal dialysis, and renal transplantation. Most of the patients prefer hemodialysis over peritoneal dialysis.
Body fluids and electrolytes
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
Hypercalcaemia usually requires the patient to be nursed in hospital under specialist advice. A patient with chronic hypercalcaemia is prone to pathological fractures and may need assistance to reposition, if bedridden. The patient may require intravenous fluids to increase the urinary output of calcium as well as the administration of drugs to inhibit bone reabsorption. Haemodialysis may be required if the condition is secondary to renal failure. Surgery to remove part of the parathyroid gland may also be considered.
Factors associated with subgroups of fatigue in maintenance hemodialysis patients: a cross-sectional study
Published in Renal Failure, 2023
Xiao-Yan Zheng, Zhi-Hong Zhang, You-Ming Cheng, Qi Yang, Bing Xu, Bao-Chun Lai, Lan-Ting Huang
All enrolled patients underwent hemodialysis three times per week for four hours per treatment. At 35.5–36.5 °C, all patients received heparin or low molecular heparin anticoagulant and standard carbonate dialysis fluid. Blood flow ranged from 200 to 300 mL/min with a 500 mL/min dialysis rate. Dialysis liquid ingredients were sodium (Na) 138–140 mmol/L, potassium (K) 2.0 mmol/L, calcium (Ca) 1.25–1.5 mmol/L, chlorine (Cl) 109–110 mmol/L, glucose (GLU) 0 mg/dL, and bicarbonate 35 mmol/L. All patients were treated with disposable synthetic biocompatible dialyzer membranes (polysulfone hollow fiber dialyzer membranes, Fresenius, Bad Homburg vor der Höhe, Germany). Dry weight was targeted for each patient during the HD session. Pre- and post-weight, blood measurements, lung US, inferior vena cava diameter (IVCD) US, and bioimpedance spectroscopy assessment were applied at the same first HD session of the week.
Risk factors for hospital-acquired bacteraemia – an explorative case–control study of hospital interventions
Published in Infectious Diseases, 2022
Viggo Holten Mortensen, Mette Søgaard, Brian Kristensen, Lone Hagens Mygind, Henrik Carl Schønheyder
Our findings suggest that haemodialysis is a risk factor for HAB. This is in line with a previous Danish study by Eliasen K et al. [18], who found a high prevalence of Staphylococcus aureus bacteraemia in haemodialysis patients. However, they did not make a direct comparison to other patients. Our findings also suggest that immunosuppressive treatment including chemotherapy may increase the risk of HAB in some patients. However, future studies using a more detailed classification are needed to assess the association for this heterogenous group of treatments, since this most likely depend on choice of drug and regimen [19]. We found a slight association between device inserted in the CNS and HAB; however, this intervention is heavily correlated with other interventions, which might bias the association.
Temporal processing, spectral processing, and speech perception in noise abilities among individuals with chronic kidney disease undergoing hemodialysis
Published in Acta Oto-Laryngologica, 2021
Kaushlendra Kumar, Livingston Sengolraj, Mohan Kumar Kalaiah
Hearing loss is very common among patients with chronic kidney disease compared to the general population [1,2]. Chronic kidney disease is a condition in which the kidneys are damaged and cannot filter waste products (such as creatinine and urea) and fluids from the blood. Among individuals with chronic kidney disease, the excess fluids and waste products that remain in the body caused health problems which also include hearing loss. It is a progressive condition that can lead to total kidney failure, also called end-stage renal disease [3]. The treatments for individuals with end-stage renal failure are dialysis or a kidney transplant. Hemodialysis is a process where the patient’s blood is passed through a dialysis venous catheter, via a dialysis fluid solution in a hemodialysis machine, to be filtered externally, then returned to the patient.