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The Urinary System and Its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Renal failure may necessitate dialysis, from the Greek words dia (across) and lysis (dissolution). Peritoneal dialysis (peritoneal lavage) uses the patient's own peritoneum as a semipermeable membrane to remove dissolved wastes. Hemodialysis, on the other hand, cycles the blood from an arteriovenous shunt or fistula to a synthetic membrane where it contacts the dialysate (dialysis solution) for removal of the wastes. Kidney transplant may be the necessary outcome.
Renal disorders
Published in Rachel U Sidwell, Mike A Thomson, Concise Paediatrics, 2020
Rachel U Sidwell, Mike A Thomson
Peritoneal membrane used as a semi-permeable membrane. The dialysate is run through a tube into the peritoneal cavity and the fluid changed regularly to repeat the process.CAPD (continuous ambulatory peritoneal dialysis); 2–4 cycles/day done manuallyCCPD (continuous cycling peritoneal dialysis); dialysis occurs only at night with 8–12 cycles done by machine
Flucytosine
Published in Mahmoud A. Ghannoum, John R. Perfect, Antifungal Therapy, 2019
There are limited pharmacokinetic data for flucytosine in patients undergoing concomitant dialysis. Intermittent hemodialysis may remove a significant quantity of flucytosine [115]. A dialysate clearance ratio of approximately 70% has been reported [115,116]. Peritoneal dialysis may also enhance flucytosine elimination [92,117]. Limited data also exist for patients receiving flucytosine and undergoing concomitant continuous hemofiltration [95,118,119]. Serum half-lives ranging between 15.9 and 37.2 hours following an intravenous dose of 2.5 gm have been reported [95]. Removal may vary with ultrafiltration flow rate, serum concentration, and hemofilter type [95,118,119]. Mean clearance of 77.0% ± 15.6% (SD) and 51.0% ± 5.7% (SD) of the ultrafiltrate flow rate were observed with polysulfone and polyacrylonitrile membranes, respectively [118]. Therefore, continuous hemofiltration can remove an appreciable quantity of flucytosine.
U-shaped association of serum magnesium with mild cognitive impairment among hemodialysis patients: a multicenter study
Published in Renal Failure, 2023
Yuqi Yang, Yanjun Long, Jing Yuan, Yan Zha
This was a multicenter, observational cohort study, and recruited the patients undergoing maintenance HD from 22 HD centers in Guizhou Province, China between 1 June 2019 and 30 September 2020. Patients were eligible for inclusion if aged ≥ 18 years old, receiving maintenance HD for at least three months, and had completed the biochemical measurements, and questionnaire records. Our analysis excluded individuals with prior receipt of dialysis or organ transplant, with severe mood disorders or psychotic disorders, and missing magnesium and cognition measurements. More details on the inclusion process of studied populations were provided in Figure 1. All the patients performed HD with conventional dialyzers under the standard temperature (35.5–36.5 °C). The dialysate composition is usually composed of sodium (130–140mmol/L), potassium (3-4mmol/L), chloride (96–110mmol/L), calcium (1.5–1.75 mmol/L), magnesium (0.6–1.0 mmol/L), bicarbonate (32–38mmol/L). The electrolyte concentrations would be adjusted accordingly.
Risk factors and prognosis for coronavirus disease 2019 among 131 hemodialysis patients during the Omicron variant epidemic
Published in Renal Failure, 2023
Wen Wen, Shiming Cai, Yuehong Li, Xianglan Wu
Adult patients (≥18 years of age), who underwent MHD (dialysis vintage ≥3 months) at the Hemodialysis Center in Beijing Tsinghua Changgung Hospital from December 2022 to January 2023, were included. Participants were excluded if related symptoms were not documented and/or could not be assessed. After excluding one patient who previously experienced severe complications and unconsciousness before COVID-19, 131 patients were included. Included patients were undergoing MHD 2–3 times per week using a dialysis machine (4008s, Fresenius Medical Care, Bad Homburg, Germany) and dialyzer (FX80, Fresenius, Bad Homburg, Germany), with a blood flow of 200–280 mL/min and a dialysate flow rate of 500 mL/min. The dialysate consisted of the following: sodium, 138–140 mmol/L; potassium, 2.0–3.0 mmol/L; calcium, 1.25–1.5 mmol/L; and magnesium, 0.5 mmol/L. All patients provided informed written consent to participate in the present study, which was approved by the Ethics Committee of Beijing Tsinghua Changgung Hospital, Tsinghua University.
Potential clinical value of catheters impregnated with antimicrobials for the prevention of infections associated with peritoneal dialysis
Published in Expert Review of Medical Devices, 2023
Hari Dukka, Maarten W. Taal, Roger Bayston
PD fluid is commercially supplied in bags, which come connected to a Y-shaped giving set. The patient manually connects the short arm of the Y connector to the PD catheter. The other arm of the Y-shaped giving set is attached to an empty dialyzate bag (Figure 2). A small volume of dialysis fluid is drained directly from the new bag into the empty bag and in principle this flushes away any bacteria at the end of the catheter. This has been named the ‘flush before fill’ technique. After this, the dialysate in the peritoneal cavity from the previous exchange is drained out into the empty bag. Once this process is finished, fresh dialysis fluid is infused into the peritoneal cavity via the PD catheter after clamping the long arm of the Y connector, which leads to the bag that now contains drained dialysate. The ‘flush before fill’ technique has been shown to reduce peritonitis rates [11]. Patients are trained to follow strict hand hygiene and to follow an aseptic technique while performing exchanges to reduce the risk of infections.