Fluid balance and continence care
Barbara Smith, Linda Field in Nursing Care, 2019
Certain abnormalities occur in the production and the elimination of urine: Polyuria: this is the production by the kidneys of abnormally high amounts of urine, sometimes as much as several litres per day. Polyuria is usually associated with diseases such as diabetes mellitus, diabetes insipidus and chronic nephritis (inflammation of the nephrons within the kidney).Oliguria: this is decreased urine output, usually less than 500 mL a day or 30 mL an hour. Oliguria often indicates impaired blood flow to the kidneys or impending renal failure and should be dealt with immediately.Anuria: this is the absence of urine production. Anuria is a serious medical condition that usually follows oliguria. It must be treated immediately in order to prevent death from renal failure. Renal dialysis is used when the kidneys are no longer able to filter blood.
Interpretative phenomenological analysis and the psychology of health and illness1
Lucy Yardley in Material discourses of health and illness, 2013
Haemodialysis is a treatment regime for end-stage renal disease (ESRD). During dialysis, the patient is connected to a machine which takes over the function of the damaged kidneys, extracting, cleansing and replacing the blood. Treatment sessions are long and frequent, commonly lasting three hours three times a week, and can take place either in hospital or, if the patient has their own machine, at home. Psychological research on ESRD, and more particularly haemodialysis treatment, tends to paint a gloomy picture of its effects on psychological well-being with high levels of depression and anxiety being reported. Most of the existing studies on ESRD have, not surprisingly, adopted the quantitative paradigm. This study, by contrast, aims to explore in detail the perceptions of a dialysis patient by examining one woman's account of her experience. A semi-structured interview with the woman was subjected to interpretative phenomenological analysis.2
Answers
Andrew Schofield, Paul Schofield in The Complete SAQ Study Guide, 2019
Renal replacement therapy is commonly started in patients with an eGFR <15 and who are symptomatic. Generally speaking, the three options are haemodialysis, peritoneal dialysis and renal transplant. Haemodialysis involves the formation of an arteriovenous fistula. The patient is then connected to a haemodialysis machine, where their blood and dialysis fluid flow in opposite directions on either side of a semipermeable membrane. Molecules diffuse down their concentration gradients, maintaining normal electrolyte concentrations, a normal extracellular volume and removing nitrogenous waste. Peritoneal dialysis involves the insertion of a Tenckhoff catheter, which allows dialysis fluid to be introduced into the peritoneal cavity. The peritoneal membrane is used as a semipermeable membrane, and molecules again diffuse down their concentration gradients to achieve the same goals. Transplantation is often the treatment of choice, and dialysis may be used until an appropriate donor kidney is found. The transplant may be from a cadaveric donor (a brainstem-dead donor who is still being supported and ventilated), from a non-heart-beating donor, from a living related donor or a live unrelated donor. Patients must be ABO compatible with their donor, and HLA matching increases the chance of graft survival. Lifelong immunosuppressive agents are used following this.
Association of Malnutrition Inflammation Score With Anthropometric Parameters, Depression, and Quality of Life in Hemodialysis Patients
Published in Journal of the American College of Nutrition, 2019
Feray Gencer, Hilal Yıldıran, Yasemin Erten
Dialysis is a treatment based on the fluid–solute exchange between the patient's blood and dialysis solution through a semipermeable membrane. Fluid and solute exchange is usually from the patient's blood to dialysate, and fluid–solute imbalance shows improvement in the patient due to dialysis treatment (1). However, hemodialysis patients may be at risk for malnutrition due to catabolic effects caused by dialysis, including loss of amino acids, inadequate nutrient intake, acidosis, and inflammation (2). Protein energy wasting (PEW) is a type of malnutrition seen in these patients, which is clinically different, especially inflammation accompanies this condition (3). Because malnutrition affects the prognosis of disease and quality of life in hemodialysis patients, evaluation and monitoring of malnutrition are very important. Malnutrition Inflammation Score (MIS) is used to help assess the clinical and nutritional status of dialysis patients. The serum albumin, total iron binding capacity (TIBC), body mass index (BMI), weight change, food consumption, gastrointestinal symptoms, functional capacity, disease status, and nutritional requirements are assessed through MIS (4). The impaired quality of life reported in hemodialysis patients has attracted attention, with depressive disorders as well as many diseases seen in these patients, and has been associated with MIS (5,6). Despite the advances of theurepatic approaches in hemodialysis patients, low quality of life and depression can negatively affect disease status and mortality (7).
In Vitro models for thrombogenicity testing of blood-recirculating medical devices
Published in Expert Review of Medical Devices, 2019
Blood-recirculating medical devices play a large role in the delivery of modern healthcare through treating or improving the quality of life in patients with a wide range of diseases. For example, stents, catheters, vascular grafts, and heart valves are commonly used devices in cardiovascular medicine. Dialysis is commonly used to perform blood filtration in patients with impaired kidney function. The regulation of these devices by the U.S. Food and Drug Administration (FDA) reaches back to the late 1900s. As the field has expanded, guidelines for the classification, efficiency, and safety of these devices have expanded alongside them. Advancements in the medical device field aim to improve efficiency, biocompatibility and provide longer term solutions to chronic diseases. While all blood-recirculating devices require an evaluation of biocompatibility to assess their safety, this review will focus on the thrombosis testing in MCS, ECMO, and hemodialyzers because of their relatively large blood-contacting surface areas and advancement in these technologies are increasingly moving towards the development of wearable and implantable replacement organs.
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.
Related Knowledge Centers
- Acute Kidney Injury
- Chronic Kidney Disease
- Renal Replacement Therapy
- Toxin
- Uremia
- Blood
- Kidney Transplantation
- Solution
- Glomerular Filtration Rate
- Creatinine