By William L. Henrich MD
ISBN-10: 0781781639
ISBN-13: 9780781781633
This e-book is an evidence-based overview of the sensible demanding situations of facing sufferers receiving dialysis. the 1st part covers technical and procedural issues comparable to picking out the hemodialysis membrane and selecting the easiest dialysis choice. the second one part covers medical concerns similar to an infection and the remedy of particular renal ailment issues. The publication contains various illustrations and tables and drug charts for dialysis patients.
This edition's present results bankruptcy has been extended to incorporate sufferer melancholy and enhancing caliber of care. New chapters conceal dialysis within the ICU, valvular center illness, and pre-emptive renal transplantation.
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Additional resources for Principles and Practice of Dialysis
Sample text
When dialyzers that were both high flux and more biocompatible became available, they were so expensive that reuse became an economic necessity. Dialyzer reprocessing was initially performed manually. Patient safety concerns centered on the delivery of the proper concentrations of sterilants and complete filling of the dialyzer with sterilant. Exposure to toxic chemicals was a major risk for both patients and staff. By 1982, approximately 20% of dialysis centers practiced reuse (50). With the change in reimbursement from a reasonable charge basis to a fixed composite rate, reuse participation increased rapidly to more than 80% of all patients and dialysis facilities in 2000 (Fig.
Initially, formaldehyde was the most commonly used germicide for reuse (50). By the 1990s, 40% of reuse facilities used either PAM or formaldehyde and less than 10% used glutaraldehyde as the germicide (50). As of 2000, 59% of dialysis facilities used PAM germicide, 36% used formalin, and approximately an equal percentage (4%) used either heat or glutaraldehyde (Fig. 2) (49). THE NUMBER OF REUSE The potential for decreased solute transport resulting from either alterations in membrane integrity or loss of fiber bundles from occlusion and/or thrombosis are major limiting factors to the number of times that a dialyzer can be reprocessed (58,75).
Longer treatment time and slower ultrafiltration in hemodialysis: associations with reduced mortality in the DOPPS. Kidney Int 2006;69:1222–1228. 79. Vanholder R, Glorieux G, De Smet R, et al. New insights in uremic toxins. Kidney Int 2003;63(Suppl 84):S6–S10. 80. Leypoldt JK, Cheung AK, Carroll CE, et al. Effect of dialysis membranes and middle molecule removal on chronic hemodialysis patient survival. Am J Kidney Dis 1999;33:349–355. 81. Woods HF, Nandakumar M. Improved outcome for hemodialysis patients treated with high-flux membranes.
Principles and Practice of Dialysis by William L. Henrich MD
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