PRINCIPLES AND PRACTICE OF DIALYSIS

Author: William Henrich, MD, MACP
Affiliation: University of Texas Health Science Center, San Antonio
Publisher: Lippincott Williams & Wilkins
Publication Date: 2009
ISBN 10: 0781781639
ISBN 13: 9780781781633
Edition: 4th

Description:

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.

Table of Contents

Front Matter

  • ABOUT
  • DEDICATION
  • CONTRIBUTING AUTHORS
  • PREFACE
  • ACKNOWLEDGEMENTS

Choice of the Hemodialysis Membrane

  • MEMBRANE CLASSIFICATIONS
  • MEMBRANE PROPERTIES AND MECHANISMS OF SOLUTE REMOVAL
  • CLINICAL TERMS USED TO CHARACTERIZE DIALYZER PERFORMANCE
  • BIOCOMPATIBILITY
  • CLINICAL OUTCOMES
  • REFERENCES

Reuse of Hemodialysis Membranes in Chronic Dialysis Therapy

  • HISTORICAL INTRODUCTION
  • TYPES OF REUSE
  • THE NUMBER OF REUSE
  • BLOOD CELLULOSIC INTERACTIONS
  • SAFETY
  • POTENTIAL LONG-TERM HAZARDS OF DIALYZER REUSE
  • INFECTION RISK
  • TOXICITY OF LONG-TERM ACCUMULATIVE EXPOSURE TO DIALYZER REUSE
  • MORTALITY
  • REPROCESSING TECHNIQUE
  • IDENTIFICATION
  • RINSING
  • CLEANING
  • TEST OF DIALYZER PERFORMANCE
  • TEST OF FIBER BUNDLE VOLUME
  • DISINFECTANT AND STERILIZATION
  • INSPECTION
  • SUMMARY
  • REFERENCES

Dialysate Composition in Hemodialysis and Peritoneal Dialysis

  • DIALYSATE COMPOSITION IN HEMODIALYSIS
  • DIALYSATE COMPOSITION IN PERITONEAL DIALYSIS
  • REFERENCES

Hemodialysis Vascular Access

  • ACUTE VASCULAR ACCESS
  • PERMANENT VASCULAR ACCESS
  • SUMMARY
  • REFERENCES

Anticoagulation Strategies During Hemodialysis Procedures

  • COAGULATION IN DIALYSIS PATIENTS
  • UNFRACTIONATED HEPARIN
  • LOW MOLECULAR WEIGHT HEPARIN
  • ALTERNATIVE ANTICOAGULATION STRATEGIES
  • FACTORS PREVENTING ADEQUATE ANTICOAGULATION
  • SUMMARY
  • REFERENCES

Approach to Hemodialysis Kinetic Modeling

  • HISTORICAL PERSPECTIVE
  • UREA, A MARKER FOR CLEARANCE AND PROTEIN CATABOLISM
  • FACTORS THAT DETERMINE THE REQUIREMENT FOR DIALYSIS
  • TARGETING THE AMOUNT OF DIALYSIS
  • SINGLE-COMPARTMENT KINETIC MODELING
  • MULTIPLE-COMPARTMENT KINETIC MODELING
  • DIALYSATE METHODS
  • THE DIALYSIS SCHEDULE: MORE FREQUENT IS MORE EFFICIENT
  • SIMPLIFIED APPROACHES TO QUANTIFYING DIALYSIS
  • PRACTICE GUIDELINES AND STANDARDS
  • PITFALLS OF UREA MODELING
  • SUMMARY
  • REFERENCES

Choosing the Best Dialysis Option in the Patient with End-Stage Kidney Disease

  • OVERVIEW OF TREATMENT OPTIONS
  • DIALYSIS MODALITY DISTRIBUTION
  • MODALITY SELECTION
  • HEMODIALYSIS VERSUS PERITONEAL DIALYSIS: WHICH IS BETTER?
  • PERITONEAL DIALYSIS
  • HEMODIALYSIS
  • RECOMMENDATIONS
  • REFERENCES

Hemodialysis Adequacy and the Timing of Dialysis Initiation

  • HISTORICAL PERSPECTIVE
  • NUTRITION AND THE TIMING OF DIALYSIS INITIATION
  • DIALYSIS QUANTIFICATION
  • HEMODIALYSIS DOSE AND OUTCOME
  • BARRIERS TO ADEQUATE HEMODIALYSIS
  • CONCLUSION
  • REFERENCES

High-Flux and High-Efficiency Procedures

  • DEFINITION OF HIGH-EFFICIENCY AND HIGH-FLUX DIALYSIS
  • TECHNICAL REQUIREMENTS FOR HIGH-EFFICIENCY AND HIGH-FLUX TREATMENTS
  • CLINICAL APPLICATIONS OF HIGH-EFFICIENCY AND HIGH-FLUX THERAPIES
  • SHORT HEMODIALYSIS
  • LONG-TERM SURVIVAL OF PATIENTS ON HIGH-EFFICIENCY AND HIGH-FLUX DIALYSIS
  • CONCLUSION
  • ACKNOWLEDGMENTS
  • REFERENCES

Long and Daily Hemodialysis

  • HISTORICAL PERSPECTIVE
  • TERMINOLOGY
  • THEORY/KINETICS
  • OUTCOMES
  • CONCLUSION
  • REFERENCES

Prescribing Drugs for Dialysis Patients

  • INITIAL PATIENT ASSESSMENT
  • REFERENCES
  • APPENDIX

Continuous Dialysis Therapeutic Techniques

  • TERMINOLOGY
  • COMPONENTS
  • OPERATIONAL CHARACTERISTICS
  • APPLICATIONS
  • RESULTS WITH CONTINUOUS TECHNIQUES
  • THE FUTURE
  • SUMMARY
  • REFERENCES

Choosing the Best Dialysis Option in Patients with Acute Renal Failure and in the Intensive Care Unit

  • HOW IS THE APPLICATION OF EXTRACORPOREAL BLOOD PURIFICATION DIFFERENT IN THE INTENSIVE CARE UNIT?
  • EXTRACORPOREAL BLOOD PURIFICATION: CURRENT TECHNOLOGY, HYBRID CIRCUITS, AND EMERGING MODALITIES
  • SPECIAL CIRCUMSTANCES
  • ROLE OF NEPHROLOGISTS IN THE INTENSIVE CARE UNIT
  • CONCLUSION
  • ACKNOWLEDGMENTS
  • REFERENCES

Adequacy of Peritoneal Dialysis

  • WHAT YARDSTICK FOR ADEQUACY OF DIALYSIS SHOULD WE USE?
  • RECOMMENDED ACCEPTABLE TOTAL SOLUTE CLEARANCE TARGETS FOR PERITONEAL DIALYSIS
  • IMPORTANCE OF RESIDUAL RENAL FUNCTION
  • IMPACT OF NUTRITIONAL STATUS ON PATIENT OUTCOME
  • MEASUREMENTS OF NUTRITIONAL STATUS
  • MAJOR DETERMINANTS OF TOTAL SOLUTE CLEARANCE
  • SPECIAL CONSIDERATIONS
  • VOLUME AND BLOOD PRESSURE CONTROL ISSUES
  • HOW TO MONITOR DIALYSIS DOSE?
  • NONCOMPLIANCE
  • PRESCRIPTION DIALYSIS
  • SUMMARY
  • REFERENCES

Causes, Diagnosis, and Treatment of Peritoneal Membrane Failure

  • SOLUTE AND FLUID TRANSPORT IN PERITONEAL DIALYSIS
  • EVALUATION OF PERITONEAL MEMBRANE FUNCTION
  • DIAGNOSTIC APPROACH, DIFFERENTIAL DIAGNOSIS, AND TREATMENT OF THE PATIENT WITH ULTRAFILTRATION FAILURE
  • FLUID OVERLOAD WITHOUT ULTRAFILTRATION FAILURE
  • FLUID OVERLOAD WITH ULTRAFILTRATION FAILURE
  • CONCLUSION
  • REFERENCES

Hypertension in Dialysis Patients

  • INTRODUCTION
  • PATHOGENESIS OF HYPERTENSION IN PATIENTS WITH END-STAGE RENAL DISEASE
  • MANAGEMENT OF HYPERTENSION IN DIALYSIS SUBJECTS
  • RESISTANT HYPERTENSION IN DIALYSIS PATIENTS
  • REFERENCES

Left Ventricular Dysfunction and Valvular Heart Disease in Dialysis Patients

  • LEFT VENTRICULAR HYPERTROPHY AND HEART FAILURE
  • CARDIAC ARRHYTHMIAS
  • DIALYSIS-ASSOCIATED HYPOTENSION
  • CONCLUSION
  • REFERENCES

Coronary Artery Disease in End-Stage Renal Disease Patients

  • PATHOGENESIS OF ATHEROSCLEROSIS IN PATIENTS WITH END-STAGE RENAL DISEASE
  • CLINICAL PRESENTATION OF CORONARY ARTERY DISEASE IN PATIENTS WITH END-STAGE RENAL DISEASE
  • DIAGNOSIS OF CORONARY ARTERY DISEASE IN PATIENTS WITH END-STAGE RENAL DISEASE
  • MANAGEMENT OF CORONAY ARTERY DISEASE IN PATIENTS WITH END-STAGE RENAL DISEASE
  • REFERENCES

Hemodynamic Stability and Autonomic Dysfunction in End-Stage Renal Disease

  • OVERVIEW OF THE PROBLEM
  • VASCULAR REFILLING
  • CARDIAC REFILLING AND VENOUS DYSFUNCTION
  • SYSTOLIC AND DIASTOLIC FUNCTION OF THE HEART
  • ARTERIAL DYSFUNCTION
  • AUTONOMIC NEUROPATHY
  • THERAPY FOR HEMODYNAMIC INSTABILITY DURING HEMODIALYSIS
  • INDIVIDUALIZING THE DIALYSIS PRESCRIPTION
  • ACUTE TREATMENT OF HYPOTENSION
  • REFERENCES

Oxidant Stress in End-Stage Renal Disease

  • DEFINITION OF OXIDANT STRESS
  • GENERATION OF REACTIVE OXYGEN SPECIES IN THE BIOLOGIC SYSTEM
  • PHYSIOLOGIC ANTIOXIDANT SYSTEM
  • PATHOPHYSIOLOGY OF OXIDATIVE STRESS IN DIALYSIS PATIENTS
  • BIOMARKERS OF OXIDATIVE STRESS
  • ADVANCED GLYCATION END PRODUCTS
  • ADVANCED LIPID PEROXIDATION (ATOMIC LAYER EPITAXIES)
  • ADVANCED OXIDIZED PROTEIN PRODUCTS
  • THE EUROPEAN UREMIC TOXIN WORK GROUP
  • CONSEQUENCES OF INCREASED OXIDATIVE STRESS
  • OXIDANT STRESS AND ACCELERATED ATHEROSCLEROSIS
  • ROLE OF REACTIVE OXYGEN SPECIES IN THE PATHOGENESIS OF β2 MICROGLOBULIN DISEASE
  • REACTIVE OXYGEN SPECIES AND THEIR ROLE IN PERITONEAL MEMBRANE FAILURE IN PERITONEAL DIALYSIS PATIENTS
  • REACTIVE OXYGEN SPECIES AND THEIR ROLE IN THE PATHOGENESIS OF INFLAMMATION AND CARDIOVASCULAR DISEASE
  • ENDOTHELIAL DYSFUNCTION
  • CAN DIALYSIS-ASSOCIATED INCREASED OXIDATIVE STRESS BE PREVENTED?
  • SUMMARY
  • REFERENCES

Low-Grade Persistent Inflammation and Immune Dysfunction in Uremia

  • INTRODUCTION
  • ALTERED IMMUNITY IN CHRONIC KIDNEY DISEASE
  • MANY CAUSES FOR INCREASED PREVALENCE OF INFLAMMATION IN CHRONIC KIDNEY DISEASE
  • Consequences of Inflammation in the Clinical Setting of Uremia
  • PREVENTION AND TREATMENT OF INFLAMMATION
  • ACKNOWLEDGMENTS
  • REFERENCES

Hepatitis and Human Immunodeficiency Virus Infections in End-Stage Renal Disease Patients

  • EPIDEMIOLOGY OF HEPATITIS B VIRUS, HEPATITIS C VIRUS, AND HUMAN IMMUNODEFICIENCY VIRUS INFECTIONS IN HEMODIALYSIS PATIENTS
  • MORBIDITY AND MORTALITY OF HUMAN IMMUNODEFICIENCY VIRUS, HEPATITIS C VIRUS, AND HEPATITIS B VIRUS INFECTION IN HEMODIALYSIS PATIENTS
  • SCREENING AND PREVENTION RECOMMENDATIONS FOR HUMAN IMMUNODEFICIENCY VIRUS, HEPATITIS B VIRUS, AND HEPATITIS C VIRUS IN HEMODIALYSIS PATIENTS
  • HEPATITIS C VIRUS SCREENING
  • TREATMENT OF HEPATITIS C VIRUS, HEPATITIS B VIRUS, AND HUMAN IMMUNODEFICIENCY VIRUS IN HEMODIALYSIS PATIENTS
  • TREATMENT OF HUMAN IMMUNODEFICIENCY VIRUS IN HEMODIALYSIS PATIENTS
  • INFECTION CONTROL MEASURES IN THE DIALYSIS UNIT
  • POSTEXPOSURE PROPHYLAXIS GUIDELINES FOR PATIENTS AND STAFF
  • HEPATITIS B VIRUS
  • HEPATITIS C VIRUS
  • REFERENCES

Endocrine Disease in Dialysis Patients

  • THYROID DISORDERS
  • ADRENOCORTICOTROPHIC HORMONE
  • DISORDERS OF THE ADRENAL CORTEX
  • REFERENCES

Gastrointestinal Complications in End-Stage Renal Disease

  • ESOPHAGUS
  • STOMACH/DUODENUM
  • GASTROINTESTINAL BLEEDING
  • PANCREAS
  • NEPHROGENIC ASCITES
  • CONSTIPATION
  • REFERENCES

Renal Osteodystrophy

  • SPECTRUM OF BONE DISEASE IN PATIENTS WITH END-STAGE RENAL DISEASE
  • PATHOPHYSIOLOGY OF RENAL OSTEODYSTROPHY
  • RENAL TRANSPLANTATION—OSTEODYSTROPHY
  • REFERENCES

Acid–Base Considerations in End-Stage Renal Disease

  • GENERAL PRINCIPLES
  • ACID–BASE HOMEOSTASIS IN PERITONEAL DIALYSIS
  • ACID–BASE HOMEOSTASIS IN HEMODIALYSIS
  • EFFECTS OF METABOLIC ACIDOSIS ON BONE AND MUSCLE METABOLISM
  • EFFECT OF PREDIALYSIS SERUM SERUM [HCO3−] ON MORTALITY
  • MANAGEMENT OF PATIENTS WITH LOW SERUM [HCO3−]
  • DAILY HEMODIALYSIS
  • CONTINUOUS RENAL REPLACEMENT THERAPIES
  • ACID–BASE DISORDERS IN PATIENTS WITH END-STAGE RENAL DISEASE
  • SUMMARY
  • REFERENCES

Dyslipidemia in Dialysis Patients

  • RISK FACTORS FOR CARDIOVASCULAR DISEASE IN DIALYSIS PATIENTS
  • DYSLIPIDEMIA IN DIALYSIS PATIENTS
  • MEASUREMENT AND MONITORING OF PLASMA LIPID LEVELS
  • MANAGEMENT OF DYSLIPIDEMIA
  • PHARMACOLOGIC TREATMENT OF SPECIFIC HYPERLIPIDEMIAS
  • REFERENCES

Malnutrition and Intradialytic Parenteral Nutrition in Patients with End-Stage Renal Disease

  • PROTEIN-ENERGY WASTING IN MAINTENANCE DIALYSIS PATIENTS
  • DIETARY THERAPY FOR MAINTENANCE DIALYSIS PATIENTS
  • RECOMMENDED DIETARY INTAKES
  • TREATMENT OF RISK FACTORS FOR VASCULAR DISEASE
  • PRIORITIZING DIETARY GOALS
  • ADJUSTED EDEMA-FREE BODY WEIGHT
  • INTRADIALYTIC PARENTERAL NUTRITION
  • REFERENCES

Disorders of Hemostasis in Dialysis Patients

  • CAUSES OF UREMIC BLEEDING
  • CONSEQUENCES OF THE BLEEDING TENDENCY IN UREMIA
  • THERAPEUTIC STRATEGIES
  • ABNORMALITIES OF COAGULATION AND FIBRINOLYSIS
  • THROMBOTIC COMPLICATIONS
  • CONCLUSION
  • REFERENCES

Treatment of Anemia in Patients with End-Stage Renal Disease

  • ANEMIA OF CHRONIC KIDNEY DISEASE: MAGNITUDE OF THE PROBLEM
  • PHYSIOLOGY OF ERYTHROPOIETIN AND ERYTHROPOIESIS
  • CLINICAL AND LABORATORY FEATURES
  • PATHOPHYSIOLOGY OF THE ANEMIA OF RENAL DISEASE
  • THERAPY OF RENAL ANEMIA
  • ADVERSE EVENTS OF RECOMBINANT HUMAN ERYTHROPOIETIN THERAPY
  • TREATMENT OF ANEMIA
  • REFERENCES

Neurologic Complications Associated with Dialysis and Chronic Renal Insufficiency

  • CENTRAL NERVOUS SYSTEM ABNORMALITIES
  • PERIPHERAL NERVOUS SYSTEM INVOLVEMENT IN UREMIA
  • REFERENCES

The Geriatric Dialysis Patient

  • DEMOGRAPHIC CHARACTERISTICS OF THE GERIATRIC POPULATION WITH END-STAGE RENAL DISEASE
  • INDICATIONS FOR INITIATION OF DIALYSIS
  • CHOOSING A KIDNEY REPLACEMENT THERAPY MODALITY
  • DIALYSIS TECHNICAL CONSIDERATIONS
  • SPECIAL SITUATIONS IN THE ELDERLY DIALYSIS PATIENT
  • SPECIAL SITUATIONS IN THE ELDERLY PERITONEAL DIALYSIS PATIENT
  • DIALYSIS IN A NURSING HOME SETTING
  • ETHICAL ISSUES IN ELDERLY DIALYSIS PATIENTS
  • REFERENCES

Dialytic Therapy for Renal Failure in Pandemic Diabetes and Nephropathy

  • EPIDEMIOLOGY
  • IMPACT OF DIABETES ON PATIENTS AND NATIONAL RESOURCES
  • DIABETIC RENAL DISEASE
  • PREPARING FOR RENAL REPLACEMENT THERAPY
  • HEMODIALYSIS-RELATED COMPLICATIONS
  • CONTINUOUS AMBULATORY PERITONEAL DIALYSIS IN DIABETIC PATIENTS
  • RENAL TRANSPLANTATION IN PATIENTS WITH DIABETIC NEPHROPATHY
  • CONCLUSION
  • REFERENCES

Quality of Life and Rehabilitation in Dialysis Patients

  • DEFINITION OF QUALITY OF LIFE
  • MEASUREMENT OF QUALITY OF LIFE
  • QUALITY OF LIFE IN END-STAGE RENAL DISEASE
  • IMPACT OF QUALITY OF LIFE
  • EARLY REFERRAL
  • SLEEP DISTURBANCES
  • SOCIAL SUPPORT AND THE QUALITY OF LIFE FOR CAREGIVERS
  • ANEMIA
  • DEPRESSION
  • DEMOGRAPHIC VARIABLES
  • HEALTH-RELATED QUALITY OF LIFE
  • DIALYSIS-RELATED FACTORS
  • NUTRITION AND PHYSICAL ACTIVITY
  • CONCLUSION
  • REFERENCES

Extracorporeal Treatment of Poisoning and Drug Overdose

  • EPIDEMIOLOGY
  • GENERAL TREATMENT MEASURES
  • EXTRACORPOREAL METHODS OF DETOXIFICATION
  • CRITERIA FOR THE USE OF EXTRACORPOREAL TECHNIQUES IN THE TREATMENT OF EXOGENOUS INTOXICATIONS
  • ETHYLENE GLYCOL
  • METHANOL
  • ISOPROPANOL (ISOPROPYL ALCOHOL)
  • SALICYLATES
  • LITHIUM
  • THEOPHYLLINE
  • ETHANOL
  • ACETAMINOPHEN OVERDOSE
  • REFERENCES

Chronic Dialysis in Children

  • EPIDEMIOLOGIC ISSUES
  • PRINCIPLES OF DIALYSIS IN CHILDREN: PERITONEAL DIALYSIS
  • PRINCIPLES OF DIALYSIS IN CHILDREN: HEMODIALYSIS
  • DIALYSIS FOR ACUTE RENAL FAILURE IN CHILDREN
  • DIALYSIS FOR END-STAGE RENAL DISEASE IN CHILDREN
  • CHRONIC PERITONEAL DIALYSIS FOR CHILDREN
  • COMPLICATIONS OF CHRONIC PERITONEAL DIALYSIS IN CHILDREN
  • CHRONIC HEMODIALYSIS FOR CHILDREN
  • METHODS TO PREVENT ULTRAFILTRATION-ASSOCIATED SYMPTOMS
  • HEMODIALYSIS FOR NEONATES AND INFANTS
  • ADDITIONAL CLINICAL ISSUES IN THE PEDIATRIC DIALYSIS PATIENT
  • REFERENCES

Acute Dialysis in Children

  • ACUTE RENAL FAILURE IN CHILDREN
  • INDICATIONS FOR RENAL REPLACEMENT THERAPY
  • PERITONEAL DIALYSIS
  • HEMODIALYSIS
  • CONTINUOUS RENAL REPLACEMENT THERAPIES
  • SUMMARY
  • REFERENCES

Infections in Patients on Peritoneal Dialysis

  • INTRAPERITONEAL INFECTIONS
  • EXIT-SITE AND TUNNEL INFECTIONS
  • CONCLUSION
  • ACKNOWLEDGEMENTS
  • REFERENCES

Preparing Dialysis Patients for Renal Transplantation

  • CHOOSING THE APPROPRIATE TRANSPLANT PROCEDURE
  • MEDICAL EVALUATION OF THE PATIENT WITH END-STAGE RENAL DISEASE
  • MANAGEMENT OF PATIENTS ON THE CADAVERIC KIDNEY WAITING LIST
  • REFERENCES

Current Outcomes for Dialysis Patients and Improving Quality of Care for Dialysis Patients

  • Epidemiologic and Demographic Trends in End-Stage Renal Disease
  • Medicare End-Stage Renal Disease Program and the Cost of Caring for This Population
  • Choices for Renal Replacement Therapy
  • Clinical Performance Measures For Dialysis
  • Chronic Kidney Disease Care and End-Stage Renal Disease Outcomes
  • REFERENCES