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Pediatric Nephrology (Berlin, Germany) May 2020Acute kidney injury (AKI) is an increasingly frequent complication among hospitalized children. It is associated with high morbidity and mortality, especially in... (Review)
Review
Acute kidney injury (AKI) is an increasingly frequent complication among hospitalized children. It is associated with high morbidity and mortality, especially in neonates and children requiring dialysis. The different renal replacement therapy (RRT) options for AKI have expanded from peritoneal dialysis (PD) and intermittent hemodialysis (HD) to continuous RRT (CRRT) and hybrid modalities. Recent advances in the provision of RRT in children allow a higher standard of care for increasingly ill and young patients. In the absence of evidence indicating better survival with any dialysis method, the most appropriate dialysis choice for children with AKI is based on the patient's characteristics, on dialytic modality performance, and on the institutional resources and local practice. In this review, the available dialysis modalities for pediatric AKI will be discussed, focusing on indications, advantages, and limitations of each of them.
Topics: Acute Kidney Injury; Child; Clinical Decision-Making; Humans; Nephrology; Pediatrics; Peritoneal Dialysis; Practice Guidelines as Topic; Renal Dialysis; Treatment Outcome
PubMed: 30887109
DOI: 10.1007/s00467-019-04213-x -
Nature Reviews. Nephrology Oct 2020The development of dialysis by early pioneers such as Willem Kolff and Belding Scribner set in motion several dramatic changes in the epidemiology, economics and ethical... (Review)
Review
The development of dialysis by early pioneers such as Willem Kolff and Belding Scribner set in motion several dramatic changes in the epidemiology, economics and ethical frameworks for the treatment of kidney failure. However, despite a rapid expansion in the provision of dialysis - particularly haemodialysis and most notably in high-income countries (HICs) - the rate of true patient-centred innovation has slowed. Current trends are particularly concerning from a global perspective: current costs are not sustainable, even for HICs, and globally, most people who develop kidney failure forego treatment, resulting in millions of deaths every year. Thus, there is an urgent need to develop new approaches and dialysis modalities that are cost-effective, accessible and offer improved patient outcomes. Nephrology researchers are increasingly engaging with patients to determine their priorities for meaningful outcomes that should be used to measure progress. The overarching message from this engagement is that while patients value longevity, reducing symptom burden and achieving maximal functional and social rehabilitation are prioritized more highly. In response, patients, payors, regulators and health-care systems are increasingly demanding improved value, which can only come about through true patient-centred innovation that supports high-quality, high-value care. Substantial efforts are now underway to support requisite transformative changes. These efforts need to be catalysed, promoted and fostered through international collaboration and harmonization.
Topics: Dialysis; Forecasting; Global Health; Health Care Costs; Humans; Inventions; Kidneys, Artificial; Peritoneal Dialysis; Renal Dialysis; Renal Insufficiency
PubMed: 32733095
DOI: 10.1038/s41581-020-0315-4 -
The Medical Journal of Australia Apr 1990
Topics: Aged; Australia; Humans; Middle Aged; Renal Dialysis
PubMed: 2093799
DOI: 10.5694/j.1326-5377.1990.tb125179.x -
JNMA; Journal of the Nepal Medical... 2018
Topics: Clinical Decision-Making; Humans; Kidney Transplantation; Patient Acceptance of Health Care; Patient Selection; Peritoneal Dialysis; Procedures and Techniques Utilization; Quality of Life; Renal Dialysis; Renal Insufficiency
PubMed: 30375996
DOI: No ID Found -
Clinical Techniques in Small Animal... Aug 2000Hemodialysis is a therapeutic procedure that uses the extracorporeal circulation of a patient's blood to ameliorate the azotemia, fluid, electrolyte, and acid-base... (Review)
Review
Hemodialysis is a therapeutic procedure that uses the extracorporeal circulation of a patient's blood to ameliorate the azotemia, fluid, electrolyte, and acid-base abnormalities characteristic of the uremic syndrome. Hemodialysis is principally used for the management of acute and chronic renal failure that is refractory to conventional medical therapy. Additional applications include acute intoxications (e.g., ethylene glycol poisoning) and preoperative conditioning of renal transplant recipients. Hemodialysis is a technically demanding procedure that requires an extensive array of sophisticated delivery equipment and specifically trained and dedicated staff to perform, monitor, and ensure the integrity and safety of the procedure in critically ill patients. The advent of neonatal dialysis delivery equipment has ensured that hemodialysis is a feasible, efficacious, safe, and indispensable therapy for dogs and cats with life-threatening renal failure. Increased awareness and acceptance of hemodialysis as an effective renal replacement therapy coupled with increased owner demand guarantee a bright future for hemodialysis as a viable therapeutic modality.
Topics: Animals; Cat Diseases; Cats; Dog Diseases; Dogs; Kidney Diseases; Renal Dialysis
PubMed: 11109715
DOI: 10.1053/svms.2000.18297 -
American Journal of Kidney Diseases :... Jan 2014
Topics: Curriculum; Education, Medical, Continuing; Humans; Kidney Diseases; Nephrology; Renal Dialysis
PubMed: 24268927
DOI: 10.1053/j.ajkd.2013.07.028 -
International Urology and Nephrology Mar 2020Hemodialysis (HD) is one of the resource hungry medical interventions. A huge volume of water (about 500 L) and significant amounts of energy (over 7 kW) are used for... (Review)
Review
Hemodialysis (HD) is one of the resource hungry medical interventions. A huge volume of water (about 500 L) and significant amounts of energy (over 7 kW) are used for a hemodialysis session; over a kilogram of waste is produced during this procedure. Thus, HD contributes to global warming while saving patients' lives. In this paper, we showed these crucial points in HD treatment and possible ways (e.g. modifications in dialysate flow rate) to reduce environmental impact maintaining therapy standards.
Topics: Conservation of Natural Resources; Ecological and Environmental Phenomena; Humans; Kidney Failure, Chronic; Renal Dialysis
PubMed: 32008203
DOI: 10.1007/s11255-020-02393-2 -
Contributions To Nephrology 2017Despite advances in renal replacement therapy, the adequate removal of uremic toxins over a broad molecular weight range remains one of the unmet needs in hemodialysis.... (Review)
Review
Despite advances in renal replacement therapy, the adequate removal of uremic toxins over a broad molecular weight range remains one of the unmet needs in hemodialysis. Therefore, membrane innovation is currently directed towards enhanced removal of uremic toxins and increased membrane permeability. This chapter presents a variety of opportunities where innovation is brought into dialysis membranes. It covers the membrane formation from solution, describing different approaches to control the phase inversion process through additives that either swell in the polymer solution or influence the pore shrinkage during the membrane drying process. Additionally, large-scale manufacturing is described, and the influence of raw materials, spinning, and drying processes on membrane selectivity are presented. Finally, new characterization methods developed for the latest innovations around the application of membranes in dialysis are discussed, which allow the membrane performance for removal of a broad range of uremic toxins and the expected albumin loss in clinical use.
Topics: Humans; Manufactured Materials; Membranes, Artificial; Renal Dialysis; Uremia
PubMed: 28910794
DOI: 10.1159/000479259 -
Nursing Standard (Royal College of... Jun 1988
Topics: Arteriovenous Shunt, Surgical; Humans; Renal Dialysis
PubMed: 3045634
DOI: No ID Found -
JAMA Jan 2024
Topics: Renal Dialysis; Healthcare Disparities; Government Regulation; Federal Government; United States
PubMed: 38193972
DOI: 10.1001/jama.2023.18590