Continuous renal replacement therapy (CRRT) has evolved as the preferred form of dialysis in hemodynamically unstable critically ill patients with acute kidney injury (AKI). It is applied continuously and achieves solute clearance and fluid removal by convection, as in continuous…
Acute kidney injury (AKI) is a clinical syndrome characterized by an abrupt decrease in kidney function. It leads to the inability of the kidney to excrete waste products, manage electrolytes, regulate fluid balance, and maintain acid-base status. Based on the…
Telemedicine in Kidney Failure: Overview of the Opportunity and Issues Telemedicine is rapidly becoming a consistent part of health care delivery. While the term “telemedicine” includes any delivery or monitoring of care remotely, including telephonic care, the contemporary definition includes…
Introduction The challenges found in end-stage kidney disease (ESKD) facilities in the United States mirror fundamental shortcomings in the American health care system in general, as described in the Institute of Medicine (IOM) 2001 report Crossing the Quality Chasm: A…
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Ethics in the care of patients is about doing the right and good thing. Nephrologists want to do the right thing and treat their patients ethically, but unfortunately, most have not received formal training in the ethics of dialysis patient…
Preventive care of dialysis patients encompasses general medical care issues as well as dialysis-specific issues that are detailed in preceding chapters. In this chapter, aspects of general medical preventive care are discussed as they apply to maintenance dialysis patients. The…
Whatever the cause of kidney failure, for most patients, the effects are the same. The insidious progression of symptoms parallels the slow worsening of blood chemistries as glomerular filtration declines. Many patients fail to recognize the change in their vigor…
Introduction The focus on increasing physical activity for those people with a high burden of cardiometabolic) conditions and complications (i.e., kidney failure, diabetes, cardiovascular comorbidities) for managing symptoms and maintaining physical well-being is at an all-time high. Rehabilitation, meaning recovering…
Medication management is a patient-centered care process that optimizes safe, effective, and appropriate drug therapy. Medication management is a repeating process that involves patient assessment, creating and implementing a care plan, and follow-up and evaluation ( Fig. 59.1 ). Care…