Chronic Hemodialysis in Children Although renal transplantation is the optimal treatment for end-stage kidney disease in children and adolescents, many pediatric patients nonetheless must spend some time on chronic dialysis. Historically, a much larger proportion of children than adults undergo…
Vascular Access Hemodialysis requires a central venous catheter, and in infants, this poses technical challenges because of their smaller vessel size and the likelihood that they may require vascular access throughout their lifetime if end-stage renal disease is present. Dialysis…
Dialysis Access in the Pediatric ESRD Patient Vascular Access in Children Introduction Renal transplantation is the most common renal replacement modality for prevalent children with end-stage renal disease (ESRD). However, hemodialysis (HD) continues to be the most common initial treatment.…
More than 2 million poisonings were reported to the American Association of Poison Control Centers in 2021. Outcomes are generally favorable, and supportive measures alone are sufficient to manage the majority of poisonings. In selected situations, gastrointestinal decontamination, timely administration…
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…