Manual of clinical dialysis
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| Format: | Buch |
| Sprache: | English |
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Springer
2009
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| Ausgabe: | 2nd ed. |
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| 100 | 1 | |a Ahmad, Suhail |e Verfasser |4 aut | |
| 245 | 1 | 0 | |a Manual of clinical dialysis |c Suhail Ahmad |
| 250 | |a 2nd ed. | ||
| 264 | 1 | |a New York |b Springer |c 2009 | |
| 300 | |a XXIII, 245 S. |b Ill., graph. Darst. | ||
| 336 | |b txt |2 rdacontent | ||
| 337 | |b n |2 rdamedia | ||
| 338 | |b nc |2 rdacarrier | ||
| 650 | 4 | |a Hemodialysis | |
| 650 | 4 | |a Kidney Failure, Chronic |x therapy | |
| 650 | 4 | |a Peritoneal Dialysis |x methods | |
| 650 | 4 | |a Renal Dialysis |x methods | |
| 650 | 0 | 7 | |a Dialyse |0 (DE-588)4012064-8 |2 gnd |9 rswk-swf |
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| 943 | 1 | |a oai:aleph.bib-bvb.de:BVB01-017610461 | |
Datensatz im Suchindex
| DE-BY-TUM_call_number | 1102 MED 500f 2009 A 7164(2) |
|---|---|
| DE-BY-TUM_katkey | 1694512 |
| DE-BY-TUM_location | 11 |
| DE-BY-TUM_media_number | 040080304774 |
| _version_ | 1820896650815602688 |
| adam_text | Titel: Manual of clinical dialysis
Autor: Ahmad, Suhail
Jahr: 2009
Contents
Foreword (For First Edition) vii
Acknowledgements ix
Abbreviations xxi
1 Brief History of Clinical Dialysis: The Seattle Experience 1
1.1 Definition of Dialysis 3
1.2 Mechanisms Involved in Molecular Movement 3
1.2.1 Diffusion 4
1.2.2 Ultrafiltration 4
1.2.3 Osmosis 5
1.2.4 Convection 5
1.3 Clearance 5
1.3.1 Blood vs Plasma Clearance 6
1.3.2 Clinical Factors Influencing Dialysis Urea Clearance 6
Reference 6
2 Hemodialysis Technique 7
2.1 Blood Flow Rate 7
2.2 Dialysate Flow Rate 7
2.3 Dialyzer Efficiency and Mass Transfer Area Coefficient (KoA) .... 8
2.4 Different Hemodialysis Techniques 8
2.4.1 Traditional Hemodialysis 8
2.4.2 Hemofiltration 9
2.4.3 Hemodiafiltration 10
2.4.4 Slow Low Efficiency Dialysis (SLED) 10
2.4.5 Ultrafiltration 10
2.5 Hemodialysis Setup 10
2.5.1 Blood Circuit 11
2.5.2 Dialysate Circuit 18
References 27
xiii
xiv Contents
3 Anticoagulation 29
3.1 Heparin Anticoagulation 30
3.1.1 Systemic Standard Heparinization 31
3.1.2 Low-Dose Heparinization 31
3.1.3 Low Molecular Weight Heparin 31
3.2 Problems with Heparin Anticoagulation 32
3.3 Alternatives to Heparin 33
3.3.1 Citrate Anticoagulation 33
3.4 No Anticoagulation 35
References 36
4 Vascular Access 37
4.1 Permanent Access 37
4.1.1 Preparation 37
4.1.2 Arteriovenous Fistula 38
4.1.3 Arteriovenous Graft 41
4.1.4 Diagnosis and Management of Arteriovenous
Dialysis Access 43
4.1.5 Dual-Lumen Catheters with Dacron Cuff 45
4.1.6 Special Arteriovenous Shunts 48
4.2 Temporary Access 49
4.2.1 General Technique 50
4.2.2 Complications of Temporary Access 52
4.2.3 Comparison of the Three Access Sites 55
4.3 Impact of Access 55
4.3.1 Access Surveillance 56
References 58
5 Complications of Hemodialysis 59
5.1 Medical Complications 59
5.1.1 Hypotension 59
5.1.2 Cardiac Arrhythmias 68
5.1.3 Intradialytic Hypertension 69
5.1.4 Muscle Cramps 69
5.1.5 Carnitine and Intradialytic Hypotension, Arrhythmias,
and Muscle Cramps 70
5.1.6 Nausea and Vomiting 71
5.1.7 Headache 71
5.1.8 Serious, Less Common Complications 72
5.2 Machine-Related Complications 75
5.2.1 Air Embolism 75
5.2.2 Hemolysis 76
References 76
Contents xv
6 Dose of Hemodialysis 79
6.1 Historical Background 79
6.1.1 Dialysis Index 80
6.1.2 Urea Clearance 80
6.1.3 Urea as a Marker for Uremic Toxins 81
6.1.4 Current Methods of Measuring Dialysis Dose 81
6.2 Potential Problems with the Calculation of Dialysis Dose 83
6.2.1 Influence of the Single-Pool Model 83
6.3 Determining Adequate Dialysis 91
6.3.1 Acceptable Kt/V Values 92
6.3.2 Frequency of Dose Measurement 92
References 92
7 Continuous Therapies 95
7.1 Overview 95
7.2 Types of Continuous Therapies 95
7.2.1 Continuous Arteriovenous Hemofiltration (CAVH) 95
7.2.2 Continuous Venovenous Hemofiltration (CVVH) 96
7.2.3 Continuous Venovenous Hemodialysis (CVVHD) 98
7.2.4 Continuous Venovenous Hemodiafiltration (CVVHDF) 99
7.2.5 Slow Low-Efficiency Diffusion Hemodialysis (SLEDD) 99
7.2.6 Slow Continuous Ultrafiltration (SCUF) 100
7.2.7 Newer Technologies 100
7.3 Components of Continuous Therapies 102
7.3.1 Vascular Access 102
7.3.2 Tubing 103
7.3.3 Filter 104
7.3.4 Replacement Fluid 104
7.3.5 Dialysis Fluid 109
7.3.6 Machines 110
7.4 Dialysate Flow and Ultrafiltration Rates 110
7.5 Anticoagulation 112
7.5.1 Heparin 113
7.5.2 Low Molecular Weight Heparin 113
7.5.3 Citrate 113
7.5.4 Prostacyclin 114
7.5.5 Argatroban 115
7.5.6 Lepirudin 115
7.5.7 Danaparoid 115
7.5.8 Fondaparinux 116
7.5.9 Nafamostat 117
7.5.10 No Anticoagulation 117
7.6 Drug Removal During CRRT 117
xvi Contents
7.7 Intraoperative Dialysis 118
7.8 Dose of Dialysis in Continuous Therapies 119
References 120
8 Peritoneal Dialysis 123
8.1 Historical-Background 123
8.2 Anatomy and Physiology 123
8.3 Kinetics of Peritoneal Transport 125
8.3.1 Diffusion 125
8.3.2 Ultrafiltration 126
References 127
9 Technique of Peritoneal Dialysis 129
9.1 Peritoneal Dialysis Catheters 129
9.1.1 Description 129
9.1.2 Catheter Insertion Technique 131
9.2 Peritoneal Dialysis Fluid 137
9.2.1 Osmotic Agents 137
9.3 Delivery Mechanism 140
9.4 Peritoneal Dialysis Techniques 140
9.4.1 Continuous Ambulatory Peritoneal Dialysis (CAPD) 140
9.4.2 Automated Peritoneal Dialysis (APD) 140
References 143
10 Dose of Peritoneal Dialysis 145
10.1 Weekly Creatinine Clearance 145
10.1.1 Residual Glomerular Filtration Rate 146
10.1.2 Peritoneal Creatinine Clearance 146
10.1.3 Correction for Body Surface Area 147
10.1.4 Total Weekly Creatinine Clearance Calculation 148
10.2 Urea Clearance Concept (Kt/Vurea) 148
10.2.1 Volume of Distribution of Urea 148
10.3 Recommended Dose of Dialysis 149
10.3.1 Potential Problem with Dose Measurements 150
10.3.2 Frequency of Dose Determination 150
10.4 Peritoneal Function Test 151
10.4.1 Traditional Peritoneal Equilibration Test 151
10.4.2 Fast Peritoneal Equilibration Test 151
10.4.3 Results of the Peritoneal Equilibration Test 152
10.5 Use of Fast Peritoneal Equilibration Test Results in Selecting
a Peritoneal Dialysis Regimen 153
10.5.1 Selection of Technique 154
References 155
Contents xvii
11 Complications of Peritoneal Dialysis 157
11.1 Peritonitis 157
11.1.1 Clinical Diagnosis 157
11.1.2 Therapy 160
11.2 Exit Site and Tunnel Infection (also see Chapter 9) 165
11.3 Under-dialysis 165
11.4 Malnutrition 166
11.5 Membrane Failure 166
11.6 Cardiovascular Complications 166
11.7 Intra-Abdominal Pressure 167
11.8 Hemoperitoneum 167
References 167
12 Nutritional Issues 169
12.1 Protein Calorie and Nutritional Status of Dialysis Patients 169
12.2 Significance of Nutritional Status 170
12.2.1 Hemodialysis 170
12.2.2 Peritoneal Dialysis 170
12.3 Factors Causing Malnutrition 172
12.3.1 Uremia 172
12.3.2 Other Factors 172
12.4 Assessment of Nutritional Status 173
12.4.1 Dietary Intake 173
12.4.2 Anthropometry and Body Weights 175
12.4.3 Bioelectric Impedance Analysis 175
12.4.4 Dual Energy X-Ray Absorptiometry 175
12.4.5 Subjective Global Assessment 175
12.4.6 Biochemical Assessment 176
12.5 Nutritional Requirements 176
12.5.1 Protein 178
12.5.2 Caloric Intake 178
12.5.3 Lipids 178
12.5.4 Fatty Acids, Lipids, and Carnitine 178
12.5.5 Vitamins and Trace Elements 179
12.5.6 Additional Nutritional Support 180
12.5.7 Metabolic Acidosis 180
References 8 •
13 Hypertension 8-^
13.1 Prevalence $3
13.2 Control of Hypertension 183
13.3 Significance of Hypertension Control 186
13.4 Pathogenesis 186
13.4.1 Sodium Excess 187
13.4.2 Other Factors 188
xviii Contents
13.5 Treatment of Hypertension 188
13.5.1 Sodium and Volume Control 188
13.5.2 Ultrafiltration 190
13.5.3 Pharmacological Agents 192
13.6 Conclusions 197
References 197
14 Anemia 199
14.1 Pathogenesis 199
14.1.1 Erythropoietin 199
14.1.2 Uremic Factors 200
14.1.3 Other Factors 201
14.2 Treatment of Anemia 201
14.2.1 Erythropoietin-Stimulating Agents (ESA)
and Administration 201
14.3 Iron Status 205
14.3.1 Tests to Evaluate Iron Status 205
14.3.2 Iron Supplementation 206
14.4 Carnitine 207
14.5 Other Measures to Improve Hematocrit Response 208
References 208
15 Renal Osteodystrophy 211
15.1 Pathophysiology of Renal Osteodystrophy 211
15.1.1 Vitamin D Metabolism 211
15.1.2 Phosphorus Retention 212
15.1.3 Parathyroid Hormone 212
15.2 Histological Classification of Renal Osteodystrophy 214
15.2.1 High-Turnover Bone Disease 215
15.2.2 Low-Turnover Bone Disease 215
15.2.3 Mixed (Uremic) Bone Disease 216
15.3 Clinical Manifestation of Renal Osteodystrophy 216
15.4 Metastatic Calcification 217
15.5 Laboratory Findings and Management of ROD 218
15.5.1 Laboratory Findings 218
15.5.2 High Turnover Disease 221
15.6 Low-Turnover Disease 224
15.6.1 Aluminum Control 224
15.6.2 Low Parathyroid Hormone 224
15.6.3 Other Therapies 224
15.6.4 Prevention 225
References 225
Contents xix
16 Atypical Dialysis Circumstances 227
16.1 Pregnancy 227
16.1.1 Dialysis 227
16.1.2 Associated Conditions 229
16.2 Drug Removal in Overdose Situations 229
16.2.1 Peritoneal Dialysis 230
16.2.2 Hemodialysis 230
16.2.3 Hemoperfusion 230
16.2.4 Specific Examples 231
Reference 232
17 The Future 233
17.1 Increasing Financial Pressure 233
17.2 Changing Population 233
17.3 Patient Outcome Measures 233
17.4 Limited Transplantation Options 234
17.5 Low Rates of Rehabilitation 234
17.6 Ideal Renal Replacement Therapy 234
17.7 Simpler Machines and Daily Dialysis 235
17.7.1 Diffusion vs Convection 235
17.8 Mechanical Artificial Kidney 235
17.8.1 Implantable Mechanical, Artificial Kidney 236
Reference 237
Index 239
|
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| isbn | 9780387096506 |
| language | English |
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| spellingShingle | Ahmad, Suhail Manual of clinical dialysis Hemodialysis Kidney Failure, Chronic therapy Peritoneal Dialysis methods Renal Dialysis methods Dialyse (DE-588)4012064-8 gnd |
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| title | Manual of clinical dialysis |
| title_auth | Manual of clinical dialysis |
| title_exact_search | Manual of clinical dialysis |
| title_full | Manual of clinical dialysis Suhail Ahmad |
| title_fullStr | Manual of clinical dialysis Suhail Ahmad |
| title_full_unstemmed | Manual of clinical dialysis Suhail Ahmad |
| title_short | Manual of clinical dialysis |
| title_sort | manual of clinical dialysis |
| topic | Hemodialysis Kidney Failure, Chronic therapy Peritoneal Dialysis methods Renal Dialysis methods Dialyse (DE-588)4012064-8 gnd |
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