Abstract:
:Withdrawal from dialysis is an appropriate decision for situations in which the burdens of treatment outweigh the benefits. Alternately, it can be viewed as a public health problem and suicide equivalent that contributes to the high mortality of end-stage renal disease (ESRD). More than one in five deaths of patients with ESRD are preceded by dialysis cessation, and approximately 15,000 Americans died last year following a determination to stop this life-support treatment. This article discusses what is known about the psychosocial aspects of the patients who terminate dialysis, the role of depression and other psychiatric disorders, the family perspective, and the relationship of these decisions to suicide.
journal_name
Semin Dialjournal_title
Seminars in dialysisauthors
Cohen LM,Germain MJdoi
10.1111/j.1525-139X.2005.18201.xsubject
Has Abstractpub_date
2005-03-01 00:00:00pages
147-53issue
2eissn
0894-0959issn
1525-139Xpii
SDI18201journal_volume
18pub_type
杂志文章,评审abstract::Diabetes mellitus (DM) is a common and devastating disease, affecting up to 19.3 million Americans. It is the leading cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD) in the United States. Diabetic patients with ESRD have a high incidence of cardiovascular disease and death. For those kidney tr...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.1525-139X.2010.00708.x
更新日期:2010-03-01 00:00:00
abstract::Patients on hemodialysis are physically inactive. Less than 50% of hemodialysis patients undertake exercise once a week and such patients have increased mortality compared to patients who undertake regular exercise. The reasons for physical inactivity and reduced functional capacity are complex and inter-related, with...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12789
更新日期:2019-07-01 00:00:00
abstract::The treatment of chronically ill patients with end stage renal disease (ESRD) receiving dialysis therapies has advanced greatly over the years and accomplished many successes in prolonging the life of patients with ESRD, yet has had considerable failures due to the inability to compensate for all functions of the kidn...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/sdi.12471
更新日期:2016-03-01 00:00:00
abstract::We describe the use of directional atherectomy (DA) to restore patency of a thrombosed polytetrafluoroethylene arteriovenous graft with an in-stent restenosis at the venous anastomosis. Technically, the procedure described is not an atherectomy per se, but rather the removal of fibrosis and intimal hyperplasia with sh...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/j.1525-139X.2007.00418.x
更新日期:2008-05-01 00:00:00
abstract::This report reviews the most common surgical interventions and complications of chronic peritoneal dialysis (PD) patients. Based on the current knowledge as well as our experience we detail the role of these surgical procedures. We supplement the reported knowledge in the field with our own experience in this area. Th...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12538
更新日期:2017-01-01 00:00:00
abstract::Depression has been documented as the most frequently encountered psychological problem in end-stage renal disease (ESRD) patients and has been correlated with both mortality and morbidity in these patients. Previous work by our group has shown that clinical depression is treatable with psychotropic medications in the...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1046/j.1525-139x.2003.16094.x
更新日期:2003-11-01 00:00:00
abstract::There is abundant evidence that chronic renal failure (CRF) and end-stage renal disease (ESRD) alter drug disposition by affecting protein and tissue binding and reducing systemic clearance of renally cleared drugs. What is not fully appreciated is that CRF can significantly reduce nonrenal clearance and alter the bio...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1046/j.1525-139x.2003.03011.x
更新日期:2003-01-01 00:00:00
abstract::Laughter and humor therapy have been used in health care to achieve physiological and psychological health-related benefits. The application of these therapies to the dialysis context remains unclear. This paper reviews the evidence related to laughter and humor therapy as a medical therapy relevant to the dialysis pa...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12194
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:The aim of the present study was to perform a comparative analysis of peritoneal dialysis catheter (PDC) insertion between blind and surgical methods by nephrologists. PATIENTS AND METHODS:The present study enrolled 249 peritoneal dialysis patients who received first-time PDC insertion. All PDC insertions w...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/sdi.12904
更新日期:2020-07-23 00:00:00
abstract::Analysis of tissues, plasma, urine, other body fluids, and dialysate for glycation adducts has revealed the presence of two major forms: glycation adduct residues of proteins and related glycated amino acids--called glycation free adducts. The major effect on protein glycation in uremia is loss of clearance of glycati...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.1525-139X.2009.00589.x
更新日期:2009-07-01 00:00:00
abstract::A patient with newly diagnosed end-stage renal disease (ESRD) received a femoral catheter for hemodialysis (HD). Shortly thereafter he developed fever, and blood cultures grew methicillin-resistant Staphylococcus aureus. The catheter was removed and the patient was treated with both vancomycin and rifampin; however, b...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/j.1525-139X.2005.18323.x
更新日期:2005-07-01 00:00:00
abstract::Arteriovenous grafts (AVGs) suffer from high thrombosis rates. It is not known whether placement of stent grafts at the venous anastomosis (VA) of thrombosed AVGs would impact future thrombosis. This is a retrospective study evaluating a group of AVGs that underwent endovascular thrombectomy with placement of a stent ...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/sdi.12254
更新日期:2014-11-01 00:00:00
abstract::Nephrologists offer renal replacement therapy (RRT) to patients who are unlikely to benefit in part because of our discomfort discussing goals of care in the setting of an uncertain prognosis for a given individual. Permanent neurological impairment, terminal illness (life expectancy <6 months), medical conditions pre...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/sdi.12492
更新日期:2016-07-01 00:00:00
abstract::There are numerous patient, provider, and health system barriers to accessing kidney transplantation. Patient barriers such as sociocultural and clinical characteristics and provider factors such as provider knowledge and awareness of transplantation play important roles in facilitating transplant. Health system facto...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/sdi.12860
更新日期:2020-01-01 00:00:00
abstract::Hepatitis C virus (HCV) infection is not only an important cause of chronic liver disease, but extrahepatic manifestations are common and include chronic kidney disease (CKD). HCV is classically associated with cryoglobulinemic glomerulonephritis in the context of mixed cryoglobulinemia syndrome, but other glomerular ...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12759
更新日期:2019-03-01 00:00:00
abstract::Why do functional assessments in patients with end-stage renal disease (ESRD) matter? Multiple studies show that new dialysis patients undergo a substantial decline among activities of daily living. Moreover, poor functional status in ESRD patients is associated with early morality. That is why CMS has developed new c...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/sdi.12466
更新日期:2016-03-01 00:00:00
abstract::Translumbar tunneled dialysis catheter (TLDC) is a temporary dialysis access for patients exhausted traditional access for dialysis. While few small studies reported successes with TLDC, additional studies are warranted to understand the short- and long-term patency and safety of TLDC. We conducted a retrospective ana...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/sdi.12358
更新日期:2015-07-01 00:00:00
abstract::Dialysis vascular access associated coronary-subclavian steal or hypoperfusion syndrome is an uncommon but potentially life threatening condition. Awareness of this syndrome is important in the management of vascular access in hemodialysis patients. We report a case of dialysis vascular access associated coronary-subc...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12077
更新日期:2013-09-01 00:00:00
abstract::The elderly people, 65 years old and above, are growing in number. The structural and functional changes associated with aging place the elderly at risk when challenged by extracorporeal therapies, such as therapeutic plasma exchange (TPE). We retrospectively analyzed data on all patients who underwent TPE for renal i...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/j.1525-139X.2011.01027.x
更新日期:2012-03-01 00:00:00
abstract::The treatment of end-stage renal disease (ESRD) makes extensive use of presterilized disposable items which, after use, are contaminated by blood. The preferred route of disposal of such items is by incineration. Disposal costs have risen and this increase in costs has not been matched by waste management programs in ...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.1525-139X.2005.00078.x
更新日期:2005-09-01 00:00:00
abstract::Acute kidney injury (AKI) is common in patients with multiple myeloma (MM), most commonly caused by cast nephropathy resulting from precipitation of free light chains (FLC) in renal tubules. AKI may be irreversible and require dialysis and predicts a poor prognosis. Reduction in serum FLC concentration is thought to b...
journal_title:Seminars in dialysis
pub_type: 社论
doi:10.1111/j.1525-139X.2010.00814.x
更新日期:2011-01-01 00:00:00
abstract::Arteriovenous fistula (AVF) failure is mainly due to venous stenosis characterized by significant amount of intima-media thickening (IMT), probably in the presence of negative (inward) remodeling. Our hypothesis is that the longitudinal changes in wall shear stress (WSS) within different configurations of AVF can infl...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/sdi.12045
更新日期:2013-07-01 00:00:00
abstract::In the United States, presently there are more than 50,000 patients with end-stage renal disease (ESRD) awaiting a cadaveric kidney and each year less than a quarter receive kidney transplantation. Although the real incidence in unknown, a significant number of these patients die due to lack of dialysis access. While ...
journal_title:Seminars in dialysis
pub_type: 社论
doi:10.1046/j.1525-139x.2002.00001.x
更新日期:2002-01-01 00:00:00
abstract::Heart failure (HF) is very common in the general population, and risk factors for HF, such as coronary artery disease, diabetes, obesity, and hypertension, are frequently present in patients with CKD. Therefore, HF is also an important cause of morbidity and mortality in this population. Diastolic heart failure (DHF),...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.1525-139X.2011.01011.x
更新日期:2012-01-01 00:00:00
abstract::Calcific uremic arteriolopathy (CUA) is a rare but serious life-threatening complication of CRF that manifests as painful nonhealing eschars in association with panniculitis and dermal necrosis. This condition is being increasingly recognized and reported as a contributing factor to death in dialysis patients. The pat...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/j.1525-139X.2007.00263.x
更新日期:2007-03-01 00:00:00
abstract::Hypertension among patients on hemodialysis is common, difficult to diagnose and often inadequately controlled. Although specific blood pressure (BP) targets in this particular population are not yet established, meta-analyses of randomized trials showed that deliberate BP-lowering with antihypertensive drugs improves...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12741
更新日期:2018-11-01 00:00:00
abstract::Peritoneal dialysis (PD) is a markedly underutilized modality for permanent renal replacement therapy in the United States owing to a low rate of patient referral and high rate of patient dropout or transfer to hemodialysis. One cause for patient loss from PD is problematic PD catheters that often are removed rather t...
journal_title:Seminars in dialysis
pub_type: 杂志文章
doi:10.1111/j.1525-139X.2006.00148.x
更新日期:2006-03-01 00:00:00
abstract::Pregnancy occurs uncommonly in women with chronic kidney disease (CKD) and fetal outcome tends to be poor, with high rates of prematurity and mortality. Dialysis, by complementing residual renal function, may improve fetal outcome in pregnant women with CKD. Although there are no prospective or randomized trials that ...
journal_title:Seminars in dialysis
pub_type: 社论,评审
doi:10.1046/j.1525-139x.2003.16084_1.x
更新日期:2003-09-01 00:00:00
abstract::Cardiovascular morbidity and mortality remain frustratingly common in dialysis patients. A dearth of established evidence-based treatment calls for alternative therapeutic avenues to be embraced. Sympathetic hyperactivity, predominantly due to afferent nerve signaling from the diseased native kidneys, has been establi...
journal_title:Seminars in dialysis
pub_type: 杂志文章,评审
doi:10.1111/sdi.12756
更新日期:2019-05-01 00:00:00
abstract::Secondary hyperparathyroidism almost universally accompanies end-stage renal disease (ESRD). In some, but not all studies, elevated serum parathyroid hormone (PTH) concentrations are associated with increased fracture rates, cardiovascular disease, and mortality in ESRD. The serum concentration of PTH required for opt...
journal_title:Seminars in dialysis
pub_type: 社论
doi:10.1111/sdi.12457
更新日期:2016-05-01 00:00:00