The medical-legal responsibilities of a dialysis unit medical director.

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

authors： Luan FL,Samaniego M

更新日期：2010-03-01 00:00:00

abstract：:Congestive heart failure (CHF) is highly prevalent in patients on renal replacement therapy and is a leading cause of death in such patients. Several studies suggest that therapeutic agents for the treatment of CHF, particularly angiotensin converting enzyme inhibitors and beta-blockers, are underused in end-stage ren...

journal_title：Seminars in dialysis

authors： Bouchard J,Madore F

更新日期：2007-09-01 00:00:00

abstract：:Peritoneal dialysis (PD) is a simple, safe, gentle, and efficient renal replacement therapy (RRT) method. It is able to correct acute kidney injury (AKI)-induced metabolic, electrolytic, and acid-base disorders and volume overload both in and out the intensive care unit setting. Some PD modalities, such as high-volume...

journal_title：Seminars in dialysis

authors： Burdmann EA,Chakravarthi R

更新日期：2011-03-01 00:00:00

abstract：:Determining dry weight and assessing extracellular fluid volume in hemodialysis (HD) patients is one of the greatest challenges to practicing nephrologists. The clinical examination has limited accuracy, so different strategies have been investigated to aid in this evaluation. Biochemical markers of volume overload (A...

journal_title：Seminars in dialysis

authors： Ishibe S,Peixoto AJ

更新日期：2004-01-01 00:00:00

abstract：:Renal osteodystrophy (ROD) is a bone disorder that occurs in chronic kidney disease (CKD) patients and is associated with 2- to 14-fold increased fracture risk compared to the general population. Risk of fractures is also increased in kidney transplant recipients especially within the first 5 years after transplantati...

journal_title：Seminars in dialysis

authors： Babayev R,Nickolas TL

更新日期：2015-11-01 00:00:00

abstract：:A good catheter implantation technique is important to allow for effective peritoneal access function and long-term technique survival. Studies regarding results obtained by nephrologists in comparison with surgeons have been limited to small single-center experiences. Thus, the objective of this study was to explore ...

journal_title：Seminars in dialysis

authors： de Moraes TP,Campos RP,de Alcântara MT,Chula D,Vieira MA,Riella MC,Olandowski M,Divino-Filho JC,Pecoits-Filho R,Investigators of BRAZPD.

更新日期：2012-09-01 00:00:00

abstract：:Few prospective studies have looked at the incidence of hyperkalemia in outpatient hemodialysis access procedures. Our study prospectively evaluated 167 procedures using a preadmit venous blood gas (VBG) and found that 14.3% had moderate or severe hyperkalemia. When the individual procedures were analyzed it was found...

journal_title：Seminars in dialysis

authors： Ross J,DeatherageHand D

更新日期：2015-01-01 00:00:00

abstract：:Treatment of thrombosed dialysis ateriovenous (AV) grafts in the radiology interventional suite requires percutaneous mechanical thrombectomy, along with angioplasty of the underlying stenotic lesion. We analyzed the anatomic reasons for unsuccessful percutaneous thrombectomy of AV grafts, and assessed the feasibility...

journal_title：Seminars in dialysis

authors： Maya ID,Smith T,Young CJ,Allon M

更新日期：2008-03-01 00:00:00

abstract：:Dialysis-related amyloidosis (DRA) is a serious complication in long-term dialysis patients, and presents with carpal tunnel syndrome, cystic bone lesions, destructive spondylarthropathy, diffuse arthritis and periarthritis, systemic organ involvement, and dialysis-related spinal canal stenosis (DSCS). Recently a new ...

journal_title：Seminars in dialysis

authors： Niwa T

更新日期：2001-03-01 00:00:00

abstract：:Hemodialysis patients are susceptible to coronavirus disease 2019 (COVID-19). The aim of this study was to describe the epidemiological, clinical characteristics, and mortality-related risk factors for those who undergoing hemodialysis with COVID-19. We conducted a retrospective study. A total of 49 hemodialysis patie...

journal_title：Seminars in dialysis

authors： Tian M,Li H,Yan T,Dai Y,Dong L,Wei H,Song X,Dong J,Cheng F,Li W

更新日期：2020-10-29 00:00:00

abstract：:Elderly individuals comprise an ever-increasing proportion of patients on renal replacement therapy (RRT). As in younger patients, cardiovascular events are the major cause of death in the elderly on RRT, although the relative proportion succumbing to cardiovascular events is similar to that in young patients. An impo...

journal_title：Seminars in dialysis

authors： Dikow R,Zeier M,Ritz E

更新日期：2002-03-01 00:00:00

abstract：:While oral diuretics are commonly used in patients with chronic kidney disease for the management of volume and blood pressure, they are often discontinued upon initiation of dialysis. We suggest that diuretics are considerably underutilized in peritoneal dialysis and haemodialysis patients despite numerous potential ...

journal_title：Seminars in dialysis

authors： Trinh E,Bargman JM

更新日期：2016-09-01 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

authors： Bennett PN,Parsons T,Ben-Moshe R,Weinberg M,Neal M,Gilbert K,Rawson H,Ockerby C,Finlay P,Hutchinson A

更新日期：2014-09-01 00:00:00

abstract：:Catheter malfunction due to poor flow is a common problem. When it occurs early, the cause is generally technical. Late occurrences are most often related to thrombus formation. Several types of thrombus may be seen, differing by location and supposed mechanism of formation. The most common offender, however, is the f...

journal_title：Seminars in dialysis

authors： Beathard GA

更新日期：2001-11-01 00:00:00

abstract：:The patency of the vascular access (VA) is a fight for the attending nephrologist. A retrospective observational study was conducted to compare the success rate of surgical versus endovascular technique percutaneous transluminal angioplasty (PTA) for graft thrombosis treatment. Of 3008 patients, 22.1% patients were di...

journal_title：Seminars in dialysis

authors： Ponce P,Carvalho T,Messias H,Neves F,Lisbon VAC Interventional Nephrology Team.

更新日期：2014-09-01 00:00:00

abstract：:In an attempt to improve patient outcomes in peritoneal dialysis (PD), national organizations (such as the National Kidney Foundation Dialysis Outcomes Quality Initiative [NKF-DOQI] process) have formulated clinical practice guidelines based on clinical evidence available at the time of development. For "adequacy" of ...

journal_title：Seminars in dialysis

authors： Burkart JM

更新日期：2003-01-01 00:00:00

abstract：:Porphyria cutanea tarda (PCT) is a vesiculobullous skin disorder characterized by a defect in heme biosynthesis. Reduced activity of the hepatic enzyme uroporphyrinogen decarboxylase (URO-D) results in accumulation of photosensitive porphyrins; this ultimately leads to the skin fragility and blistering that is charact...

journal_title：Seminars in dialysis

authors： Ryali ME,Whittier WL

更新日期：2010-01-01 00:00:00

abstract：:Almost 30% of prevalent hemodialysis patients use catheters for vascular access although outcomes are superior with the use of either an arteriovenous fistula or a synthetic graft. Catheter complications are a major cause of morbidity and mortality for hemodialysis patients and increase the burden on the health care s...

journal_title：Seminars in dialysis

authors： Dwyer A

更新日期：2008-11-01 00:00:00

abstract：:This review aims to summarize the available evidence of the effectiveness of oral iron in patients receiving dialysis. Four small randomized controlled trials (105 evaluated patients) compared oral iron supplements with placebo or no treatment; hemoglobin and ferritin levels did not differ significantly between groups...

journal_title：Seminars in dialysis

authors： Hodson EM,Craig JC

更新日期：2014-01-01 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

authors： Ratajczak A,Lange-Ratajczak M,Bobkiewicz A,Studniarek A

更新日期：2017-01-01 00:00:00

abstract：:There has been substantial growth in the variety of available antidiabetic agents during the last decade and a half. The role of these newer agents in patients with diabetes and end-stage renal disease (ESRD) population, and their relative benefits and risks in this population compared to patients without ESRD are not...

journal_title：Seminars in dialysis

authors： Boyle SM,Simon B,Kobrin SM

更新日期：2015-07-01 00:00:00

abstract：:There has been a dramatic, worldwide expansion in life expectancy across the last century. This has resulted in a progressively more elderly and comorbid population. It is increasingly recognized that healthcare in this group needs to move to the concept of "adding life to years". Recognition and assessment of frailty...

journal_title：Seminars in dialysis

authors： Corbett RW,Brown EA

更新日期：2018-11-01 00:00:00

abstract：:Home dialysis (home HD or home PD) remains underutilized in most jurisdictions. Physicians, advanced-practice nurses, and policy makers working with chronic kidney disease populations can provide insights into patient, healthcare professional, and system-level barriers to home dialysis selection by suitable patients. ...

journal_title：Seminars in dialysis

authors： Osterlund K,Mendelssohn D,Clase C,Guyatt G,Nesrallah G

更新日期：2014-03-01 00:00:00

abstract：:Withholding and withdrawal of dialysis has been a reality since dialysis was invented. Only in the past 20 years has it been formally studied, and we still have a great deal to learn. The nephrology community has slowly come to accept that, for some of our patients, not having dialysis is a better option than continui...

journal_title：Seminars in dialysis

authors： Germain MJ,Cohen LM,Davison SN

更新日期：2007-05-01 00:00:00

abstract：:Continuous Renal Replacement Therapy (CRRT) usually requires anticoagulation to prevent clotting of the extracorporeal circuit. Interruptions due to filter clotting significantly reduce total therapy time and CRRT efficacy. Although heparin has traditionally been the most common anticoagulant used for CRRT, increasing...

journal_title：Seminars in dialysis

authors： Karakala N,Tolwani A

更新日期：2016-07-01 00:00:00

abstract：:The majority of end-stage renal disease (ESRD) patients are hypertensive. Drug therapy for hypertension in hemodialysis (HD) patients includes all classes of antihypertensive drugs, with the sole exception of diuretics. Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers may decrease mo...

journal_title：Seminars in dialysis

authors： Hörl MP,Hörl WH

更新日期：2004-07-01 00:00:00

abstract：:Hemodialysis patient outcomes are often suboptimal, with one-sixth of patients receiving an inadequate dialysis dose, one-fourth using catheters for vascular access, and more than one-half being malnourished. This review describes a four-step approach for improving dialysis patient outcomes. First, select an outcome t...

journal_title：Seminars in dialysis

authors： Sehgal AR

更新日期：2002-01-01 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

authors： Holley JL

更新日期：2016-07-01 00:00:00

abstract：:Dialysis-dependent chronic kidney disease (CKD) is an expanding problem for healthcare systems worldwide. The prevalence of end-stage renal disease (ESRD) has increased by 20% since 2000 and stands at 1699 per million people in the USA. ESRD is associated with an increased risk of cardiovascular comorbidity, increased...

journal_title：Seminars in dialysis

authors： Trainor D,Borthwick E,Ferguson A

更新日期：2011-05-01 00:00:00

abstract：:National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF KDOQI) guidelines recommend Doppler ultrasound (DU) for surveillance of vascular access (VA), but trials have not been unanimous about its benefit on VA patency. The aim of this study was to evaluate the accuracy of DU for patency, as well as t...

journal_title：Seminars in dialysis

authors： Guedes Marques M,Ibeas J,Botelho C,Maia P,Ponce P

更新日期：2015-03-01 00:00:00