Contents
- Front matter
- Chapter 1 The new patient with renal failure
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- Chapter 1 The new patient with renal failure
- Incidence and prevalence of kidney disease
- Definition and prevalence of chronic kidney disease
- Causes of end-stage kidney disease
- Causes of end-stage kidney disease: details
- Causes of acute kidney injury
- Modality of renal replacement therapy worldwide
- Patient survival with ESKD
- Presentation of renal disease
- Presenting clinical features of ESKD
- Examination findings in ESKD
- Investigations for patients with ESKD
- Assessment of kidney function at/near end stage: serum biochemistry
- Assessment of kidney function at/near end stage: reciprocal creatinine plots
- Assessment of renal function at/near end stage: creatinine clearance
- Assessment of renal function at/near end stage: eGFR and calculated creatinine clearance
- Assessment of renal function at/near end stage: other methods
- Complications of renal failure: symptomatic
- Complications of renal failure: renal bone disease
- Complications of renal failure: malnutrition
- Complications of renal failure: fluid overload
- Complications of renal failure: metabolic
- Complications of renal failure: cardiovascular
- Management of renal failure: aims
- Management of renal failure: blood pressure control
- Management of renal failure: which drugs for BP?
- Management of renal failure: how to achieve blood pressure control
- Management of renal failure: slowing the rate of decline
- Management of renal failure: lipids and fluid balance
- Management of renal failure: treatment of anaemia
- Management of renal failure: calcium and phosphate
- Management of renal failure: metabolic complications
- Management of renal failure: prevention of symptoms
- Assessment of patients for dialysis: early referral
- Assessment of patients for dialysis: when to start
- Assessment of patients for dialysis: factors to be assessed
- Assessment of patients for dialysis: when not to dialyse
- Supportive care in ESKD
- Assessment of patients for dialysis: role of pre-dialysis nurses
- Checklist for assessing patients in a low clearance clinic
- Haemodialysis vs peritoneal dialysis
- Choosing which dialysis modality
- Concept of integrated care
- Education for dialysis
- Choice of dialysis modality: case histories
- When to start dialysis in ESKD
- How to persuade the patient to start dialysis
- Clinical indications for starting dialysis in ESKD
- The acutely presenting patient or ‘crashlander’
- Psychosocial effects of starting dialysis in ESKD
- Psychosocial effects of starting dialysis in ESKD: depression and anxiety
- Psychosocial effects of starting dialysis in ESKD: others
- Chapter 2 Haemodialysis
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- Chapter 2 Haemodialysis
- Principles of haemodialysis
- Principles of haemodialysis in practice
- Factors affecting solute clearance on haemodialysis
- Ultrafiltration during haemodialysis
- Methods of ultrafiltration during haemodialysis
- High efficiency and high flux haemodialysis
- Haemofiltration and haemodiafiltration
- Dialysers
- Technical specifications
- Dialysis membranes
- Reactions to membranes
- Biocompatibility of membranes
- Biocompatibility and acute and chronic kidney disease
- Dialysis machines: key features
- Dialysis machines: additional facilities
- Dialysis machines: monitors
- Dialysis machine: patient monitors
- Dialysate
- Dialysate: sodium
- Dialysate: other electrolytes and glucose
- Dialysate: acid–base
- Water purification
- Water purification: treatment and toxicity
- Vascular access: overview
- Evaluation prior to access surgery
- Permanent vascular access
- Disadvantages of permanent vascular access
- Formation of permanent access
- Stenosis of fistulae and grafts
- Thrombosis of fistulae and grafts
- Screening for arteriovenous fistula/graft stenosis and thrombosis
- Other complications of fistulae and grafts
- Tunnelled cuffed catheters
- Temporary vascular access
- Insertion of vascular access catheters
- Complications of temporary access insertion
- Other complications of temporary access
- Management of access (catheter) infections
- Prevention of infection of dialysis access
- Arteriovenous shunt (Scribner shunt)
- Cardiopulmonary recirculation
- Access recirculation
- The first dialysis session in chronic and acute kidney disease
- The first dialysis session
- Complications during dialysis
- Complications during dialysis: hypotension
- Hypotension from excessive ultrafiltration
- Management of hypotension
- Prevention of hypotension
- Prevention of hypotension: blood volume monitoring
- Other complications during dialysis
- Complications during dialysis: dialyser reactions
- Blood clotting during haemodialysis
- Anticoagulation for haemodialysis: heparin
- Anticoagulation for haemodialysis: heparin administration
- Anticoagulation for haemodialysis: heparin-free dialysis
- Regional anticoagulation for haemodialysis
- Other methods of anticoagulation for haemodialysis
- Dialysis adequacy: overview
- Dialysis adequacy: solute clearance
- Dialysis adequacy: urea kinetic modelling
- Calculation of Kt/V
- Dialysis adequacy: other measures of solute clearance
- Dialysis adequacy: online measures of clearance
- Residual renal function
- Other markers of adequacy: protein catabolic rate
- Other markers of adequacy
- Targets for adequate dialysis
- The HEMO study
- Increasing dialysis dose delivered
- Prescribing chronic haemodialysis: urea clearance
- Prescribing chronic haemodialysis: patient factors
- Prescribing chronic haemodialysis: dialyser factors
- Laboratory tests for patients on regular haemodialysis
- Dry weight
- Novel measures of dry weight
- Re-use of dialysers
- Re-use of dialysers: technique
- Home haemodialysis
- Daily haemodialysis
- Haemodialysis and surgery: pre-operative
- Haemodialysis and surgery: bleeding risks
- Haemodialysis and surgery: peri-operative
- Haemodialysis and surgery: post-operative
- Haemodialysis in transplant recipients
- Haemodialysis in terminal care
- Haemodialysis for non-renal disease
- Chapter 3 Nursing a patient on haemodialysis
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- Chapter 3 Nursing a patient on haemodialysis
- Approaching patients on haemodialysis
- Nursing care of vascular access
- Pre- and post-operative care of access
- Cannulation of fistulae
- Complications of fistulae and their management
- Grafts
- Percutaneous tunnelled vascular catheters
- Percutaneous temporary vascular catheters
- Complications of vascular catheters and their management
- Strategy for improving vascular access
- Preparation for haemodialysis
- The haemodialysis prescription
- Anticoagulation for haemodialysis
- Initiation of treatment
- Intradialytic monitoring
- Discontinuing haemodialysis
- Post-dialysis evaluation
- Dialysis machine alarms
- Care of dialysis machines
- Psychological care of haemodialysis patients
- The dialysis unit: staffing
- The dialysis unit: satellites
- The dialysis unit: nursing education and audit
- Infection on the dialysis unit
- Infection control policies
- Chapter 4 Peritoneal dialysis
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- Chapter 4 Peritoneal dialysis
- Principles of peritoneal dialysis
- Factors affecting efficiency of peritoneal dialysis
- Effect of dwell time on solute and fluid transfer
- Modes of peritoneal dialysis: CAPD and intermittent peritoneal dialysis
- Modes of peritoneal dialysis: automated peritoneal dialysis techniques
- CAPD technique and systems
- CAPD technique and systems: disconnect systems
- Peritoneal dialysis catheters
- Insertion of peritoneal dialysis catheters
- Pre-operative preparation for peritoneal catheter insertion
- Peritoneal dialysis catheter insertion technique
- Laparoscopic peritoneal dialysis catheter insertion
- Complications of peritoneal dialysis catheter insertion
- Malfunctioning catheters
- Investigation and management of malfunctioning catheters
- Constipation in peritoneal dialysis patients
- Repositioning peritoneal dialysis catheters
- Peritoneal dialysate: composition
- Peritoneal dialysate: problems with lactate/dextrose
- Peritoneal dialysate: newer fluids
- Peritoneal dialysate: new bag designs
- Advantages and disadvantages of different dialysates
- Prescribing CAPD
- Prescribing CAPD: volumes and ultrafiltration requirements
- Adequacy of peritoneal dialysis
- Adequacy of peritoneal dialysis: measurement
- Peritoneal dialysis adequacy: goals
- Peritoneal dialysis adequacy: key trials
- Peritoneal dialysis adequacy: targets
- A practical approach to peritoneal dialysis adequacy
- Peritoneal equilibration test and modelling
- Technique for performing the peritoneal equilibration test
- Peritoneal equilibration test results
- Other measures of peritoneal membrane function
- Increasing dialysis delivered by CAPD
- Examples of alterations in CAPD prescription
- Prescribing automated peritoneal dialysis
- Increasing delivered dialysis and ultrafiltration in automated peritoneal dialysis
- Examples of alterations in automated peritoneal dialysis prescription
- Peritoneal dialysis in anuric patients
- Residual renal function
- Causes of underdialysis
- Some patient examples
- Exit site infections
- Exit site infections: treatment
- Prevention of exit site infections
- Performing an exit site dressing
- Peritonitis
- Risk factors and prevention of peritonitis
- Clinical features of peritonitis
- Diagnosis of peritonitis
- Treatment of peritonitis: principles (1)
- Treatment of peritonitis: principles (2)
- Treatment of peritonitis
- Treatment of peritonitis: treatment based on microbiology
- Treatment of peritonitis: clinical monitoring
- TB peritonitis
- Treatment of automated peritoneal dialysis peritonitis
- Treatment of resistant peritonitis
- Treatment of resistant peritonitis: removal of catheter
- Complications of peritonitis
- Encapsulating peritoneal sclerosis: clinical features
- Encapsulating peritoneal sclerosis: diagnosis
- Encapsulating peritoneal sclerosis: treatment
- Encapsulating peritoneal sclerosis: causes
- Hernias, leaks, and other complications
- Hernias
- Fluid leaks
- Prolapses and pain
- Other complications of peritoneal dialysis
- Pre-operative assessment for peritoneal dialysis patients
- Post-operative management for peritoneal dialysis patients
- Peritoneal dialysis and transplantation
- Transfer of PD patient to HD
- Chapter 5 Nursing issues in peritoneal dialysis
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- Chapter 5 Nursing issues in peritoneal dialysis
- Role of the nurse in peritoneal dialysis
- Nursing care of peritoneal catheters: exit site
- Nursing care of peritoneal catheters: catheters
- Line changes
- Training patients for CAPD
- Training programme
- Training patients for APD
- Organizing outpatient care of peritoneal dialysis patients
- Chapter 6 Dialysis in acute kidney injury
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- Chapter 6 Dialysis in acute kidney injury
- Indications for acute dialysis
- Acute dialysis: choice of modality
- Psychosocial effects of dialysis in AKI
- Dialysis adequacy in AKI
- Prescribing acute haemodialysis
- Continuous renal replacement therapy: overview
- Continuous renal replacement therapy: performance
- Continuous renal replacement therapy: technical
- Continuous renal replacement therapy: dialysate
- Other continuous renal replacement techniques
- Anticoagulation for continuous renal replacement therapy: heparin
- Anticoagulation for continuous renal replacement therapy: heparin-free
- Anticoagulation for continuous renal replacement therapy: regional citrate
- Complications of continuous renal replacement therapy
- CRRT trouble-shooting guide
- Peritoneal dialysis in acute kidney injury
- Prescribing peritoneal dialysis in acute kidney injury
- Haemodialysis and haemoperfusion for poisoning
- Haemodialysis and haemoperfusion for poisoning: methods
- Drugs and toxins removed by haemodialysis
- Drugs and toxins removed by haemoperfusion
- Chapter 7 Nutrition on dialysis
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- Chapter 7 Nutrition on dialysis
- Malnutrition in ESKD
- Nutritional requirements in chronic kidney disease (pre-dialysis)
- Dietetic treatment plan for pre-dialysis patients
- Assessment of nutritional status: clinical (1)
- Assessment of nutritional status: clinical (2)
- Assessment of nutritional status: food intake
- Assessment of nutritional status: biochemical (1)
- Assessment of nutritional status: biochemical (2)
- Nutritional requirements in haemodialysis and peritoneal dialysis
- Strategies for achieving nutritional aims: energy and protein
- Strategies for achieving nutritional aims: potassium
- Strategies for achieving nutritional aims: phosphate
- Dietary problems specific to ethnic minority patients
- Supplemental vitamins and trace elements
- Use of nutritional supplements
- Intradialytic nutrition
- Carnitine and ESKD
- Fluid requirements in renal failure
- Nutrition in acute kidney injury: energy requirements
- Nutrition in acute kidney injury: protein requirements
- Nutrition in acute kidney injury: electrolyte requirements
- Routes for nutritional support in acute kidney injury
- Chapter 8 Special situations
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- Chapter 8 Special situations
- Dialysis in the elderly
- Assisted PD
- Managing diabetic patients on dialysis
- Managing diabetic patients on dialysis: initiation of dialysis
- Problems for diabetic patients on dialysis
- Surgery in dialysis patients
- Surgery in dialysis patients: haemodialysis and peritoneal dialysis
- Myeloma and renal failure
- Myeloma and renal failure: treatment
- Myeloma and renal failure: dialysis and outcome
- Pain management in ESKD
- Difficulty of pain management in renal patients
- Managing pain
- Analgesic drugs
- Pain at the end of life
- Pregnancy in dialysis patients
- Managing pregnancy in dialysis patients
- Travelling and holidays
- Plasmapheresis
- Techniques of plasmapheresis
- Techniques of plasmapheresis: ancillary measures
- Complications of plasmapheresis
- Specific indications for plasmapheresis
- Immunoadsorption techniques
- Indications for immunoadsorption
- Chapter 9 Complications of ESKD: anaemia
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- Chapter 9 Complications of ESKD: anaemia
- Causes of anaemia
- Assessment of anaemia and haemolysis
- Management of anaemia
- Erythropoietin: administration
- Erythropoietin: initiating therapy
- Erythropoietin: maintenance therapy
- Erythropoietin: side effects
- Erythropoietin: target haemoglobin
- Erythropoietin: failure to respond (resistance)
- Iron metabolism
- Assessing iron status
- Iron supplements: oral iron
- Intravenous iron
- Intravenous iron preparations: iron sucrose
- Intravenous iron preparations: iron gluconate and dextran
- High ferritin and low transferrin saturation index
- Non-iron adjuvants to EPO therapy
- Chapter 10 Complications of ESKD: bone mineral disorders
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- Chapter 10 Complications of ESKD: bone mineral disorders
- Renal bone disease
- Hyperparathyroidism and hyperphosphataemia
- Hyperparathyroid bone disease: clinical features
- Hyperparathyroid bone disease: radiology and histology
- Hyperparathyroid renal bone disease: biochemical features
- Parathyroid hormone assays
- Low turnover bone disease: clinical features
- Low turnover bone disease: radiology and histology
- Low turnover bone disease: biochemical features
- Medical management of hyperparathyroid bone disease
- Maintenance of normal phosphate levels
- Vitamin D
- Paricalcitol
- Systemic effects of vitamin D
- Calcimimetics
- Examples of treatment plans for renal bone disease
- Parathyroidectomy
- Parathyroidectomy: pre-operative management
- Parathyroidectomy: post-operative management
- Calciphylaxis
- Chapter 11 Complications of ESKD: cardiovascular disease
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- Chapter 11 Complications of ESKD: cardiovascular disease
- Cardiovascular disease
- Cardiovascular risk factor intervention in dialysis patients
- Management of ischaemic heart disease
- Acute coronary syndrome
- Acute coronary syndrome: cardiac management
- Acute coronary syndrome: renal management
- Hypertension
- BP control in patients on haemodialysis
- Management of BP on haemodialysis
- Achieving BP control on haemodialysis
- BP control in patients on peritoneal dialysis
- Cerebrovascular disease
- Peripheral vascular disease
- Chapter 12 Complications of ESKD: infection
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- Chapter 12 Complications of ESKD: infection
- Infection risk in dialysis patients
- Non-access-related infections in dialysis patients
- Tuberculosis
- Resistant organisms: MRSA
- Resistant organisms: VISA, VRSA, VRE, and others
- Viral infections: HBV
- Viral infections: HCV
- Viral infections: other viruses
- Viral infections: HIV
- Chapter 13 Symptoms related to ESKD
- Chapter 14 Other complications of ESKD
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- Chapter 14 Other complications of ESKD
- Dialysis amyloid: clinical features
- Dialysis amyloid: pathogenesis and risk factors
- Dialysis amyloid: diagnosis
- Dialysis amyloid: management
- Renal cysts and retroperitoneal bleeding
- Renal cell carcinoma
- Neurological complications: peripheral neuropathies
- Neurological complications: CNS disorders
- Depression
- Cognitive impairment
- GI bleeding
- GI bleeding: management
- Acidosis: consequences
- Acidosis: treatment
- Sexual dysfunction
- Sexual dysfunction: medical factors
- Sexual dysfunction: management
- Aluminium toxicity
- Aluminium toxicity: diagnosis
- Aluminium toxicity: management
- Nephrogenic systemic fibrosis
- Gadolinium: recommendations
- Blood biochemistry in ESKD
- Tumour markers in ESKD
- Quality of life
- Compliance
- Employment and rehabilitation
- Chapter 15 Death in dialysis patients
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- Chapter 15 Death in dialysis patients
- Survival rates
- Causes of death
- Cardiac arrest during dialysis
- Management of cardiac arrest during dialysis
- End of life issues
- Palliative care
- Palliative care: management of symptoms
- Withdrawal of dialysis
- Withdrawal of dialysis: case histories
- Withdrawal of dialysis: discussion of cases
- Quality of death
- Chapter 16 Transplantation for dialysis patients
- Chapter 17 Drug prescribing in patients on dialysis
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- Chapter 17 Drug prescribing in patients on dialysis
- Drug handling in renal failure
- Dosing of commonly used drugs
- Dosing of antimicrobial drugs
- Dosing of antifungal drugs
- Dosing of antiretroviral drugs
- Dosing of antiviral drugs
- Dosing of antituberculous drugs
- Dosing of cardiovascular drugs
- Dosing of analgesics
- Dosing of CNS drugs
- Dosing of gastrointestinal drugs
- Dosing of immunosuppressants
- Miscellaneous drugs
- Drugs that do not require dosage alteration in CKD stage 5, haemodialysis, and CAPD
- Drugs to be avoided in CKD stage 5, haemodialysis, and PD
- Notes on specific cardiovascular drugs
- Notes on specific opioid analgesics
- Notes on NSAIDs
- Notes on specific antibiotics
- Factors affecting drug removal by continuous renal replacement therapy
- Dosing of drugs commonly used during continuous renal replacement therapy
- Chapter 18 Standards documents: the UK Renal Association, the US K/DOQI guidelines, and the European Best Practice guidelines
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- Chapter 18 Standards documents: the UK Renal Association, the US K/DOQI guidelines, and the European Best Practice guidelines
- Overview of UK Renal Association clinical practice guidelines
- UK Renal Association guidelines: CKD
- UK Renal Association guidelines: CKD complications
- UK Renal Association guidelines: haemodialysis
- UK Renal Association guidelines: peritoneal dialysis
- UK Renal Association guidelines: AKI
- Overview of American K/DOQI guidelines
- K/DOQI: haemodialysis adequacy
- K/DOQI: peritoneal dialysis adequacy
- K/DOQI: vascular access
- K/DOQI: anaemia
- K/DOQI: nutrition in dialysis patients
- K/DOQI: dyslipidaemia in CKD
- K/DOQI: bone metabolism and disease in CKD
- K/DOQI: cardiovascular disease in dialysis patients
- European Best Practice guidelines: pre-dialysis
- European Best Practice guidelines: haemodialysis
- European Best Practice guidelines: intradialytic hypotension
- European Best Practice guidelines: infection
- European Best Practice guidelines: vascular risk factors
- European Best Practice guidelines: vascular access
- European Best Practice guidelines: peritoneal dialysis
- European Best Practice guidelines: nutrition
- Appendix: useful websites




