- Contents
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- 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
The Oxford Handbook of Dialysis provides a patient-centred and comprehensive guide to all aspects of dialysis, covering everything from patient preparation and details of both haemo- and peritoneal dialysis, to continuous haemofiltration techniques and complications of end stage kidney disease.
- About the Editors
-
Jeremy Levy, Consultant Nephrologist and Honorary Clinical Senior Lecturer, Imperial College Healthcare NHS Trust, London, UK
Edwina Brown, Consultant Nephrologist and Honorary Professor of Renal Medicine, Imperial College Healthcare NHS Trust, London, UK
Christine Daley, Lecturer Practitioner, Renal Medicine and Transplantation, Imperial College Healthcare NHS Trust, London, UK
Anastasia Lawrence, Lecturer Practitioner, Renal Medicine and Transplantation, Imperial College Healthcare NHS Trust, London, UK
- Disclaimer
Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work.
© Oxford University Press 2009
