Peritoneal Dialysis Should Be the First Choice for Renal Replacement Therapy in the Elderly

2012 ◽  
Vol 25 (6) ◽  
pp. 668-670 ◽  
Author(s):  
Joanne M. Bargman
2012 ◽  
Vol 25 (6) ◽  
pp. 671-674 ◽  
Author(s):  
Mary Mallappallil ◽  
Ankita Patel ◽  
Eli A. Friedman

2018 ◽  
Vol 1 (1) ◽  
pp. 5-8
Author(s):  
William White ◽  
Edwina Brown

AbstractPeritoneal dialysis (PD) can provide an improved quality of life to older patients requiring renal replacement therapy (RRT) compared to in-centre haemodialysis (HD). Frailty in the elderly poses challenges to PD, which may be met by assisted PD, and integration with geriatric and palliative services. The focus of PD care in the elderly should be on meeting patients’ goals, controlling symptoms, maintaining fluid balance and maintaining residual renal function


PEDIATRICS ◽  
1990 ◽  
Vol 85 (5) ◽  
pp. 819-823
Author(s):  
Nancy A. Bishof ◽  
Thomas R. Welch ◽  
C. Frederic Strife ◽  
Frederick C. Ryckman

Continuous arteriovenous hemofiltration is a form of renal replacement therapy whereby small molecular weight solutes and water are removed from the blood via convection, alleviating fluid overload and, to a degree, azotemia. It has been used in many adults and several children. However, in patients with multisystem organ dysfunction and acute renal failure, continuous arteriovenous hemofiltration alone may not be sufficient for control of azotemia; intermittent hemodialysis or peritoneal dialysis may be undesirable in such unstable patients. Recently, the technique of continuous arteriovenous hemodiafiltration has been used in many severely ill adults. We have used continuous arteriovenous hemodiafiltration in four patients at Children's Hospital Medical Center. Patient 1 suffered perinatal asphyxia and oliguria while on extracorporeal membrane oxygenation. Patients 2 and 4 both had Burkitt lymphoma and tumor lysis syndrome. Patient 3 had septic shock several months after a bone marrow transplant. All had acute renal failure and contraindications to hemodialysis or peritoneal dialysis. A blood pump was used in three of the four patients, while spontaneous arterial flow was adequate in one. Continuous arteriovenous hemodiafiltration was performed for varying lengths of time, from 11 hours to 7 days. No patient had worsening of cardiovascular status or required increased pressor support during continuous arteriovenous hemodiafiltration. The two survivors (patients 2 and 4) eventually recovered normal renal function. Continuous arteriovenous hemodiafiltration is a safe and effective means of renal replacement therapy in the critically ill child. It may be ideal for control of the metabolic and electrolyte abnormalities of the tumor lysis syndrome.


2017 ◽  
Vol 108 ◽  
pp. 128-132 ◽  
Author(s):  
Tibor Fülöp ◽  
Lajos Zsom ◽  
Mihály B. Tapolyai ◽  
Miklos Z. Molnar ◽  
Sohail Abdul Salim ◽  
...  

2021 ◽  
Author(s):  
Anna Buckenmayer ◽  
Lotte Dahmen ◽  
Joachim Hoyer ◽  
Sahana Kamalanabhaiah ◽  
Christian S. Haas

Abstract Background: The erythrocyte sedimentation rate (ESR) is a simple laboratory diagnostic tool for estimating systemic inflammation. It remains unclear, if renal function affects ESR, thereby compromising its validity. This pilot study aims to compare prevalence and extent of ESR elevations in hospitalized patients with or without kidney disease. In addition, the impact of renal replacement therapy (RRT) modality on ESR was determined.Methods: In this single-center, retrospective study, patients were screened for ESR values. ESR was compared in patients with and without renal disease and/or RRT. In addition, ESR was correlated with other inflammatory markers, the extent of renal insufficiency and clinical characteristics.Results: A total of 203 patients was identified, showing an overall elevated ESR in the study population (mean 51.7±34.6 mm/h). ESR was significantly increased in all patients with severe infection, active vasculitis or cancer, respectively, independent from renal function. Interestingly, there was no difference in ESR between patients with and without kidney disease or those having received a prior renal transplant or being on hemodialysis. However, ESRD patients treated with peritoneal dialysis presented with a significantly higher ESR (78.3±33.1 mm/h, p<0.001), while correlation with other inflammatory markers was not persuasive.Conclusions: We showed that ESR: (1) does not differ between various stages of renal insufficiency; (2) may be helpful as a screening tool also in patients with renal insufficiency; and (3) is significantly increased in ESRD patients on peritoneal dialysis per se, while it seems not to be affected by hemodialysis or renal transplantation (see graphical abstract as supplementary material).


2018 ◽  
Vol 143 (12) ◽  
pp. 863-870
Author(s):  
Jan Galle ◽  
Jana Reitlinger

AbstractIn renal replacement therapy, different methods are available: hemodialysis (HD), peritoneal dialysis (PD), and kidney transplantation (KTx). In addition, variants can be used: HD as a home HD or center HD, PD as a conventional PD or automated (cycler) PD, KTx as a potentially short-term predictable living donation or conventional donor kidney donation. The patient and his familiar or caring environment must be informed accordingly. This means first of all: information about which procedures of kidney replacement therapy are possible and can be offered. Then the specific risks associated with each procedure should be elucidated (e. g. HD and shunt bleeding, PD and peritonitis, KTx and infections/neoplasias). This necessarily includes a structured documentation of the educating center/doctor about the communicated information and decisions taken.


2017 ◽  
Vol 32 (suppl_3) ◽  
pp. iii476-iii477
Author(s):  
Sudhaharan Sivathasan ◽  
Lily Mushahar

2019 ◽  
Vol 74 (5) ◽  
pp. 620-628 ◽  
Author(s):  
Rita L. McGill ◽  
Daniel E. Weiner ◽  
Robin Ruthazer ◽  
Dana C. Miskulin ◽  
Klemens B. Meyer ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document