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What the non‐nephrologist needs to know about dialysis
Author(s) -
Foy Matt,
Sperati C. John
Publication year - 2018
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/sdi.12671
Subject(s) - medicine , nephrology , intensive care medicine , dialysis , hemodialysis , peritoneal dialysis , modalities , population , kidney disease , disease , renal replacement therapy , home hemodialysis , end stage renal disease , social science , environmental health , sociology
The End‐Stage Renal Disease ( ESRD ) program now serves approximately 675,000 individuals in the United States at a cost of $26.1 billion to the Medicare system. Given the size of this population, healthcare providers from all disciplines will deliver care to patients on dialysis. Mortality remains high among patients on chronic dialysis, with 42.3% surviving 5 years. As this is a vulnerable population, it is important in the care of ESRD patients that non‐nephrologists have a working knowledge of issues germane to dialysis. This review examines the physiology, mechanics, complications, and care delivery concerns of kidney dialysis modalities relevant to the non‐nephrologist. The majority of patients receive in‐center hemodialysis thrice weekly, with a small proportion on home‐based therapies such as peritoneal dialysis or home hemodialysis. Inpatients may undergo hemodialysis or peritoneal dialysis, and in critically ill patients, continuous renal replacement therapies are utilized. Practical aspects of each of these modalities are discussed.