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Manual of Clinical Dialysis

:	Suhail Ahmad
:	Manual of Clinical Dialysis
:	Springer-Verlag
:	9780387096513
:	2
:	CHF 85.40
:

:	Klinische Fächer
:	English

:	245
:	Wasserzeichen/DRM
:	PC/MAC/eReader/Tablet
:	PDF

This second edition of the Manual of Clinical Dialysis is a concise and well-illustrated guide to all aspects of dialysis. All chapters have been revised and present a complete overview of the techniques, processes and equipment involved in clinical dialysis as well as an overview of the complications of dialysis. The manual also provides an overview of common clinical problems related to renal failure such as hypertension, anemia and renal osteodystrophy.

	Foreword (For First Edition)	6
	Acknowledgements	8
	Contents	11
	Abbreviations	18
	Chapter 1	21
	Brief History of Clinical Dialysis: The Seattle Experience	21
	1.1 Definition of Dialysis	23
	1.2 Mechanisms Involved in Molecular Movement	23
	1.2.1 Diffusion	24
	1.2.2 Ultrafiltration	24
	1.2.3 Osmosis	25
	1.2.4 Convection	25
	1.3 Clearance	25
	1.3.1 Blood vs Plasma Clearance	26
	1.3.2 Clinical Factors Influencing Dialysis Urea Clearance	26
	Reference	26
	Chapter 2	27
	Hemodialysis Technique	27
	2.1 Blood Flow Rate	27
	2.2 Dialysate Flow Rate	27
	2.3 Dialyzer Efficiency and Mass Transfer Area Coefficient (KoA)	28
	2.4 Different Hemodialysis Techniques	28
	2.4.1 Traditional Hemodialysis	28
	2.4.2 Hemofiltration	29
	2.4.3 Hemodiafiltration	30
	2.4.4 Slow Low Efficiency Dialysis (SLED)	30
	2.4.5 Ultrafiltration	30
	2.5 Hemodialysis Setup	30
	2.5.1 Blood Circuit	31
	2.5.1.1 Tubing Set	31
	2.5.1.2 Blood Pump	32
	2.5.1.3 Hemodialyzer	33
	Dialyzer Characteristics	34
	Reuse of Dialyzers	38
	2.5.2 Dialysate Circuit	38
	2.5.2.1 Dialysate	38
	2.5.2.2 Dialysate Delivery System	40
	2.5.2.3 DialysisWater	43
	2.5.2.4 Water Treatment System	44
	References	47
	Chapter 3	48
	Anticoagulation	48
	3.1 Heparin Anticoagulation	49
	3.1.1 Systemic Standard Heparinization	50
	3.1.2 Low-Dose Heparinization	50
	3.1.3 Low Molecular Weight Heparin	50
	3.2 Problems with Heparin Anticoagulation	51
	3.3 Alternatives to Heparin	52
	3.3.1 Citrate Anticoagulation	52
	3.3.1.1 Citrate Dialysate (Local Citrate) Anticoagulation	52
	3.3.1.2 Regional Citrate Anticoagulation	53
	3.3.1.3 Heparinoids	53
	3.3.1.4 Direct Thrombin Inhibitors	54
	3.3.1.5 Prostacyclin and other Prostanoids	54
	3.4 No Anticoagulation	54
	References	55
	Chapter 4	56
	Vascular Access	56
	4.1 Permanent Access	56
	4.1.1 Preparation	56
	4.1.1.1 Preferred Access Choice	57
	4.1.2 Arteriovenous Fistula	57
	4.1.2.1 Technique	57
	4.1.2.2 Fistula Use	59
	4.1.2.3 Arteriovenous Fistula Complications	59
	4.1.3 Arteriovenous Graft	60
	4.1.3.1 Graft Use	61
	4.1.3.2 Graft Complications	61
	4.1.4 Diagnosis and Management of Arteriovenous Dialysis Access	62
	4.1.4.1 Clinical Indicators of Problems with Grafts and Fistulae	62
	4.1.4.2 Diagnostic Tests	63
	4.1.4.3 Management	64
	4.1.5 Dual-Lumen Catheters with Dacron Cuff	64
	4.1.5.1 Complications	65
	4.1.6 Special Arteriovenous Shunts	67
	4.1.6.1 Scribner Shunt	67
	4.1.6.2 Thomas Shunt	68
	4.2 Temporary Access	68
	4.2.1 General Technique	69
	4.2.1.1 Internal Jugular Access	69
	4.2.1.2 Subclavian Access (Least Desirable)	70
	4.2.1.3 Femoral Access	71
	4.2.2 Complications of Temporary Access	71
	4.2.2.1 Procedure-Related Complications of Superior Vena Cava Access (Subclavian and Internal Jugular)	73
	4.2.2.2 Procedure-Related Complications of Femoral Vein Catheters	73
	4.2.2.3 Late Complications	74
	4.2.3 Comparison of the Three Access Sites	74
	4.3 Impact of Access	74
	4.3.1 Access Surveillance	75
	References	77
	Chapter 5	78
	Complications of Hemodialysis	78
	5.1 Medical Complications	78
	5.1.1 Hypotension	78
	5.1.1.1 Effect of Ultrafiltration	79
	5.1.1.2 Prevention of Hemodynamic Instability	84
	5.1.1.3 Clinical Manifestation of Hypotension	85
	5.1.1.4 Treatment of Hypotension	85
	5.1.1.5 Convective vs Diffusive Transport and Hypotension	86
	5.1.2 Cardiac Arrhythmias	87
	5.1.3 Intradialytic Hypertension	88
	5.1.4 Muscle Cramps	88
	5.1.4.1 Prevention	89
	5.1.4.2 Treatment	89
	5.1.5 Carnitine and Intradialytic Hypotension, Arrhythmias, and Muscle Cramps	89
	5.1.6 Nausea and Vomiting	90
	5.1.7 Headache	90
	5.1.8 Serious, Less Common Complications	91
	5.1.8.1 Dialysis Disequilibrium Syndrome	91
	5.1.8.2 Dialyzer-Related Reactions	92
	5.2 Machine-Related Complications	94
	5.2.1 Air Embolism	94
	5.2.1.1 Management	94
	5.2.2 Hemolysis	95
	References	95
	Chapter 6	97
	Dose of Hemodialysis	97
	6.1 Historical Background	97
	6.1.1 Dialysis Index	98
	6.1.2 Urea Clearance	98
	6.1.3 Urea as a Marker for Uremic Toxins	99
	6.1.4 Current Methods of Measuring Dialysis Dose	99
	6.1.4.1 Urea Reduction Ratio	100
	6.1.4.2 Calculating Kt/V from Urea Reduction	100
	6.1.4.3 Urea Kinetic Modeling	101
	6.2 Potential Problems with the Calculation of Dialysis Dose	101
	6.2.1 Influence of the Single-Pool Model	101
	6.2.1.1 Correcting for the Two-Pool Model	103