Treatments for End-stage renal disease
Treatments for End-stage renal disease
The list of treatments mentioned in various sources
for End-stage renal disease
includes the following list.
Always seek professional medical advice about any treatment
or change in treatment plans.
End-stage renal disease: Marketplace Products, Discounts & Offers
Products, offers and promotion categories available for End-stage renal disease:
End-stage renal disease: Research Doctors & Specialists
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Drugs and Medications used to treat End-stage renal disease:
Note:You must always seek professional medical advice about any prescription drug, OTC drug, medication, treatment
or change in treatment plans.
Some of the different medications used in the treatment of End-stage renal disease include:
Hospital statistics for End-stage renal disease:
These medical statistics relate to hospitals, hospitalization and End-stage renal disease:
- end-stage renal disease resulted in 636,010 hospitalisations for dialysis related care in Australia 2001-02 (McDonald & Russ, 2003, Australia’s Health 2004, AIHW)
- end-stage renal disease resulted in 367,861 men hospitalised for dialysis related care in Australia 2001-02 (McDonald & Russ, 2003, Australia’s Health 2004, AIHW)
- end-stage renal disease resulted in 268,149 women hospitalised for dialysis related care in Australia 2001-02 (McDonald & Russ, 2003, Australia’s Health 2004, AIHW)
- 11,601 people were hospitalised for kidney failure in Australia 2001-02 (Australia’s Health 2004, AIHW)
- 44% of people hospitalised for kidney failure were women in Australia 2001-02 (Australia’s Health 2004, AIHW)
- more hospital information...»
Hospitals & Medical Clinics: End-stage renal disease
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More general information, not necessarily in relation to End-stage renal disease,
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Medical news summaries about treatments for End-stage renal disease:
The following medical news items
are relevant to treatment of End-stage renal disease:
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Book Excerpts: Treatment of End-stage renal disease
Treatments of End-stage renal disease: Online Medical Books
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for more information about the treatments of End-stage renal disease.
Acute renal failure:
Treatment (Tx)
(Professional Guide to Diseases (Eighth Edition))
Strict fluid management, supportive care (electrolyte replacement; high-calorie, low-
protein diet), hemodialysis or peritoneal dialysis
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Chronic renal failure:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Treatment focuses on controlling the symptoms, minimizing complications, and slowing the progression of the disease. Associated diseases that cause or result from chronic renal failure must be controlled such as hypertension. Conservative treatment aims to correct specific symptoms. A low-protein diet reduces the production of end products of protein metabolism that the kidneys can’t excrete. (A patient receiving continuous peritoneal dialysis should have a high-protein diet.) A high-calorie diet prevents ketoacidosis and the negative nitrogen balance that results in catabolism and tissue atrophy, and restricts sodium and potassium.
Maintaining fluid balance requires careful monitoring of vital signs, weight changes, and urine volume (if present). If some renal function remains, administration of loop diuretics such as furosemide, and fluid restriction can reduce fluid retention. Cardiac glycosides may be used to mobilize edema fluids; antihypertensives, to control blood pressure and associated edema. Antiemetics taken before meals may relieve nausea and vomiting; cimetidine or ranitidine may decrease gastric irritation. Methylcellulose or docusate can help prevent constipation.
Treatment may also include regular stool analysis (guaiac test) to detect occult blood and, as needed, cleaning enemas to remove blood from the GI tract. Anemia necessitates iron and folate supplements; severe anemia requires infusion of fresh frozen packed cells or washed packed cells. However, transfusions relieve anemia only temporarily. Epoetin alpha (erythropoietin) increases RBC production.
Drug therapy often relieves associated symptoms: an antipruritic, such as trimeprazine or diphenhydramine, for itching and aluminum hydroxide gel to lower serum phosphate levels. The patient may also benefit from supplementary vitamins (particularly B vitamins and vitamin D) and essential amino acids.
Careful monitoring of serum potassium levels is necessary to detect hyperkalemia. Emergency treatment for severe hyperkalemia includes dialysis therapy and administration of 50% hypertonic glucose I.V., regular insulin, calcium gluconate I.V., sodium bicarbonate I.V., and cation exchange resins such as sodium polystyrene sulfonate.
Alert Cardiac tamponade resulting from pericardial effusion may require emergency pericardial tap or surgery.
Blood gas measurements may indicate acidosis; intensive dialysis and thoracentesis can relieve pulmonary edema and pleural effusions.
Hemodialysis or peritoneal dialysis (particularly continuous ambulatory peritoneal dialysis and continuous cyclic peritoneal dialysis) can help control most manifestations of end-stage renal disease; altering dialyzing bath fluids can correct fluid and electrolyte disturbances. (See Comparing peritoneal dialysis and hemodialysis, page 806. Also see Continuous ambulatory peritoneal dialysis, page 807.) But anemia, peripheral neuropathy, cardiopulmonary and GI complications, sexual dysfunction, and skeletal defects may persist. Maintenance dialysis itself may produce complications, such as protein wasting, refractory ascites, and dialysis dementia. Kidney transplantation may eventually be the treatment of choice for some patients with end-stage renal disease.
PEDIATRIC TIP Children require more dialysis in relation to their body weight than adults because their metabolic rates and, therefore, food intake, are higher.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Introduction: Renal and Urologic Disorders:
Treatment methods
(Professional Guide to Diseases (Eighth Edition))
Treatment of intractable renal or urinary system dysfunction may require urinary diversion, dialysis, or kidney transplantation. Urinary diversion is the surgical creation of an outlet for excreting urine. The types of urinary diversion include ileal conduit, cutaneous ureterostomy, ureterosigmoidostomy, and creation of a rectal bladder.
In dialysis, a semipermeable membrane, osmosis, and diffusion imitate normal renal function by eliminating excess body fluids, maintaining or restoring plasma electrolyte and acid-base balance, and removing waste products and dialyzable poisons from the blood. Dialysis is most often used for patients with acute or chronic renal failure. The two most common types of dialysis are peritoneal dialysis and hemodialysis.
In peritoneal dialysis, a dialysate solution is infused into the peritoneal cavity. Substances then diffuse through the peritoneal membrane. Waste products remain in the dialysate solution and are removed.
Hemodialysis separates solutes by differential diffusion through a cellophane membrane placed between the blood and the dialysate solution, in an external receptacle. Because the blood must actually pass out of the body into a dialysis machine, hemodialysis requires an access route to the blood supply by an arteriovenous fistula or cannula or by a bovine or synthetic graft. When caring for a patient with such an access route, monitor the patency of the access route, prevent infection, and promote safety and adequate function. After dialysis, watch for such complications as headache, vomiting, agitation, and twitching.
Patients with end-stage renal disease may benefit from kidney transplantation, despite its limitations: a shortage of donor kidneys, the chance of transplant rejection, and the need for lifelong medications and follow-up care. After kidney transplantation, maintain fluid and electrolyte balance, prevent infection, monitor for rejection, and promote psychological well-being.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Renal failure, acute:
Treatment
(Handbook of Diseases)
The goals of treatment include identifying and treating reversible causes, such as nephrotoxic drug therapy, obstructive uropathy, and volume depletion. Supportive measures include a diet high in calories and low in protein, sodium, and potassium, with supplemental vitamins and restricted fluids. Meticulous electrolyte monitoring is essential to detect hyperkalemia.
If hyperkalemia occurs, acute therapy may include dialysis, hypertonic glucose and insulin infusions, and calcium — all administered I.V. — and oral or rectal administration of potassium exchange resin to remove potassium from the body.
If measures fail to control uremic symptoms, hemodialysis or peritoneal dialysis may be necessary.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Renal failure, chronic:
Treatment
(Handbook of Diseases)
Conservative treatment aims to correct specific symptoms, minimize complications, and slow progression of the disease. Underlying conditions that cause chronic renal failure must be controlled.
Diet
A low-protein diet reduces the production of end products of protein metabolism that the kidneys can’t excrete. (A patient receiving continuous peritoneal dialysis should receive a high-protein diet.)
A high-calorie diet prevents ketoacidosis and the negative nitrogen balance that results in catabolism and tissue atrophy. Such a diet also restricts sodium and potassium.
Fluid status
Maintaining fluid balance requires careful monitoring of vital signs, weight changes, and urine volume (if present). Loop diuretics, such as furosemide (if some renal function remains), and fluid restriction can reduce fluid retention. A cardiac glycoside may be used to mobilize edema fluids; an antihypertensive, especially an angiotensin-converting enzyme inhibitor, to control blood pressure and associated edema.
Treatment of GI and blood problems
An antiemetic taken before meals may relieve nausea and vomiting; cimetidine, omeprazole, or ranitidine may decrease gastric irritation. Methylcellulose or docusate can help prevent constipation.
Treatment may also include regular stool analysis (guaiac test) to detect occult blood and, as needed, cleansing enemas to remove blood from the GI tract.
Anemia necessitates iron and folate supplements; severe anemia requires infusion of fresh frozen packed cells or washed packed cells. However, transfusions relieve anemia only temporarily. Synthetic erythropoietin (epoetin alfa) may be given to stimulate the division and differentiation of cells within the bone marrow to produce RBCs. An-drogen therapy (testosterone or nandrolone) may increase RBC production.
Drug therapy, surgery, and dialysis
Drug therapy can help relieve associated symptoms: an antipruritic, such as trimeprazine or diphenhydramine, to relieve itching and aluminum hydroxide gel to lower serum phosphate levels.
CLINICAL TIP: Be alert for aluminum toxicity, an adverse reaction to aluminum hydroxide.
The patient may also benefit from supplementary vitamins (particularly B vitamins and vitamin D) and essential amino acids.
Careful monitoring of serum potassium levels is necessary to detect hyperkalemia. Emergency treatment for severe hyperkalemia includes dialysis therapy and administration of 50% hypertonic glucose I.V., regular insulin, calcium gluconate I.V., sodium bicarbonate I.V., and cation exchange resins such as sodium polystyrene sulfonate. Cardiac tamponade resulting from pericardial effusion may require emergency pericardial tap or surgery.
Blood gas measurements may indicate acidosis; intensive dialysis and thoracentesis can relieve pulmonary edema and pleural effusions.
Hemodialysis or peritoneal dialysis (particularly continuous ambulatory peritoneal dialysis and continuous cyclic peritoneal dialysis) can help control most manifestations of end-stage renal disease. (See Continuous ambulatory peritoneal dialysis, page 718.) Altering dialyzing bath fluids can correct fluid and electrolyte disturbances. However, anemia, peripheral neuropathy, cardiopulmonary and GI complications, sexual dysfunction, and skeletal defects may persist.
Maintenance dialysis may produce complications, such as protein wasting, refractory ascites, and dialysis dementia. A kidney transplant may eventually be the treatment of choice for some patients with end-stage renal disease.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
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