What Do I want ??? Sudhakar Venturi ST4.

Slides:



Advertisements
Similar presentations
G. Simonetti and F. Schaefer Pediatric Nephrology, Center for Pediatric and Adolescent Medicine, University of Heidelberg, Germany Management of High and.
Advertisements

Cardiac Risk In ESRD Patient
RENAL REPLACEMENT THERAPY
Hemodiafiltration and Hemofiltration
SUPPORTING THE DIALYSIS PATIENT IN TIMES OF DISASTER.
Dialysis in AMU Dr Mary Rogerson, Nephrologist, SGH.
NxStage® HHD Therapy Overview
Kidney Dialysis and Transplants
By Zachary Jacobson.  First practiced on animals in early 1900’s  Developed by Dr. Willem Kolff in 1943  First successful treatment administered in.
Renal Replacement Therapy (RRT)
End-Stage Renal Disease  By  Jason Klein  BMB Seminar  May 3, 1999.
Kidney.
End Stage Renal Disease in Children. End stage kidney disease occurs when the kidneys are no longer able to function at a level that is necessary for.
The future of haemodialysis in the UK RCP advanced medicine 2013 Cormac Breen Consultant Nephrologist Guy's and St Thomas' Hospitals London.
NxStage Kidney Care Encourage,Enhance,Empower Crystal Dean RN
NON-TRADITIONAL RENAL REPLACEMENT THERAPY Hafez Bazaraa.
Treatment Options for End Stage Kidney Disease Dr Vipula De Silva.
DIALYSIS.
Renal Replacement Therapy: What the PCP Needs to Know.
AWAK- Automated Wearable Artificial Kidney
Annette Butler CNM II Home Therapies Beaumont Hospital Dublin.
Measurement and preservation of residual renal function (RRF) in haemodialysis patients Elizabeth Lindley and David Keane Leeds Teaching Hospitals NHS.
Chronic Kidney Disease Treatment Options
Dialysis Facility Compare Valarie Ashby Co-Managing Director UM-KECC.
PRINCIPLES OF DIALYSIS DR SAAD ALSHOHAIB ASSOCIATE PROFESSOR IN MEDICINE AND NEPHROLOGY KAUH.
Chronic Kidney Disease
Dialysis What is it and why do we need it?. What do you already know?
APPENDIX 1. D-1 New cases of diagnosed diabetes D-2.1 All cause mortality* D-2.2 Cardiovascular disease deaths* D-3 Diabetes death rate, multiple cause.
What is Kidney Dialysis? The kidneys are responsible for filtering waste products from the blood. The kidneys are responsible for filtering waste products.
Diseases of the Renal System KNH 413. CKD - Renal Replacement Therapy Hemodialysis (HD) or Peritoneal Dialysis (PD) Type based on underlying kidney disease.
Landmark developments in dialysis
Peritoneal Dialysis End Stage Renal Disease Causes and Treatment Methods.
URINARY DISORDERS.
Hemodialysis. Hemodialysis (also haemodialysis) is a method for removing waste products such as potassium and urea, as well as free water from the blood.
Diabetic Nephropathy.  Over 40% of new cases of end-stage renal disease (ESRD) are attributed to diabetes.  In 2001, 41,312 people with diabetes began.
DIALYSIS Dr. Frank Edwin.
Renal Replacement Therapy (RRT) Types of therapy available to patients who have failing kidneys Debbie Jones RN CNeph(C)
4/9/08 Urinary System Chapter 24 – Day 4. 4/9/08 Renal Failure  Decrease or increase in normal renal function  Acute & Chronic – discussed in next few.
Case Report and Lit Review: Reduction of Proteinuria in Diabetic Nephropathy with Spironolactone Harry W. Floyd, M.D. Family Medicine Kingstree, South.
Home Haemodialysis in Wales An Evaluation of Nutritional Needs Harriet Williams Clinical Dietitian - Renal Lead, BCU.
Dialysis Clinic Process Improvement Analysis Adam Roy Dorothy Fisher Janelle Bryant Joel Mikuta Sherri Mesquita Michelle Himes.
Kidney Failure. Functions of the Kidney n Remove waste products and excess fluid n Produce hormones and vitamins n Help regulate blood pressure n Produce.
NIPEC Annual Conference Professional Standards Enhancing Person-Centred Care Assisted Automated Peritoneal Dialysis(aAPD) Susie Mawhinney PD Nurse BCH.
Creative marketing strategies can drive significant financial returns Please turn your audio on.
Dialysis - The Artificial Kidney What is it? Dialysis is a form of treatment that replicates many of the kidney’s functions. It is often used to treat.
Health issues linked to the kidney. Sometimes the kidney stops working properly, and may even stop working altogether If this happens, excess water and.
Bloods – it’s all about blood.
The Caregiver’s Tip Guide
RENAL REPLACEMENT THERAPIES
McCullough PA, Chan CT, Weinhandl ED, Burkart JM, Bakris GL
Optimization of pre-ESRD care: The key to improved dialysis outcomes
Intensive Hemodialysis, Treatment Complications and Tolerability
Principles of dialysis
Intensive Hemodialysis, Treatment Complications and Tolerability
Intensive Hemodialysis: Applied Clinical Practice
McCullough PA, Chan CT, Weinhandl ED, Burkart JM, Bakris GL
CARDIOVASCULAR CORELATIONS IN CHILDREN WITH END STAGE RENAL DISEASE
The Caregiver’s Tip Guide
Diseases of the Renal System
Current and future management of diabetic renal failure
Dialysis Options: What is the Best Choice for You. Ana C
Nephrology Skills Laboratory
A Six-hour Hemodialysis Without a Significant Increase in Dialysis Dose, as Judged by Kt/V, Can Reduce the Dosage of Erythropoietin Department of Kidney.
Kariah Healthcare Solutions
Renal replacement therapy
Homocysteine and risk in end-stage renal disease: a matter of context
Diseases of the Renal System
Volume 68, Issue 1, Pages (July 2005)
Diseases of the Renal System
Optimization of pre-ESRD care: The key to improved dialysis outcomes
Presentation transcript:

What Do I want ??? Sudhakar Venturi ST4

History Dialysis – 1861 Thomas Graham, Professor of Chemistry at Anderson's University in Glasgow He noticed that crystalloids were able to diffuse through vegetable parchment coated with albumin (which acted as a semi-permeable membrane). Using this method he was able to extract urea from urine He noticed that crystalloids were able to diffuse through vegetable parchment coated with albumin (which acted as a semi-permeable membrane). He called this "dialysis". Using this method he was able to extract urea from urine

WJ Kolff and H Berk (Netherlands) George Haas (Germany) First successful human dialysis - 1924. The dialysis lasted for 15 minutes with out any complications. WJ Kolff and H Berk (Netherlands) 1943 - The first practical human haemodialysis machine.

One of Kolff's first artificial kidneys 1946-1950

Haemodialysis in the U K 1948 - Bywaters and Joekes - published a report on 12 patients treated with the artificial kidney at Hammersmith. Dialysis for chronic renal failure Quinton and Scribner (1960) – arteriovenous shunt was the key development.

1967 - The only renal unit in Wales, at Cardiff Royal Infirmary

Renal Replacement Therapy Haemodialysis Institutional Home Conventional / Long duration Nocturnal Peritoneal Dialysis CAPD APD Transplantation Live DBD/DCD

Nocturnal home Haemodialysis Three to seven times per week at night during sleep, for six to ten hours More total time dialyzing shorter periods between treatments fluid removal speeds can be lower and gradual.

Advantages of nocturnal home HD Better blood pressure management less need for BP medication. Avoidance of intradialytic hypotension. "Nocturnal hemodialysis increases arterial baroreflex sensitivity and compliance and normalizes blood pressure of hypertensive patients with end-stage renal disease". Kidney Int. (2005).

More energy and less 'wash-out' after treatment Less dietary restrictions - Phosphate binders, food restrictions.

Cardiovascular disease in ESRD patients is the leading cause of mortality. Nocturnal hemodialysis is proven to improve Ejection Fraction, lead to a regression in left ventricular hypertrophy "Effect of Frequent Nocturnal Hemodialysis vs Conventional Hemodialysis on Left Ventricular Mass and Quality of Life". Journal of the American Medical Association (2007) "Regression of left ventricular hypertrophy after conversion to nocturnal hemodialysis". Kidney Int.

Less expensive overall for the health system due to lower rates of hospitalization "Reduction in cardiovascular related hospitalization with nocturnal home hemodialysis". Clin. Nephrol. (2008). More control over the dialysis treatment schedules - Greater life satisfaction My Journey to Nocturnal Dialysis Marion Higgins

Survival among NHHD patients compared to kidney transplant recipients, Robert P. Pauly and others Nephrology Dialysis and Transplantation, May 2009

Disadvantages of nocturnal home hemodialysis Cost and effort Longer duration of training Home circumstances Night sleep Machine alarms. (Experience from Lynchburg suggests it happens once every 10 days for people using a fistula and 1-2 times per night if using a catheter) NHHD - caregiver burden, depression, quality of life – Hemodialysis International (FEB 2012)

In Wales UHW – None Swansea – 3 + 1 Bangor – None Glan Clwyd – None Wrexham - ?1

What Do I want NHHD Live related transplant – Identical twin DBD preferred than DCD Dialysis Peritoneal Dialysis Prefer APD with day dwells Haemodialysis NHHD

Thank You