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Book Description
L'insuffisance rénale chronique (IRC) est très fréquente chez les sujets âgés. Le bénéfice de la dialyse est parfois incertain dans cette population, notamment chez les patients ayant des comorbidités importantes. L'identification de ces patients reste difficile. L'objectif de notre travail est de rechercher des facteurs prédictifs du devenir des sujets âgés en insuffisance rénale chronique. Nous avons réalisé une étude monocentrique rétrospective incluant les patients de plus de 75 ans avec un DFG ≤ 20 ml/min/1,73 m2 et analysé leur devenir à 3 ans. Sur les 81 patients de notre population, 54 % sont des hommes, 42 % diabétiques et 32 % ont des troubles cognitifs. L'âge médian est de 81 ans et le DFG médian de 17 ml/min/1,73 m2. L'IRC est responsable de 20 % d'anémie. A 3 ans, 26 patients sont dialysés (32 %). Le groupe des non dialysés comprend les patients en traitement conservateur et les patients n'ayant pas encore d'indication à la dialyse. Les patients dialysés sont plus jeunes et plus souvent diabétiques. Ils ont un DFG à l'inclusion plus bas et une évolution depuis le début de leur suivi plus rapide. Aucun ne présente de troubles cognitifs ou de perte d'autonomie. L'évaluation gériatrique pré-dialyse n'a concerné que des patients en traitement conservateur. Les patients dialysés ont une meilleure survie : on ne relève que 6 décès (23 %), contre 39 chez les non dialysés (71 %), p
Book Description
L'insuffisance rénale chronique (IRC) est très fréquente chez les sujets âgés. Le bénéfice de la dialyse est parfois incertain dans cette population, notamment chez les patients ayant des comorbidités importantes. L'identification de ces patients reste difficile. L'objectif de notre travail est de rechercher des facteurs prédictifs du devenir des sujets âgés en insuffisance rénale chronique. Nous avons réalisé une étude monocentrique rétrospective incluant les patients de plus de 75 ans avec un DFG ≤ 20 ml/min/1,73 m2 et analysé leur devenir à 3 ans. Sur les 81 patients de notre population, 54 % sont des hommes, 42 % diabétiques et 32 % ont des troubles cognitifs. L'âge médian est de 81 ans et le DFG médian de 17 ml/min/1,73 m2. L'IRC est responsable de 20 % d'anémie. A 3 ans, 26 patients sont dialysés (32 %). Le groupe des non dialysés comprend les patients en traitement conservateur et les patients n'ayant pas encore d'indication à la dialyse. Les patients dialysés sont plus jeunes et plus souvent diabétiques. Ils ont un DFG à l'inclusion plus bas et une évolution depuis le début de leur suivi plus rapide. Aucun ne présente de troubles cognitifs ou de perte d'autonomie. L'évaluation gériatrique pré-dialyse n'a concerné que des patients en traitement conservateur. Les patients dialysés ont une meilleure survie : on ne relève que 6 décès (23 %), contre 39 chez les non dialysés (71 %), p
Author: Sergio Giovannetti Publisher: Springer Science & Business Media ISBN: 1461315832 Category : Medical Languages : en Pages : 384
Book Description
Enormous progress has been made in the treatment of chronic renal failure over the last decades. Until the 1950s, chronic renal failure was considered to be an inexorably lethal condition. This is no longer the case. In addition, the disease, severe uremic syndrome, is now extremely rare, if existent at all, in industrialized countries. Physicians of my generation who saw patients hospitalized with hemor raghes, pericarditis, severe anemia, cardiac failure, "malignant hypertension," pruritus, vomiting, generalized edema, and convulsions are particularly grate ful for this progress. I well remember seeing such patients hospitalized in the last days or weeks of their lives and also remember the sense of impotence I suffered for the com plete lack of efficient measures I had at my disposal to manage their condition. Nowadays, hemodialysis, peritoneal dialysis, and kidney transplantation allow patients with chronic renal failure to survive for very long periods of time in a satisfactory condition. Why then is there still a sense of dissatisfaction and why should we study dietary management? The drawbacks of dialysis and transplantation are the main reasons, but the certainty that dietary therapy is complementary to dialysis and even better than dialysis in certain conditions, is also very important.
Author: G. Krick Publisher: Karger Medical and Scientific Publishers ISBN: 3805599072 Category : Medical Languages : en Pages : 202
Book Description
On-line HDF represents a major technical development in the delivery of hemodialysis therapy: It combines the properties of increased diffusion available in current high-flux membranes with convective removal of between 6 and 30 liters per treatment and requires the use of ultrapure water and online filtration of replacement fluid. On-line HDF has been successfully introduced in Europe and Asia and is routinely prescribed for dialysis patients in these regions.The book at hand summarizes the history and achievements of on-line HDF in four parts: A report of the technological development in both machine and fiber/dialyzer is followed by a description of the challenges encountered in the evolution of on-line HDF, collecting the accounts of clinical key opinion leaders who had been involved in its early application. The third part presents a comprehensive review of the clinical results achieved with on-line HDF from its inception to the present times, in which it represents the clinical golden standard. The fourth and final part is dedicated to on-line HDF as a ‘vision’ for the future.
Author: Claudio Ronco Publisher: Karger Medical and Scientific Publishers ISBN: 3805582889 Category : Medical Languages : en Pages : 249
Book Description
A concise handbook on clinical and technical possibilities The application of hemodiafiltration has been restricted until recently, when a broader clinical application has been made possible due to evidence from large studies and clinical investigations. This book provides an updated review of the evolution, advances and recent results achieved by hemodiafiltration in the clinical arena. The first part is devoted to historical notes and an outline of the evolution of different forms of hemodiafiltration, made possible by technological developments in the fields of membranes, machines and fluids. The next section describes the theoretical rationale for hemodiafiltration, providing a detailed analysis of the involved mass separation processes, the hydraulic properties of the dialyzers, fluid mechanics and crossfiltration in hollow fiber hemodialyzers. An outline of different hemodiafiltration techniques, also reporting peculiar transport mechanisms and related technology, is given next, and a section on the clinical effects of hemodiafiltration concludes this book. Including different technologies, the publication offers a complete overview of the technical and clinical possibilities provided by hemodiafiltration in its widest concept, ranging from the molecular basis to the most practical application. It will be a valuable tool for the implementation of hemodiafiltration in daily practice aimed at beginners and experts, scientists and physicians, students and senior faculty members alike.
Author: Walter H. Hörl Publisher: Springer Science & Business Media ISBN: 1402022751 Category : Medical Languages : en Pages : 1640
Book Description
The leading Textbook on the subject. A completely rewritten and up-to-date fifth edition, based upon the highly respected fourth edition, edited by C. Jacobs, C.M. Kjellstrand, K.M. Koch and J.F. Winchester. This new edition is truly global in scope and features the contributions of the top experts from around the world.
Author: R. L. Mehta Publisher: ISBN: 9783805573719 Category : Languages : en Pages : 0
Book Description
The management of critically ill patients is rapidly undergoing change as new technology for the diagnosis, monitoring and treatment of these patients is being utilized. Moreover, the understanding of the pathophysiology of multi-organ failure has greatly increased, a key element in its management involving the support of organ function to allow specific interventions or time for recovery. Originally introduced as an alternative for intermittent hemodialysis, CRRT techniques are now also used for renal support not only in the traditional setting of acute renal failure, but also in other settings as diverse as liver support systems for end-stage liver disease and cancer chemotherapy. This utilization of a common mechanism of blood and plasma membrane interactions is truly an exciting advance, which is likely to be further developed in the next decade. In this multidisciplinary publication, recent advances in our understanding of pathophysiology and critical illness are highlighted, as well as emerging strategies in the management of sepsis, liver failure, acute renal failure, technical advances in CRRT and targeted intervention with these techniques. Since this publication provides articles relevant to the management of critically ill patients requiring renal support in the ICU setting, it should be read not only by nephrologists and critical care physicians, but by all those involved in the care of patients with multi-organ failure.
Author: Institute of Medicine Publisher: National Academies Press ISBN: 0309148057 Category : Medical Languages : en Pages : 506
Book Description
Reducing the intake of sodium is an important public health goal for Americans. Since the 1970s, an array of public health interventions and national dietary guidelines has sought to reduce sodium intake. However, the U.S. population still consumes more sodium than is recommended, placing individuals at risk for diseases related to elevated blood pressure. Strategies to Reduce Sodium Intake in the United States evaluates and makes recommendations about strategies that could be implemented to reduce dietary sodium intake to levels recommended by the Dietary Guidelines for Americans. The book reviews past and ongoing efforts to reduce the sodium content of the food supply and to motivate consumers to change behavior. Based on past lessons learned, the book makes recommendations for future initiatives. It is an excellent resource for federal and state public health officials, the processed food and food service industries, health care professionals, consumer advocacy groups, and academic researchers.
Author: Mathilde Bordage
Author: Mathilde Bordage
Author: Sergio Giovannetti
Author: G. Krick
Author: Claudio Ronco
Author: Walter H. Hörl
Author: Jack W. Moncrief
Author: R. L. Mehta
Author: Stuart Hill
Author: Carsten Bokemeyer
Author: Institute of Medicine