End-Stage Renal Disease (eBook)

Front Cover 1
End-Stage Renal Disease: An Integrated Approach 4
Copyright Page 5
Table of Contents 6
Contributors 12
Foreword 14
Preface 16
Chapter 1. Renal Physiology and Pathophysiology of Renal Failure 18
I. Anatomy 19
II. Renal Blood Flow 21
III. Glomerular Filtration 21
IV. Renal Handling of Macromolecules 24
V. Renal Tubular Function 24
VI. Sodium 27
VII. Potassium 29
VIII. Calcium and Inorganic Phosphorus (Phosphate) 31
IX. Renal Regulation of Acid-Base Balance 33
X. Urinary Dilution and Concentration 35
XI. Renal Endocrine Function 38
General References 42
References 42
Chapter 2. The Presentation of the Patient with Chronic Renal Failure 48
I. A Summary of Patients' Initial Modes of Presentation 48
II. The Uremic Illness 57
General References 71
References 71
Chapter 3. Medical Complications of End-Stage Renal Disease 74
I. Introduction 74
II. Reversible Aspects of Renal Failure 75
III. Organ System Involvement and Other Complications 76
References 97
Chapter 4. Endocrine and Metabolic Changes Accompanying End-Stage Renal Disease 102
I. Introduction 102
II. Abnormalities of Basal Metabolism and Thyroid Hormone Economy 103
III. Glucose and Insulin Metabolism in Uremia 107
IV. The Hyperlipidemias 109
V. Growth Hormone and Somatomedin Metabolism in Uremia 111
VI. Pituitary Adrenocortical Function in Uremia 112
VII. Pituitary-Gonadal Axis 115
VIII. Gastrointestinal Hormones 119
IX. Synthesis 120
General Reference 121
References 121
Chapter 5. Psychiatric Aspects of End-Stage Renal Disease: Diagnosis and Management 128
I. Personality Changes in End-Stage Renal Disease 129
II. Education for Patients with Pre-End-Stage and End-Stage Renal Disease 140
III. Psychological Factors Influencing the Choice of Alternative Methods of Treatment 142
IV. Neuropsychiatric Manifestations Associated with End-Stage Renal Disease 148
V. Reactions of Staff in a Dialysis Center 154
VI. The Role of Psychiatrist as a Team Member of a Nephrology Unit 160
VII. Summary 161
General References 162
References 162
Chapter 6. Social Work with Renal Failure Patients: Roles of the Social Worker 166
I. Introduction 166
II. Roles of the Social Worker 167
III. Concluding Statement 8
General References 181
References 181
Chapter 7. The Problem of Vascular Access in the Management of End-Stage Renal Disease: The Various Possibilities of Producing a Shunt 182
I. Access for Hemodialysis 182
II. Access for Peritoneal Dialysis 194
III. Conclusion 196
General References 196
References 196
Chapter 8. Dialysis 200
I. Introduction 200
II. Hemodialysis 205
III. Peritoneal Dialysis 218
IV. Results of Dialysis 228
References 229
Chapter 9. Technical Aspects of Dialysis 236
I. Introduction 236
II. Water Treatment 237
III. Hemodialysis Systems 241
IV. Dialyzer Reuse 245
V. Peritoneal Dialysis 251
VI. Patient Education 254
References 256
Chapter 10. The Case for Renal Transplantation 258
I. The Concept of Transplantation 259
II. Recipient Selection 265
III. The Evaluation of Prospective Kidney Donors 272
IV. The Surgical Procedure 281
V. Immunosuppression 302
VI. Long-Term Management 306
VII. Long-Term Complications Following Transplantation 310
VIII. Data Analysis 315
General References 321
References 321
Chapter 11. Nursing Care of the Patient with End-Stage Renal Disease 326
I. Introduction 326
II. The Renal Clinic 327
III. Hemodialysis 331
IV. Peritoneal Dialysis 342
V. In-Center Dialysis 346
VI. Renal Transplantation 346
VII. Conclusion 347
References 348
Chapter 12. The Role of Nutrition in End-Stage Renal Disease 350
I. Introduction and General Principles 350
II. Predialysis and Dialysis: Individual Components of the Diet 351
III. Transplantation 362
IV. Special Considerations 369
V. Compliance 370
VI. Conclusion 371
References 371
Chapter 13. End-Stage Renal Disease: An Integrated Approach 374
SUBJECT INDEX 376