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renal dialysis

Dialysis of body fluids to remove substances generally excreted by the kidney, including: 1) hemodialysis 2) peritoneal dialysis Indications: - end-stage renal disease Complications: - hypovolemia or hypervolemia given the exchange of large volume of fluid - mortality may be 8% higher for hemodialysis than peritoneal dialysis [2] - mortality is similar for hemodialysis & peritoneal dialysis [3] - among Medicare patients, ~ 50% die during the first year of dialysis [4] - quality of life for in-home peritoneal dialysis may be better than for in-center hemodialysis [3]

Specific

hemodialysis peritoneal dialysis; continuous abdominal/ambulatory (cycling) peritoneal dialysis (CAPD, CCPD)

General

dialysis renal replacement therapy

References

  1. Medical Knowledge Self Assessment Program (MKSAP) 17, American College of Physicians, Philadelphia 2015
  2. Weinhandl ED, Foley RN, Gilbertson DT et al Propensity-matched mortality comparison of incident hemodialysis and peritoneal dialysis patients. J Am Soc Nephrol. 2010 Mar;21(3):499-506. PMID: 20133483 Free PMC Article
  3. Wong B, Ravani P, Oliver MJ et al. Comparison of patient survival between hemodialysis and peritoneal dialysis among patients eligible for both modalities. Am J Kidney Dis 2018 Mar; 71:344 PMID: 29174322
  4. Wachterman MW, O'Hare AM, Rahman OK et al One-Year Mortality After Dialysis Initiation Among Older Adults. JAMA Intern Med. Published online April 22, 2019. PMID: 31009039 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2730766