DIALYSIS IN THE TREATMENT OF RENAL FAILURE: INTRODUCTION
Dialysis may be required for the treatment of either acute or chronic kidney disease. The use of continuous renal replac and slow, low-efficiency dialysis (SLED) is specific to the management of acute renal failure and is discussed in Chap. 2 performed continuously (CRRT) or over 6-12 hours per session (SLED), in contrast to the 3-4 hours of an intermittent Advantages and disadvantages of CRRT and SLED.
Peritoneal dialysis is rarely used in developed countries for the treatment of acute renal failure because of the increased will be discussed in more detail below) less efficient clearance per unit of time. The focus of the majority of this chapter dialysis for end-stage renal disease (ESRD).
With the widespread availability of dialysis, the lives of hundreds of thousands of patients with ESRD have been prolong alone, there are now approximately 450,000 patients with ESRD, the vast majority of whom require dialysis. The incide cases per million population per year. The incidence of ESRD is disproportionately higher in African Americans (approxim population per year) as compared with white Americans (259 per million population per year). In the United States, the diabetes mellitus, currently accounting for nearly 45% of newly diagnosed cases of ESRD. Over one-quarter (27%) of p been attributed to hypertension, although it is unclear whether in these cases hypertension is the cause or a consequen other unknown causes of kidney failure. Other important causes of ESRD include glomerulonephritis, polycystic kidney d uropathy.
Globally, mortality rates for patients with ESRD are lowest in Europe and Japan but very high in the developing world b availability of dialysis. In the United States, the mortality rate of patients on dialysis is approximately 18-20% per year of approximately 30-35%. Deaths are due mainly to cardiovascular diseases and infections (approximately 50 and 15% Older age, male sex, nonblack race, diabetes mellitus, malnutrition, and underlying heart disease are important predict
