how to can haemodialysis save and prolong the life of uraemic patients
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Drugs & Diseases > Nephrology
Uremia Treatment & Management
Updated: May 27, 2020
Author: A Brent Alper, Jr, MD, MPH; Chief Editor: Vecihi Batuman, MD, FASN more...
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The ultimate treatment for uremia is renal replacement therapy, which can be accomplished by hemodialysis, peritoneal dialysis, or kidney transplantation. Initiation of dialysis is indicated when signs or symptoms of uremia (eg, nausea, vomiting, volume overload, hyperkalemia, severe acidosis) are present and are not treatable by other medical means. Patients with uremia must have dialysis initiated as soon as symptoms appear, regardless of the glomerular filtration rate (GFR).
Unfortunately, although dialysis effectively removes urea, it is less effective than the normal kidney at removing a number of toxic solutes, the accumulation of which is thought to lead to signs and symptoms that have been labeled residual syndrome. [26] For patients with uremic pruritus, Shirazian et al propose a multifaceted approach that includes the following [27] :
Ensure that patients are meeting goals for dialysis efficiency and mineral bone disease treatment, as defined by Kidney Disease: Improving Global Outcomes (KDIGO).
Treat patients with xerosis with a trial of emollient cream.
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Contributor Information and Disclosures
Author
A Brent Alper, Jr, MD, MPH Associate Professor of Medicine, Section of Nephrology and Hypertension, Department of Medicine, Tulane University School of Medicine
A Brent Alper, Jr, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Society of Hypertension, American Society of Nephrology, National Kidney Foundation, Phi Beta Kappa
Disclosure: Nothing to disclose.
Coauthor(s)
Rajesh G Shenava, MD Former Assistant Professor of Medicine, Section of Nephrology and Hypertension, Department of Internal Medicine, Louisiana State University School of Medicine in New Orleans
Rajesh G Shenava, MD is a member of the following medical societies: American College of Physicians, American Society of Nephrology, National Kidney Foundation, Renal Physicians Association
Disclosure: Nothing to disclose.
Bessie A Young, MD, MPH Associate Professor of Medicine, Division of Nephrology, University of Washington School of Medicine; Core Investigator, Seattle Epidemiologic Research and Information Center
Bessie A Young, MD, MPH is a member of the following medical societies: American College of Physicians, American Diabetes Association, International Society of Nephrology, National Kidney Foundation, American Society of Nephrology
Disclosure: Nothing to disclose.
Chief Editor
Vecihi Batuman, MD, FASN Huberwald Professor of Medicine, Section of Nephrology-Hypertension, Interim Chair, Deming Department of Medicine, Tulane University School of Medicine
Vecihi Batuman, MD, FASN is a member of the following medical societies: American College of Physicians, American Society of Hypertension, American Society of Nephrology, International Society of Nephrology, Southern Society for Clinical Investigation
Disclosure: Nothing to disclose.
Acknowledgements
Eleanor Lederer, MD Professor of Medicine, Chief, Nephrology Division, Director, Nephrology Training Program, Director, Metabolic Stone Clinic, Kidney Disease Program, University of Louisville School of Medicine; Consulting Staff, Louisville Veterans Affairs Hospital
Eleanor Lederer, MD is a member of the following medical societies: American Association for the Advancement of Science, American Federation for Medical Research, American Society for Biochemistry and Molecular Biology, American Society for Bone and Mineral Research, American Society of Nephrology, American Society of Transplantation, International Society of Nephrology, Kentucky Medical Association, National Kidney Foundation, and Phi Beta Kappa
Disclosure: Dept of Veterans Affairs Grant/research funds Research
Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference
Disclosure: Medscape Salary Employment