Dialysis in Treatment of Uremia

Kolff, W J

doi:10.1001/archinte.1954.00250010148012

Cited by 39 publications

(5 citation statements)

References 25 publications

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“…In the seminal description of the first hemodialysis treatment by W.J. Kolff, the duration of the treatment was 11.5 hours, with a blood flow of 116 ml/min (1,2). A dialysis treatment with these parameters (blood flow rate and duration) would now be considered as a hybrid therapy and labeled PIKRT.…”

Section: Evolution Of Pikrtmentioning

confidence: 99%

Prolonged Intermittent Kidney Replacement Therapy

Levine

Vijayan

2023

CJASN

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Kidney replacement therapy (KRT) is a vital, supportive treatment for patients with critical illness and severe AKI. The optimal timing, dose, and modality of KRT have been studied extensively, but gaps in knowledge remain. With respect to modalities, continuous KRT and intermittent hemodialysis are well-established options, but prolonged intermittent KRT is becoming more prevalent worldwide, particularly in emerging countries. Compared with continuous KRT, prolonged intermittent KRT offers similar hemodynamic stability and overall cost savings, and its intermittent nature allows patients time off therapy for mobilization and procedures. When compared with intermittent hemodialysis, prolonged intermittent KRT offers more hemodynamic stability, particularly in patients who remain highly vulnerable to hypotension from aggressive ultrafiltration over a shorter duration of treatment. The prescription of prolonged intermittent KRT can be tailored to patients’ progression in their recovery from critical illness, and the frequency, flow rates, and duration of treatment can be modified to avert hemodynamic instability during de-escalation of care. Dosing of prolonged intermittent KRT can be extrapolated from urea kinetics used to calculate clearance for continuous KRT and intermittent hemodialysis. Practice variations across institutions with respect to terminology, prescription, and dosing of prolonged intermittent KRT create significant challenges, especially in creating specific drug dosing recommendations during prolonged intermittent KRT. During the coronavirus disease 2019 pandemic, prolonged intermittent KRT was rapidly implemented to meet the KRT demands during patient surges in some of the medical centers overwhelmed by sheer volume of patients with AKI. Ideally, implementation of prolonged intermittent KRT at any institution should be conducted in a timely manner, with judicious planning and collaboration among nephrology, critical care, dialysis and intensive care nursing, and pharmacy leadership. Future analyses and clinical trials with respect to prescription and delivery of prolonged intermittent KRT and clinical outcomes will help to guide standardization of practice.

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Section: Evolution Of Pikrtmentioning

confidence: 99%

Prolonged Intermittent Kidney Replacement Therapy

Levine

Vijayan

2023

CJASN

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“…Hemodialysis was demonstrated to be feasible, although only for a small number of patients, following the development of circulatory access by the team led by Quinton and Scribner in 1960 (1,2). Kolff and Berk were successful in developing a large rotating drum dialyzer (3), which was used in a few medical centers in the United States and other countries (3)(4)(5)(6)(7)(8) but was not suitable for widespread ESRD patient use. A more complete description of the nature of dialysis in the 1960s, the economic and technical challenges, and these initial programs are referenced (9)(10)(11)(12)(13)(14)(15).…”

Section: Historical Backgroundmentioning

confidence: 99%

Conservation of Mass: An Important Tool in Renal Research

Sargent¹

2015

Seminars in Dialysis

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The dialytic treatment of end-stage renal disease (ESRD) patients is based on control of solute concentrations and management of fluid volume. The application of the principal of conservation of mass, or mass balance, is fundamental to the study of such treatment and can be extended to chronic kidney disease (CKD) in general. This review discusses the development and use of mass conservation and transport concepts, incorporated into mathematical models. These concepts, which can be applied to a wide range of solutes of interest, represent a powerful tool for quantitatively guided studies of dialysis issues currently and into the future. Incorporating these quantitative concepts in future investigations is key to achieving positive control of known solutes, and in the analysis of such studies; to relate future research to known results of prior studies; and to help in the understanding of the obligatory physiological perturbations that result from dialysis therapy.

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“…The Kolff rotating drum kidney used a cellulose tube wound around a wooden skeleton built as a large drum-styled cage. The drum with the blood-filled cellulose tubing wound around it was immersed in a bath of weak salt solution and, as blood passed through the rotating drum cellulose tubing, waste exchange occurred [10,11] .…”

Section: Historical Review and Key Concepts Of Dialysismentioning

confidence: 99%

Nursing for Renal Replacement Therapies in the Intensive Care Unit: Historical, Educational, and Protocol Review

Baldwin

Fealy

2009

Blood Purif

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Nurses have made a significant contribution to the development and application of dialysis in the 1950s and continuous renal replacement therapies (CRRT) in the Intensive Care Unit (ICU) setting from the 1980s. Any treatment requires patient and machine-circuit preparation, connection of the extracorporeal circuit (EC) to the patient vascular access catheter and regular tasks to maintain a treatment in progress. During treatment, nurses prepare fluids, adjust fluid settings to provide fluid balance, prepare electrolyte additives, monitor acid base and electrolyte levels, monitor patient and machine ‘vital signs’, and then when necessary diagnose circuit clotting and perform a disconnection of the EC from the patient. All of these aspects of CRRT nursing are essential to a suitable nursing policy or protocol. This paper provides a clinical review for this every day sequence when using CRRT in the ICU setting.

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Dialysis in Treatment of Uremia

Cited by 39 publications

References 25 publications

Prolonged Intermittent Kidney Replacement Therapy

Prolonged Intermittent Kidney Replacement Therapy

Conservation of Mass: An Important Tool in Renal Research

Nursing for Renal Replacement Therapies in the Intensive Care Unit: Historical, Educational, and Protocol Review

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