TECHNICAL PROBLEMS IN PATIENTS ON HEMODIALYSIS pptx

TECHNICAL PROBLEMS IN PATIENTS ON HEMODIALYSIS Edited by Maria Goretti Penido Technical Problems in Patients on Hemodialysis Edited by Maria Goretti Penido Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2011 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. As for readers, this license allows users to download, copy and build upon published chapters even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. Notice Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published chapters. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Masa Vidovic Technical Editor Teodora Smiljanic Cover Designer InTech Design Team Image Copyright Barghest, 2011. Used under license from Shutterstock.com First published November, 2011 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechweb.org Technical Problems in Patients on Hemodialysis, Edited by Maria Goretti Penido p. cm. ISBN 978-953-307-403-0 free online editions of InTech Books and Journals can be found at www.intechopen.com Contents Preface IX Chapter 1 Bedside Linear Regression Equations to Estimate Equilibrated Blood Urea 1 Elmer A. Fernández, Mónica Balzarini and Rodolfo Valtuille Chapter 2 Hemodialysis Access: The Fistula 17 Mary Hammes Chapter 3 The Brachio-Brachial Arteriovenous Fistula 35 Lucian Florin Dorobanţu, Ovidiu Ştiru, Cristian Bulescu, Şerban Bubenek and Vlad Anton Iliescu Chapter 4 Vascular Access for Hemodialysis 45 Konstantinos Pantelias and Eirini Grapsa Chapter 5 Subjective Well-Being Measures of Hemodialysis Patients 69 Paulo Roberto Santos Chapter 6 Hemodialysis Access Infections, Epidemiology, Pathogenesis and Prevention 87 Nirosha D. Gunatillake, Elizabeth M. Jarvis and David W. Johnson Chapter 7 Acute and Chronic Catheter in Hemodialysis 107 Andrew S. H. Lai and Kar Neng Lai Chapter 8 Complex Wounds in Patients Receiving Hemodialysis 121 Masaki Fujioka Chapter 9 Specifications of the Quality of Granulated Activated Charcoal Used in Water Systems Treatment in Hemodialysis Centers in Brazil 147 Eden Cavalcanti Albuquerque Júnior, Marcos Antonio de Souza Barros, Manoel O. Mendez, Aparecido R. Coutinho and Telma T. Franco VI Contents Chapter 10 Bioimpedance Measurement in the Kidney Disease Patient 165 Joëlle Cridlig, Mustapha Nadi and Michèle Kessler Chapter 11 Management of Fluid Status in Haemodialysis Patients: The Roles of Technology and Dietary Advice 185 Elizabeth Lindley, Lynne Aspinall, Claire Gardiner and Elizabeth Garthwaite Chapter 12 Cell-Free Nucleic Acids as Biomarkers of Biocompatibility in Dialytic Process 199 Marie Korabečná and Aleš Hořínek Chapter 13 Measuring System of Urea in Blood by Application in Recirculation for Hemodialysis Treatment 215 G.A. Martinez Chapter 14 Acetate Free Biofiltration with Potassium Profiled Dialysate (AFB-K) 227 R.I. Muñoz, I. Gallardo and J. Montenegro Chapter 15 Blood Volume Regulation 235 Roland E. Winkler, Fabio Grandi and Antonio Santoro Chapter 16 Acute Complications of Hemodialysis 251 Gülsüm Özkan and Şükrü Ulusoy Chapter 17 Review of the Effectiveness of Cellulose- and Polysulfone-Based Vitamin E-Bonded Dialysis Membranes 295 Masaharu Aritomi and Francesco Galli Preface This book provides an overview of technical aspects in treatment of hemodialysis patients. Authors have contributed their most interesting findings in dealing with hemodialysis from the aspect of the tools and techniques used. Each chapter has been thoroughly revised and updated so the readers are acquainted with the latest data and observations in the area, where several aspects are to be considered. The book is comprehensive and not limited to a partial discussion of hemodialysis. To accomplish this we are pleased to have been able to summarize state of the art knowledge in each chapter of the book. This book provides practical and accessible information. It is quite comprehensive as it covers various established as well as emerging techniques and equipment. We wish to thank each author for taking considerable time and effort to ensure their chapter provides state of the art information. We hope that readers achieve the same level of acquisition of new knowledge as we have attained by editing this book. Dr. Maria Goretti Penido Department of Pediatrics School of Medicine Federal University of Minas Gerais Minas Gerais Brasil [...]... 3.2.3 Infection The incidence of infection of an AVF is relatively low given that the native vein is used as a conduit Predisposing factors to infection include: inadequate skin disinfection prior to cannulation, pseudo aneurisms, perifistular hematomas (often due to inappropriate cannulation), puritis with skin excoriation over needle sites, or the use of the fistula for IV drug use Infection occurring... machine learning method that can be implemented in hemodialysis centres The fitted model can be used for daily treatment monitoring and is 2 Technical Problems in Patients on Hemodialysis easily implemented in common available spreadsheets A linear model is based on linear combinations of unknown parameters which must be estimated from data The first step in looking for an appropriate model relies on. .. fistula results in blood flow from an artery to a vein that is inherently nonphysiologic in many ways The initial flow rate in the radial artery of 20-30 mL/min increases to 200-300 mL/min immediately after creation of an AV fistula, reaching flow rates of 600-1200 mL/min after maturation (Wedgewood, 1984) In addition, the blood flow in the vein is not pulsatile prior to fistula insertion, whereas it... uses maximization of co-variance information by means of repetitive deflation of the input and output matrices based on correlation Finally, the Support Vector Machine Regression is based on the empirical risk minimization of non-linear loss function Theoretically, none of the method requires any specific assumption; however, it is known that if the observed variable (the equilibrated urea in this case)... et al 1997 proposed taking them within 60 min from the beginning of the session and at 20 min before its finalization We, however, decided to take the intradialysis sample 120 min after the beginning of the HD session (U120), which allowed us to compare our results with those reported by Guh et al 1999 Urea (U) determinations were performed in triplicate on each blood sample using autoanalyzers (see... Distribution of the β coefficients for each input variable from the 20-Fold cross- validation 10 Technical Problems in Patients on Hemodialysis 3.1 Bed side equations for equilibrated urea prediction Final models were built using the whole patients and using the parameters found in the previous section (for PLS and SVM) We found that the coefficients estimated using the full data set (equations 14 to... occur in up to 77% of patients with BCF compared to 30% of 22 Technical Problems in Patients on Hemodialysis patients with RCF with an average clinical significance at 2 years necessitating a venogram with intervention The risk of development of CAS is less in diabetics for unclear reasons (Hammes, 2008) The BCF has been shown to be a superior access in older diabetic patients (Papanikolaou, 2009) Once... the β coefficients were estimated using only %70 of the data base On the contrary, the other two methods require the full data set to build the solution 4 Discussion In this work we show how to build linear models from three different linear regression estimation procedures relying on different optimization algorithms Ordinary Least squares is based on the minimization of the sum of squared residuals... duration of long term access patency With national initiatives to place more fistulas, the number of fistulas has and will continue to increase There are gaps in knowledge as to surveillance, maturation, cannulation techniques and mechanism and treatment of stenosis and thrombosis The following chapter on fistula access for hemodialysis will help to fill these voids 18 Technical Problems in Patients on. .. Flow Recirculation Intimal Hyperplasia Thrombus EC Denudation Stenosis High WSS Fig 5 Proposed cycle of fistula creation which eventually leads to intimal hyperplasia and fistula failure 26 Technical Problems in Patients on Hemodialysis 5.2 Histology of the vein Arterial and venous dialation is critical for fistula maturation There is no exact definition of fistula maturation, but it is considered mature . treatment monitoring and is Technical Problems in Patients on Hemodialysis 2 easily implemented in common available spreadsheets. A linear model is based on linear combinations of unknown. Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechweb.org Technical Problems in Patients on Hemodialysis, . book provides an overview of technical aspects in treatment of hemodialysis patients. Authors have contributed their most interesting findings in dealing with hemodialysis from the aspect of