(Oxford Medical Handbooks) Jeremy Levy, Edwina Brown, Anastasia Lawrence-Oxford handbook of dialysis-Oxford University Press (2016)

OXFORD MEDICAL PUBLICATIONS Oxford Handbook of Dialysis Published and forthcoming Oxford Handbooks Oxford Handbook for the Foundation Programme 4e Oxford Handbook of Acute Medicine 3e Oxford Handbook of Anaesthesia 4e Oxford Handbook of Applied Dental Sciences Oxford Handbook of Cardiology 2e Oxford Handbook of Clinical and Healthcare Research Oxford Handbook of Clinical and Laboratory Investigation 3e Oxford Handbook of Clinical Dentistry 6e Oxford Handbook of Clinical Diagnosis 3e Oxford Handbook of Clinical Examination and Practical Skills 2e Oxford Handbook of Clinical Haematology 4e Oxford Handbook of Clinical Immunology and Allergy 3e Oxford Handbook of Clinical Medicine – Mini Edition 9e Oxford Handbook of Clinical Medicine 9e Oxford Handbook of Clinical Pathology Oxford Handbook of Clinical Pharmacy 2e Oxford Handbook of Clinical Rehabilitation 2e Oxford Handbook of Clinical Specialties 9e Oxford Handbook of Clinical Surgery 4e Oxford Handbook of Complementary Medicine Oxford Handbook of Critical Care 3e Oxford Handbook of Dental Patient Care Oxford Handbook of Dialysis 4e Oxford Handbook of Emergency Medicine 4e Oxford Handbook of Endocrinology and Diabetes 3e Oxford Handbook of ENT and Head and Neck Surgery 2e Oxford Handbook of Epidemiology for Clinicians Oxford Handbook of Expedition and Wilderness Medicine 2e Oxford Handbook of Forensic Medicine Oxford Handbook of Gastroenterology & Hepatology 2e Oxford Handbook of General Practice 4e Oxford Handbook of Genetics Oxford Handbook of Genitourinary Medicine, HIV and AIDS 2e Oxford Handbook of Geriatric Medicine 2e Oxford Handbook of Infectious Diseases and Microbiology Oxford Handbook of Key Clinical Evidence Oxford Handbook of Medical Dermatology Oxford Handbook of Medical Imaging Oxford Handbook of Medical Sciences 2e Oxford Handbook of Medical Statistics Oxford Handbook of Neonatology Oxford Handbook of Nephrology and Hypertension 2e Oxford Handbook of Neurology 2e Oxford Handbook of Nutrition and Dietetics 2e Oxford Handbook of Obstetrics and Gynaecology 3e Oxford Handbook of Occupational Health 2e Oxford Handbook of Oncology 3e Oxford Handbook of Ophthalmology 3e Oxford Handbook of Oral and Maxillofacial Surgery Oxford Handbook of Orthopaedics and Trauma Oxford Handbook of Paediatrics 2e Oxford Handbook of Pain Management Oxford Handbook of Palliative Care 2e Oxford Handbook of Practical Drug Therapy 2e Oxford Handbook of Pre-Hospital Care Oxford Handbook of Psychiatry 3e Oxford Handbook of Public Health Practice 3e Oxford Handbook of Reproductive Medicine & Family Planning 2e Oxford Handbook of Respiratory Medicine 3e Oxford Handbook of Rheumatology 3e Oxford Handbook of Sport and Exercise Medicine 2e Handbook of Surgical Consent Oxford Handbook of Tropical Medicine 4e Oxford Handbook of Urology 3e Oxford Handbook of Dialysis FOURTH EDITION Jeremy Levy Consultant Nephrologist and Adjunct Professor of Medicine Imperial College Healthcare NHS Trust, London, UK Edwina Brown Consultant Nephrologist and Honorary Professor of Renal Medicine Imperial College Healthcare NHS Trust, London, UK Anastasia Lawrence Senior Renal Lecturer Practitioner and Honorary Senior Lecturer Imperial College Healthcare NHS Trust & Buckinghamshire New University, London, UK 1 Great Clarendon Street, Oxford, OX2 6DP, United Kingdom Oxford University Press is a department of the University of Oxford It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide Oxford is a registered trade mark of Oxford University Press in the UK and in certain other countries © Oxford University Press 2016 The moral rights of the authors‌have been asserted First Edition published in 2001 Second Edition published in 2004 Third Edition published in 2009 Fourth Edition published in 2016 Impression: 1 All rights reserved No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without the prior permission in writing of Oxford University Press, or as expressly permitted by law, by licence or under terms agreed with the appropriate reprographics rights organization Enquiries concerning reproduction outside the scope of the above should be sent to the Rights Department, Oxford University Press, at the address above You must not circulate this work in any other form and you must impose this same condition on any acquirer Published in the United States of America by Oxford University Press 198 Madison Avenue, New York, NY 10016, United States of America British Library Cataloguing in Publication Data Data available Library of Congress Control Number: 2015941610 ISBN 978–0–19–964476–6 Printed and bound in China by C&C Offset Printing Co., Ltd Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct Readers must therefore always check the product information and clinical procedures with the most up-to-date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations The authors and the publishers not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work Except where otherwise stated, drug dosages and recommendations are for the non-pregnant adult who is not breast-feeding Links to third party websites are provided by Oxford in good faith and for information only Oxford disclaims any responsibility for the materials contained in any third party website referenced in this work v Foreword Dialysis is at the same time one of the most exciting aspects of the care of kidney patients, yet to the beginner also the most mysterious and daunting Unfamiliar concepts, impressive technology, new jargon, expert patients—all of these can make for anxious times for the young doctor, nurse, or other health worker joining the multiprofessional team which cares for people with end-stage renal disease This Oxford Handbook provides much solace for the beginner It provides plenty of easily navigable practical advice across every aspect of dialysis and its related challenges, with sufficient theoretical background to make sense of the day-to-day clinical decision-making And all in a true handbook—both small enough and light enough to fit in most pockets Since I was a tyro nephrologist much has changed in the world of dialysis For one thing there are many more patients, and many are older and frailer There has been greater creativity in strategies to improve clinical outcomes and increase independence for the hospital environment—frequent home haemodialysis, and assisted peritoneal dialysis are just two examples And we need a proper understanding of the complex end-of-life issues which arise for more patients on dialysis and their carers This new edition addresses these recent issues and many more with advice which is both authoritative and practical, as well as refreshing all the content familiar to the readers of earlier editions Although its authors are all from the UK, this book has global value, especially in the several parts of the world where the provision of dialysis has been inadequate for many reasons, but is now rapidly expanding When there is such rapid expansion, the education and training needs of the local clinical team in ensuring high-quality dialysis care, can easily outstrip locally available resources In such situations this Oxford Handbook will be an invaluable pragmatic educational tool I wish this book had been available when I started out in nephrology It would have saved me many anxieties, and I am sure would have improved the care I was able to give John Feehally University of Leicester, UK vii Preface Welcome to the fourth, completely updated, edition of the Oxford Handbook of Dialysis, which we hope you will find useful It has been 7 years since the last edition, and amazingly 15  years since the first edition, and in that time there have been many developments in dialysis and in treating patients with end-stage kidney disease We now have much better evidence for various interventions (although renal medicine remains relatively poorer at generating high-quality evidence than other areas of medicine), and for the first time now some good trial data to support choices in treating patients, ranging from managing their anaemia or bone disease through to haemodialysis strategies We have therefore updated every section of the book which now covers all haemodialysis techniques, haemodiafiltration, nocturnal and home dialysis, frequent dialysis, peritoneal dialysis in all its forms, plasma exchange, the medical, nursing, and psychosocial aspects of managing patients with end-stage kidney disease, nutrition, the acute management of renal transplantation particularly with reference to dialysis patients, palliative and end-of-life care in renal disease and use of analgesics, a completely new section on renal replacement therapy in acute kidney injury, updated drug dosing guidelines including new drugs, and summaries of the most recent guidelines from Europe (European Best Practice Guidelines), the UK Renal Association, the USA (KDOQI and KDIGO) and Australasia Bone disease, anaemia, cardiovascular disease, infections, pain, and the widespread complications of chronic kidney disease are all discussed, with practical guidance and management, presented in a compact and easy-to-use format We have added new sections on home haemodialysis, frequent haemodialysis, new intradialytic monitoring techniques, new peritoneal dialysis fluids, encapsulating peritoneal sclerosis, sleep disorders, management of patients with stroke, care of dying patients with kidney disease or on dialysis, and a new section on acute kidney injury New drugs such as the new epoetins and phosphate binders are included We have ensured that the sections on nursing and nutrition for dialysis patients have been written by the appropriate experts, experienced renal nurses and dieticians respectively, and both completely refreshed and updated We hope we ensured the book remains easy to use and read, which has always been one of our primary aims, but also comprehensive, focussed, and practical, and clearly aimed at the whole multiprofessional team of colleagues looking after patients on dialysis We hope this book will have a home in every renal unit, dialysis centre, intensive care unit, renal ward, and be close to hand for every nephrologist, intensivist, renal trainee, renal nurse, dietician, technician, and pharmacist, and that it helps improve the care of patients with kidney disease ix Contents Contributors  xi Symbols and abbreviations  xiii The new patient with renal failure    2 Haemodialysis   71 Nursing a patient on haemodialysis 195 Home and frequent haemodialysis 237 Peritoneal dialysis 253 Nursing issues in peritoneal dialysis 353 Renal replacement therapy in acute kidney injury 365 Nutrition on dialysis 393 Special situations 415 10 Complications of ESKD: anaemia 457 11 Complications of ESKD: bone mineral disorders 481 12 Complications of ESKD: cardiovascular disease 513 13 Complications of ESKD: infection 529 14 Symptoms related to ESKD 539 15 Other complications of ESKD 559 16 Death in dialysis patients 591 17 Transplantation for dialysis patients 611 18 Drug dosing 621 19 Standards and guidelines 651 Index  659 ... Microbiology Oxford Handbook of Key Clinical Evidence Oxford Handbook of Medical Dermatology Oxford Handbook of Medical Imaging Oxford Handbook of Medical Sciences 2e Oxford Handbook of Medical Statistics... Gynaecology 3e Oxford Handbook of Occupational Health 2e Oxford Handbook of Oncology 3e Oxford Handbook of Ophthalmology 3e Oxford Handbook of Oral and Maxillofacial Surgery Oxford Handbook of Orthopaedics... Oxford Handbook of Paediatrics 2e Oxford Handbook of Pain Management Oxford Handbook of Palliative Care 2e Oxford Handbook of Practical Drug Therapy 2e Oxford Handbook of Pre-Hospital Care Oxford Handbook