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140122 ||| eng |
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|a 9781461315094
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| 100 |
1 |
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|a Depner, T.A.
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| 245 |
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|a Prescribing Hemodialysis
|h Elektronische Ressource
|b A Guide to Urea Modeling
|c by T.A. Depner
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| 250 |
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|a 1st ed. 1991
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| 260 |
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|a New York, NY
|b Springer US
|c 1991, 1991
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| 300 |
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|a XXIV, 292 p
|b online resource
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| 505 |
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|a 1. Uremic Toxins & Dialysis -- The uremic syndrome -- Role of protein nitrogen metabolism -- Clinical measurement of uremia -- Effect of dialysis on the uremic syndrome -- Proposed uremic toxins -- Alternatives to the single-toxin theory -- Protein and tissue binding of proposed uremic toxins -- Toxic contributions of dialysis itself -- Where urea fits into the toxin theories -- 2. Urea Metabolism: Clinical Chemistry of Urea -- Excretion of nitrogenous waste products: comparative physiology -- Biochemistry of urea -- Inborn errors of urea metabolism: urea cycle enzymopathies -- Urea transport -- Nitrogen recycling -- Methods of urea measurement -- The toxicity of urea -- 3. Urea Modeling: Introduction -- Definition of modeling -- Evolution of urea modeling -- Why urea instead of other solutes? -- Quantifying hemodialysis therapy -- Quality assurance programs and urea modeling -- Urea modeling development and techniques -- What is the purpose of urea modeling? --
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|a Case 2: A case with no residual function and no weight gain between dialyses; the effect of changing Kd. -- Case 3: The patient with significant residual renal function (Kr) -- Case 4: Effects of habitually large weight gains between dialyses -- Case 5: The patient with high protein intake -- Case 6: The patient with low protein intake -- Case 7: The patient treated with high-flux dialysis -- Case 8: The patient whose dialyzer clearance (Kd) varies from the expected clearance -- Case 9: Small patients and the pediatric patient -- 10. The Future -- Dialysis versus other treatments for end-stage renal failure -- Outcome parameters for high-flux dialysis -- More complex models -- Modeling other solutes -- Better markers for uremia -- Improved blood flow monitoring -- Dialysate modeling -- Real-time monitoring of urea kinetics -- Urea modeling from the total-care perspective -- Appendicies -- Appendix A. Source code for a single-compartment, variable-volume model: three-BUN method --
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|a Appendix B. Source code for a single-compartment, variable-volume model: two-BUN method -- Appendix C. Source code for a two-compartment, fixed-volume model -- Appendix D. Numerical solution for a two-compartment, variable-ECV model -- Appendix E. Description of a two-compartment, osmotic model with variable ECV and ICV -- Appendix F. Interpreting the results of urea modeling -- Appendix G. Useful equations -- Appendix H. Examples of data collection forms -- Appendix I. Examples of modeling reports
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|a Limitations of the single-compartment model -- Description of the two-compartment model -- Site of urea generation -- Postdialysis rebound in urea concentration -- Two-compartment modeling techniques -- Solutions to equations for the two-compartment model -- Graphic description of the two-compartment model -- High-flux dialysis and two compartments -- Solutes with low mass transfer coefficients -- Measuring the intercompartment mass transfer area coefficient -- A comparison of one-compartment with two-compartment models -- The direct quantification method -- Impact of pool number on calculated variables -- Determinants of postdialysis urea rebound -- Two-compartment model with variable ECF volume -- Two-compartment model with variable ECF and ICF volume -- The magnitude of intracellular swelling -- Additional compartments -- Recommendations regarding modeling with one versus two compartments -- Blood sampling techniques and precautions -- 6. A Practical Solution: Ureakin --
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|a Urea modeling for high-flux, short-duration dialysis -- What clinical data are provided by urea modeling? -- Significance of the urea distribution volume (V) -- Significance of the urea nitrogen generation rate (G) -- Components of the dialysis prescription -- Measures of prescription effectiveness -- 4. Single-Compartment Model -- Models for hemodialysis urea kinetics -- Overview of kinetic analysis -- Laws of diffusion -- First-order kinetics: clearance, rate constant, half-life, and exponential decline -- The single-compartment model -- Constant-volume model, three BUN measurements -- Evaluation of the constant-volume model -- Variable-volume model, three BUN measurements -- Source code for the variable-volume model, three BUN values -- Two-BUN method, variable volume -- Comparison of the two-BUN method with the three-BUN method -- Source code for thevariable-volume model, two BUN values -- 5. Multicompartment Models -- Urea compartments in normal humans --
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|a Value of the computer program -- Description of the program -- Theoretical basis for the program -- Conventions and assumptions -- Files and file extensions used by UREAKIN -- Options available from the main menu -- Refinements to UREAKIN -- 7. Refinements and Application of Urea Modeling -- Measuring blood urea concentrations -- Compensation for blood and plasma water content -- Dialyzer urea clearance -- Effect of fluid balance on kinetic measurements -- Recirculation of dialyzer venous blood -- Residual (native kidney) urea clearance: its significance -- Simplified methods for urea modeling -- 8. Measuring Dialysis: How Much is Enough? -- Historical methods -- Kt/V: A yardstick for dialysis therapy -- Measuring dialysis outcome -- The adequacy of dialysis -- Comparing dialysis outcome with the prescription -- 9. Examples of Urea Modeling -- Case 1: Expected results in an average adult patient --
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| 653 |
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|a Nephrology
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| 653 |
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|a Internal medicine
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| 653 |
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|a Internal Medicine
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| 041 |
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7 |
|a eng
|2 ISO 639-2
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| 989 |
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|b SBA
|a Springer Book Archives -2004
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| 490 |
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|a Developments in Nephrology
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| 028 |
5 |
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|a 10.1007/978-1-4613-1509-4
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| 856 |
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|u https://doi.org/10.1007/978-1-4613-1509-4?nosfx=y
|x Verlag
|3 Volltext
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| 082 |
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|a 616.61
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| 520 |
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|a What regulation shall we have for the operation? Shall a man transfuse he knows not what. to correct he knows not what. God knows how (l)? Dr. Henry Stubbs Royal College of Physicians circa 1670 If dialysis therapy were a new phannaceutical product being evaluated by the FDA now, it might not be approved for marketing. The recommended dose, its potential toxicity, the side effects of under-or over-dialysis as well as its efficacy have been the subject of very few studies. The high mortality rate associated with the treatment may raise a few eyebrows. That it is a life-saving modality of treatment is undoubtedly true for more than 100,000 patients in the United States and for more than a million patients world wide. Because dialysis has extended the lives of many people by a variable period of time, most nephrologists have "rested on their laurels" and did not vigorously pursue studies to optimize these treatments. But facts have a way of intruding in all our lives and the facts are that the overall mortality rate of dialysis patients in the United States is rising and stands close to 25% per year and is closer to 33% per year for patients between the ages of 65 and 74 (2). These mortality figures are considerably higher for age-adjusted dialysis populations in Europe and particu larly in Japan, and certainly for the age-adjusted nonnal population
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