Seminars in dialysis
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Seminars in dialysis · May 2008
Retrospective analysis of catheter recirculation in prevalent dialysis patients.
Catheter recirculation (CR) occurs when blood returning from the venous limb of the catheter re-enters the arterial limb of the catheter without passage through the circulation. Adequacy of dialysis is influenced by the degree of access recirculation. In this study we evaluate factors influencing the degree of dialysis central venous catheter (CVC) recirculation in prevalent hemodialysis patients. ⋯ These results are borderline significant if temporary catheters are included (p = 0.052); however, the overall p-value is only 0.80 for tunneled dialysis catheters. There was no correlation between CR and time on dialysis (p = 0.66) or time on the current catheter (p = 0.48). The current study suggests that the CVC recirculation is independent of catheter brand, type, time on dialysis, or time on current catheter.
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Seminars in dialysis · May 2008
EditorialPalliative care: misconceptions that limit access for patients with chronic renal disease.
There is an urgent need to incorporate palliative care into the treatment of patients with end-stage renal disease (ESRD). These patients have a shortened lifespan and face end-of-life decisions as renal function declines and renal replacement therapy becomes necessary. ⋯ Why, then, do patients with ESRD rarely receive expert palliative care services that have been shown to enhance the quality of life of patients with other life-limiting illnesses? The lack of access to palliative care can be attributed, in part, to misconceptions about its philosophy and goals. It is hoped that clarification of these misconceptions will facilitate integration of palliative care into routine nephrology practice.