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Author: Mélanie Balland
Publisher:
ISBN:
Category :
Languages : fr
Pages : 0
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Book Description
L"hémodialyse, la dialyse péritonéale et la transplantation sont les trois seules méthodes de traitement pour l"insuffisance rénale terminale. Aucune n"est définitive, et ces modes de suppléance sont souvent proposés successivement chez un même patient dans le cadre d"un projet global et personnalisé. Cette thèse développe en particulier la technique de dialyse péritonéale. Cette technique, réalisée pour la première fois en 1923, après expérimentation animale, a prouvé dans les années suivantes son efficacité comme substitut à court terme de la fonction rénale normale. Automatisée depuis les années 70, essentiellement développée depuis les années 80, la dialyse péritonéale est une épuration intracorporelle à travers le péritoine au moyen d"un dialysat introduit directement via un cathéter implantédans la paroi abdominaleet laissé à demeure. Le péritoine est une membrane semi-perméable permettant les transferts de l"eau et des solutés selon les mécanismes de diffusion et convection. Tapissant la cavité abdominale et les viscères, il délimite un espacevirtuelappelé cavité péritonéale, pouvant contenir plusieurs litres de liquide. Bien que les échanges de soluté nécessitent une régularité et une rigueur de prise en charge, la dialyse péritonéale est un traitement doux et continu réalisé à domicile, moins fatiguant que l"hémodialyse. Toutefois la survie de cette technique est moindre en raison principalement de la perte fonctionnelle de la membrane péritonéale dans le temps en termes d"épuration et d"ultrafiltration. Les méthodes de dialyse péritonéale, automatisée et/ou manuelles, ont pour objectif une dialyse adéquate, définie par des critères faisant l"objet de recommandations, nécessitant un compromis avec la qualité de vie du patient. Il est ainsi possible de déterminer le temps de stase, le volume à infuser, le nombre d"échanges, la concentration en glucose et/ou la nature de l"agent osmotique de la solution. L"amélioration des systèmes de connexion a permis de réduire la contamination et la fréquence des péritonites, première complication liée à la dialyse péritonéale.La bioincompatibilité des dialysats, ainsi que les épisodes répétés de péritonites interviennentdans le développement progressif des altérations de la membrane péritonéale. Les solutés conventionnels ont évolué vers des solutés physiologiques compartimentés, de pH neutre, à teneur moindre en glucose et produits de dégradationdu glucose. Les intérêts de ces nouvelles solutions biocompatibles sont nombreux et leur rôle dans la préservation de la membrane a été démontré par de multiples travaux.
Author: Mélanie Balland
Publisher:
ISBN:
Category :
Languages : fr
Pages : 0
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Book Description
L"hémodialyse, la dialyse péritonéale et la transplantation sont les trois seules méthodes de traitement pour l"insuffisance rénale terminale. Aucune n"est définitive, et ces modes de suppléance sont souvent proposés successivement chez un même patient dans le cadre d"un projet global et personnalisé. Cette thèse développe en particulier la technique de dialyse péritonéale. Cette technique, réalisée pour la première fois en 1923, après expérimentation animale, a prouvé dans les années suivantes son efficacité comme substitut à court terme de la fonction rénale normale. Automatisée depuis les années 70, essentiellement développée depuis les années 80, la dialyse péritonéale est une épuration intracorporelle à travers le péritoine au moyen d"un dialysat introduit directement via un cathéter implantédans la paroi abdominaleet laissé à demeure. Le péritoine est une membrane semi-perméable permettant les transferts de l"eau et des solutés selon les mécanismes de diffusion et convection. Tapissant la cavité abdominale et les viscères, il délimite un espacevirtuelappelé cavité péritonéale, pouvant contenir plusieurs litres de liquide. Bien que les échanges de soluté nécessitent une régularité et une rigueur de prise en charge, la dialyse péritonéale est un traitement doux et continu réalisé à domicile, moins fatiguant que l"hémodialyse. Toutefois la survie de cette technique est moindre en raison principalement de la perte fonctionnelle de la membrane péritonéale dans le temps en termes d"épuration et d"ultrafiltration. Les méthodes de dialyse péritonéale, automatisée et/ou manuelles, ont pour objectif une dialyse adéquate, définie par des critères faisant l"objet de recommandations, nécessitant un compromis avec la qualité de vie du patient. Il est ainsi possible de déterminer le temps de stase, le volume à infuser, le nombre d"échanges, la concentration en glucose et/ou la nature de l"agent osmotique de la solution. L"amélioration des systèmes de connexion a permis de réduire la contamination et la fréquence des péritonites, première complication liée à la dialyse péritonéale.La bioincompatibilité des dialysats, ainsi que les épisodes répétés de péritonites interviennentdans le développement progressif des altérations de la membrane péritonéale. Les solutés conventionnels ont évolué vers des solutés physiologiques compartimentés, de pH neutre, à teneur moindre en glucose et produits de dégradationdu glucose. Les intérêts de ces nouvelles solutions biocompatibles sont nombreux et leur rôle dans la préservation de la membrane a été démontré par de multiples travaux.
Author: K.D. Nolph
Publisher: Springer Science & Business Media
ISBN: 9780898384062
Category : Medical
Languages : en
Pages : 478
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Book Description
Peritoneal dialysis represents an internal technique for membrane are becoming apparent. Studies of peritoneal blood purification. In this dialyzer the blood path, the dialysis increase understanding of the anatomy and phy membrane and the dialysate compartment are provided by siology of biological membranes and the factors influencing nature. The developments of chronic peritoneal catheters, the passive movement of solutes across the microcirculation and related structures. Peritoneal dialysis provides a 'win automated cycling equipment, solution preparation by reversed osmosis, manipulations of transport with drugs dow' to the visceral microcirculation in animals and hu and the experiences with continuous ambulatory peritoneal mans. dialysis and continuous cycling peritoneal dialysis have Peritoneal dialysis may be useful to treat problems other increased the interest in peritoneal dialysis. Publications than renal failure. Beneficial effects in the treatment of related to peritoneal dialysis probably exceed 400 annually. dysproteinemias, psoriasis, hypothermia, and many meta Peritoneal Dialysis International (formally Peritoneal Dialy bolic problems have been reported. The intraperitoneal sis Bulletin) the official journal of the International Society administration of chemotherapeutic agents draws upon and for Peritoneal Dialysis is a journal solely devoted to contributes to our understanding of peritoneal dialysis.
Author: R. Gokal
Publisher: Springer Science & Business Media
ISBN: 9401108145
Category : Medical
Languages : en
Pages : 1185
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Book Description
In 1986 the first edition of Continuous Ambulatory Peritoneal Dialysis, edited by R. Gokal, was published. In 1989 the third edition of Peritoneal Dialysis, edited by K.D. Nolph, was published. Both books were widely recognized for their comprehensive discussion of this particular field. Rather than edit new editions of each of these books separately, two of the most prominent figures in this field have decided to combine their knowledge and enthusiasm in this single book: The Textbook of Peritoneal Dialysis. The book is unique in its detailed discussion of a complete range of topics, including new advances in our understanding of the physiology of peritoneal dialysis, peritoneal dialysis kinetics, clinical results and a chapter dealing with the concepts of intraperitoneal chemotherapy. These examples of the dynamic nature of the field further illustrate the importance of this textbook, and make it required reading for everybody working within the field of peritoneal dialysis.
Author: Ramesh Khanna
Publisher: Springer Science & Business Media
ISBN: 0387789405
Category : Medical
Languages : en
Pages : 927
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Book Description
Nolph and Gokal's Text Book of Peritoneal Dialysis, Third Edition, covers advances made in the field for the past 30 years. During the past two decades, the time during which this therapy has been increasingly utilized, this text has continued to be recognized as the major source of the discipline's base knowledge. The evolution of this text to its newest edition parallels the growth of peritoneal dialysis from Continuous Ambulatory Peritoneal Dialysis in the eighties to the current therapy that encompasses manual and automated therapies with full emphasis on adequacy of dialysis dose. Peritoneal dialysis represents an intracorporeal technique for blood purification. This unique dialysis system represents one of many human attempts to manipulate nature for sustenance of life. The past few years of advances have focused on further improvement of the technique. Areas that have fueled the interest of researchers include: (1) Physiology of high transporters (and the role of genetics and inflammation); (2) Continued debate over the most appropriate adequacy indices (small solute clearances, large solute clearances, clinical assessment etc.); (3) Understanding, preventing and treating the MIA syndrome in PD patients ( including the roles of leptin, and adiponectin); (4) Pathogenesis and newer management strategies of vascular calcification; (5) Continued improvements in infectious complications including peritonitis; (6) Further improvements in catheter technology; (7) Automated techniques; (8) Explaining and correcting PD underutilization; (9) Rationale and applications of newer dialysis solutions; (10) New understanding and approaches to management of osteodystrophy; (11) Refinements in anemia management including new insights in iron metabolism in PD patients; (12) Further definition of indications for PD; (13) The ideal time to initiate dialysis. Newer insight into host defense mechanisms have also made the past decade of advances in the field more meaningful for clinicians. This text also covers the knowledge gained from animal models of peritoneal dialysis. Nolph and Gokal's Textbook of Peritoneal Dialysis, Third Edition is a compilation of the latest knowledge in the field. It cites and describes in great detail, the new discoveries and the evolution of understanding the subject of these discoveries.
Author: R. Gokal
Publisher: Springer Science & Business Media
ISBN: 9401732256
Category : Medical
Languages : en
Pages : 852
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Book Description
In 1994, the expert knowledge of Ram Gokal and Karl D. Nolph, the two foremost figures in the field of peritoneal dialysis, was combined to produce the first edition of the Textbook of Peritoneal Dialysis. The work quickly became recognised as the `gold standard' for those working in the field. Since its conception, however, our understanding of peritoneal dialysis related physiology, kinetics and clinical outcomes, as well as the concepts of intraperitoneal chemotherapy, has increased sufficiently to make an updated and completely revised edition of the work necessary. An expansion of the editorial team by fellow-experts Ramesh Khanna and Raymond Krediet enabled an even more comprehensive approach to be taken. This second edition reasserts the book's uniqueness in its detailed discussion of the topic, making it required reading for all those working within the field of peritoneal dialysis.
Author: Claudio Ronco
Publisher: Karger Medical and Scientific Publishers
ISBN: 3805569343
Category : Medical
Languages : en
Pages : 284
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Book Description
While continuous ambulatory peritoneal dialysis (CAPD) has been the standard peritoneal procedure since the seventies, different schedules of automated peritoneal dialysis (APD) have emerged during the eighties. Today, APD is considered a valuable tool in the management of ESRD patients, together with CAPD and hemodialysis. However, despite its frequent use, APD has not yet been well assessed, and most pathophysiological and clinical studies on PD refer to CAPD. In this book, major experts in the field therefore discuss and evaluate the insights gained on APD up to now, presenting a comprehensive review of all experimental, technical and clinical aspects related to the various treatments grouped under the definition of APD. The recent developments presented are divided into four sections: membrane permeability, transport mechanisms and kinetic modeling applied to APD; prescription and adequacy of different APD treatment schedules; dialysis machines and solutions for APD, and, lastly, different clinical aspects such as the possibility to maintain APD program and residual renal function. Physicians involved in ESRD care, renal fellows and scientists both in the academic world and in the hospital setting will undoubtedly profit from this timely publication.
Author: V.E. Andreucci
Publisher: Springer Science & Business Media
ISBN: 1461315891
Category : Medical
Languages : en
Pages : 379
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Book Description
When the external Quinton-Scribner arteriovenous shunt was developed in 1960, and, a little later, the internal Brescia-Cimino arteriovenous fistula was developed as a vascular access for hemodialysis, thereby making possible regular dialysis therapy of chronic uremic patients, many nephrologists became surgeons, having learned the type of vascular surgery related to hemodialysis quite well. The same series of events occurred with regards to peritoneal dialysis with the introduction of the Tenckhoff catheter and the need for gaining a permanent access to the peritoneum for chronic ambulatory peritoneal dialysis (CAPD) therapy. With time, however, problems relating to vascular and peritoneal access have forced many nephrologists to give up their surgery; meanwhile, many surgeons have become quite expert in some sophisticated techniques relating to dial ysis (e. g., vessel grafting, prosthesis implantation, etc.). Today, whether or not involved in this type of surgery, both nephrologists and surgeons remain interested in knowing all available access devices for dialysis as well as the surgical techniques involved. However, all nephrologists involved in dialysis must know how to prevent or treat complications related to dialysis access. Thus, it appeared to me to be quite advisable to have a book in my series, Topics in Renal Medicine, dealing with vascular and peritoneal access for dialysis.
Author: San Tjiang Boen
Publisher:
ISBN:
Category : Dialysis
Languages : en
Pages : 184
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Book Description
Author: G.M. Addison
Publisher: Springer Science & Business Media
ISBN: 9400956126
Category : Medical
Languages : en
Pages : 298
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Book Description
The first symposium of the Society for the Study ofInborn valuable overview of advances in the application of Errors of Metabolism (SSIEM) on the organic acid urias chemical analysis of amniotic fluid to their early prenatal was held in Leeds in 1971 and published by the Society in diagnosis. The continuing complexity of diagnosis, 1972 (the 9th Annual SSIEM Symposium). Although biochemistry and aetiology ofthe dicarboxylic acid urias relatively few of these disorders were recognized at that has been admirably reduced by the papers from Dr time, the symposium was prompted by the then recent Gregersen and Dr Goodman, with Dr Goodman clearly identification between 1966 and 1970 of isovaleric identifying the primary defect in the polycystic variant of acidaemia, methylmalonic aciduria, propionic aci multiple acyl CoA dehydrogenase deficiency ("glutaric daemia, pyroglutamic aciduria and 3-methylcrotonyl aciduria type II") as a deficiency of electron transfer glycinuria. Identification and diagnosis of diseases of this flavoprotein (ETF) dehydrogenase. Dr Engel's paper kind had greatly improved primarily through the also provides a useful overview from currently available application of gas chromatography and mass spectro data of the place of L-carnitine in the organic acid urias, metry to medicine, although the complexity of the an area in which rapid developments are occurring. The underlying biochemistry and the genetic heterogeneity of emerging understanding of the aetiologies of the the organic acidurias was not then realised.
Author: John F. Maher
Publisher: Springer Science & Business Media
ISBN: 3662117843
Category : Medical
Languages : en
Pages : 970
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Book Description
III. International Symposium on Peritoneal Dialysis
