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Along with kidney transplantation, it is a type of renal replacement therapy. Dialysis may need to be initiated when there is a sudden rapid loss of kidney function, known as acute kidney injury (previously called acute renal failure), or when a gradual decline in kidney function, chronic kidney failure, reaches stage 5.
Hemodialysis, also spelled haemodialysis, or simply dialysis, is a process of filtering the blood of a person whose kidneys are not working normally. This type of dialysis achieves the extracorporeal removal of waste products such as creatinine and urea and free water from the blood when the kidneys are in a state of kidney failure.
In 1972 the United States Congress passed legislation authorizing the End Stage Renal Disease Program (ESRD) under Medicare. Section 299I of Public Law 92-603, passed on October 30, 1972, extended Medicare coverage to Americans if they had stage five chronic kidney disease (CKD) and were otherwise qualified under Medicare's work history ...
It was developed by Frank Gotch and John Sargent as a way for measuring the dose of dialysis when they analyzed the data from the National Cooperative Dialysis Study. [2] In hemodialysis the US National Kidney Foundation Kt/V target is ≥ 1.3, so that one can be sure that the delivered dose is at least 1.2. [3]
Two other urinary indices, are the fractional sodium excretion (FENa) index and the renal failure index (RFI). [36] The renal failure index is equal to urine sodium times plasma creatinine divided by urine creatinine. [36] A FENa score greater than 3% or a renal failure index (RFI) greater than 3 are helpful in confirming acute renal failure. [37]
Can be used to compare any dialysis schedule (i.e. nocturnal home hemodialysis vs. daily hemodialysis vs. conventional hemodialysis) Applicable to peritoneal dialysis. Can be applied to patients with residual renal function; it is possible to demonstrate that C o is a function of the residual kidney function and the "cleaning" provided by dialysis.