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.
University of Leicester, UK
Symbols and abbreviations xiii
1 The new patient with renal failure 1
2 Haemodialysis 71
3 Nursing a patient on haemodialysis 195
4 Home and frequent haemodialysis 237
5 Peritoneal dialysis 253
6 Nursing issues in peritoneal dialysis 353
7 Renal replacement therapy in acute kidney injury 365
8 Nutrition on dialysis 393
9 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