No abstract available.
Dialysis

No abstract available.
Dialysis*

Dialysis disequilibrium syndrome (DDS) is a neurological disorder with varying severity that is postulated to be associated with cerebral oedema. We described a case of DDS resulting in irreversible brain injury and death following acute haemodialysis. A 13-year-old male with no past medical history and weighing 30kg, presented to hospital with severe urosepsis complicated by acute kidney injury (Creatinine 1422mmol/L; Urea 74.2mmol/L, Potassium 6.3mmol/L, Sodium 137mmol/L) and severe metabolic acidosis (pH 6.99, HC03 1.7mmol/L). Chest radiograph was normal. Elective intubation was done for respiratory distress. Acute haemodialysis performed due to refractory metabolic acidosis. Following haemodialysis, he became hypotensive which required inotropes. His Riker's score was low with absence of brainstem reflexes after withholding sedation. CT Brain showed generalised cerebral oedema consistent with global hypoxic changes involving the brainstem. The symptoms of DDS are caused by water movement into the brain causing cerebral oedema. Two theories have been proposed: reverse osmotic shift induced by urea removal and a fall in cerebral intracellular pH. Prevention is the key to the management of DDS. It is important to identify high risk patients and haemodialysis with reduced dialysis efficacy and gradual urea reduction is recommended. Patients who are vulnerable to DDS should be monitored closely. Low efficiency haemodialysis is recommended. Acute peritoneal dialysis might be an alternative option, but further studies are needed.
Dialysis

The cross-sectional study was conducted among ESRD patients required haemodialysis in Ipoh aimed at determining their level of knowledge, attitude, and practice (KAP) towards drug phosphate binders. A total of 105 patients on phosphate binders’ medication participated in the study. The questionnaires on sociodemographic characteristics and KAP towards phosphate binder medication were used to obtain the data. In this study, most patients were aged 40 to 60 and slightly more women. Patients were generally highly knowledgeable about phosphate binders. Over 90% of respondents were aware of the importance of the medication and the need to follow the regimen. More 70% of the patients have a positive attitude toward medication. In terms of practice, most of patients take the medication daily (90.5%) and always taking it with meals (93.3%). The older patients aged more than 45 years old, married and not working patients had significantly better compliance to medication. In conclusion, most patients in this study have a good knowledge of phosphate binder medications, a high positive attitude and good adherence to a medication. There is still a need for a structured health education method and counselling session to improve the knowledge of patients, change an attitude of a specific group of patients and increase the treatment compliance focusing on a specific ethnic group, young, unmarried, and employed patients.
Dialysis

No abstract available.
Peritoneal Dialysis*

No abstract available.
Peritoneal Dialysis*

No abstract available.
Peritoneal Dialysis*

No abstract available.
Renal Dialysis*

No abstract available.
Dialysis* ; Stroke*

No abstract available.
Dialysis* ; Korea*