Technology in nephrology

Pascoe, M D; Halkett, J

Technology in nephrology

Journal Article

2003

Journal Title

South African Journal for Continuing Medical Education

Link to Journal

http://www.samj.org.za/index.php/samj

Publisher

Health and Medical Publishing Group

Publisher

University of Cape Town

Department

Division of Nephrology and Hypertension

Faculty

Faculty of Health Sciences

License

https://creativecommons.org/licenses/by-nc/3.0/

Abstract

Early nephrological referral allows for uncomplicated transition to dialysis and improves long-term survival. Peripheral veins require careful preservation for future vascular access in patients with renal disease. Improved biocompatibility of modern polysulphone and other membranes reduces the inflammatory response to dialysis. The increased permeability of these modern membranes improves the clearance of solutes but does require volumetrically controlled machines. Volumetric dialysis equipment allows the patient’s fluid balance to be very precisely controlled. Continuous dialysis therapies for acute renal failure allow for dialysis for acutely ill patients who would not tolerate standard intermittent haemodialysis. Continuous dialysis for acute renal failure allows for intensive nutritional support and improved and more stable metabolic and volume control than standard dialysis. Continuous dialysis is the treatment of choice for patients with raised intracranial pressure. Bicarbonate-buffered dialysis fluid provides better acid-base control than standard acetate dialysis. Advances in technology are expensive and cost control is of increasing importance.