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Dialysis in Older Adults: A Clinical Handbook by Madhukar Misra

By Madhukar Misra

This functional instruction manual bargains quickly and sound recommendation at the many matters confronted while dialyzing the older sufferer. it's authored through famous foreign specialists who've lined the entire variety of finish degree renal issues together with healing procedures, sufferer administration and maximization of caliber of existence. obtainable and easy-to-read, Dialysis in Older Adults serves because the go-to reference for clinicians and participants in their staff as they deal with this tough sufferer population.

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8). Without the physician encouraging home hemodialysis, the patient and their family will not likely choose this form of treatment since the patient turns to the physician for advice and direction as to which therapy to choose. When patients 39 4 The Pros and Cons of Home vs. 8 0–12 mo. 4 >12 mo. S. Renal Data System, USRDS 2011 Annual Data Report: Atlas of End-Stage Renal Disease in the United States, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2011 were asked who first made them aware of home hemodialysis, only 35 % stated that their physician first made them aware of the home treatment.

In summary, the cognitive and psychiatric manifestations in the elderly patients on HD can be due to a multitude of factors that include age-induced changes, ischemic cortical atrophy, rapid osmolar shifts, cerebral microembolism, and demyelination. Prevention and Management of Complications Given the above discussion, it is imperative that the HD prescription should be individualized to prevent the above complications. Avoidance of hypotension is paramount in the elderly for the above-stated reasons.

Infiltration by collagen and calcium deposition into the myocardium may lead to diastolic dysfunction. Valvular abnormalities like sclerosis and regurgitation are M. edu © Springer Science+Business Media New York 2016 M. 1007/978-1-4939-3320-4_3 21 M. 1 Age-related changes in heart Changes Decreased HR response Longer PR Interval Increased atrial ectopy Increased ventricular ectopy Altered diastolic function Aortic sclerosis Annular mitral calcification Consequences Sinus pause Heart blocks and bundle branch blocks Atrial fibrillation Sustained ventricular tachycardia Impaired ejection fraction Aortic stenosis and regurgitation Mitral regurgitation Adapted from Santoro and Mancini [3], with permission) common due to aging related calcification and myxomatous degeneration.

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