title: Impaired delivery of dialysis: diagnosis and correction.
abstract: Hemodialysis treatments yielding inadequate amounts of dialysis, as defined by urea kinetic modeling, are partially responsible for considerable mortality and morbidity in the United States. In almost 50% of dialysis treatments resulting in a Kt/V of < 1.0, the culprit is impaired delivery of the prescribed amount of dialysis. The factors involved in impaired delivery of dialysis are many and often elusive. If present and widespread, a search for the cause of the problem entails careful examination of the equipment and nursing procedures. If impaired delivery is a sporadic and infrequent event, a patient-specific investigation should be undertaken. In either circumstance, a clear understanding of the principles and practical aspects of hemodialysis greatly assists the nephrologist as a sleuth.
authors.affiliation: Department of Internal Medicine, Chromalloy American Kidney Center, Washington University, School of Medicine, St. Louis, Mo 63110, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Delmez
authors.forename: D W
authors.initials: DW
authors.lastname: Windus
mesh_terms: D001775:Blood Circulation; D006436:Hemodialysis Units, Hospital; D006801:Humans; D055656:Prescriptions / Q000592:standards*; D006435:Renal Dialysis / Q000379:methods / Q000592:standards*; D051437:Renal Insufficiency / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D014508:Urea / Q000378:metabolism
chemical_list: D014508:Urea