It is not surprising that there is no documented evidence supporting a standard for safe infusion of recirculated saline or blood in hemodialysis. A number of factors affect the bacteriologic and pyrogenic quality of recirculated saline and how individuals will physiologically respond to the final product. Attention to strict asepsis when preparing the dialysis circuit, bacterial quality of the dialysate, characteristics of the dialyzer used, and individual physiological response to the presence of endotoxins all play a part in whether individuals being dialyzed experience a pyrogenic response.
View Article and Find Full Text PDFThis six-month prospective, multi-site study incorporated no dressing coverage over hemodialysis central venous catheter exit sites and compared the outcomes of two groups of patients receiving incenter hemodialysis: a shower group and a non-shower group. Outcomes included exit site infection rates, tunnel infection rates, and catheter-related bloodstream infection rates. The study enrolled 40 patients--31 patients in the shower group and nine patients in the non-shower group.
View Article and Find Full Text PDFWhen individuals with chronic kidney disease require ongoing assistance with activities of daily living and disease management, the consistent care provided by family caregivers often averts the need for institutional placement These caregivers may experience physical and mental burden when supports are not in place to provide occasional help and relief In some states, public programs have been developed to provide assistance to family caregivers, such as respite care, caregiver training, and tax credits. However, policies among the states are not consistent. This study identified factors that have influenced the development of family caregiver-friendly policies and programs in two study states, Connecticut and New Jersey.
View Article and Find Full Text PDF