Guide for treating patients by chronic dialyses with the twin-coil artificial kidney

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THE number of patients in need of maintenance dialysis is large, but the number actually treated is small. Maintenance dialysis with the twin-taught the technical procedure and the patient can dialyze himself at home. The family physician or internist not trained in the use of the artificial kidney does not have to know the technical details. This guide, we hope, will help him and the intelligent patient to anticipate and to prevent common causes of difficulties, and to meet with understanding the problems that may arise.

  1. Initial period.

    1. Diagnosis. A definitive diagnosis of the primary disease of the patient in chronic renal failure may or may not be possible. However, in regard to the patients in need of maintenance dialysis, the diagnosis often is merely an academic matter.

    2. Improvement of uremic syndrome and complications. These conditions can be dealt with by repeated short dialyses while the patient is undergoing the initial diagnostic workup.

    3. One should obtain base line assessments of:

      1. Calcium and phosphorus metabolisms

      2. Peripheral neuropathy

      3. Cardiac status

      4. Liver function

      5. Carbohydrate and protein metabolisms

  2. Maintaining the patient on chronic or intermittent dialyses. The outline covers five aspects:

    1. Maintenance of “ideal” predialysis weight and “ideal” predialysis standing blood pressure. A rationale of consequences of excessive losses.

    2. Mobilization at the earliest possible time.

    3. Surveillance of the patient’s clinical state and prevention of complications. D. Education of the patient and his family.

    4. Complications of chronic dialyses.

    1. Maintenance of. . .



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