Chapter

Management of dialysis and transplantation patients: perspectives for primary care

Monica Beaulieu, Jagbir Gill and Adeera Levin

in Chronic Kidney Disease

Published on behalf of Oxford University Press

Published in print December 2009 | ISBN: 9780199549313
Published online February 2013 | e-ISBN: 9780191763465 | DOI: http://dx.doi.org/10.1093/med/9780199549313.003.0010

Series: Oxford Clinical Nephrology Series

Management of dialysis and transplantation patients: perspectives for primary care

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In some cases, the care of patients with chronic kidney disease (CKD) culminates in the need for renal replacement therapy (RRT). RRT refers to either transitioning to dialysis or receiving a kidney transplant. The purpose of this chapter is to review the key issues to consider when providing care for patients on the various forms of dialysis or with a kidney transplant. It is beyond the scope of this chapter to give detailed advice on each and every potential clinical problem that these patients may face, but with this framework, it is hoped that the general physician/non-nephrology specialist will have an improved understanding of the complexity of care, while also appreciating the need for standard general approaches.

First and foremost, we would support and foster the importance of a good communication plan between generalists and nephrologists, irrespective of whether they are in the haemodialysis (HD) unit, peritoneal dialysis (PD) unit, or a transplant programme. Individual countries or geographic regions organize the care of patient receiving RRT differently so the generalist is encouraged to understand the organization of that system in order to ensure a good knowledge of how renal care is provided and to ensure good information flow. The establishment of bidirectional communication, including potentially formalizing a framework for shared care, may be of benefit in those locations where the expectations of the patient and the care team are for sharing of care plans, implementation, and follow-up.

The following chapter describes issues related to: ♦ The specific processes of HD, peritoneal dialysis and transplantation, and common management issues. ♦ Preventative care of patients on RRT. ♦ Diet. ♦ Common comorbidities of patients on RRT. ♦ Common drug questions with respect to avoidance of drug interactions, contraindications, and cessation.

While each of these aspects of care could lead to its own chapter, the format of this is to give a wide overview of key questions so as to encourage the participation of generalists in the care of these patients who continue to need general care providers. A list of key references is given for each of the sections for further more in-depth reading.

Chapter.  5330 words. 

Subjects: Nephrology

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