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Evidence from both observational and randomized controlled studies indicates that the use of bioimpedance in the care of chronic hemodialysis patients is associated with improved outcomes, in particular better volume and blood pressure control. Bioimpedance as a means to assess fluid status in dialysis patients has been approved by numerous regulatory agencies and is being used in dozens of countries around the globe. The most notable exception to the worldwide acceptance of this technique is the US where no BIA device has been approved by the US Food and Drug Administration for use in dialysis patients. The reasons for this unfortunate situation are manifold and mostly flawed. They include the view that bioimpedance is inaccurate and not sufficiently validated, that clinical judgment is good enough to assess fluid status, that interdialytic changes in weight are satisfactory indicators of fluid status (overload, depletion, and euvolemia), costs, and regulatory and marketing barriers. Easing the path to approval and modifying the dialysis payment structure are necessary to bring dialysis care closer to the levels that will optimize patient outcomes.
This article was published in the following journal.
Name: Seminars in dialysis
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Therapy for the insufficient cleansing of the BLOOD by the kidneys based on dialysis and including hemodialysis, PERITONEAL DIALYSIS, and HEMODIAFILTRATION.
Portable peritoneal dialysis using the continuous (24 hours a day, 7 days a week) presence of peritoneal dialysis solution in the peritoneal cavity except for periods of drainage and instillation of fresh solution.
Dialysis fluid being introduced into and removed from the peritoneal cavity as either a continuous or an intermittent procedure.
The volume of BLOOD passing through the HEART per unit of time. It is usually expressed as liters (volume) per minute so as not to be confused with STROKE VOLUME (volume per beat).
The volume of air contained in the lungs at the end of a maximal inspiration. It is the equivalent to each of the following sums: VITAL CAPACITY plus RESIDUAL VOLUME; INSPIRATORY CAPACITY plus FUNCTIONAL RESIDUAL CAPACITY; TIDAL VOLUME plus INSPIRATORY RESERVE VOLUME plus functional residual capacity; or tidal volume plus inspiratory reserve volume plus EXPIRATORY RESERVE VOLUME plus residual volume.
In medicine, dialysis is a process for removing waste and excess water from the blood, and is primarily used to provide an artificial replacement for lost kidney function in people with renal failure. Dialysis may be used for those with an acute disturba...