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dc.contributor.authorAshby, Damien
dc.contributor.authorBorman, Natalie
dc.contributor.authorBurton, James
dc.contributor.authorCorbett, Richard
dc.contributor.authorDavenport, Andrew
dc.contributor.authorFarrington, Ken
dc.contributor.authorFlowers, Katey
dc.contributor.authorFotheringham, James
dc.contributor.authorAndrea Fox, R N
dc.contributor.authorFranklin, Gail
dc.contributor.authorGardiner, Claire
dc.contributor.authorMartin Gerrish, R N
dc.contributor.authorGreenwood, Sharlene
dc.contributor.authorHothi, Daljit
dc.contributor.authorKhares, Abdul
dc.contributor.authorKoufaki, Pelagia
dc.contributor.authorLevy, Jeremy
dc.contributor.authorLindley, Elizabeth
dc.contributor.authorMacdonald, Jamie
dc.contributor.authorMafrici, Bruno
dc.contributor.authorMooney, Andrew
dc.contributor.authorTattersall, James
dc.contributor.authorTyerman, Kay
dc.contributor.authorVillar, Enric
dc.contributor.authorWilkie, Martin
dc.date.accessioned2019-10-26T00:09:29Z
dc.date.available2019-10-26T00:09:29Z
dc.date.issued2019-10-17
dc.identifier.citationAshby , D , Borman , N , Burton , J , Corbett , R , Davenport , A , Farrington , K , Flowers , K , Fotheringham , J , Andrea Fox , R N , Franklin , G , Gardiner , C , Martin Gerrish , R N , Greenwood , S , Hothi , D , Khares , A , Koufaki , P , Levy , J , Lindley , E , Macdonald , J , Mafrici , B , Mooney , A , Tattersall , J , Tyerman , K , Villar , E & Wilkie , M 2019 , ' Renal Association Clinical Practice Guideline on Haemodialysis ' , BMC Nephrology , vol. 20 , no. 1 , 379 . https://doi.org/10.1186/s12882-019-1527-3
dc.identifier.issn1471-2369
dc.identifier.otherPURE: 17603273
dc.identifier.otherPURE UUID: 110f2c3b-08c0-4774-906a-17c7021c0b6e
dc.identifier.otherPubMed: 31623578
dc.identifier.otherScopus: 85073610492
dc.identifier.urihttp://hdl.handle.net/2299/21801
dc.description© The Author(s) 2019. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
dc.description.abstractThis guideline is written primarily for doctors and nurses working in dialysis units and related areas of medicine in the UK, and is an update of a previous version written in 2009. It aims to provide guidance on how to look after patients and how to run dialysis units, and provides standards which units should in general aim to achieve. We would not advise patients to interpret the guideline as a rulebook, but perhaps to answer the question: "what does good quality haemodialysis look like?"The guideline is split into sections: each begins with a few statements which are graded by strength (1 is a firm recommendation, 2 is more like a sensible suggestion), and the type of research available to back up the statement, ranging from A (good quality trials so we are pretty sure this is right) to D (more like the opinion of experts than known for sure). After the statements there is a short summary explaining why we think this, often including a discussion of some of the most helpful research. There is then a list of the most important medical articles so that you can read further if you want to - most of this is freely available online, at least in summary form.A few notes on the individual sections: 1. This section is about how much dialysis a patient should have. The effectiveness of dialysis varies between patients because of differences in body size and age etc., so different people need different amounts, and this section gives guidance on what defines "enough" dialysis and how to make sure each person is getting that. Quite a bit of this section is very technical, for example, the term "eKt/V" is often used: this is a calculation based on blood tests before and after dialysis, which measures the effectiveness of a single dialysis session in a particular patient. 2. This section deals with "non-standard" dialysis, which basically means anything other than 3 times per week. For example, a few people need 4 or more sessions per week to keep healthy, and some people are fine with only 2 sessions per week - this is usually people who are older, or those who have only just started dialysis. Special considerations for children and pregnant patients are also covered here. 3. This section deals with membranes (the type of "filter" used in the dialysis machine) and "HDF" (haemodiafiltration) which is a more complex kind of dialysis which some doctors think is better. Studies are still being done, but at the moment we think it's as good as but not better than regular dialysis. 4. This section deals with fluid removal during dialysis sessions: how to remove enough fluid without causing cramps and low blood pressure. Amongst other recommendations we advise close collaboration with patients over this. 5. This section deals with dialysate, which is the fluid used to "pull" toxins out of the blood (it is sometimes called the "bath"). The level of things like potassium in the dialysate is important, otherwise too much or too little may be removed. There is a section on dialysate buffer (bicarbonate) and also a section on phosphate, which occasionally needs to be added into the dialysate. 6. This section is about anticoagulation (blood thinning) which is needed to stop the circuit from clotting, but sometimes causes side effects. 7. This section is about certain safety aspects of dialysis, not seeking to replace well-established local protocols, but focussing on just a few where we thought some national-level guidance would be useful. 8. This section draws together a few aspects of dialysis which don't easily fit elsewhere, and which impact on how dialysis feels to patients, rather than the medical outcome, though of course these are linked. This is where home haemodialysis and exercise are covered. There is an appendix at the end which covers a few aspects in more detail, especially the mathematical ideas. Several aspects of dialysis are not included in this guideline since they are covered elsewhere, often because they are aspects which affect non-dialysis patients too. This includes: anaemia, calcium and bone health, high blood pressure, nutrition, infection control, vascular access, transplant planning, and when dialysis should be started.en
dc.format.extent36
dc.language.isoeng
dc.relation.ispartofBMC Nephrology
dc.rightsOpen
dc.subjectNephrology
dc.titleRenal Association Clinical Practice Guideline on Haemodialysisen
dc.contributor.institutionCentre for Health Services and Clinical Research
dc.description.statusPeer reviewed
dc.description.versiontypeFinal Published version
dcterms.dateAccepted2019-10-17
rioxxterms.versionVoR
rioxxterms.versionofrecordhttps://doi.org/10.1186/s12882-019-1527-3
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by/4.0/
rioxxterms.typeJournal Article/Review
herts.preservation.rarelyaccessedtrue
herts.rights.accesstypeOpen


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