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Emmanuel Sitnikov
Emmanuel Sitnikov

Callan Method Stage 7 Exam Test


real-world evidence shows that patients frequently have comorbidities which may be unrecognised or inadequately treated on hd. for example, in a uk dataset, 12.4% of incident patients were known to have a previous diagnosis of diabetes, but only 46.8% were receiving adequate diabetes treatment and 25.7% had been diagnosed with heart failure, yet only 48.6% were receiving an acei. as for the discussion of new renal services, this demonstrates the limitations of what might be termed case data: it is not always representative of usual service delivery [ 65 ]. however, other factors may be more useful to consider, for example patient engagement, for example, the 1% of haemodialysis patients attending pre-dialysis education sessions has been observed to be associated with good outcomes [ 97, 98 ].




Callan Method Stage 7 Exam Test


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most studies on shared haemodialysis care have involved small numbers of patients: for example in their study of a french shared haemodialysis programme, they describe the case of 6 patients treated for 31 months [ 99 ], or in the us, they report one patient treated for 5 years (63 months) [ 99 ]


many observational studies show that phosphate control is not achieved during dialysis, and whilst it may take weeks for total body phosphorus to return to pre-dialysis levels following a dialysis session, serum phosphorus levels also remain elevated [ 100 ] for at least 6-12h. this is in contrast to pre-dialysis levels, which generally fall rapidly. chronic hyperphosphatemia is associated with left ventricular hypertrophy (lvh), myocardial calcification, increased cardiovascular mortality, mortality, hospitalisation and haemodialysis catheter use [ 101, 102 ] all of which are markers of poor outcomes. however, it is also important to recognise that high levels of phosphate may reflect poor dialysis prescription, for example, not exchanging to the upper limit of dialysate sodium concentration [ 103 ] and/or impaired kidney function [ 104 ].


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