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Essay On Haemodialysis

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HD-related complications
Generally, the most common complications related to vascular access in HD are thrombosis, stenosis, infection, aneurysm, distal limb ischemia and congestive heart failure (Potisek, Ključevšek & Leskovar, 2017). Although AVF is most recommended for long-term dialysis, it also can be a potential source of morbidity. In 2016, Chapman, Nicdao and Kairaitis stated ESRF patients are already at significant risk of cardiovascular disease, besides low flow may lead to inadequate dialysis, high flow may result in heart failure in this population. In the critiqued article, a study was done by Ghonemy et al. (2016), it shows stenosis and infection were the two most common complications in haemodialysis patients, which occupied
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(A guide to vascular access in haemodialysis patients, 2017).

Addition to stenosis and infection, thrombosis and high flow AVF also contributes to HD complications. Thrombosis was considered as the main reason for vascular access failure which usually evolves in near proximity of stenosis and mostly in the area of anastomosis or venous outflow, it might lead to central venous obstruction with clinical sign of chronic swelling of the upper limb (Potisek, Ključevšek & Leskovar, 2017). High flow AVF is a real risk leading to significant cardiovascular morbidity by increasing cardiac output (Chapman, Nicdao, & Kairaitis, 2016). Compare to high flow AVF, low flow AVF seems easier to be identified through cannulation related problems or pressure alarms during dialysis by nurses. High flow AVF may be not noticed by nurses for a while because it doesn’t cause difficulties with cannulation and trigger pressure alarm (Chapman, Nicdao, & Kairaitis, 2016).

PD in the elderly
In 2015, Pajek pointed out that the CKD patients who reaching ESRD are normally older, frail and have a great number of comorbidities. Brown, Finkelstein, Iyasere and Kliger (2017) also stated older dialysis patients are at a greater risk of cognitive, physical and sensory impairments, which may result in difficulty in performing PD at home, increased risk of peritonitis, so most of them are default to receive in-centre HD. Ivarsen and Povlsen (2014) also stated that
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