As the dialysis population grows, the number of survivors in the
second and even third decade of dialysis also increase. These long
term survivors face not only the universal complications of
dialysis such as anemia and hyparathyroidism but also the
consequences of these complications such as the long term
cardiovascular problems. They are also subjected to many years of
accumulation of "uremic metabolites" resulting in conditions unique
to this group of patients, the best example being dialysis amyloid.
This book not only describes the causes of morbidity and mortality
during the second decade of dialysis but also how these
complications can be prevented or minimised. "As you make your bed
so you must lie upon it." Survival and quality of life in the
second decade and beyond dialysis cannot be divorced from events in
the first decade. The longest survival is currently in those
patients who have dialysed long hours with tight control of fluid
status. Modern dialysis practice and its impact on survival - CAPD,
short hour hemodialysis, biocompatible membranes are all discussed
in this book.
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