Geriatric Nephrology: The Medical, Psychosocial, Nursing, Financial and Ethical Issues of Treating End-Stage Renal Disease in the Elderly
Dimitrios G. Oreopoulos
Springer Science & Business Media, Jun 30, 1986 - Medical - 293 pages
The year was 1943. As a third-year medical student at Stanford, I was about to witness the beginning of a medical miracle. Dr. Arthur Bloomfield, Professor of Medicine, had selected my patient, a middle aged man, who was dying of acute pneumococcal pneumonia, as one of the first patients to receive miniscule doses (by today's standards) of his meagre supply of a new drug - penicillin. The patient's response amazed everyone especially this impressionable medical student. The rest of the story is history. With one stroke, the introduction of penicillin removed from the medical scene the 'friend of the aged' - lobar pneumonia. The consequences, which no one could have imagined at the time, are still becoming manifest as other 'miracles' such as respirators, artificial kidneys and many potent new antibiotics have come upon the scene. All of us are aware that these miracles have created a variety of new challenges around the states of dying and near dying. We have no easy answers for these problems. Nevertheless as dialysis techniques, especially CAPD, are applied more widely to the treatment of the elderly, the task of helping the patient meet death with dignity becomes increasingly important and vexing because once begun, dialysis is difficult to terminate.
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2 PHYSIOLOGY OF AGING
PSYCHOSOCIAL ASPECTS OF AGING
4 PHARMACOKINETICS AND PHARMACODYNAMICS IN THE ELDERLY
5 FLUID AND ELECTROLYTE DISORDERS IN THE ELDERLY
6 SODIUM HOMEOSTASIS WITH SPECIAL REFERENCE TO FRACTIONAL EXCRETION OF SODIUM AND PLASMA PROSTAGLANDIN E1...
7 AGING AND BODY WATER
8 ENDSTAGE RENAL DISEASE IN THE ELDERLY A GERIATRICIANS VIEWPOINT
15 HEMODIALYSIS OF THE ELDERLY
16 PERITONEAL DIALYSIS IN THE ELDERLY
THE RECENT UNITED STATES EXPERIENCE AND RESULTS FROM A SINGLE INSTITUTION
THE CANADIAN EXPERIENCE
19 NURSING ASPECTS OF THE ELDERLY PATIENT ON DIALYSIS
20 THE ELDERLY PATIENT ON DIALYSISPSYCHOSOCIAL CONSIDERATIONS
21 REFUSAL OR TERMININATION OF A LIFESUPPORT PROGRAM LEGAL ASPECTS
CAN WE AFFORD TO TREAT EVERYONE?
MECHANISMS RISK FACTORS AND THERAPEUTIC IMPLICATIONS
10 PREVENTABLE CAUSES OF RENAL FAILURE IN THE ELDERLY
11 BACTERIURIA IN THE ELDERLY SUBJECT ITS RELATIONSHIP TO SURVIVAL
12 ACUTE RENAL FAILURE IN THE ELDERLY
13 CHRONIC RENAL FAILURE IN THE ELDERLY
14 NUTRITIONAL NEEDS FOR THE ELDERLY HEMODIALYSIS PATIENT
acute renal failure age group allograft assessment associated bacteriuria bacteriuric blood pressure CAPD patients causes cell changes chronic renal failure Clin clinical concentration creatinine clearance cyclosporine death decline decreased diabetes dialysis and transplantation diet dietary protein diuretics donor drugs effect elderly patients end-stage renal disease ESRD excretion factors FRIEDMAN geriatrician glomerular filtration rate glomeruli hemodialysis patients home dialysis home hemodialysis hospital hyperfiltration hypertension hyponatremia incidence increase individual infection kidney transplantation Kjellstrand LAMEIRE levels Medicare Medicine mortality nephrology nephron nephropathy nephrotoxic normal number of patients nursing nutritional older patients older persons osmolality osmotic pressure patients aged peritoneal dialysis physician plasma prerenal prognosis protein intake proteinuria psychosocial rats recipients reduced REIFF renal function renal transplantation risk SCHREINER serum creatinine shows sodium solute stress survival syndrome Table therapy treated treatment United uremia uremic urine vascular younger patients