Acute
Rapidly developing; severe; short duration.

Acute Renal Failure
A sudden loss of kidney function; it can be reversible.

Anaphylaxis
Anaphylaxis or anaphylactic reaction is an immediate, severe reaction to a substance to which an individual is allergic. The reaction may include signs and/or symptoms such as hives, itching or wheezing. The reaction may develop into anaphylactic shock, which can cause life-threatening consequences such as hypotension, cardiac arrhythmias or arrest, spasms of the breathing passages and swelling of the throat.

Anemia A deficiency of the oxygen carrying pigment of hemglobin often accompanied by a reduced number of circulating red blood cells; common in patients on dialysis due to decreased red blood cell production and procedural blood loss. The major symptoms are fatigue, tiredness, breathlessness on exertion, pallor and poor resistance to infection.

Antiseptic
A chemical which prevents or inhibits growth and reproduction of bacteria; it does not necessarily destroy them as a disinfectant would.

Anuric
Absence of urine formation.

Aseptic
Free from infectious organisms; sterile.

Aseptic Technique
A process of rendering an object completely free of microorganisms. A method usually involving sterile gloves, gowns and masks.

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B

Bacteria
Single cell organisms, fully capable of rapid reproduction. They are prevalent everywhere; some are harmless, others known to produce infectious diseases.

Biocompatibility
The quality of not having toxic or injurious effects on biological systems.

Blood Pressure
The pressure exerted against vessel walls resulting from the pumping force of the heart and resistance of blood vessels. It is measured by auscultating (listening to) the changing sounds produced by varying external pressures on an artery.

Blood Protein
A complex substance or very large nitrogen containing molecule found in blood.

Body Mass Index (BMI)
Anthropometric index defined as weight in kilograms/(stature in m²)².

BUN (Blood Urea Nitrogen)
Nitrogen in the blood in the form of urea. It is a result of protein breakdown due to dietary intake (digestion) or inherent bodily tissue breakdown. An increase usually indicates decreased kidney function.

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C

Cardiac Tamponade
A pathological condition which results from excess accumulation of fluid in the pericardium.

Catheter
A tubular, flexible instrument, passed through body channels for withdrawal of fluids from (or introduction of fluids into) a body cavity.

Chemoreceptor
A sense organ or sensory nerve ending that is stimulated by and reacts to certain chemical stimuli. It is located outside of the central nervous system.

Chronic
Of long duration or recurring frequently.

Chronic Kidney Disease
Persistent, long-lasting renal pathologic process, often associated with loss of kidney function.

Chronic Renal Failure
The progressive, irreversible loss of kidney function that occurs over periods of time ranging from a few months to decades. Also called Chronic Renal Insufficiency.

Clean Technique
Rendering an object partially free from organisms.

Clearance
A quantitative measure, expressed in mL/minute, of the rate at which waste products are removed from the blood by the kidney, peritoneal membrane or artificial kidney.

Clot
A mass of coagulated blood. The normal reaction of the blood to a damaged blood vessel or foreign material.

Coagulation
The process of forming a blood clot.

Coefficient
A numerical measure of a physical or chemical property that is constant for a system under specified conditions.

Contaminate
To make unclean, unsterile or impure.

Creatinine
Creatinine is a waste product of creatinine phosphate metabolism, which is found especially in the muscle and blood. Increased creatinine values in the blood can be an indication of renal failure. It is one of the primary lab values indicating a patient's need to start dialysis.

Cycle
A peritoneal cycle or exchange is the infusion and drainage of a specific volume of peritoneal dialysis solution consistent with the PD prescription. The PD prescription defines the volume, dwell time and sometimes the rate of infusion and drainage. The dwell time may vary from a few minutes to several hours.

Cycler
A machine used to infuse and drain dialysate from the peritoneal cavity.

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D

Dehydration
Excessive water loss from the body, organ or bodily part. This occurs when output of water exceeds intake.

Dialysate (dialysis fluid)
A mixture of water, electrolytes and dextrose. Sodium lactate is the most commonly used buffer in the dialysis solution. Newer solutions using pure bicarbonate or bicarbonate/lactate combinations have been developed as a more physiological buffer. Electrolyte levels in dialysate are proportioned to ensure that the levels in the blood remain within physiological range. Waste products, such as BUN and creatinine are not present in the dialysate and will readily move out of the blood into the dialysis fluid.

Dialysis
Diffusion of blood across a semi-permeable membrane to remove toxic substances. Dialysis maintains fluid, electrolyte and acid-base balance when there is impaired kidney function or there are no native kidneys.

Diastolic Blood Pressure
The blood pressure against the arteries when the heart is at rest (between beats). It is the bottom half of the blood pressure reading.

Diffusion
Process in which solutes move from an area of high solute concentration through a semi-permeable membrane to an area of low solute concentration.

Disinfectant
Chemical that destroys bacterial-organisms.

Distal
Refers to furthest from the center of the body. For example, the hands and feet are distal extremities. The opposite of proximal.

Dry Weight
The ideal body weight without excess fluid volume.

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E

Efferent
Carrying away from the central organs or section. For example, efferent arterioles carry blood away from the glomeruli of the kidney. The opposite of afferent.

Effluent
The used or spent dialysate fluid that is carried to the drain.

Electrolytes
An electrolyte is a compound that breaks apart into ions. Common electrolytes include sodium (Na+), potassium (K+) and calcium (Ca++). Electrolytes transport electrical impulses along the nerves to the muscles, including the heart. Healthy kidneys maintain electrolyte balance in the body. Electrolytes are added to dialysate in carefully controlled amounts.

Embolus
A mass of undissolved matter present in the blood or lymph brought there by the blood or lymph current.

Endotoxin
A poison harmful to all body tissues, contained within certain Gram negative bacteria and released only when the bacterial cell is broken down or dies and disintegrates.

End Stage Renal Disease
Term used for complete or irreversible loss of kidney function, the last stage of chronic renal failure. Also referred to as ESRD.

Equilibrium
The body's attempt to maintain balance or homeostasis. Used in reference to equal concentrations in two compartments across a semipermeable membrane.

Erythropoietin
A hormone that acts on the bone marrow to stimulate red blood cell production. It is produced by the kidney in response to oxygen deficiency in the tissues.

Estimated Dry Weight
The weight the patient would be if the kidneys functioned normally.

Etiology
The cause of a disease.

Exchange
A peritoneal exchange or cycle is the infusion and drainage of a specific volume of peritoneal dialysis solution consistent with the PD prescription. The PD prescription defines the volume, dwell time and sometimes the rate of infusion and drainage. The dwell time may vary from a few minutes to several hours.

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F

Febrile
Body temperature greater than 98.6F or 37.0C.

Fibrin
A whitish filamentous protein formed by the action of thrombin on fibrinogen.

Flush
Peritoneal flush or lavage is the "rapid" infusion and drainage of peritoneal dialysis solution with the purpose of removing blood, fibrin, debris or spent dialysate from the peritoneal cavity or catheter. The dwelltime is minimal or non-existent. Or, in terms of the actual exchange procedure itself, to flush is to remove the remaining air from the infusion line into the drainage bag.

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G

Gram
The basic unit of weight measure in the metric system. There are approximately thirty grams in one ounce.

Glomerular Filtration Rate (GFR)
The volume of plasma filtered from the glomerular capillaries into the Bowman's capsule each minute (mL/min).

Glomerulus
A cluster of capillary blood vessels that act as a filter in the nephron.

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H

Haematocrit
A measurement of red cells in the blood, stated as a percentage of red blood cells per total blood volume.

Haematoma
An accumulation of blood that has escaped into the tissues from blood vessels. It is commonly referred to as a bruise and appears "black and blue".

Haemodialysis
A process of removing chemical substances and water from the blood by passing it through an artificial kidney composed of semi-permeable membranes.

Haemoglobin
Protein found in erthrocytes that transports oxygen in the blood.

Haemolysis
The destruction of red blood cells resulting in the liberation of haemoglobin, potassium and other cell contents.

Haemorrhage
Abnormal bleeding, either internal or external.

Heparin
A powerful anticoagulant that blocks/suppresses clotting of the blood. In peritoneal dialysis heparin can be added to the dialysis solution. Heparin inhibits the formation of fibrin and may prevent subsequent adhesion formation.

Hepatitis
An inflammation of the liver, can be of viral or toxic origin.

Homeostasis
State of equilibrium of the internal environment of the body that is maintained by dynamic processes of feedback and regulation.

Hydrostatic Pressure
The pressure exerted by a column of water due to gravity or mechanical pressure.

Hyperkalaemia
Unusually high levels of potassium in the blood.

Hypertension
Blood pressure greater than normal.

Hypertrophy
An increase in size of an organ or structure that does not involve tumor formation.

Hypokalaemia
Not enough potassium in the blood.

Hypotension
Low blood pressure.

Hypoperfusion
Decreased blood flow through an organ, as in circulatory shock. If prolonged, it may result in permanent cellular dysfunction and death.

Hypotonic
A solution with an osmolality or concentration of solutes less than that which it is compared. In dialysis, the fluid of comparison is usually blood.

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I

Infection
Invasion of the body by disease producing organisms and the reaction of the tissues to their presence.

Intraperitoneal Volume (Vip)
The volume of fluid inside the peritoneal cavity.

Isotonic
A solution with an osmolality or concentration of solutes equal to that which it is compared. In dialysis, the fluid of comparison is usually blood.

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K

Kilogram
1,000 grams; 2.2 pounds.

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L

Lavage
Peritoneal lavage or flush is the "rapid" infusion and drainage of peritoneal dialysis solution with the purpose of removing blood, fibrin, debris or spent dialysate from the peritoneal cavity or catheter. The dwell time is minimal or non-existent.

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M

Macrophage
A large scavenger cell present in connective tissue and many major organs and tissues including the bone marrow, spleen, lymph nodes, liver and central nervous cells.

Membrane
A thin layer of tissue that covers or surrounds a surface or space. In dialysis,it can refer to either the peritoneal membrane or the material out of which the internal fibres of the artificial kidney are composed.

Metabolism
The sum of all physical and chemical changes that take place within an organism. All energy and material transformations that occur within living cells.

Molecule
Smallest particle of a substance with distinct chemical properties that identify the substance; stable group of atoms.

Morbidity
Pertaining to disease or illness.

Mortality
Pertaining to death or loss of life.

Myalgia
Tenderness or pain in the muscles.

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N

Nephritis
Inflammation of the kidney. A disease of the kidneys haematuria associated with a nephritic syndrome that includes hematuria as its distinguishing component. Other classic symptoms include hypertension, renal insufficiency, volume overload, oedema, and in some cases, proteinuria.

Nephrologist
A physician who specializes in kidney diseases and their treatment.

Nephron
The structural and functional unit of the kidney. It consists of a glomerulus enclosed within Bowman's capsule and its attached tubule (consists of proximal convoluted tubule, loop of Henle and distal convoluted tubule). Urine is formed by filtration in the glomerulus, and selective reabsorption and secretion by cells of the renal tubule.

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O

Occlude
To shut or close off.

Oedema
Excess fluid in the body tissues; swelling of the body due to excess fluid.

Oliguria
Decreased amount of urine formation.

Osmolality
The osmotic concentration characteristic of a solution that is determined by the ionic concentration of the dissolved substance per unit of solvent.

Osmolarity
The concentration of osmotically active particles in solution.

Osmosis
Passage of fluid through a semi-permeable membrane from an area of lesser concentration to an area of greater concentration in order to achieve equilibrium of solute.

Osteitis Fibrosa Cystica
Tissue level lesions, fibrosis of the marrow spaces and abundance of osteoclasts. Is characterized by severely increased bone resorption and high levels of parathyroid hormone (PTH).

Outcome
End product or result.

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P

Palpable
Perceptible to touch.

Palpitation
Irregular beating of the heart.

Pericarditis
Inflammation of the pericardium, or sac surrounding the heart.

Pericardial Effusion
Fluid in the pericardial cavity, between the visceral and parietal pericardium. It may produce symptoms of cardiac tamponade (see above for definition).

Peritonitis
Peritonitis is an inflammation of the peritoneum. Infectious peritonitis is inflammation of the peritoneum related to microorganisms. Resistant or refractory peritonitis is an episode that does not respond to treatment within 48 hours. Relapsing peritonitis is an episode that initially responds to treatment but then symptoms reappear. Recurrent peritonitis is an episode with symptoms that return within 2 weeks of the completion of therapy for peritonitis and the organism is the same as in the prior episode.

Phosphate Binder
Compounds that bind phosphorus in the GI tract, preventing absorption. Bound phosphorus becomes part of the faeces and is eliminated. Classes of binders include aluminum, calcium and magnesium as well as non-absorbable calcium and aluminum-free compounds.

Plasma
The straw coloured, non-cellular liquid portion of the blood containing clotting factors. It consists of water, electrolytes, nutrients and proteins.

Polyglucose
Mixture of glucose polymers in different chain lengths.

Pore
Small opening or hole.

Postural Hypotension
The development of hypotension when the posture is changed. This is usually manifested by dizziness on standing.

Protein
A group of nitrogen-containing compounds found widely in nature in both plants and animals. They are formed from complex combinations of amino acids. They form structural material of muscles, tissues and organs. They form enzymes and hormones.

Proximal
Nearest the point of attachment, centre of the body or point of reference. Opposite of distal.

Pruritis
Intense itching.

Pulmonary Oedema
An accumulation of fluid in the lungs caused by fluid overload.

Pulse
Rhythmical throbbing caused by the regular expansion and contraction of an artery.

Pyrogen
A substance that causes fever.

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R

Red Blood Cell (RBC)
Cells in the blood stream that carry oxygen in a complete molecule called haemoglobin.

Regimen
A regimen is a systematic plan of therapy that is generally characterized as intermittent or continuous when referring to the duration of dialysis, and supine or ambulatory when referring to the position of the patient (for PD).

Renal
Pertaining to the kidneys.

Renal Osteodystrophy
Generalized bone disease resulting from metabolic disorder caused by renal failure.

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S

Semi-permeable Membrane
A membrane with pores that are permeable to some (smaller molecules) but not to larger molecules.

Shock
Extreme hypotension.

Sphygmomanometer
An instrument used to measure blood pressure.

Solute
The substance that is dissolved in a liquid (solvent) to form a solution.

Standard Kt/V
The stdKt/V is a formula to measure the relative efficiency of the whole spectrum of dialytic therapies whether intermittent, continuous or mixed.  This method allows the measurement of clearance efficiency of HD of variable frequency, continuous PD, intermittent PD, slow continuous renal replacement therapies (CRRT), residual renal function (RRF) and all situations involving the use of clearance from various methods.

Sterile
Completely free from living microorganisms.

Stethoscope
A device used to auscultate (listen to) sounds produced by the body. It consists of rubber tubing connecting two ear pieces to a diaphragm and/or bell.

Supine position
Lying with the face upward, or on the dorsalsurface.

Systolic Blood Pressure
This is the pressure inside arteries during a heartbeat. This is the top half of the blood pressure reading.

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T

Tachycardia
An abnormally fast heart rate. If 70 to 90 beats per minute is considered normal, then 100 beats per minute would indicate tachycardia.

Technique
A technique is the procedure by which a regimen is accomplished.  These definitions can be confusing since similar terms are applied to the regimen and the technique.

Tetany
A set of symptoms which include intermittent tonic spasms, nervousness and muscular irritability induced by changes in calcium or pH.

Thrombus
Clot formed in a blood vessel or blood passage.

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U

Ultrafiltration
The process by which plasma water is removed from the blood related to an osmotic pressure gradient. The rate of ultrafiltration is highest in the beginning of an exchange when the osmotic gradient is highest.

Universal Precautions
Those necessary safeguards based upon the assumption that all human blood and certain human body fluids are treated as if they are known to be infectious for any blood borne pathogens.

Urea
Waste products formed by the breakdown of protein in the body.

Uraemia
Toxic condition that develops in kidney failure due to the accumulation of waste products in the blood that are normally excreted in the urine.

Uraemic Frost
A white, powder-like substance that results from the precipitation of urea crystals secreted in the sweat. It may be seen on the face and trunk. Unusual to see today as dialysis usually begins before this develops.

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V

Vein
Blood vessel that carries deoxygenated blood toward the heart from other parts of the body.

Vital Signs
Blood pressure, temperature, pulse and respiration.