Glossary — Dialysis study guide

Glossary

Every vocabulary row from the twelve chapters, in alphabetical order. The same word can appear more than once when two chapters define it.

A

accountability: Knowing where every patient and staff member is.; Example. Accountability at the assembly point is part of life safety.; Module 12 — Emergency Planning and Response
acidosis: Blood that is too acidic because acid is retained or bicarbonate is lost.; Example. Kidney failure often causes metabolic acidosis.; Module 2 — Kidneys and Kidney Failure
adequacy: Whether treatment is doing enough of the intended work.; Example. Do not judge adequacy from one symptom or one machine number.; Module 1 — The Dialysis Environment
adequacy: Whether the delivered dialysis dose is enough for the patient's needs.; Example. Kt/V is one lab clue to adequacy, not a complete picture by itself.; Module 2 — Kidneys and Kidney Failure
adequacy: Whether PD is clearing enough waste and water for that person.; Example. Adequacy includes Kt/V, symptoms, weight, blood pressure, and leftover kidney function.; Module 8 — Peritoneal Dialysis
adequacy: Whether the delivered treatment is enough, judged by numbers and how the person feels.; Example. Adequacy is not only Kt/V; nutrition, electrolytes, and symptoms also matter.; Module 9 — Hemodialysis Procedures
adherence: How well a person can follow the agreed treatment plan.; Example. Poor adherence may be a barrier such as cost or transport, not simple refusal.; Module 4 — The Person with End-Stage Kidney Disease
adhesion: An abnormal tissue bridge after surgery, bleeding, or inflammation.; Example. Adhesions can wall off the catheter and shrink the usable membrane area.; Module 8 — Peritoneal Dialysis
adsorption: Molecules sticking to a surface and forming a film.; Example. Adsorption on a dialyzer can remove some wastes but may also slow transport.; Module 5 — Principles of Dialysis
advance directive: Written wishes about future care if the person cannot speak for themselves.; Example. An advance directive can say whether the clinic should start or continue dialysis in a crisis.; Module 3 — Treatment Options for Kidney Failure
afferent: Coming in; the vessel that arrives at a part.; Example. The afferent arteriole brings blood into the glomerulus.; Module 2 — Kidneys and Kidney Failure
after-action review: A structured look, after the event, at what worked and what must change.; Example. Take after-action findings to QAPI and update the emergency plan.; Module 12 — Emergency Planning and Response
amyloidosis: Buildup of amyloid protein deposits in tissues over long dialysis vintage.; Example. Dialysis-related amyloidosis can cause carpal-tunnel pain and joint damage.; Module 2 — Kidneys and Kidney Failure
amyloidosis: Long-term deposit of beta-2 microglobulin in joints and bone.; Example. Dialysis-related amyloidosis can cause shoulder pain or carpal-tunnel symptoms.; Module 10 — Infection Control and Hemodialysis Complications
anaphylaxis: A severe, fast allergic reaction that can close the airway or drop blood pressure.; Example. Anaphylaxis to a dialyzer or medicine is an emergency; do not return blood unless directed.; Module 10 — Infection Control and Hemodialysis Complications
aneurysm: A dilated, thin, weak area of the access wall.; Example. Never puncture the thin top of an aneurysm.; Module 7 — Vascular Access
angioedema: Sudden deep swelling of face, lips, tongue, or airway.; Example. Angioedema with wheeze or hypotension is a severe allergic warning.; Module 10 — Infection Control and Hemodialysis Complications
angioplasty: Opening a narrowed vessel with a balloon.; Example. Angioplasty may treat stenosis; never cannulate through a stent.; Module 7 — Vascular Access
anticoagulation: Medicine or method used to limit clotting in the circuit.; Example. Anticoagulation is prescribed; more heparin is not a technician-selected fix.; Module 6 — Hemodialysis Devices and Equipment
anticoagulation: The ordered plan to limit clotting in the extracorporeal circuit.; Example. Too much anticoagulation can prolong bleeding; too little can clot the dialyzer.; Module 9 — Hemodialysis Procedures
arrhythmia: An irregular or dangerous heart rhythm.; Example. Potassium shifts or too much UF can trigger an arrhythmia.; Module 10 — Infection Control and Hemodialysis Complications
arteriovenous: Connecting an artery to a vein so the vein can carry high-flow dialysis blood.; Example. An arteriovenous fistula uses the patient's own vessels as the lifeline.; Module 7 — Vascular Access
asepsis: Keeping a space or connection free of germs that cause infection.; Example. Home PD still requires asepsis for every connection.; Module 1 — The Dialysis Environment
aseptic: Done in a way that keeps germs out of a sterile connection or space.; Example. Breaks in aseptic technique can cause peritonitis.; Module 3 — Treatment Options for Kidney Failure
aseptic: Keeping germs out of connections, dressings, and needle sites.; Example. CVC care needs aseptic technique at every cap and dressing change.; Module 7 — Vascular Access
aseptic: Keeping every connection and cap free of germs.; Example. A contaminated transfer-set end can seed peritonitis, so aseptic steps are not optional.; Module 8 — Peritoneal Dialysis
aseptic: Keeping sterile tips, ports, and fluid pathways free of germs.; Example. The open syringe hub must stay aseptic because it leads into a patient or sterile line.; Module 9 — Hemodialysis Procedures
aseptic: Keeping a sterile medicine or connection pathway free of germs.; Example. Injectable medicines require aseptic technique; a clean-looking vial is not enough.; Module 10 — Infection Control and Hemodialysis Complications
attributable: Clearly tied to the person who did the task.; Example. Good charting is timely, factual, and attributable.; Module 9 — Hemodialysis Procedures
autonomy: The patient's right to make informed choices about their own care.; Example. Staff should explain options without steering, so autonomy stays with the patient.; Module 3 — Treatment Options for Kidney Failure
azotemia: Buildup of BUN and other nitrogen wastes, sometimes with few symptoms.; Example. Azotemia can be present before a person feels uremic.; Module 2 — Kidneys and Kidney Failure

B

backflow: Water moving the wrong way into a cleaner or city supply.; Example. Backflow prevention keeps treated or dirty water from reversing into the source.; Module 11 — Water Treatment and Equipment
binder: A phosphate medicine taken with meals so phosphorus is not absorbed as much.; Example. Phosphate binders work only when taken as prescribed with the right meals.; Module 4 — The Person with End-Stage Kidney Disease
biofilm: A sticky layer of germs on a catheter that is hard to clear with medicine alone.; Example. Biofilm can cause repeated peritonitis with the same organism.; Module 8 — Peritoneal Dialysis
biofilm: A slimy, attached layer of microbes that is hard to kill once mature.; Example. Stagnant storage tanks and dead legs can grow biofilm after chlorine is removed.; Module 11 — Water Treatment and Equipment
biohazard: Material that can spread infection, such as blood-soaked tubing.; Example. Blood-contaminated items go in the labeled biohazard stream, not regular trash.; Module 10 — Infection Control and Hemodialysis Complications
biohazardous: Waste that can spread infection because it contains blood or body fluid.; Example. Used bloodlines are biohazardous and are not ordinary recycling.; Module 6 — Hemodialysis Devices and Equipment
bruit: The whooshing sound of access flow heard with a stethoscope.; Example. A new high-pitched or whistling bruit can be a stenosis warning.; Module 7 — Vascular Access
buttonhole: Using the same needle track and angle over many treatments.; Example. Buttonhole cannulation needs strict scab care and is not assumed safe for every graft.; Module 7 — Vascular Access
bypass: A safety state that sends questionable dialysate away from the dialyzer.; Example. Bypass protects the patient; it is not an alarm to override.; Module 6 — Hemodialysis Devices and Equipment

C

calciphylaxis: A rare, severe vessel and skin problem with painful wounds that may not heal.; Example. Report new sores or severe pain promptly because calciphylaxis can become septic.; Module 2 — Kidneys and Kidney Failure
calciphylaxis: Painful calcium-related skin and vessel injury that can ulcerate and infect.; Example. Report painful nodules before ulcers appear; calciphylaxis needs urgent wound care.; Module 10 — Infection Control and Hemodialysis Complications
calcitriol: The active form of vitamin D made or activated by the kidney.; Example. Low calcitriol impairs calcium absorption and bone-mineral balance.; Module 2 — Kidneys and Kidney Failure
cannulation: Placing dialysis needles into the access.; Example. Safe cannulation is gentle, mapped, and never forced.; Module 7 — Vascular Access
cartridge: A pre-strung disposable set that holds lines and often the dialyzer pathway.; Example. Home systems such as NxStage use a pre-strung cartridge to simplify setup.; Module 6 — Hemodialysis Devices and Equipment
catastrophe: A large event that can cut staffing, roads, utilities, and usual treatment capacity.; Example. A catastrophe may require daily staff briefings and alternate housing or pay methods.; Module 12 — Emergency Planning and Response
census: The current count and identity of patients in the clinic.; Example. Take the census to the assembly point if it is safe to do so.; Module 12 — Emergency Planning and Response
channeling: Water punching a fast path through a carbon or media bed instead of contacting all of it.; Example. Backwashing fluffs carbon to break channeling but does not restore exhausted carbon.; Module 11 — Water Treatment and Equipment
chloramine: A long-lasting chlorine compound used to disinfect city water.; Example. Carbon tanks must remove chloramine because it can rupture red cells.; Module 11 — Water Treatment and Equipment
clearance: How effectively the dialyzer removes a given solute over time.; Example. Clearance is not the same as total removal from the whole body.; Module 6 — Hemodialysis Devices and Equipment
coagulation: A drinking-water step that clumps fine particles so they can settle.; Example. Municipal coagulation does not make water dialysis-ready by itself.; Module 11 — Water Treatment and Equipment
cohort: Grouping people with the same infection to limit spread.; Example. During an outbreak, the clinic may cohort patients with the same suspected organism.; Module 10 — Infection Control and Hemodialysis Complications
cohort: Grouping people with the same infection risk to protect others.; Example. An outbreak plan may cohort symptomatic patients and adjust shifts.; Module 12 — Emergency Planning and Response
comorbidity: Another illness that exists along with kidney failure.; Example. Comorbidity can affect whether a person qualifies for transplant or home therapy.; Module 3 — Treatment Options for Kidney Failure
comorbidity: Another illness present along with kidney failure.; Example. Nutrition plans depend on modality, residual function, and comorbidity.; Module 4 — The Person with End-Stage Kidney Disease
conductivity: An electrical check that the mixed dialysate is in the expected salt range.; Example. A conductivity alarm can mean a wrong concentrate or mixing problem.; Module 6 — Hemodialysis Devices and Equipment
conductivity: A mixing check that dialysate salts are in the expected electrical range.; Example. A failed conductivity test is a stop condition before connection.; Module 9 — Hemodialysis Procedures
confidentiality: Keeping private information only with people who are allowed to know it.; Example. Confidentiality applies to phone calls, hallways, and social media, not only the chart.; Module 4 — The Person with End-Stage Kidney Disease
conservative care: Active medical management of symptoms without dialysis or transplant.; Example. Conservative care is planned comfort-focused treatment, not abandonment.; Module 3 — Treatment Options for Kidney Failure
contaminant: An unwanted chemical or microbe in water.; Example. A contaminant tolerated in drinking water can enter blood during dialysis.; Module 11 — Water Treatment and Equipment
contamination: Unsafe material getting into water, dialysate, equipment, or a treatment area.; Example. After fire, flood, or a chemical spill, assume contamination until the system is cleared.; Module 12 — Emergency Planning and Response
contemporaneous: Written at the time the work is done, not from memory later.; Example. Contemporaneous charting is required so the next caregiver can reconstruct the treatment.; Module 9 — Hemodialysis Procedures
continuity: Keeping essential dialysis going, even if the usual site or schedule changes.; Example. Continuity planning includes backup clinics, supplies, and a way to reach patients.; Module 12 — Emergency Planning and Response
convection: Water carrying dissolved wastes along with it as it moves.; Example. Convection can add solute removal when fluid is pulled across the membrane.; Module 1 — The Dialysis Environment
convection: Moving water carrying dissolved solutes with it.; Example. Convection helps clear larger molecules that diffuse poorly.; Module 5 — Principles of Dialysis
countercurrent: Two fluids traveling in opposite directions to keep a useful gradient.; Example. Countercurrent flow keeps blood meeting fresher dialysate along the fiber.; Module 5 — Principles of Dialysis
countercurrent: Blood and dialysate flowing in opposite directions.; Example. Countercurrent flow preserves the concentration gradient along the fiber.; Module 6 — Hemodialysis Devices and Equipment
cultural humility: Recognizing the limits of one's knowledge and asking rather than assuming.; Example. Cultural humility means using a qualified interpreter instead of guessing.; Module 4 — The Person with End-Stage Kidney Disease

D

deionization: Exchanging leftover ions for hydrogen and hydroxyl to make very pure water.; Example. DI is a backup or polish step and must alarm and divert unsafe water.; Module 11 — Water Treatment and Equipment
delegation: A licensed clinician assigning a task the technician is trained and allowed to do.; Example. Delegation never lets a technician guess a dose or change a prescription.; Module 9 — Hemodialysis Procedures
desensitization: Special immune treatment that can allow some mismatched transplants.; Example. ABO-incompatible transplant may be possible after desensitization.; Module 3 — Treatment Options for Kidney Failure
diffusion: Movement of dissolved substances from higher to lower concentration.; Example. Diffusion moves wastes from blood into dialysate.; Module 1 — The Dialysis Environment
diffusion: Solutes moving from higher to lower concentration.; Example. Diffusion clears small wastes down a concentration gradient.; Module 5 — Principles of Dialysis
dignity: Being treated as a whole person whose privacy and worth are protected.; Example. Protect dignity by asking permission before discussing body-image concerns.; Module 4 — The Person with End-Stage Kidney Disease
disequilibrium: A dangerous imbalance when blood wastes fall faster than brain wastes.; Example. Dialysis disequilibrium syndrome can cause headache, confusion, or seizures.; Module 5 — Principles of Dialysis
disinfect: To reduce germs on a cleaned surface or water path with an approved method.; Example. After a water event, disinfect and rinse the RO, loop, tanks, and machines as directed.; Module 12 — Emergency Planning and Response
disparity: An unjust, avoidable difference in care or health outcomes.; Example. A good-looking clinic average can hide a disparity among some patients.; Module 1 — The Dialysis Environment
downstream: After a component, toward the patient-use side.; Example. A downstream sample shows what actually reached the point of use.; Module 11 — Water Treatment and Equipment
dwell: The time dialysate stays in the belly so wastes and water can move into it.; Example. A PD exchange is drain, then fill, then a prescribed dwell.; Module 3 — Treatment Options for Kidney Failure
dwell: The time dialysate stays in the abdomen between fill and drain.; Example. A longer dwell can change how much waste and water move into the fluid.; Module 8 — Peritoneal Dialysis

E

efferent: Going out; the vessel that leaves a part.; Example. The efferent arteriole carries blood out of the glomerulus.; Module 2 — Kidneys and Kidney Failure
effluent: Used fluid drained from the belly in peritoneal dialysis.; Example. Report cloudy effluent instead of discarding it.; Module 1 — The Dialysis Environment
effluent: The used PD fluid that drains out.; Example. Expected effluent is clear and may be normally yellow; anything else is reportable.; Module 8 — Peritoneal Dialysis
electrolyte: A dissolved salt that carries an electrical charge in body fluids.; Example. Dialysis helps manage electrolytes such as sodium and potassium.; Module 1 — The Dialysis Environment
embolic: Related to a bubble or clot that can block a vessel.; Example. Microbubbles can act like small embolic insults; large air can be fatal.; Module 6 — Hemodialysis Devices and Equipment
embolism: A bubble or clot blocking a blood vessel.; Example. An air embolism can cause chest symptoms, cyanosis, or collapse.; Module 10 — Infection Control and Hemodialysis Complications
empathy: Trying to understand another person's burden without making the moment about yourself.; Example. Empathy helps staff hear grief under anger instead of arguing.; Module 4 — The Person with End-Stage Kidney Disease
endocrine: Related to hormones that organs make and send through the blood.; Example. Dialysis does not replace every endocrine job of healthy kidneys.; Module 1 — The Dialysis Environment
endotoxin: A fever-causing fragment from bacterial cell walls that can survive after bacteria die.; Example. Ultrafilters help remove endotoxin; a culture result is not the same test.; Module 11 — Water Treatment and Equipment
endovascular: Done from inside the blood vessel rather than through a usual open cut.; Example. An endovascular fistula may have no obvious scar and needs its own cannulation map.; Module 7 — Vascular Access
EPS: Encapsulating peritoneal sclerosis: rare, severe scarring that encases bowel.; Example. EPS can cause obstruction, malnutrition, and sepsis and is a reason PD may stop.; Module 8 — Peritoneal Dialysis
equilibrium: No net concentration difference left, even though particles may still move.; Example. As a PD dwell nears equilibrium, diffusion slows until fresh fluid restores the gradient.; Module 5 — Principles of Dialysis
equity: Fair support matched to need, not the same thing for everyone.; Example. Equity may mean arranging transportation so a patient can keep treatments.; Module 1 — The Dialysis Environment
erythropoietin: A kidney hormone that signals bone marrow to make red blood cells.; Example. Low erythropoietin is a main reason people with kidney failure become anemic.; Module 2 — Kidneys and Kidney Failure
escalate: To raise a concern quickly to someone who can act on it.; Example. Escalate a sudden blood-pressure drop to the nurse instead of waiting.; Module 1 — The Dialysis Environment
escalate: To notify the person or team who can make the next safety decision.; Example. Escalate questionable post-disaster water rather than restarting treatment.; Module 12 — Emergency Planning and Response
euvolemic: Having a normal, not overloaded or dehydrated, fluid status.; Example. A yellow bag is often used when the patient is euvolemic to avoid extra water removal.; Module 8 — Peritoneal Dialysis
evacuation: Moving people out of the building by assigned routes and priorities.; Example. Never use an elevator for evacuation when fire or power loss makes it unsafe.; Module 12 — Emergency Planning and Response
exsanguination: Life-threatening blood loss.; Example. A dislodged needle can cause exsanguination within minutes if the access is hidden.; Module 10 — Infection Control and Hemodialysis Complications
extracorporeal: Happening outside the body.; Example. Hemodialysis uses an extracorporeal circuit that takes blood out and returns it.; Module 1 — The Dialysis Environment
extracorporeal: The blood path that runs outside the body through tubing and the dialyzer.; Example. The extracorporeal circuit must stay visible because a leak can empty blood quickly.; Module 6 — Hemodialysis Devices and Equipment
extrusion: A catheter cuff working its way out through the skin.; Example. An extruded cuff exposes material where bacteria can grow.; Module 8 — Peritoneal Dialysis

F

fertility: The ability to become pregnant or cause a pregnancy.; Example. Fertility is often reduced in kidney failure; pregnancy on dialysis is high risk.; Module 4 — The Person with End-Stage Kidney Disease
fibrosis: Thickening and scarring of the peritoneum after injury, infection, or long glucose exposure.; Example. Fibrosis can speed transfer, reduce water removal, and end PD.; Module 8 — Peritoneal Dialysis
filtrate: The watery fluid pushed out of blood at the start of urine making.; Example. Most glomerular filtrate is reabsorbed; only a small part becomes urine.; Module 2 — Kidneys and Kidney Failure
fistula: A surgical join of the patient's own artery and vein used for HD access.; Example. A fistula is preferred when vessels can support it because it lasts longer and infects less often than a catheter.; Module 3 — Treatment Options for Kidney Failure
flocculation: Gentle mixing that grows those particle clumps after coagulant is added.; Example. Flocculation is part of city treatment, not the clinic RO chain.; Module 11 — Water Treatment and Equipment
food insecurity: Not always having enough safe, appropriate food.; Example. Food insecurity can worsen labs and missed medicines; connect the patient with the social worker.; Module 4 — The Person with End-Stage Kidney Disease
fouling: A membrane or filter becoming clogged so flow or rejection falls.; Example. A product-flow drop without a pump-pressure change suggests RO fouling.; Module 11 — Water Treatment and Equipment

G

GFR: Glomerular filtration rate: how much blood the kidneys filter over time.; Example. eGFR is an estimate of GFR from blood creatinine and other variables.; Module 2 — Kidneys and Kidney Failure
glomerulus: A tiny capillary tuft that starts filtration of water and small wastes.; Example. Protein in urine can mean the glomerulus is leaking.; Module 2 — Kidneys and Kidney Failure
graft: The donated kidney (or the synthetic tube used as access in later chapters).; Example. A transplant graft may last years, but it is not a guaranteed cure.; Module 3 — Treatment Options for Kidney Failure

H

hardness: Calcium and magnesium in water that can form scale.; Example. Test softener hardness daily; about 17 ppm is the teaching target in this module.; Module 11 — Water Treatment and Equipment
health literacy: How easily a person can understand and use health information.; Example. Low health literacy is not a lack of intelligence; use plain language and pictures.; Module 4 — The Person with End-Stage Kidney Disease
hematocrit: The fraction of blood made of red cells.; Example. A rising hematocrit during UF often means plasma water is falling.; Module 6 — Hemodialysis Devices and Equipment
hematoma: A collection of blood in tissue that can swell and compress the access.; Example. A large hematoma can make the access unusable and force a temporary catheter.; Module 7 — Vascular Access
hemodiafiltration: A treatment that adds high convection plus sterile replacement fluid to HD.; Example. HDF replacement fluid enters blood, so it must be sterile.; Module 5 — Principles of Dialysis
hemodynamic: Related to blood flow, blood pressure, and how the heart handles volume.; Example. Longer HD can reduce hemodynamic stress from rapid fluid shifts.; Module 3 — Treatment Options for Kidney Failure
hemolysis: Rupture of red blood cells.; Example. Overheated or wrongly mixed dialysate can cause hemolysis; do not return that blood.; Module 10 — Infection Control and Hemodialysis Complications
hemoperitoneum: Blood in the drained PD fluid.; Example. Bloody effluent is hemoperitoneum and needs evaluation even if menstruation is a possible cause.; Module 8 — Peritoneal Dialysis
hemostasis: Bleeding that has actually stopped.; Example. Do not release access pressure or send the patient out before hemostasis.; Module 9 — Hemodialysis Procedures
heparin: A common anticoagulant delivered into the extracorporeal circuit.; Example. Heparin helps prevent circuit clots but does not open a kinked line.; Module 6 — Hemodialysis Devices and Equipment
high-flux: A more open membrane that lets larger molecules and more water move.; Example. High-flux is prescribed; it is not automatically better for every patient.; Module 6 — Hemodialysis Devices and Equipment
homeostasis: The body's steady inner balance of fluids, salts, wastes, and other internals.; Example. Kidney failure disrupts homeostasis, so dialysis helps restore some of that balance.; Module 1 — The Dialysis Environment
homeostasis: The body's steady inner balance of water, salts, wastes, and other internals.; Example. Healthy kidneys keep homeostasis within a narrow range; dialysis only partly replaces that work.; Module 2 — Kidneys and Kidney Failure
hyperplasia: Thickening of the inner vessel lining after injury.; Example. Neointimal hyperplasia is a common cause of access stenosis.; Module 7 — Vascular Access
hypertonic: Having a higher solute concentration than blood.; Example. Hypertonic PD fluid pulls more water but is not a technician-chosen upgrade.; Module 5 — Principles of Dialysis
hypotension: Blood pressure that is too low for that patient.; Example. Yawning, sweating, or cramps can be early hypotension during UF.; Module 9 — Hemodialysis Procedures
hypotonic: Having a lower solute concentration than blood.; Example. A hypotonic fluid relative to blood can shift water into cells.; Module 5 — Principles of Dialysis
hypoxia: Not enough oxygen reaching tissues.; Example. Unexplained hypoxia needs escalation; give oxygen only as ordered and within scope.; Module 10 — Infection Control and Hemodialysis Complications

I

icodextrin: A non-sugar polymer used for some long PD dwells.; Example. Purple icodextrin bags need a compatible glucose meter because some meters read falsely high.; Module 8 — Peritoneal Dialysis
immunosuppression: Medicine that lowers immune attack so a transplanted kidney is not rejected.; Example. Recipients need lifelong immunosuppression while the graft works.; Module 3 — Treatment Options for Kidney Failure
implicit bias: An automatic preference that can shape care without conscious intent.; Example. Implicit bias can change how staff hear a patient's complaint.; Module 1 — The Dialysis Environment
incremental: Started at a smaller dose and increased as needed.; Example. Incremental HD may begin with fewer treatments while urine output is still high.; Module 3 — Treatment Options for Kidney Failure
incremental PD: Starting with less than a full standard PD dose while native function remains.; Example. Incremental PD can increase fills or exchanges as residual function falls.; Module 8 — Peritoneal Dialysis
induration: Hard, thickened tissue under the skin.; Example. Tunnel infection may show pain, swelling, and induration along the catheter path.; Module 8 — Peritoneal Dialysis
infiltration: Needle injury that lets blood leak into tissue instead of staying in the vessel.; Example. Poor needle position can cause infiltration and a pressure alarm.; Module 6 — Hemodialysis Devices and Equipment
infiltration: The needle going through the wall so blood leaks into tissue.; Example. Stop the pump quickly if infiltration is suspected; extra flow worsens swelling.; Module 7 — Vascular Access
interdialytic: The time between dialysis treatments.; Example. The two-day interdialytic gap can bring the greatest weight gain and electrolyte risk.; Module 3 — Treatment Options for Kidney Failure
interdialytic: Between treatments.; Example. Interdialytic weight gain is a key clue to fluid intake and thirst.; Module 4 — The Person with End-Stage Kidney Disease
interdisciplinary: Involving several care roles that work together.; Example. Share new hopelessness with the interdisciplinary team rather than handling it alone.; Module 4 — The Person with End-Stage Kidney Disease
interstitial: The fluid space between cells, outside the blood vessels.; Example. After UF removes vascular water, interstitial fluid slowly refills the blood.; Module 5 — Principles of Dialysis
intradialytic: During the dialysis treatment itself.; Example. Intradialytic hypotension can present with cramps, nausea, or dizziness.; Module 5 — Principles of Dialysis
intradialytic: Happening during the treatment.; Example. Intradialytic hypotension often follows rapid fluid removal.; Module 10 — Infection Control and Hemodialysis Complications
ischemia: Not enough arterial blood reaching the hand or fingers.; Example. Cold, painful, or dusky fingers during HD can be access-related ischemia.; Module 7 — Vascular Access
isotonic: Having a similar solute concentration to blood.; Example. Dialysate osmolality is prescribed to stay near an isotonic, physiologic range.; Module 5 — Principles of Dialysis

K

Kt/V: An estimate of delivered urea clearance compared with the patient's body-water volume.; Example. A few minutes lost each treatment can pull Kt/V down over a year.; Module 9 — Hemodialysis Procedures

L

LAL: Limulus amoebocyte lysate testing used to detect endotoxin.; Example. A gel-clot LAL test is positive when the sample clots.; Module 11 — Water Treatment and Equipment

M

malnutrition: Not getting enough of the right nutrients, even if body size looks large.; Example. Malnutrition and obesity can coexist; never assume a larger body is well nourished.; Module 4 — The Person with End-Stage Kidney Disease
maturation: The time an access enlarges and strengthens enough for safe, repeated needles.; Example. Do not assume a fistula is ready just because it is visible; wait for maturation signs.; Module 7 — Vascular Access
methemoglobinemia: A blood problem, sometimes from nitrate, that reduces oxygen carrying and can cause cyanosis.; Example. High nitrate in dialysis water can contribute to methemoglobinemia.; Module 11 — Water Treatment and Equipment
microaggression: A brief comment or action that demeans or stereotypes someone.; Example. A microaggression can harm trust even when no insult was intended.; Module 1 — The Dialysis Environment
modality: The form of treatment chosen, such as HD, PD, or transplant.; Example. Modality choice is individualized, not one-size-fits-all.; Module 1 — The Dialysis Environment
musculoskeletal: Related to muscles, joints, and the skeleton.; Example. Use legs and a wide stance to lower musculoskeletal injury when moving equipment.; Module 9 — Hemodialysis Procedures

N

nephron: The kidney's working filter unit; each kidney has hundreds of thousands of them.; Example. Lost nephrons generally do not grow back, which is why CKD can progress.; Module 2 — Kidneys and Kidney Failure
neuropathy: Nerve damage that can cause pain, numbness, tingling, or weakness.; Example. Uremic neuropathy plus poor blood flow can hide foot injuries.; Module 2 — Kidneys and Kidney Failure
neuropathy: Nerve damage that can cause pain, numbness, or burning.; Example. Neuropathy is a common source of dialysis-related pain and needs reporting, not dismissal.; Module 4 — The Person with End-Stage Kidney Disease
nocturnal: Happening at night, often while the person sleeps.; Example. Nocturnal HD gives more treatment time with slower fluid removal.; Module 3 — Treatment Options for Kidney Failure
nonpunitive: Focused on fixing systems rather than punishing the nearest person.; Example. A nonpunitive safety culture makes near-miss reporting more likely.; Module 10 — Infection Control and Hemodialysis Complications

O

omentum: A fatty apron of tissue in the abdomen that can wrap around a catheter.; Example. Omental wrapping can block PD flow and may need surgery.; Module 8 — Peritoneal Dialysis
orthostatic: A blood-pressure drop that appears when a person stands.; Example. Check for orthostatic change before sending a patient out after dialysis.; Module 9 — Hemodialysis Procedures
osmosis: Water moving across a membrane toward the side with more effective solute.; Example. PD uses osmosis so dextrose in dialysate pulls water from blood.; Module 5 — Principles of Dialysis
osmotic: Related to the pull created by dissolved agents that draw water.; Example. Dextrose is the usual osmotic agent that pulls water into PD fluid.; Module 8 — Peritoneal Dialysis
overfill: Too much fluid left in the abdomen, often from filling without a complete drain.; Example. Overfill can cause severe pressure and is more common with cycler PD.; Module 8 — Peritoneal Dialysis

P

palliative: Care focused on comfort and quality of life rather than curing the disease.; Example. Palliative support can continue when a person chooses medical management without dialysis.; Module 3 — Treatment Options for Kidney Failure
pathogen: A germ that can cause infection.; Example. Cleaning removes soil; disinfection reduces pathogens on an already-clean surface.; Module 10 — Infection Control and Hemodialysis Complications
pericarditis: Inflammation of the sac around the heart.; Example. Sharp chest pain that eases when leaning forward can be pericarditis and is urgent.; Module 2 — Kidneys and Kidney Failure
peritoneum: The living lining of the belly used as PD's exchange membrane.; Example. PD uses the peritoneum and its capillaries instead of an external dialyzer.; Module 8 — Peritoneal Dialysis
peritonitis: Infection of the lining of the belly.; Example. Cloudy PD fluid and belly pain can signal peritonitis.; Module 1 — The Dialysis Environment
peritonitis: Infection of the peritoneal lining of the belly.; Example. Cloudy effluent or new abdominal pain on PD can mean peritonitis.; Module 3 — Treatment Options for Kidney Failure
peritonitis: Infection of the sterile peritoneal space.; Example. Treat cloudy effluent as peritonitis until the team proves otherwise.; Module 8 — Peritoneal Dialysis
permeate: The purified water that has passed through the RO membrane.; Example. Percent rejection compares feed conductivity with permeate conductivity.; Module 11 — Water Treatment and Equipment
PET: Peritoneal equilibration test: a timed study of how fast the membrane transfers solute and water.; Example. A PET after about the first month helps classify slow versus fast transporters.; Module 8 — Peritoneal Dialysis
PHI: Protected health information that can identify a person's health.; Example. Looking up a neighbor's PHI without a work reason is never allowed.; Module 1 — The Dialysis Environment
photocell: A light sensor that can detect a gap or foam in the blood column.; Example. A photocell air detector looks for a change in light through the tubing.; Module 6 — Hemodialysis Devices and Equipment
plasma refill: Water moving from tissues back into blood as UF removes vascular water.; Example. If UF exceeds plasma refill, blood pressure can fall before the goal is reached.; Module 6 — Hemodialysis Devices and Equipment
polypharmacy: Taking many medicines at once, which can raise fall and side-effect risk.; Example. Polypharmacy is one reason dialysis patients may be unsteady after treatment.; Module 9 — Hemodialysis Procedures
potable: Safe enough to drink, which is not the same as safe for dialysis.; Example. Potable municipal water still needs the clinic treatment chain before it touches a dialyzer.; Module 11 — Water Treatment and Equipment
potable: Drinkable city water, which is still not automatically dialysis-safe.; Example. The medical director decides whether water is acceptable for dialysis after a disaster.; Module 12 — Emergency Planning and Response
precipitate: Solid particles that form when dissolved substances come out of solution.; Example. Treat a visible precipitate in a concentrate as a safety problem.; Module 5 — Principles of Dialysis
preemptive: Done before dialysis is needed.; Example. A preemptive transplant may be considered when GFR is about 20 or lower.; Module 3 — Treatment Options for Kidney Failure
preparedness: The ongoing cycle of planning, training, exercising, responding, and improving.; Example. Preparedness is a continuous process, not a binder on a shelf.; Module 12 — Emergency Planning and Response
prerenal: A kidney-function problem caused by not enough blood flow to the kidney.; Example. Severe dehydration can cause prerenal AKI.; Module 2 — Kidneys and Kidney Failure
prophylaxis: Treatment given to prevent infection or disease after a risk.; Example. Report a needlestick at once so post-exposure prophylaxis can start if indicated.; Module 10 — Infection Control and Hemodialysis Complications
proportioning: The machine's mixing of water and concentrates in the right amounts.; Example. Unsafe proportioning can put the machine into bypass.; Module 6 — Hemodialysis Devices and Equipment
pruritus: Itching.; Example. Uremic pruritus may reflect retained wastes, mineral imbalance, or dry skin.; Module 2 — Kidneys and Kidney Failure
pruritus: Itching.; Example. Severe pruritus can break skin and raise infection risk.; Module 10 — Infection Control and Hemodialysis Complications
pseudoaneurysm: Blood leaking through a wall defect and being held only by surrounding tissue.; Example. Repeated area puncture can cause a pseudoaneurysm and rupture risk.; Module 7 — Vascular Access
psychosocial: Related to emotions, relationships, money, housing, and support.; Example. Homelessness or abuse is a psychosocial challenge that needs the nurse and social worker.; Module 4 — The Person with End-Stage Kidney Disease
psychosocial: Emotional, family, housing, and support needs around an emergency.; Example. Social work helps with psychosocial needs and transport after a disaster.; Module 12 — Emergency Planning and Response
PTSD: A lasting trauma response that a licensed professional, not a technician, diagnoses.; Example. Do not diagnose PTSD; refer persistent disaster stress to qualified help.; Module 12 — Emergency Planning and Response
pyrogenic: Caused by fever-triggering contamination, often bacterial products in water or dialysate.; Example. A pyrogenic reaction can look like infection; stop treatment and save samples as directed.; Module 10 — Infection Control and Hemodialysis Complications

Q

QAPI: Quality Assurance and Performance Improvement: the clinic's formal improvement meeting and process.; Example. Emergency-plan updates belong in QAPI even if no disaster happened that year.; Module 12 — Emergency Planning and Response

R

RCA: Root cause analysis: a structured look at why an event happened, including system causes.; Example. RCA is not blame; it asks what in the workflow allowed the error.; Module 10 — Infection Control and Hemodialysis Complications
reabsorption: Taking useful water and solutes from the tubule back into blood.; Example. Reabsorption keeps needed salts from being lost in urine.; Module 2 — Kidneys and Kidney Failure
rebound: A rise in a blood value after treatment as wastes redistribute.; Example. Equilibrated Kt/V accounts for post-treatment urea rebound.; Module 9 — Hemodialysis Procedures
recirculation: Already-cleaned blood being drawn back into the circuit.; Example. Needles that are too close can cause recirculation and lower adequacy.; Module 7 — Vascular Access
recirculation: Saline or blood circulating in the circuit, or already-cleaned blood being redrawn.; Example. Saline recirculation may be used during setup; access recirculation later can lower dose.; Module 9 — Hemodialysis Procedures
regeneration: Rinsing a softener with brine so it can exchange hardness ions again.; Example. Never run softener regeneration during dialysis.; Module 11 — Water Treatment and Equipment
reject water: RO water that did not pass through as product water and never contacts the patient.; Example. Reject water may be reused only if local rules allow; it is not automatically clean.; Module 6 — Hemodialysis Devices and Equipment
rejection: The immune system attacking a transplanted organ as foreign.; Example. New illness after transplant can be rejection and belongs to the transplant team.; Module 3 — Treatment Options for Kidney Failure
renin: A kidney signal that starts the RAAS pathway and can raise blood pressure.; Example. Low kidney blood flow can trigger renin release.; Module 2 — Kidneys and Kidney Failure
residual: What is left over after something is reduced or removed.; Example. Residual kidney function still makes some urine, so fluid needs can differ.; Module 1 — The Dialysis Environment
residual: What kidney work is still left.; Example. As residual kidney function falls, PD may become less effective.; Module 3 — Treatment Options for Kidney Failure
residual: What is left behind, such as leftover disinfectant after a rinse.; Example. Test for residual disinfectant after emergency disinfection before restarting machines.; Module 12 — Emergency Planning and Response
residual disinfectant: Cleaning chemical still left after a disinfection cycle.; Example. Test rinse water so residual disinfectant is gone before the next patient.; Module 9 — Hemodialysis Procedures
residual kidney function: The urine and filtration the patient's own kidneys still provide.; Example. Even small residual kidney function adds clearance and may slow the need for a full PD dose.; Module 8 — Peritoneal Dialysis
resilience: The ability of staff and the clinic to recover function after shock or loss.; Example. Staff resilience includes rest, peer support, and help when distress lasts.; Module 12 — Emergency Planning and Response
resistivity: The inverse of conductivity; a purity check used on DI water.; Example. Do not send DI water to patients if resistivity falls below 1 megohm-cm.; Module 11 — Water Treatment and Equipment
reverse osmosis: Pushing water through a tight membrane that rejects many dissolved ions.; Example. RO is the main purification step; pretreatment protects that membrane.; Module 11 — Water Treatment and Equipment
rinseback: Returning the patient's blood from the circuit at the end of treatment.; Example. Rinseback must avoid air and contamination while conserving blood.; Module 9 — Hemodialysis Procedures
rope-ladder: Rotating needle sites along the usable access segment.; Example. Use rope-ladder on PTFE grafts to avoid weakening one spot.; Module 7 — Vascular Access

S

scope: The tasks a technician is trained, certified, and allowed to do.; Example. A familiar heparin task is still outside scope if the state or clinic does not authorize it.; Module 9 — Hemodialysis Procedures
secretion: Moving selected substances from blood into the tubule for removal.; Example. Secretion helps the kidney clear some wastes and medicines.; Module 2 — Kidneys and Kidney Failure
self-management: The patient learns, chooses, and carries out a plan with team support.; Example. Prefer self-management language over blaming someone for noncompliance.; Module 4 — The Person with End-Stage Kidney Disease
semipermeable: A barrier that lets some particles and water through but not others.; Example. Dialysis works across a semipermeable membrane that separates blood from dialysate.; Module 3 — Treatment Options for Kidney Failure
semipermeable: A barrier that lets selected particles and water through, often based on size.; Example. HD keeps blood and dialysate on opposite sides of a semipermeable membrane.; Module 5 — Principles of Dialysis
shelter-in-place: Staying inside a protected area when going outside is more dangerous.; Example. Shelter-in-place may be safer than evacuation during some outdoor chemical or weather events.; Module 12 — Emergency Planning and Response
sieving coefficient: A number that estimates how readily a solute follows water through the membrane.; Example. The sieving coefficient describes convective passage of a solute.; Module 6 — Hemodialysis Devices and Equipment
solubility: How completely a substance dissolves in a fluid.; Example. Temperature and pH change solubility and can create crystals in dialysate.; Module 5 — Principles of Dialysis
solute: The dissolved substance in a fluid.; Example. Urea is a solute that dialysis tries to remove from blood.; Module 5 — Principles of Dialysis
solvent: The fluid that dissolves other substances.; Example. In blood, plasma water is the solvent carrying electrolytes and wastes.; Module 5 — Principles of Dialysis
steal syndrome: The access taking so much arterial blood that the hand is starved.; Example. Steal syndrome can worsen during dialysis and needs prompt evaluation.; Module 7 — Vascular Access
stenosis: Narrowing that restricts flow and raises pressure.; Example. Stenosis can cause high pressures, prolonged bleeding, or swelling.; Module 7 — Vascular Access
structural: Related to the building's walls, floors, and ability to stand safely.; Example. A structural engineer must clear a damaged building before treatments resume.; Module 12 — Emergency Planning and Response
stunning: Organ injury from repeated low blood flow or oxygen delivery.; Example. High UFR plus symptoms can be a warning of organ stunning.; Module 5 — Principles of Dialysis
surveillance: Scheduled tests and trends used to catch access trouble before the access is lost.; Example. Surveillance looks at flow and pressure trends, not one unexplained number.; Module 7 — Vascular Access
susceptible: Not protected and therefore able to catch the infection.; Example. Staff caring for an HBsAg-positive patient should not also care for susceptible patients when policy forbids it.; Module 10 — Infection Control and Hemodialysis Complications

T

tamponade: Pressure from fluid around the heart that keeps it from filling.; Example. Pericardial effusion can progress to tamponade and is urgent.; Module 10 — Infection Control and Hemodialysis Complications
teach-back: Asking the person to explain the plan in their own words.; Example. Teach-back checks the explanation, not the patient's intelligence.; Module 4 — The Person with End-Stage Kidney Disease
thrill: The buzzing feel of blood flowing through the access.; Example. A missing thrill is urgent; do not cannulate.; Module 7 — Vascular Access
thrombosis: Clot forming inside the access.; Example. No bruit or thrill can mean thrombosis; notify the nurse at once.; Module 7 — Vascular Access
transducer protector: A filter that keeps blood or fluid out of the machine's pressure sensor.; Example. Confirm transducer protectors are dry and correctly seated before treatment.; Module 9 — Hemodialysis Procedures
transient dialysis: Arranged dialysis at another clinic while a person travels.; Example. Transient dialysis needs a receiving center, records, and coverage confirmed before the trip.; Module 4 — The Person with End-Stage Kidney Disease
transmembrane: Across the thin wall that separates blood from dialysate.; Example. Ultrafiltration depends on a transmembrane pressure gradient.; Module 1 — The Dialysis Environment
transmembrane: Across the dialyzer or peritoneal membrane.; Example. The blood pump and dialysate pressure create a transmembrane pressure for UF.; Module 5 — Principles of Dialysis
triage: Sorting people by how urgently they need care when resources are limited.; Example. A triage nurse decides who needs treatment now and who can be rescheduled.; Module 12 — Emergency Planning and Response

U

UFR: Ultrafiltration rate: how fast water is removed during treatment.; Example. A high UFR can exceed plasma refill and cause intradialytic hypotension.; Module 5 — Principles of Dialysis
ultrafilter: A fine filter that reduces bacteria and endotoxin after RO or DI.; Example. Replace or disinfect an ultrafilter when the pressure drop exceeds the clinic limit.; Module 11 — Water Treatment and Equipment
ultrafiltration: Removal of water from blood by a pressure difference.; Example. Ultrafiltration pulls extra fluid off during hemodialysis.; Module 1 — The Dialysis Environment
ultrafiltration: Removing extra water during dialysis by pressure.; Example. Rapid ultrafiltration after a large fluid gain can cause cramps and low blood pressure.; Module 4 — The Person with End-Stage Kidney Disease
ultrafiltration: Water removal into PD fluid, usually pulled by the osmotic agent.; Example. Yellow 1.5% dextrose usually gives the least ultrafiltration; red 4.25% gives the most.; Module 8 — Peritoneal Dialysis
ultrasonic: Using sound waves to sense a change, such as air in a bloodline.; Example. An ultrasonic air detector watches the venous return before blood goes back.; Module 6 — Hemodialysis Devices and Equipment
upstream: Before a component in the flow path.; Example. An upstream sample shows what is entering a tank or filter.; Module 11 — Water Treatment and Equipment
urea: A nitrogen waste used as a practical marker of dialysis clearance.; Example. Urea can rebound after treatment as it moves back from other body spaces.; Module 9 — Hemodialysis Procedures
uremia: Waste buildup plus symptoms such as nausea, itching, or confusion.; Example. Uremia can look vague, so report new itching, nausea, or fatigue.; Module 2 — Kidneys and Kidney Failure

V

viscosity: How thick a fluid is and how much it resists flow.; Example. Higher viscosity can slow diffusion across the membrane.; Module 5 — Principles of Dialysis
vocational: Related to work, job training, or returning to employment.; Example. Vocational-rehabilitation programs may help a person return to school or work.; Module 4 — The Person with End-Stage Kidney Disease
volumetric: Controlled by measuring fluid volume, not only by guessing from pressure.; Example. Volumetric UF control aims to remove the programmed amount of water.; Module 6 — Hemodialysis Devices and Equipment