7. Renal Replacement Therapy and Dialysis Flashcards
What 7 things can the kidneys do?
Salt Removal Water Removal Electrolyte Balance Acid-Base Balance Toxin Removal Make erythropoietin 1-A Hydroxylate Vitamin D
What does Dialysis do?
Salt Removal Water Removal Electrolyte Balance Acid-Base Balance Toxin Removal
What is Haemodialysis?
When blood is filtered across a membrane using a machine
How often is Haemodialysis done?
Minimum of 4 hours, 3 times a week
What are the Principles of Haemodialysis?
- Blood is exposed to a Fluid Dialysate across a Biocompatible Membrane
- Small molecules can pass through, Large cannot
- Concentration gradient allows Diffusion across the membrane
- Removes waste
- Replaces ions/molecules - Water is DRIVEN through the membrane via Ultrafiltration
- UF clears solutes via Convection
What do you require during Haemodialysis for it to work
Anticoagulation (Stops clotting)
Vascular Access (Means of taking blood)
Name three ways of Vascular access for a Haemodialysis machine
- AV fistula
- AV graft
- Tunnelled Catheter
What are the two main dialysis complications?
- Access complications
2. Dialysis complications
Name 6 Access complications of Haemodialysis
- Distal Ischaemia (AVF/G)
- Aneurysm (AVF/G)
- Failure of Access
- Thrombosis
- Central Venous Stenosis (Tunnelled Catheter)
- Infection
Name 3 Dialysis complications of Haemodialysis
- Hypotension
- Reactions to dialysis (Headache/Cramp)
- Inadequate Dialysis dose
What is Peritoneal Dialysis?
Dialysis done at home by patient/care/HCW
Focusing on Patient Autonomy and Self-care
How does PD work?
- Semi-permeable peritoneal membrane lines the abdominal cavity
- Membrane allows diffusion of toxins/electrolytes into the dialysis solution
- UF occurs via osmosis (removes fluid)
- Steady state of toxin clearance and fluid management is achieved due to daily performance of dialysis
What are the Three Main Types of Dialysis?
Haemodialysis - Home/In-centre Peritoneal Dialysis - Home/CAPD and APD Continuous Veno-Venous Haemofiltration - Inpatient treatment in Critical care setting
What does CAPD stand for in Haemodialysis?
Continuous Ambulatory Peritoneal Dialysis
How does CAPD work in Haemodialysis?
- GIve 4-5 Exchanges a day
- Fluid starts in Peritoneal Cavity
- DRAIN: Fluid is drained by gravity in a closed system
- FLUSH: Small amount is flushed into a drain bag to clear the line
- FILL: New fluid runs into peritoneal cavity via closed system
- DWELL: Fluid dwells for 4-6 hours
