Acute Indications for Dialysis Flashcards
What are the indications for dialysis?
Acidosis with pH <7.1 refractory to management
Electrolyte imbalances - severe hyperkalemia
Ingestion of toxins
Overload
Uremia - pericarditis, encephalopathy
Indications for kidney transplant
Glomerulonephritis
Diabetic nephropathy
Polycystic kidney disease
Renal hypoplasia
What is the optimum position of a patient for a renal examination?
45 degrees
Arms side by side, palms facing up
Legs uncrossed
What are you looking for on inspection?
Scars
Cachexia
Complexion - yellow for uremia, pallor for anaemia
Cushingoid features - steroids
SOB - oedema
Tachycardia
What might you see at the bedside?
- Dialysis machine
- Urinary catheters
- Nephrostomy drains
- Medications – e.g. steroids
- Fluid balance chart
- Mobility aid
What are you looking for on the hands/fingers?
Koilonychia
Leukonychia
Gouty tophi - urate crystals
Meuhercke’s lines - hypoalbuminemia
Beau’s lines - malnutrition
Lindsay’s half and half - dialysis
What do Meuhercke’s lines indicate? What do they look like?
Hypoalbuminemia
Horizontal double lines across nail
What do Beau’s lines look like? What do they mean?
Virtually a dent in the middle of the nail suggesting malnutrition
What does leukonychia look like and what does it mean?
White stripes on the nail
Damage to nail
What does Lindsay’s half and half look like and mean?
Top half of the nail is another colour from the bottom half
Seen in dialysis patients
