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Y2 Renal > Dialysis > Flashcards

Dialysis Flashcards

1
Q

what is diffusion?

A

the process by which particles move from an area of high concentration to an area of low concentration, across a semi-permeable membrane

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2
Q

name two factors that affect diffusion

A

concentration gradient

molecular weight of solute

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3
Q

name four toxins that can be removed by dialysis

A

urea
creatinine
potassium
sodium

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4
Q

what can be infused during dialysis and how?

A

bicarbonate

concentration is higher in the dialysate than the blood so it diffuses

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5
Q

what flow rate is required for haemodialysis to be effective?

A

300-350 ml/min

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6
Q

what are the four vascular access options for haemodialysis?

A

arteriovenous fistula
arteriovenous graft
tunnelled central venous catheter
temporary venous catheter

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7
Q

what is another name for a temporary venous catheter?

A

vasacath

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8
Q

what vascular access would be used in someone requiring acute short term dialysis?

A

temporary venous catheter

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9
Q

at what rate is dialysate usually ran at in haemodialysis?

A

500ml/min

= around 120L in a four hour treatment

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10
Q

what does dialysate consist of?

A

pure water
electrolytes (Na, K, HCO3)
glucose

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11
Q

how is excess fluid removed from a patients blood during dialysis?

A

a pressure gradient is set up between blood and dialysate

this forces water and all of the solutes in it to leave the blood

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12
Q

what is the movement of water out of the blood in dialysis called?

A

the convective solute drag

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13
Q

what is the whole process of water loss and the solute drag in dialysis called?

A

ultrafiltration

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14
Q

what is the usual range set for ultrafiltration in a dialysis session?

A

1-3L

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15
Q

what is affected by adsorption?

A

plasma proteins

any solutes bound to them

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16
Q

what happens to plasma proteins in adosrption?

A

become stuck to the membrane of the dialysis kidney

removed by membrane binding

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17
Q

how is most solute removed in haemodialysis?

A

diffusion

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18
Q

how is most solute removed in hemodiafiltration?

A

convection

massive amounts of ultrafiltration

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19
Q

what defines high volume hemodiafiltration?

A

replacement volumes of >21 L

20
Q

what can improve the efficiency of dialysis?

A

longer treatment times

21
Q

what is the usual dialysis schedule?

A

four hours

three times a week

22
Q

what four things need to be restricted in the diet if someone is on dialysis?

A

fluid
salt
potassium
phosphate

23
Q

how much fluid can an anuric dialysis patient consume a day?

A

one litre

24
Q

how much salt should a dialysis patient consume per day?

A

less than 2.3g

25
Q

if the phosphate levels remain high in a dialysis patient, what do they need to take?

A

phosphate binders with meals

26
Q

what is a tunnelled central venous catheter?

A

a catheter inserted into a large vein

27
Q

what vein is often used for a TCVC?

A

internal jugular

28
Q

what are the pros of TCVC?

A

easy to insert

can be used immediately

29
Q

what is there high risk of in a TCVC?

A

infection

30
Q

what is the most common cause of an infection of a TCVC?

A

staph aureus

31
Q

what antibiotics should be given for an infected TCVC?

A

vancomycin and gentamicin

32
Q

what is the gold standard for dialysis vascular access?

A

an arteriovenous fistula

33
Q

what is an AVF?

A

when an artery and vein are surgically created for dialysis access

34
Q

what are the three possible sites for an AVF?

A

radio cephalic
brachio cephalic
brachio basilic transposition

35
Q

how is an AVF formed?

A

surgically

36
Q

when can an AVF be used?

A

after a maturation period of 6-12 weeks

37
Q

what is it called when an AVF limits blood flow to the distal arm?

A

steal syndrome

38
Q

if a patient cannot have an AVF, what are the next best options?

A

arteriovenous graft

HeRo graft

39
Q

what is a life threatening complication of an AVF?

A

rupture causing massive haemorrhage

40
Q

what acts as the semi permeable membrane in peritoneal dialysis?

A

the peritoneum

41
Q

how are solutes removed in peritoneal dialysis?

A

by diffusion of solutes across the peritoneal membrane

42
Q

how is water removed in peritoneal dialysis?

A

osmosis driving by the high glucose concentration of the dialysate

43
Q

what are the two types of peritoneal dialysis available?

A

continuous ambulatory peritoneal dialysis (CAPD)

automated peritoneal dialysis (APD)

44
Q

which PD is done overnight?

A

automated PD

45
Q

what are three possible complications of peritoneal dialysis?

A

infections
peritoneal membrane failure
hernias

46
Q

what needs to be done if there is peritoneal membrane failure in someone on peritoneal dialysis?

A

switch to haemodialysis

Y2 Renal (29 decks)

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