dialysis Flashcards
indications for starting emergency dialysis
hyperkalaemia // eGFR <7 // urea >40 // unresponsive met acidosis
what is eGFR renal failure
<15
symptoms renal failure
SOB, fatigue, itch, can’t eat, N+V, muscle cramp, anxiety + depression,
frequency of haemodialysis
3/wk for 3-5 hours each
what is removed and replaced in haemodialysis
out = urea, K, Na // in = water, HCO3, glucose
dietary restrictions dialysis
1L fluid // low salt // low K // low phosphate
gold standard access for dialysis
AV fistula
how long do fistulas take to develop
6-8 weeks
sites for AV fistula
Radio-cephalic / Brachiocephalic / Brachio-basilic
SE AV fistulas (4)
infection, thrombosis, stenosis, steal syndrome
what is a tunnelled venous catheter
catheter –> large vein eg internal jugular (not preferred anymore)
what drives waste exchange in PD
dextrose in dialysis solution
what is Continuous ambulatory peritoneal dialysis (CAPD)
exchange lasts 30-40 minutes then dialysis solution inserted into abdomen for 4-8 hours // patient can go about day with solution in abdomen // 4x2L per day
what is automated peritoneal dialysis (APD)
dialysis machine fills and drains abdomen whilst patient is sleeping // 3-5 exchanges over 8-10 hours
when is PD preferred
when patients do not want to enter hospital 3x a week
commonest complication PD
peritonitis
orgnaism peritonitis
1 = staph epi // 2 = staph A // sometimes gram-ives from gut
mx peritonitis
vanco + ceftazidime into PD // OR vanco into PD + cipro oral
what antigens are present on type O blood
none
who can type O blood donate + recieve
donate to everyone // receive only
who can type O blood donate + recieve
donate to everyone // receive only O
who can type AB donate + recieve from
receive everyone only donate to AB
what are the 4 most important HLA alleles + which are most important to match
DR most –> B –> A (–> C least)
what happens if the body encounters and HLA allele not found within the body
sensitising event –> activate T cells –> auto-antibodies
