Dialysis Flashcards
What is dialysis?
Method for performing the filtration tasks of kidneys artificially in patients with end stage renal failure or complications of renal failure
What are the indications for acute dialysis (severe AKI)?
AEIOU
- Acidosis
- Electrolyte abnormalities
- Intoxication
- Oedema
- Uraemia symptoms
What are indications for long term dialysis?
End stage renal failure (CKD stage 5)
What are the 3 options for maintenance dialysis?
Continuous ambulatory peritoneal dialysis
Automated peritoneal dialysis
Haemodialysis
What is peritoneal dialysis?
Uses the peritoneal membrane as the filtration membrane
Special dialysis solution containing dextrose is added to the peritoneal cavity
Ultrafiltration occurs across the peritoneal membrane into the dialysis solution
Dialysis solution is then replaced
What is used to insert and remove dialysis solution in peritoneal dialysis?
Tenckhoff catheter
What is continuous ambulatory peritoneal dialysis?
Dialysis solution in the peritoneum at all times
Changed 4 times a day
What is automated dialysis?
Peritoneal dialysis overnight (8-10 hours)
What are some complications of peritoneal dialysis?
Bacterial peritonitis
Peritoneal sclerosis
Ultrafiltration failure
Weight gain
Psychosocial effects
What is haemodialysis?
Blood filtered by haemodialysis machine
4 hours a day for 3 days a week
What are the options for blood supply in haemodialysis?
Tunnelled cuffed catheter
Arterio-venous catheter
What is a tunnelled cuffed catheter?
Tube inserted into subclavian or jugular vein with a tip sitting in the SVC or right atrium
What is AV- fistula?
Artificial connection between an artery and a vein
- Permanent, large, easy access blood vessel with high pressure arterial blood dlow
- Requires surgical operation and maturation period
What are common locations for A-V fistulas?
Radio-cephalic
Brachio-cephalic
Brachio-basilic (less common)
What are the complications of A-V fistulas?
Aneurysm
Infection
Thrombosis
Stenosis
STEAL syndrome
Heart failure
