Dialysis Flashcards
Dialysis has a lot of problems associated with it.
Aside from usually having to spend 3-4 hours multiple times per week… lots of other problems.
Particularly, cardiovascular disease.
2 major types of dialysis?
Hemodialysis.
Peritoneal dialysis.
2 main tasks to be accomplished in dialysis?
Ultrafiltration (fluid removal).
Solute removal.
What does “dry weight” refer to?
It’s not really the dry weight, but it refers to the patient’s weight right after dialysis is done.
Weight gained between dialysis sessions is considered to be water, and that must be taken often off.
What doesn’t dialysate (the fluid on the other side of the membrane from the blood) contain?
BUN, Cr, and other undesirable solutes - so that these can be efficiently removed.
3 ways to achieve hemodialysis access?
Arteriovenous fistulae.
Grafts.
Double lumen central vein catheters.
Why isn’t a normal vein good enough for hemodialysis?
It can’t deliver the 350-500ml/min of blood necessary.
A fistula can be formed by plugging an artery into a vein -> increased flow (and muscularity) with time.
What’s a dialysis graft?
Some artificial tubing linking artery to vein.
The graft gets stuck with the needles.
Big downside of fistulae vs. other forms of access?
They take weeks to mature.
other methods have higher risk for clotting and infection
If you needed to give somebody hemodialysis right away for acute kidney failure, what form of access would be best?
Intravenous catheter - goes into SVC.
What percentage of normal clearance is achieved by 3x/wk in-center chronic dialysis?
Only about 10%.
this method also mandates unpleasant dietary restrictions
At home dialysis is nice.
It is, if the patient can handle it and has a partner to help.
Peritoneal dialysis is pretty simple.
Yeah. Just put the dialysis fluid into the peritoneal cavity, let it sit there for a while, then drain it.
2 types of peritoneal dialysis?
Continuous ambulatory peritoneal dialysis (CAPD) - manual.
Continuous cycler-assisted PD (CCPD) - automatic. Can be done overnight.
In acute injury, how must dialysis be different?
Basically, the hemodialysis must be done more frequently, or continuously.
