Dialysis Flashcards
Minimum time spent on dialysis
4 hours, three times a week
Diet restrictions put on patient
Fluid
If anuric 1litre per day (including food based fluid)
Salt
Low salt diet to reduce thirst and help with fluid balance
Potassium
Low potassium diet.
Banana’s, chocolate, Potatoes, Avocado
Phosphate
Low phosphate diet
Phosphate binders with meals (6-12 pills per day)
Gold standard of dialysis access
Fistula
What is a fistula?
Joins an artery and a vein to make an enlarged thick walled vein called an ateriovenous fistula
Pros of fistula
Good blood flow
Unlikely to cause infection
Cons of fistula
Requires surgery
Required maturation of about 6 weeks before can be used
Can limit blood flow to distal arm “steal”
Can block
What is a tunneled venous catheter?
A catheter inserted into a large vein -jugular, subclavian or femoral
Pros of a tunneled catheter
Easy to insert
Can be used straight away
Cons of a tunneled venous catheter
High risk of infection
Can cause damage to veins making placing replacements difficult
Become blocked
Antibiotics if tunneled venous catheter gets infected
Vancomycin
You may need to consider line removal or exhange
What happens if you leave an infected tuneled venous catheter untreated
Endocarditis
Discitis
Death
CAPD
Continuous peritoneal dialysis
4 Bag exchanges per day
Fluid drained then fresh fluid instilled
½ Hour per exchange
APD
Automated peritoneal dialysis
1 Bag of fluid stays in all day
Overnight machine drains in and out fluid for 9-10 hours per night
In peritoneal dialysis, if the membrane fails and not enough water is removed, the body can become fluid overloaded. What do you have to do?
Switch to haemodialysis
Why is there an increased chance of hernias with peritoneal dialysis?
Increased intra-abdominal pressure
-This requires hernia repair and smaller fill volumes
