Dialysis Flashcards
What toxins are removed during dialysis?
urea
potassium
sodium
What is the point of dialysis?
remove toxins from the blood that build up in end stage renal disease - allows the infusion of bicarbonate
What is absorbed into the blood during dialysis?
bicarbonate
What absorb the plasma proteins that stick to the membrane surface?
high flux membranes
What is haemodialysis?
blood is passed over a semi permeable membrane against dialysis fluid flowing in the opposite direction
What is used to clear excess fluid in haemodialysis?
convective solute drag - hydrostatic gradient
What is the preferred access for haemodialysis?
arteriovenous fistula
What is the process of ultrafiltration?
H2O goes from the blood to the dialysis fluid
What is haemodiafiltration?
the greater the convective force, the greater the generated volume of pressure driven ultrafiltrate
What helps haemodiafiltration?
larger volumes of ultra filtrate that create a positive pressure to clear water
What is smoother and less symptomatic - HD or HF?
haemodifiltration
What does haemodiafiltration rely on?
water flux membrane pore size hydrostatic pressure difference viscosity of fluid size, shape and electrical charge of each molecule
What is the difference between HD and HF?
in HF a replacement volume must be given directly back to the patients circulation
What must the patient change, lifestyle wise, while being on dialysis?
salt restriction
phosphate restriction
potassium restriction
What are the pros of a tunneled venous catheter?
easy to insert into the jugular vein
What are the cons of a tunneled venous catheter?
prone to infection
can become blocked
can cause damage - stenosis/thrombosis
What pathogen commonly causes catheter infections?
staph aureus
How are catheter infections treated?
IV vancomycin and gentamicin
What is the gold standard dialysis access?
fistula
What are the different types of fistula?
brachio cephalic
radio cephaic
brachio basillic
What are the complications of dialysis?
intra-dialytic hypotension (H20 removed 3 times a week instead of continuously so under filling of intravascular space and low BP)
cadiac arrest
haemorrhage
arrhythmia
What is peritoneal dialysis?
solute removal by diffusion of solutes across the peritoneal membrane
water is removed by osmosis which is driven by high glucose concs in dialysate fluid
In peritoneal dialysis, what goes into the blood?
glucose
In peritoneal dialysis, what goes into the perioneal fluid?
Na
urea
K
H20
How is peritoneal dialysis done?
continous ambulatory peritoneal dialysis - into a bag (4 bag exchanges a day)
automated peritoneal dialysis (1 bag stays in all day)
What causes disequilibrium syndrome?
too rapid correction of uraemic toxin levels
What is disequilibrium syndrome?
cerebral oedema
confusion
seizures
death
