Dialysis Flashcards
What’s the difference between haemodialysis and haemofiltration?
uses replacement fluid rather than dialysate
What are the complications of AV fistula?
steal syndrome, bruising/haematoma, aneurysmal fistula
What is dialysis disequilibrium syndrome?
cerebral oedema due to osmotic effects of urea - to prevent start dialysis slowly
What is dialysis related amylodosis?
due to long term accumulation of beta 2 microglobulin which isn’t dialysed off - doesn’t happen often anymore due to change in machines
Why can’t you use peritoneal dialysis lifelong?
the membranes sclerose due to the high glucose load
What is the difference between CAPD and APD?
CAPD: continuous ambulatory PD - involves manual changing of the bags
APD: automated PD - machine does the exchanges
How can you tell what type of peritoneal membrane a patient has?
by doing a peritoneal equilibration test (PET) - will tell you if they are fast, slow or average
What is an alternative to glucose for PD fluid?
icodextrin
What is the typical presentation for PD peritonitis?
abdominal pain and cloudy peritoneal fluid
How can you determine if there is a diaphragmatic leak leading to PD causes pleural effusion?
peritoneal scintigraphy
What is encapsulating peritoneal sclerosis?
a progressive inflammatory process that causes fibrosis of the peritoneum which can lead to small bowel obstruction
What are the relative contraindications to PD?
abdominal hernia, previous abdominal surgery, high BMI, poor dexterity/vision/strength
What are the absolute contraindications to PD?
non compliance, psychiatric issues, inability to maintain hygiene/sterile environment, poor social circumstance
What are the acute indications for RRT?
fluid overload
acidosis
hyperkalaemia
uraemia
What are the indications for starting dialysis in CKD?
fatigue, difficulty concentrating, loss of appeitite/weight loss, metallic taste, itch
OR any acute indications
