Dialysis Flashcards
Since the use of long term dialysis the …
UK renal replacement therapy population is increasing
what are the types of renal replacement therapy
- Haemodialysis
- Peritoneal dialysis
- kidney transplant
What is the function of the kidneys
- Salt removal
- Water removal
- Electrolyte balance
- Acid-base balance
- Toxin removal
- Make erythropeitin
- 1-α hydroxylate vitamin D
What can dialysis do that the kidney can also do
- Salt removal
- Water removal
- Electrolyte balance
- Acid-base balance
- Toxin removal
SWEAT
How do you replace the erythropoietin that the kidney makes
- can give EPO subcutaneously or intravenously to replace what the kidneys would have made
How can you give 1 alpha - hydroxylate vitamin D
Give oral 1 alpha hydroxylate vitamin D
Name the two types of dialysis
- Haemodialysis
- Peritoneal dialysis
where can you give Haemodialysis
• Can be done at home but (in the UK) is usually done haemodialysis units (either standalone or in hospital)
where can you give peritoneal dialysis
at home
What are the two types of peritoneal dialysis
Continuous ambulatory peritoneal dialysis (CAPD)
Ambulatory peritoneal dialysis (APD)
when is continuous veno-venous haemofiltration used
- Usually an inpatient treatment in a critical care setting
What is continuous veno-venous haemofiltration
Continuous Veno-Venous Hemofiltration (CVVH) is a temporary treatment for patients with acute renal failure who are unable to tolerate hemodialysis and are unstable
- used in critical care when HD is not possible due to low blood pressure
- not used for chronic RRT unless in combination with HD
How is haemodialysis done basically
• Blood is filtered across a membrane using a machine
How many times does haemodialysis have to be done a week and for how long
• Minimum of 4 hours three times per week
Describe the mechanism of action of haemodialysis
- Blood is exposed to fluid dialysate across a biocompatible membrane
• Small molecules pass through the pores, large molecules such as albumin do not
• A concentration gradient allows diffusion of molecules across the membrane, enabling removal of waste products and replacement of desirable molecules or ions
• Water is driven through the membrane by hydrostatic force (ultrafiltration or UF)
• UF can also clear some solutes via convection - pressure monitors keep an eye on the flow rate and any sign of pressure change which means bleeding
- dialyser - this is the membrane and where the diffusion takes place
what does haemodialysis require
– vascular access (a means of taking blood to and from the patient)
– Anticoagulation (prevent clotting in the circuit)
What should you take while you are on haemodialysis
– Anticoagulation (prevent clotting in the circuit)
What is the area in the dialysis machine where the semipermeable membrane is
- dialyser - this is the membrane and where the diffusion takes place
what are the three types of vascular access used in haemodialysis
- AV fistula - most common and most optimum
- AV graft
- Tunnelled catheter
Describe an AV fistula
- most common used
- most optimum
How do you form an AV fistula in the arm
- surgical procedure takes place between an artery and vein in the arm
Can be:
- Radial Cephalic fistula.
- Brachial Cephalic.
- Brachial Basilic Transposition.
What are the types of AV fistulas
Radial Cephalic fistula.
Brachial Cephalic.
Brachial Basilic Transposition.
Describe how an AV graft works
- when PTFE graft is placed between the artery and the vein and the graft can be used for dialysis
- plastic tube that links the artery and vein
described tunnelled Catheter
- Cather that sits in the central vessels
- tunneled under the skin and comes up in the chest wall
