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DPD > Dialysis for Nephropathy > Flashcards

Dialysis for Nephropathy Flashcards

1
Q

What are the implications of renal failure?

A

Electroylyte imbalance; hyperkalemia, hyponatremia

Acidosis
Fluid retention
??
Secretory failure

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2
Q

Symptoms of renal failure

A 
Tiredness
Lethargy
SOB + oedema
Pruritis
Nocturia (osmotic diuresis)
Feeling cold
Twitching
Poor appetite 
Nausea
Loss of taste
Weight loss
Anaemia
Renal bone disease - aches and pains, pruritis
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3
Q

What are the consequences of renal failure? How do people present?

A 
Hyperkalemia - arrthymias, cardiac arrest
Pulmonary oedema
NV
malnutrition
Fits
Coma
Death
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4
Q

Name two types of dialysis and where they happen

A

Peritoneal dialysis - home

Haemodialysis - hospital based

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5
Q

When do you the convo about starting dialysis?

A

If eGFR is below 20ml/min

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6
Q

Peritoneal dialysis needs

A

Catheter in abdomen

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7
Q

Haemodialysis needs

A

Fistula

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8
Q

When do you actually start dialysis?

A

<6ml/min eGFR

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9
Q

Benefits of dialysis

A

Improves uremic symptoms e.g. tiredness, nausea and pruritis
Corrects fluid balance
Avoids life threatening events like severe acidosis
Severe hyperkalaemia
Pulmonary oedema resistant to diuretics

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10
Q

Risks of dialysis

A

Infection
Hypotension arrhythmias - HD
Access-related

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11
Q

Dialysis does not treat

A 
Lack of erythroprotein
Lack of vit D 
Lupus
Diabetes
Vascular disease
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12
Q

Explain the regimen of haemodialysis

A

3x a week
4hrs
takes 6hr to travel

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13
Q

Explain the regimen of peritoneal dialysis

A

Home based
Daily and continuous
Less haemodynamic stress (less drops in BP)

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14
Q

What are the advantages of peritoneal dialysis?

A

Less dietary and fluid restrictions
Maintains independence
Easier to travel and work

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15
Q

What causes the fits?

A

Uremic toxins damage

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16
Q

What is the advantage of transplatnion over dialysis?

A 
Better renal replacement
Improvement in metabolic disorders like anemia and renal bone disease
Costs less long term
Prolonged survival
Better QOL
17
Q

Problems with transplants?

A

Older and sicker patients aren’t eligible
Immunosuppression caused infection
Rejection

18
Q

What is important for patients?

A 
Ability to travel 
Dialysis-free time
Fatigue
Anaemia
Impact on family/friends
Washed out after dialysis
19
Q

What does it mean to become nephrotic?

A

Proteinuria more than 3g
Protein/creatine ratio of above 300
Low albumin
oedema

????

20
Q

Is there a survival advantage for people starting dialysis after the age of 75?

A

No…

21
Q

What is the alternative for dialysis?

A

Conservative care

Active management of anaemia
Fluid balance

DPD (38 decks)

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