Final study guide: HD and CRRT

Question 1

two types of renal replacement therapies

Answer 1

 Intermittent hemodialysis
 Continuous renal replacement therapy (CRRT)

Question 2

Intermittent HD: what (2)

Answer 2

 Separates and removes from the blood excess electrolytes, fluids and toxins
 Treatments last 3 – 4 hours a day

Question 3

Intermittent HD: Hemodialyzer (artificial kidney) (3)

Answer 3

 Blood flows in one end
 Dialysate bath through the other end
 They “meet” at the membranes and through osmosis and diffusion fluid, electrolytes and toxins are exchanged

Question 4

Intermittent HD: Ultrafiltration (to remove fluid) (3)

Answer 4

 Positive hydrostatic pressure is applied to blood
 Negative hydrostatic pressure is applied to the dialysate bath
 The two forces together create transmembrane pressure to simultaneously push and pull the excess fluid from the blood

Question 5

Intermittent HD: Anticoagulation (3)

Answer 5

 Heparin (sodium citrate) is added to the blood just before it enters the dialyzer
 The blood won’t clot (hemolyze) as it goes through the machine
 Short half-life and dialyzes out

Question 6

Intermittent HD: Vascular access (1)

Answer 6

Most common sites are subclavian and femoral veins for temporary acute access

Question 7

Continuous Renal Replacement
Therapy (CRRT): what

Answer 7

Used specifically for patients who are hemodynamically unstable and can be on therapy for greater than 12 hours and up to several days

Question 8

CRRT: 4 types

Answer 8

 Slow continuous ultrafiltration
 Continuous Venovenous hemofiltration
 Continuous Venovenous hemodialysis
 Continuous Venovenous hemodiafiltration