Haemodialysis Flashcards
What is haemodialysis?
Haemodialysis is a renal replacement therapy that filters blood using an external dialyser to remove waste products and excess fluids.
What are the main types of haemodialysis?
The two main types are conventional haemodialysis (sessions lasting about four hours, three times a week) and continuous haemodialysis used in critical care.
What are the primary indications for initiating haemodialysis?
Indications include severe metabolic acidosis, refractory hyperkalaemia, toxin ingestion, refractory pulmonary oedema, and symptomatic uraemia.
How does a dialyser work in haemodialysis?
A dialyser is an artificial kidney that uses a semipermeable membrane to filter waste products and excess electrolytes from the blood.
What vascular access options are available for haemodialysis?
Options include arteriovenous fistulas, arteriovenous grafts, and central venous catheters, with fistulas preferred for long-term use.
What are common complications associated with haemodialysis?
Complications include hypotension, muscle cramps, itching, sleep disturbances, and access-related issues like infection or thrombosis.
How is fluid balance managed in patients undergoing haemodialysis?
Fluid balance is managed by restricting fluid intake and using ultrafiltration during dialysis to remove excess fluid.
What dietary restrictions are typically recommended for haemodialysis patients?
Patients are advised to limit potassium, phosphorus, sodium, and fluids while ensuring adequate protein intake.
How does haemodialysis differ from peritoneal dialysis?
Haemodialysis uses an external machine and dialyser, often in clinical settings, while peritoneal dialysis uses the patient’s peritoneum as a filter at home.
What is the role of anticoagulation during haemodialysis?
Anticoagulation, usually with heparin, prevents clotting in the extracorporeal circuit during haemodialysis.
How often do patients typically undergo haemodialysis sessions?
Patients typically undergo haemodialysis three times a week, with each session lasting about four hours.
What is an arteriovenous (AV) fistula, and why is it preferred for haemodialysis access?
An AV fistula is a surgically created connection between an artery and a vein, offering lower risks of infection and thrombosis compared to other access types.
What are the potential risks of using central venous catheters for haemodialysis access?
Risks include higher rates of infection, thrombosis, and central vein stenosis compared to AV fistulas or grafts.
How does haemodialysis help manage hyperkalaemia in patients with kidney failure?
Haemodialysis removes excess potassium from the bloodstream, correcting hyperkalaemia.
What is the significance of dialysis adequacy, and how is it measured?
Dialysis adequacy measures how effectively haemodialysis removes waste products, often assessed using Kt/V or urea reduction ratio.
How can patients manage the common side effect of muscle cramps during haemodialysis?
Muscle cramps can be managed by adjusting ultrafiltration rates, ensuring hydration, and using medications like quinine or vitamin E if needed.
What lifestyle modifications are recommended for patients on haemodialysis?
Recommendations include adhering to dietary restrictions, managing fluid intake, exercising regularly, and avoiding smoking and alcohol.
How does haemodialysis impact medication management in patients?
Some medications are removed during dialysis, requiring dose adjustments or timing changes to maintain their effectiveness.
What psychological support options are available for patients undergoing haemodialysis?
Support options include counselling, support groups, and access to mental health professionals experienced with chronic illness.
How does haemodialysis affect a patient’s daily life and work schedule?
Haemodialysis requires significant time, impacting daily activities and work, but many patients can work with flexible scheduling and support.
What is the role of the multidisciplinary team in managing patients on haemodialysis?
The team includes nephrologists, dialysis nurses, dietitians, social workers, and technicians working together for comprehensive care.
How can patients prevent infections related to haemodialysis access sites?
Patients should maintain proper hand hygiene, clean and inspect access sites regularly, and follow aseptic techniques during dialysis.
What are the signs and symptoms of dialysis disequilibrium syndrome?
Symptoms include headache, nausea, vomiting, restlessness, blurred vision, muscle twitching, seizures, or coma during or after dialysis.
How is dialysis disequilibrium syndrome managed and prevented?
Management includes slowing or stopping dialysis, administering hypertonic saline or mannitol, and preventing it by starting dialysis with shorter sessions.
What factors influence the choice between haemodialysis and peritoneal dialysis?
Factors include the patient’s medical condition, lifestyle, home environment, and personal preferences, discussed with the healthcare team.
