Renal emergencies

Question 1

What is the criteria for diagnosing bacterial peritonitis in a patient with a PD catheter?

Answer 1

> 100 WCC/ml with >50% Neutrophils
And/Or
Bacteria on gram stain (10-40% sens)

Must be on a sample with at least 2hrs of dwell time

Must also have one of
- Consistent clinical features
- Positive effluent culture/Gram stain

Question 2

What are the indications for dialysis?

Answer 2

• Refractory acidosis
• Refractory fluid overload
• Toxins
• Complications from uremia ie serositis, encephalopathy
• Refractory hyperkalaemia

Question 3

What are the organisms that typically cause bacterial peritonitis from PD catheters?

Answer 3

S. epidermidis
S. aureus
E. coli
Klebsiella
Enterococcus
Streoptococcus

Question 4

What is the typical treatment for PD catheter peritonitis?

Answer 4

Cefazolin 500mg/L dialysate followed by 125mg/L dialysate with every subsequent exchange
AND/OR
Vancomycin 2gm followed by 20mg/L of dialysate with every subsequent exchange

Question 5

What are the different medications used to treat hyperkalaemia and how long do they take/last?

Answer 5