renal replacement therapies Flashcards
what are indications for dialysis
AEIOU acidosis electrolyte imbalances - hyperkalaemia intoxication - overdose oedema uraemia
what is continuous ambulatory peritoneal dialysis
peritoneum membrane is used as a filter
dialysis solution containing dextrose is pumped in to make a gradient and blood gets filtered
waste is removed
what are side effects of continuous and overnight ambulatory peritoneal dialysis
weight gain
thickening of membrane/sclerosis
infection
social and psychological effects
what is overnight ambulatory peritoneal dialysis
same as ambulatory but done over night
what is haemodialysis
machine filters blood
need at least 4hrs a day, 3 days a week
blood is accessed from a fistula or tunnelled cuffed catheter
NEVER TAKE BLOOD FROM A FISTULA - IT IS ONLY FOR DIALYSIS
what can you inspect on a fistula site
aneurysms
skin integrity
palpable thrill
machinery murmur on auscultation
what are side effects of haemodialysis
steal syndrome if fistula
what is an indication for renal transplant
end stage renal disease - GFR less than 15
bicarbonate less than 10mmoles/l
how is the new kidney fitted in
in the suprapubic area
old kidneys are not removed
artery and vein are attached to external iliac artery and veins, ureter attached directly to bladder
how is rejection avoided
match kidney to patient by HLA types
life long immunosuppression - prednisolone, tacrolimus, mycophenolate
what investigations would you do in renal transplant
post op vascular scan to see if new kidney is well perfused
biopsy to look for any signs of rejection like immune cells
