Renal Replacement Therapies

Question 1

What are the 3 blood priming methods for dialysers

Answer 1

Recirculating

Buffer the blood

Baby buffer/bleed on

Question 2

Name three priming solutions for dialyzers

Answer 2

1. Saline for large dogs
2. Hetastarch
3. Blood

Question 3

What size molecule is urea

Answer 3

60 Daltons

Question 4

What is Kuf and it’s definition

Answer 4

Kuf is the ultrafiltration coefficient
Defined as ml of fluid transferred per hour per mmHg of transmembrane pressure

Question 5

Intermittent haemodialysis IHD uses what predominant method

Answer 5

Ultrafiltration

Question 6

What is the minimum transmembrane pressure required for ultrafiltration?

Answer 6

25mmHg

Question 7

What complication is there for using blood as a dialyser primer?

Answer 7

blood can react to AN 69 within synthetic dialyzer membranes causing release of bradykinin

Question 8

Name reasons for haemodialysis use

Answer 8

Azotaemia
Hyperkalaemia
Toxins
Acid/base disturbances
Fluid overload

Question 9

What is the major determinant of clearance of urea

Answer 9

Blood flow rate

Question 10

Name 3 theories of dialysis disquilibirum syndrome

Answer 10

Rapid removal of urea or reverse urea effect

Rapid correction of acidosis and paradoxical CNS acidosis

Idiogenic osmole changes

Question 11

What size of molecules does diffusion remove

Answer 11

60-113Da

Question 12

What size of molecules does convection remove

Answer 12

50-60,000 Da

Can also remove small amounts of larger size molecules e.g >60k Da

Question 13

Name the stages of AKI

Answer 13

Insult
Initiation
Extension
Maintenance
Recovery

Question 14

Name three theories of why dialysis disequilibrium syndrome develops?

Answer 14

Reverse Urea effect

Cns

Idiogenic osmoles