Renal Replacement Therapy

Question 1

When do guidelines say that dialysis should be started?

Answer 1

when GFR is less that 15L/min

Question 2

What must must a patient have to be started on haemodialysis?

Answer 2

an arteriovenous fistula

Question 3

What is haemodialysis?

Answer 3

blood passes past a semi-permiable membrane one way while dialysis fluid flows the other was so that filtrates pass into machine by diffusion

Question 4

what are the problems with haemodialysis?

Answer 4

disequilibration syndrome
hypotension
arrythmias
time consuming
fistula thrombosis, stenosis, infection, blockage

Question 5

what is haemofiltration?

Answer 5

dialysis where blood is filtered across a highly permiable membrane which removed waste products by convection

Question 6

when is haemoflitration used over haemodialysis?

Answer 6

in critically ill patients where waste products needs removed quickly and there can be no haemodynamic instability

Question 7

What is peritoneal dialysis?

Answer 7

peritoneal dialysis fluid is introduced to a tenchkoff catheter and waste products are filtrated across the peritoneum by diffusion.

Question 8

When is peritoneal dialysis used?

Answer 8

in patients who want to remain independant but need dialysis. can be done at home

Question 9

What are the problem with peritoneal dialysis?

Answer 9

peritonitis
catheter problems
hernias

Question 10

what complications arise in all dialysis patients?

Answer 10

CV disease - IHD cardiac failure and stroke
anaemia - low EPO
bleeding tendancy - platalet dysfunction